CHILD HEALTH IN INDIA MATERNAL HEALTH IN INDIA MATERNAL HEALTH IN INDIA

Child Health in India

I nfant and under-five child mortality rates are often

used as indicators of national health development.
In India over the last 35 years, the rate of deaths
• The main killers of children are diarrhea, pneumonia,
neonatal diseases and malaria globally#.

to infants under one year of age has more than
halved from 129 per 1000 live births in 1971 to 57
in 2006*. Under-five child mortality has declined by
one-third from 109 per 1000 live births in 1991-92 to
74 in 2005-06†. Despite this progress, current child
mortality rates in India are high compared to other
countries of similar socio-economic conditions.
The National Rural Health Mission aims to reduce
the Infant Mortality Rate to 30 per 1000 live births
by 2012. This will require a further halving of infant
mortality in a relatively short period of time. Though
ambitious, this goal can be achieved with intensive
efforts to scale up evidence-based child survival
• Two-thirds of deaths to children are preventable
using simple, cost effective interventions.
• The Infant Mortality Rates in most of the EAG
states of the country are higher than the national
average*. Madhya Pradesh, Rajasthan, Orissa,
and Chhattisgarh have the highest rates in the
country.
Infant Mortality Rate, 2001 & 2006,
India and EAG states, SRS
100

90
80

86

82
79
76

74

73
interventions backed by strong leadership, effective

71
60
66

67
62
62

61
60
57

program management, and increased human and 40

49

48
43
financial resources. 20

0
India Bihar attisgarh rkhand Pradesh a n h
Oriss Rajastha ar Prades tarakhan
d
Did you know? Chh Jha adhya
M Utt Ut

2001 2006

• 1.5 million children die in India each year before

their first birthday‡. • Universal immunization among children against
vaccine preventable disease is crucial to reduce
• 1 in 5 deaths to children under 5 years of age infant and child mortality.
throughout the world each year occurs in India£.
Percent of children 12-23 months old fully
• 2.4 million children under 5 years of age die immunized and children under three taken to health
annually£. facility while suffering from illness, NFHS II & III
70
• Every minute, 3 infants under 12 months and 4-5 60 65 64
50 58
children under 5 years of age die in India. 40
42 44
30
20

Major causes of global under-five mortality 10

0
WHO world health statistics, 2007# % children 12-23 % children with % of children with acute
months fully diarrhoea in last 2 weeks respiratory infection or
Others Pneumonia immunized taken to a health facility fever in the last 2 weeks
11% 19% taken to a health facility
1998-99 2005-06

Neonatal
Diarrheal
diseases
diseases
36%
17% • Only 44% of children 12 – 23 months of age are
fully immunized. Universal immunization rates
Injuries
Measles
3%
have only improved by 2 percentage points in the
3% Malaria
HIV/AIDS 8% last 6 years†.
3%

POPULATION FOUNDATION OF INDIA

• There is substantial drop out in immunization
coverage. Whereas 78% of children received BCG
vaccine, only 58% of children were given measles
immunization†.
• Health seeking behavior for childhood illnesses are
far from satisfactory. Only half of the children
who suffered from diarrhea are taken to a health
facility for treatment†.
• Only two out of three children suffering from
acute respiratory infection or fever are taken to a
health facility for treatment†.
• Though there has been significant improvement
in full immunization coverage in some of the
states such as Bihar, Jharkhand, Chhattisgarh and
Uttarakhand, still most of the EAG states have
lower coverage than the national average†.
Percent of children 12-23 months old fully immunized
and children under three taken to health facility while
suffering from illness, EAG states, NFHS III
80
72
70
for pneumonia and sepsis, and oral rehydration
therapy during diarrhea±.
• Ensuring child survival interventions reach and
benefit the most vulnerable children, especially
the poor and marginalized¥.
What more needs to be done?
• Enhancing capacity to use information to support
child-health programs.
• Establishing strong and unified leadership at
national and sub-national levels.
• Strengthening health systems for sustainable gains
in child survival.
• Adequate and targeted resources to rapidly scale
up child survival interventions while assuring
quality of care.
• Generating awareness and commitment beyond
the public-health community to mobilize support
for child survival interventions.

69
69

60
65

65
63

64
60

60
59
55

57

56
52

40
49
49

46

40

References
35
33
33

20
27

23

0
h a h
*
Sample Registration System, Registrar General of India, New Delhi,
n
Bihar attisgarh harkhand a Prades Oriss Rajastha ar Prades nd
akha 2001 and 2006.
Chh J
Madh
y Utt Uttar
‡
Estimate based on the project population of India by the Technical
% children 12-23 % children with % children with acute respiratory
months fully diarrhea in last 2 weeks infection or fever in last 2 weeks
Group on Population Projection, RGI, India, 2008.
immunized taken to a health facility taken to a health facility £
Black, Robert E, S. Morris, and J. Bryce, “Where and Why are 10
Million Children Dying Every Year?” Lancet, Child Survival I, 2003,
361: 2226-34.
What we know that works #
WHO Measuring Child Mortality, (http://www.who.int /child_
adolescent_health/data/child/en/)
• About two-thirds of child deaths could be
€
Bellagio Study Group on Child Survival, “Knowledge into Action for
Child Survival’ Lancet Child Survival, 2003, 362: 323-27.
prevented by interventions that are available †
National Family Health Survey (NFHS 3), 2005 – 06, India:
today and are feasible for implementation. There Volume I, International Institute for Population Sciences, Mumbai,
is no need to wait for new vaccines, new drugs or September 2007.
new technology€. ±
Gareth Jones, Richard W Steketee, Robert E Black, Zulfiqar A Bhutta,
Saul S Morris, and the Bellagio Child Survival Study Group. “How
many child deaths can we prevent this year?” Lancet Child Survival,
• Effective child survival interventions include 2003, 362: 65–71.
promoting breastfeeding, complementary feeding, ¥
Cesar G Victora, Adam Wagstaff, Joanna Armstrong Schellenberg,
water sanitation and hygiene, vitamin A and zinc Davidson Gwatkin, Mariam Claeson, Jean-Pierre Habicht. “Applying
an equity lens to child health and mortality: more of the same is not
supplementation, measles vaccine, antibiotics enough.” Lancet Child Survival, 2003, 362: 233-41.

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