Child mortality, child growth failure indicators improve from 2000 to 2017: Study

Although child mortality and child growth failure indicators have improved substantially across India from 2000 to 2017, inequality between districts has increased within many states, and there are wide variations between the districts, according to findings of the India State-Level Disease Burden Initiative released on Tuesday.

The first comprehensive estimate of district-level trends of child mortality and child growth failure in India published in The Lancet and EClinicalMedicine, stated that if the trends observed up to 2017 were to continue, India would meet the SDG 2030under-5 Mortality Rate (U5MR) target but not the SDG 2030 Neonatal Mortality Rate (NMR) target.

"Thirty-four per cent of the districts in India would need higher U5MR reduction and 60 per cent districts would need higher NMR reduction to individually meet the SDG targets," it stated.

Child and maternal malnutrition were behind 68 per cent of the under-five fatalities in India, while low-birth weight and short gestation led to83 per cent of neonatal deaths.

The findings, which are part of two scientific papers on child survival, have been published at a time when thecountry is fighting COVID-19 pandemic.

Health experts say "they remind us that while we must do all that we can to control coronavirus infection, other crucial health issues in India should also continue to receive attention commensurate with their contribution to health loss in India".

The studies stated that the under-5 Mortality Rate (U5MR) dropped in India since 2000 by 49 per cent but there is a 6-fold variation in the rate between the states and 11-fold variation between districts of India.

There were 1.04 million under-5 deaths in India in 2017, of which 0.57 million were neonatal deaths, down from 2.24 million under-5 deaths, including 1.02 million neonatal deaths in 2000.

The NMR has dropped by 38 per cent since 2000 but there is a 5-fold variation in the rate between the states and 8-fold variation between districts of India, the study stated.

"The reduction in NMR has been less than for U5MR, and this reduction has been quite variable across states and districts," the study said.

Child growth failure, measured as stunting, wasting and underweight has improved in India since 2000, but their rates vary 4-5 fold between the districts of India and the inequality between districts within many states has increased, it stated.

Lower respiratory infections (179 pc), preterm birth (156 pc), diarrhoeal diseases (9.9 pc), and birth asphyxia and trauma (8.1 pc) were the leading causes of under-5 death in 2017
K Srinath Reddy, President, Public Health Foundation of India said, "Reductions in under-5 child mortality and neonatal mortality are promising as we move towards SDG targets."
"Even neonatal mortality which was previously slow to change is now showing improvement. This decline needs to be further accelerated. Child malnutrition is a major determinant along with maternal malnutrition for these deaths and should be accorded highest priority for corrective action," he said,