In what is a major milestone in reduction of child deaths in India, the country’s under five mortality rate, for the first time, has been estimated at 39 deaths per 1,000 live births, the same as the global average. But the gender gap in child survival remains far below the global average — it means that girl children, after they are born, face discrimination in India, according to new mortality estimates released as part of a report by UNICEF, WHO, UN Population Division and the World Bank Group.
The under-five mortality of the girl child is 2.5 per cent higher (40 deaths per 1,000 live births) than the under-five mortality of the boy child (39 deaths per 1,000 live births). This gender gap has reduced significantly given that the difference was nearly 10 per cent in 2012. Globally, girl child survival rates are 11 per cent higher than boys.
This is in line with government data which show that in sick newborn care units across the country, there is a 60:40 ratio of boys and girls admitted. The Ministry of Health and Family Welfare has also flagged this issue to states but it has not borne results. This year’s Economic Survey estimated that 21 million Indian girls are unwanted — parents wanted a boy but had a girl instead.
Following initiatives like Mission Indradhanush, Mother and Child Tracking System and neonatal ICUs in every district, India has made remarkable progress over the last five years. The number of Indian children who died before their fifth birthday went below one million for the first time. But at 9,89,000, the absolute number is still staggering.
The new report estimates that one child under 15 years dies every five seconds around the world but India’s share of global child deaths, for the first time, equals its share in the global birth cohort. India accounts for 18 per cent of global births, and now also 18 per cent of global child deaths following a steady decline from 22 per cent in 2012.
Last year, a report on the pneumonia and diarrhoea situation of the world — it was brought out by the International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health — had showered praise on Mission Indradhanush for bringing down the incidence of the two biggest killers of children below the age of five. In its first four phases, Mission Indradhanush vaccinated about 25 million children in over 500 districts, the report estimated.
Dr Yasmin Ali Haque, UNICEF India Representative, said, “India continues to show impressive decline in child deaths, with its share of global under-five deaths for the first time equalling its share of child births. The efforts for improving institutional delivery, along with countrywide scale-up of special newborn care units and strengthening of routine immunisation, have been instrumental towards this. Even more heartening is the fourfold decline in the gender gap in survival of the girl child over the last five years. The investment on ensuring holistic nutrition under POSHAN Abhiyan (National Nutrition Mission), and the national commitment to make India open defecation free by 2019, are steps that will help accelerate progress further.”
Mortality estimates put the global child death burden in 2017 at 6.3 million children under 15 years of age, or 1 every 5 seconds, mostly of preventable causes. The vast majority of these deaths — 5.4 million — occurred in the first five years of life, with newborns accounting for around half the deaths. However the number of children dying under five has fallen dramatically from 12.6 million in 1990 to 5.4 million in 2017. The number of deaths in older children, aged between 5 to 14 years, dropped from 1.7 million to under a million in the same period.