The present study aims to assess the efficiency of the rural health system to foreshorten the under-five (U5) mortality rates across Indian states. The study further attempts to pinpoint the factors responsible for state-level inefficiency of the rural health system performance. The empirical results reveal that among the Indian states, Kerala is the most-efficient in foreshortening the U5 mortality rate. The results convey that the states with better health indicators may not have efficient health systems. The study concludes that along with investment in the health sector, efficient management of the investment is intrinsic to better health outcomes.
Changes in the spatial distribution of the under-five mortality rate: Small-area analysis of 122 DHS surveys in 262 subregions of 35 countries in Africa