‘1 mn under-5 deaths in India every year’

NEW DELHI: Even as the under-5 mortality rate (U5MR) in India has reduced by almost 50% in the past two decades, the country is still losing at least a million children annually before they reach their fifth birthday.

Of these, half a million children die within 28 days of being born (neonatal mortality) primarily due to lower respiratory tract infection, pre-term birth and diarrhoeal diseases, show recent papers published in The Lancet.

“U5MR in India reduced by 49% from 83 in 2000 to 42 per 1000 live births in 2017, and neonatal mortality rate (NMR) reduced by 38% from 38 to 23 per 1000 live births during this period. 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,” says the study published on Tuesday. The two papers on child survival are published under the India State

Level Disease Burden Initiative, and have the first comprehensive estimates of district-level trends of child mortality in India from 2000. “What this study shows is that India needs to have an areaspecific plan to reduce child deaths as no two states have the same problem. It has mentioned the issues individual states face, and solutions will have to be created accordingly,” said Dr Rakhi Dandona, Public Health Foundation of India, one of the lead authors of the study.

“Given the inequalities in the burden and reductions in neonatal mortality across districts, a granular approach at the district level to determine the strategies for improving newborn survival is needed. Continuum of care has to be the pivot around which newborn and child survival strategies must revolve but to homogenize all continuum of care strategies and move them in tandem is a challenge...,” said Dr Siddartha Ramji, professor of pediatrics and neonatology, Maulana Azad Medical College, New Delhi.