India has avoided around one million deaths of children under five since 2005 claims a study recently published in The Lancet. Despite this reduction, India still has more child deaths than any other country, with 0.9 million child deaths occurring annually.
The reduction since 2005 does indicate a positive trend, though India requires a great deal of improvement in its healthcare system to further bring down child mortality. It is thought that the decline in deaths over the last decade stems from significant reductions in deaths from pneumonia, diarrhoea, tetanus and measles.
The finding comes as part of a wider study that has been in place since 2005, referred to as the ‘Prospective Study of One Million Deaths in India’. The study spans the from the year 1998 to 2014, taking data from the Registrar General of India’s Sample Registration System to analyse the causes of mortality in India.
Specifically trained census staff performed what the study refers to as “verbal autopsies”, knocking on more than 1.3 million doors over the course of the study. Information was gathered regarding any deaths that had occurred in the household, with this information being reviewed by two physicians to establish the most probable cause of death.
The study began with the intention of assessing the relevance of different contributors to the risk of dying early — physical (blood pressure, obesity, etc), behavioural (smoking, alcohol, HIV risk behaviour, immunisation history) and biological (blood lipids, gene polymorphisms) — to disease in individuals or disease rates in populations. By assessing these risk factors the most widespread causes of death were monitored.
The study found a 3.3% annual decline in mortality rates of infants less than one month old and 5.4% for those ages one to five. It was also found this rate of decline was fastest in the years 2010 to 2015, indicating that more progress has been made in curbing child deaths in recent years. It was also noted that, in both richer and urbanised areas, this trend towards a decrease in deaths was more pronounced.
Per 1,000 live births, the mortality rates among children under one month fell from 45 in 2000 to 27 in 2015. The one to five mortality rate fell from 45.2 to 19.6.It is clear how the reduction in mortality rates have been brought about: mortality rates from neonatal tetanus and measles fell by at least 90%, neonatal infection and birth trauma both fell more than 66%.
To further reduce child mortality in India, more needs to be done to combat issues such as malaria and deaths amongst infants born at a low weight, said Prabhat Jha, the lead investigator of the survey. The survey indicates that progress has clearly been made, but as the country with the highest child mortality count, India needs to prioritise the issue to further reduce deaths.