Child survival in India
Gareth Jones1, Werner Schultink, Marzio Babille
1Child Development and Nutrition, United Nations Children's Fund, India Country Office, New Delhi, India.
Insights
Child mortality in India remains high, with millions of deaths annually. Implementing proven interventions like exclusive breastfeeding and oral rehydration therapy could prevent over 50% of deaths among young children.
Area of Science:
- Public Health
- Pediatrics
- Global Health
Background:
- India faces a significant child mortality challenge, with 2.1 million deaths annually among children under five.
- Despite reductions, the child mortality rate remains high at 87 per 1000 live births.
- Key causes include diarrhea, pneumonia, neonatal asphyxia, preterm delivery, sepsis, and tetanus, with undernutrition as a major underlying factor.
Purpose of the Study:
- To identify high-impact child survival interventions feasible for widespread implementation in India.
- To calculate the potential reduction in child mortality if these interventions achieve high coverage.
Main Methods:
- Identification of proven, feasible child survival interventions for India.
- Modeling the impact of universal coverage of these interventions on child mortality rates.
Main Results:
- Exclusive breastfeeding, oral rehydration therapy, and adequate complementary feeding are identified as highly effective interventions.
- Universal application of these interventions could prevent 57% of preschooler mortality.
- Analysis suggests that 50-70% of child deaths could be preventable at the state level, despite a lack of state-specific cause-of-death data.
Conclusions:
- Achieving high coverage of key child survival interventions can significantly reduce child mortality in India.
- The identified interventions offer a viable strategy to meet national and international child mortality reduction targets, including those in the Millennium Development Goals and the Tenth Five Year Plan.
Abstract:
About 2.1 million Indian children under 5 years of age die each year. In spite of reductions in child mortality rate over the past two decades, the rate remains high at 87 per 1000 live births. The main causes are diarrhoea, pneumonia, and for deaths among the neonates asphyxia, pre-term delivery, sepsis and tetanus. The major underlying cause of death is undernutrition. Child survival interventions of proven impact, feasible for use at high coverage in India were identified, and their effect on child mortality was calculated if high coverage were to be achieved. Exclusive breastfeeding, oral rehydration therapy, and adequate complementary feeding were among the most effective interventions. If these interventions would be applied universally 57% of mortality among pre-schoolers could be prevented. No cause specific mortality data were available from individual Indian states. Nevertheless, the range of child mortality, as well as the proportion of neo-natal deaths, occurring across the states, suggests that at state level 50-70% of deaths can be prevented. The results show that the targets set in the millennium development goals as well as in the Tenth Five Year plan can be reached.
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