Two papers published in May 2020 have indicated that the under 5 mortality rate in India was halved between the years 2000 to 2017. The papers on child survival published by the India State-Level Disease Burden Initiative depicted a significant decline of 49%. The initiative was driven by the Indian Council of Medical Research (ICMR) and the Public Health Foundation of India. It was found that there was a variation of 5-6 fold in the rates between states, whereas 8-11 fold between districts. 

 

What is under 5 mortality rate? Under-5 mortality, a Millennium Development Goal (MDG) indicator, is a leading indicator of child health and overall development. This indicator measures child survival. It also reflects the social, economic and environmental conditions in which children live, including their health care. Since data on the incidences and prevalence of frequently are unavailable, mortality rates are often used to identify vulnerable populations. The under-five mortality rate captures more than 90% of global mortality among children under the age of 18.

 

·68% under 5 deaths are due to child and maternal malnutrition.

·83% of neonatal deaths are attributed to low birth weight and short gestation.

·Neonatal deaths in India have gone down from 1.02 million deaths in 2000 to 0.57 million deaths in 2017. The neonatal mortality rate has dropped by 38% since 2000.

·The highest number of under-5 deaths in 2017 were in UP (312,800, which included 165,800 neonatal deaths) and Bihar (141,500, including 75,300 neonatal deaths).

·The rates were lower with the increasing level of development of the states.

·In 2017, there was a 5.7 fold variation in ranging from 10 per 1,000 live births in the more developed state of Kerala to 60 in less developed UP, and a 4.5 fold variation of NMR ranging from 7 per 1,000 live births in Kerala to 32 in UP.

·The research paper has shown that India has made positive strides in protecting the lives of newborns over the last two decades.

 

The world has made progress in child survival in the past 3 decades, and millions of children have better survival chances than in 1990 - 1 in 27 children died before reaching age five in 2019, compared to 1 in 11 in 1990. Moreover, progress in reducing child mortality has been accelerated in the 2000-2019 period compared with the 1990s, with the annual rate of reduction in the global under-5 mortality rate increasing from 1.9% in 1990–1999 to 3.7% in 2000-2019.

 

The global under-5 mortality rate declined by 59% from 93 deaths per 1,000 live births in 1990 to 38 in 2019. Despite this considerable progress, improving child survival remains a matter of urgent concern.