India reduces baby deaths but still hasn't met 2012 targets
37 babies died for every 1,000 that were born in 2015, two better than the government's projections of an infant mortality rate (IMR) of 39 for that year, according to new data released last week.
New Delhi, Jan 9: First, the good news: 37 babies died for every 1,000 that were born in 2015, two better than the government's projections of an infant mortality rate (IMR) of 39 for that year, according to new data released last week. That's a drop of 53 per cent over 25 years.
Now, the bad news: The target for IMR reduction was 67 per cent; it has fallen 10 short of the target 27 that India agreed to under the 2015 millennium development goals (MDGs), set in consultation with the United Nations. India has also not achieved the IMR target of 30 that the government itself set for 2012.
To get an idea of India's global standing, compare its 2015 IMR average of 37 with IMRs of 35 for 154 low- and middle-income nations; five for 26 north American nations and three for 39 nations in the Euro area.
There were wide variations in IMR -- a bellwether of national health -- across India, according to the latest report from the Sample Registration System (SRS) bulletin, with smaller, more literate states reporting IMRs close to or better than richer countries and larger, poorer states reporting more deaths than poorer countries, indicating the uneven nature of healthcare.
The overall improvement in IMR over a quarter century is likely linked to a variety of government interventions, including institutional deliveries and providing iron and folic-acid tablets to pregnant women, and rising incomes and living circumstances since economic liberalisation in 1991.
Of 36 Indian states and Union territories (UTs), the lowest IMRs were reported from Goa and Manipur with nine infant deaths per 1,000 live births -- that is the same as China, Bulgaria and Costa Rica and one better than the consolidated figure for Europe and Central Asia, according to 2015 World Bank data.
In contrast, Madhya Pradesh reported India's highest IMR with 50 infant deaths per 1,000 live births, or worse than Ethiopia and Ghana and marginally better than disaster-wracked Haiti (52) and unstable Zimbabwe (47), but better than its 2014 rate of 52.
Uttarakhand was the only state that reported a worsening in its IMR, from 33 infant deaths for every 1,000 live births in 2014 to 34 in 2015.
In
terms
of
MDG
progress,
from
the
larger
states,
only
Tamil
Nadu
has
met
its
state
MDG
target
with
a
reduction
of
67
per
cent
in
IMR
to
reach
19
infant
deaths
per
1,000
live
births
in
2015.
Sikkim,
Manipur
and
Daman
and
Diu
have
all
achieved
a
two-third
reduction
from
their
1991
estimates.
Goa,
Maharashtra,
Puducherry,
Punjab,
Jammu
and
Kashmir,
Arunachal
Pradesh
and
Odisha
have
all
come
very
close
to
achieving
their
MDG
state-specific
targets.
While Kerala doesn't feature on the list -- its IMR for 2015 is 12, and well within India's national MDG target -- that is because its IMR for 1990 was as low as 17 to begin with.
Infant girls in India continue to die at a greater rates than infant boys, and there has been almost no reduction in the gap in IMRs, the new data reveal.
Male babies have an IMR of 35 deaths per 1,000 live births, while female babies have an IMR of 39 per 1,000 live births.
The factors that impact the IMR also reflect the well-being of a nation. Environmental and living conditions, rates of illness, health of mothers and their access to quality pre- and post-natal care contribute to infant survival rates.
Just
as
rural-urban
differentials
in
the
IMR
are
sizeable
and
significant,
so
too
are
the
differentials
by
wealth.
In
other
words,
babies
born
in
poorer
families
tend
to
die
in
larger
numbers.
The
poor
are
the
most
vulnerable
to
health
disadvantages
and
the
IMR
tends
to
reflect
that.
However, these inequities in mortality reflect not just differences in access to health services for both children and mothers but also inadequacies of India's public health system and its inability to deliver quality and equitable services.
The National Rural Health Mission, launched in 2005, set India's IMR target as 30 deaths per 1,000 live births by 2012. However, we have still not been able to achieve in 2017 the target set for 2012.
The MDG achievements of 2015 set the base for the 2030 sustainable development goals (SDGs). While infant mortality is not a target the SDGs will monitor, it will monitor neonatal mortality -- death during the first 28 days of life -- a key component of infant mortality.
Neonatal mortality largely stems from poor maternal health, inadequate antenatal care, improper management of pregnancy complications and delivery-related complications.
In
2013,
neonatal
mortality
contributed
to
68
per
cent
of
all
infant
deaths
in
India,
and
it
will
continue
to
represent
an
increasing
proportion
of
child
deaths.
The
prime
minister's
Maternity
Benefit
Scheme
--
which
appears
to
be
a
universalisation
and
expansion
of
the
Indira
Gandhi
Matritva
Sahyog
Yojana
--
could
possibly
be
a
step
that
will
better
maternal
health
and
delivery
outcomes
through
conditional
cash
transfers.
If India is to achieve its SDG targets across gender, wealth and caste, it needs more attention directed towards infant and maternal health policies, or 2030 will -- once again -- see India falling short of its health targets.
IANS