Objectives To assess household amenities in districts of high focus states and their association with child health in India.

Design The data for the study are extracted from Annual Health Survey (AHS) and Census 2011.

Settings Districts in high focus states in India.

Participants Information regarding children below 5 years of age and women aged 15–49 has been extracted from the AHS (2010–2011), and household amenities information has been obtained from the Census (2011).

Measures Household amenities were assessed from the census at the district level in the high focus states. Child health indicators and wealth index were borrowed from AHS and used in this study to check their linkage with household amenities.

Results Absence of drinking water from a treated source, improved sanitation, usage of clean cooking fuel and drainage facility in the household were adversely associated with the incidence of acute respiratory infection, diarrhoea, infant mortality rate (IMR) and under 5 mortality rate (U5MR). The mean IMR declined from 64 to 54 for districts where a high proportion of household have improved sanitation. The result of ordinary least square regression shows that improved sanitation has a negative and statistically significant association (β=−0.0067, p<0.01) with U5MR.

Conclusions Although child healthcare services are important in addressing child health issues, they barely touch on the root of the problem. Building toilets and providing safe drinking water, clean cooking fuel and drainage facilities at the household level, may prevent a number of adverse child health issues and may reduce the burden on the healthcare system in India.