The main factor behind under-5 mortality is child and maternal malnutrition—accounting for around 68.2% of under-5 deaths and 83% of neonatal deaths in India in 2017.
A rapid fall in under-5 mortality rate (U5MR) is clearly one of Indian health policy’s major wins in recent times. A Lancet study shows that the country’s U5MR declined by as much as 49% between 2000 and 2017. The researchers, however, note that this progress is not uniform. For instance, there is a variation of 5.7 times between states, and of around 10.5 times between the 723 districts in 2017. They also note that this progress may still not be sufficient to meet the various Sustainable Development Goals (SDGs) and the National Health Policy 2025 targets. The variations across states show that a ‘one size fits all’ policy will not work. In order to achieve the targets, states need to design their own interventions tailored to their needs, with support from the Centre.
The main factor behind under-5 mortality is child and maternal malnutrition—accounting for around 68.2% of under-5 deaths and 83% of neonatal deaths in India in 2017. The other reasons for under-5 deaths are lack of access to drinking water and sanitation (10.8%) and air pollution (8.8%). The pandemic compounds the risks of malnutrition, if the government doesn’t provide support to the most vulnerable sections of the population. As per the Global Nutrition Report 2020, one in every nine people in the world is hungry; India is among the 88 countries that are likely to miss global nutrition targets by 2025, with a huge stunting burden. As per a 2019 Lancet study, Rajasthan, Uttar Pradesh, Bihar and Assam have the highest malnutrition levels in the country. They lose more than 60,000 disability adjusted life-years (DALYs) per 100,000 due to child and maternal malnutrition, while the second set of poor performers—Madhya Pradesh, Chhattisgarh, Odisha, Nagaland and Tripura—have DALYs between 50,000 and 59,999.Some solutions suggested by the researchers on the U5MR trends in India include microplanning based on real data of deaths and their causes. Also, quality care, knowledge transfer to frontline health workers, etc, remain important for beating child mortality.