India prevented the deaths of about one million children under five in 2005-15, driven by significant reductions in the mortality rates of pneumonia, diarrhea, tetanus, and measles, according to the latest study published in The Lancet.
To achieve UN global goals of reducing child mortality to at least 25 percent 1,000 live births by 2030, India would need to maintain the rapid decline in mortality of children in the 1-59 month group.
The United Nations data revealed that between 2000 and 2015, 29 million children below five died of different causes in India.
"However, since 2005, the progress in terms of reduction in mortality accelerated. Had the mortality rates of 2000-2005 remain unchanged, 30 million children would have died by 2015," said Dr Prabhat Jha, one of the authors and head of the Centre for Global Health Research of St Michael's Hospital in Toronto.
Notably, all the significant changes have occurred due to an increase in spending on public health by the Indian government. Not only this, the government has been launching programmes to encourage women to give birth in hospitals and for children to have a measles vaccine, the study noted that.
Meanwhile, the study also found a slower decline in malaria death rates in children in the 1-59 month group.It also underlined that neonatal mortality rates in rural areas were twice that in urban areas.
The study also emphasized the need for giving special attention to maternal factors such as anemia and tobacco chewing.
The research was done in collaboration with the Registrar General of India, based on 1,00,000 interviews with parents who lost a child. "Hundreds of specially trained census staff in India knocked on the doors of more than 1.3 million homes to interview household members about deaths. Two physicians independently examined these 'verbal autopsies' to establish the most probable cause of death," Dr Jha said.
The study showed a 3.3 percent annual decline in the mortality rates of neonates (babies less than one-month-old) and 5.4 percent for those aged one month to 59 months.The declines in numbers have started accelerating from 2005 and were the fastest between 2010 and 2015 and in urban areas and the richer states.
Per 1,000 live births, the mortality rates among neonates fell from 45 in 2000 to 27 in 2015, while the 1-59-month mortality rate fell from 45.2 to 19.6
Pneumonia and diarrhoea mortality rates for the 1-59- month group declined substantially in 2010-15, at an average of 8-10 percent annual decline nationally
Mortality rates from vaccine-preventable diseases such as tetanus and measles fell by about 90 percent from 2005 and neonatal infection and birth trauma by more than 66 percent.
For the 1-59-month group, mortality rates from pneumonia and diarrhoea fell by more than 60 percent.
Co-author of the study, professor Rajesh Kumar, Dean (Academic) at the Post Graduate Institute of Medical Education and Research in Chandigarh, said to meet the UN Sustainable Development Goals of halving child mortality rates by 2030, India must maintain its current trajectory for the 1-59-month group and accelerate declines in neonatal mortality.
Reducing the number of neonatal deaths will require efforts to bring down deaths caused by premature delivery and low birth weights, especially in poorer states, he said
Both are strongly linked to largely modifiable maternal and prenatal factors such as health care during pregnancy, education, nutrition, anaemia and tobacco use.
The author also said that there is a need for a stricter assessment of child mortality at district levels.