India’s under-five mortality rate (U-5MR) dropped four points in a single year in 2016, to 39 deaths per 1,000 live births from 43 in 2015. Apart from being the sharpest fall in a year, the decline also brought down India’s U-5MR below the global average of 39.1, according to data released by the United Nations on Tuesday. With 26 million births each year, India has the world’s largest birth cohort, and the four-point reduction in Infant Mortality Rate has led to 120,000 lives saved in one year. Another first for India is that its proportion of child deaths equals its share of the global births, with India accounting for 18% of the total births and 18% of U-5MR deaths worldwide.

Just three years ago, more than one million children died before reaching their fifth birthday from preventable and treatable causes, such as preterm birth complications, acute respiratory infections such as pneumonia, intrapartum-related complications, congenital anomalies and diarrhoea. Neonatal deaths, or newborn deaths within 28 days of birth, because of pregnancy-related complications, accounted for 53% of all under-five deaths in 2016. Many of these newborns and children could have been saved by increasing institutional deliveries, postnatal follow-ups, improving mother and child nutrition, and providing water, sanitation and immunisations. Only one in five new mothers in India get the full antenatal care, shows National Family Health Survey 2016.

The sharp decadal increase in institutional deliveries in public and private hospitals, up from 38.7% in 2006 to 78.9% in 2016, has lowered birth-related complications and helped India eliminate maternal and neonatal tetanus. But more needs to be done. It is imperative to widen the immunisation net so that all children are protected against vaccine-preventable diseases, such as diarrhoea and childhood pneumonia. Boosting breastfeeding is another low-resource method to heighten childhood immunity and lower risk of infections. Only 41.6% of children under the age of three were breastfed within one hour of birth in 2015, up from 23.4% in 2005.

Though there has been fourfold decline in the gender gap in survival of the girl child from 10% in 2012 to 2.5%, the bias against the girl child remains high in India. Globally, girl child survival rates are 11% higher than boys.

Further increasing institutional delivery, strengthening routine immunisation under Mission Indradhanush, scaling up of special newborn care units to treat malnourished and ill newborns, providing holistic nutrition under Poshan Abhiyan (national nutrition mission), and meeting the national commitment to make the country open-defecation free by 2019, will collectively help reach its Sustainable Development Target to bring down U-5MR below 25 by 2030.

First Published: Sep 19, 2018 17:44 IST