NEW DELHI: The first comprehensive report of district-level trends of child mortality and child growth failure in India from 2000 to 2017 shows that the under-five mortality rate and neonatal mortality rate in the first month of life have dropped substantially in India since 2000, but inequality between states has gone up.
While there is a five-six fold variation in the rates between states, there is also an eight-eleven fold variation between the districts of India, noted the report by the Indian Council of Medical Research and the Public Health Foundation of India published in The Lancet.
While under-five mortality rate and neonatal mortality rate have been decreasing in almost all districts of India, the progress in this decline has been highly variable because of which the inequality in these rates has increased between districts within many states.
The estimates say that 68 per of the under-5 deaths in India can be attributed to child and maternal malnutrition, 83 per cent of the neonatal deaths to low birth weight and short gestation.
Also, child growth failure - measured as stunting, wasting and underweight - has reduced in India since 2000, but their rates vary four-five fold between the districts of India and the inequality between districts within many states has increased.
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If the trends observed up to 2017 were to continue, India would meet the Sustainable Development Goals (SDG) 2030 Under 5 Mortality Rate target but not the Sustainable Development Goals 2030 Neonatal Mortality Rate target and 34 per cent of the districts in India would need higher under 5 mortality rate reduction and 60 per cent districts would need higher neonatal mortality rate reduction to individually meet the SDG targets.
The child mortality and child growth failure trends reported in these papers utilized all accessible georeferenced survey data from a variety of sources in India, which enabled more robust estimates than the estimates based on single sources that may have more biases, said a statement by the ICMR.
"These research findings have shown that India has made positive strides in protecting the lives of newborns over the last two decades," said Dr V K Paul, member (health) Niti Aayog. "Introduction of contextually relevant multi-sectorial actions by Central and state governments like maternal nutrition programmes during pregnancy, access to skilled health providers during childbirth, and famly or community-based care through postnatal home visits have shown to have made a difference."
Dr Balram Bhargava, the director general of the ICMR said that the granular data can facilitate a further reduction in child mortality in India.