India's progress towards the Millennium Development Goals 4 and 5 on infant and maternal mortality

Area of Science:

• Public Health
• Demography
• Health Policy

Background:

• India's progress towards Millennium Development Goals (MDGs) 4 and 5 for reducing infant mortality rate (IMR) and maternal mortality ratio (MMR) by 2015.
• Urgency to assess state and period contributions to IMR/MMR trends and predict future outcomes.

Purpose of the Study:

• To estimate the percent net contribution of Indian states and time periods to the decline in IMR and MMR.
• To predict future IMR and MMR levels for India and its most populous states by 2015.

Main Methods:

• Standardized decomposition technique to quantify state and period contributions to IMR/MMR decline.
• Linear and exponential regression analysis of IMR/MMR data from the past two decades.
• Forecasting IMR/MMR for 2015 for India and 15 most populous states.

Main Results:

• India projected to achieve MDG-5 target by 2016 if linear MMR decline continues; exponential decline suggests achievement by 2023-2024.
• MDG-4 target attainment for IMR may be delayed until 2023-2024 due to slow progress in certain states.
• Peak MMR decline (2004-2009) correlated with the National Rural Health Mission (NRHM) launch and utilization.

Conclusions:

• While India may not achieve all MDG 4 and 5 targets nationally, at least four major states are predicted to meet them.
• MMR reduction strategies have demonstrated greater effectiveness compared to IMR reduction efforts over the past two decades.