How India cut child deaths faster than the world, Pg15

Key Highlights:

• India achieved a 41% decline in Under-five Mortality Rate (U5MR) and a 37% decline in Neonatal Mortality Rate (NMR) between 2014 and 2024, significantly surpassing global reductions.
• The UN Inter-Agency Group for Child Mortality Estimation (UN IGME) 2023 Report highlighted this achievement in March 2024.
• India is on track to meet the UN Sustainable Development Goal (SDG) targets for U5MR (25 per 1000 live births) and NMR (12 per 1000 live births) before the 2030 deadline.
• This progress is attributed to a structured life-cycle approach anchored in the Reproductive, Maternal, Newborn, Child and Adolescent Health plus Nutrition (RMNCAH+N) strategy.
• The National Family Health Survey (NFHS)-6 reported increased institutional deliveries to 90.6% and full immunization coverage to 82.6%.

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Detailed Insights:

• The RMNCAH+N strategy integrates maternal health, newborn care, immunization, nutrition, and early childhood development into a continuous care framework.
• Maternal health improvements include strengthened antenatal care, maternal nutrition, and early risk detection, leading to 90.6% institutional deliveries as per NFHS-6.
• Over 1,100 Special Newborn Care Units (SNCUs) and Neonatal Intensive Care Units (NICUs) provide specialized care to sick and small newborns annually.
• Accredited Social Health Activists (ASHAs) play a crucial role in providing home-based newborn care and post-discharge support.
• Immunization efforts have been bolstered by the scale-up of Rotavirus vaccine coverage to 85.4% and the introduction of the Pneumococcal Conjugate Vaccine (PCV).
• Nutritional indicators show significant improvement, with stunting among children under five declining from 35.5% to 29.3% and severe wasting from 7.7% to 5.8% as per NFHS-6.
• The Mother and Child Protection Card serves as a comprehensive tool for growth monitoring at the community level.

Key Concepts Involved:

• Under-five Mortality Rate (U5MR): The probability of a child born in a specific year or period dying before reaching the age of five.
• Neonatal Mortality Rate (NMR): The number of deaths among live births during the first 28 completed days of life per 1,000 live births.
• RMNCAH+N Strategy: A comprehensive public health framework focusing on the continuum of care for reproductive, maternal, newborn, child, and adolescent health, including nutrition.
• Accredited Social Health Activists (ASHAs): Community health workers who act as a link between the community and the public health system in India.