Levels and Trends in Child Mortality: UN Report

General Studies Paper -2

Context:

• Global child deaths reached a historic low in 2022,according to the latest estimates by the United Nations Inter-agency Group for Child Mortality Estimation. 

About

• The report noted the annual number of global under-five deaths in 2022 declined by more than half from the 2000 estimate — from 9.9 million to 4.9 million.
• However, the numbers are still bad. Globally,
• neonatal deaths, or the death of a baby within 28 days of birth, happened every 14 seconds;
• a child aged under five died every six seconds and
• an adolescent (ages 10 to 19)died every 35 seconds in 2022, the report found.

Major Highlights of the Report

• Decline in child deaths: The report noted a62 per cent decline in child deaths from the 1990 estimates.
• However, it warned that “these averages mask persistent and entrenched inequities among vulnerable populations of children.”
• Neonatal deaths:While the larger trend shows a decline, the trend of under-five deaths has increased in the neonatal period from 41 per cent in 2000 to 47 per cent in 2022.
• The slower decline in neonatal deaths is due to factors like population change and differences in the cause-of-death structure by age.
• Mortality among 1–59-month-olds is generally more responsive to basic public health interventions, while neonatal mortality relates more to complications around the time of birth.
• Sub-saharan Africa:Sub-Saharan Africa, where annual neonatal deaths have stagnated at about 1 million, bears the greatest burden of under-five deaths in the world.
• The mortality rate for children aged 28 days was 46 deaths per 1,000children in the region, more than two times higher than the global average of 20 deaths per 1,000 children aged 28 days.
• Leading causes:Prematurity, pneumonia, trauma, malaria and diarrhoea are among the leading causes of death for newborns and children, all preventable causes.
• These illnesses could have been prevented with vaccinations, availability of skilled health personnel at birth, support for early and continued breastfeeding.
• Survival factors:The child’s survival largely depends on the place of birth; whether the child belongs to a low-income or high-income country, and also on the inequity within countries.
• On average, children living in rural areas are at a higher risk of death before age 5 compared to their urban counterparts.
• Predictions: The report estimates that 35 million children under the age of 5 will lose their life before 2030 and sub-Saharan Africa will bear most of the death toll.
• It further warned that under current trends, 59 countries will miss the SDG under-five mortality target and 64 countries will miss the neonatal mortality target.

Child Mortality in India: Status and Trends

• As per the Sample Registration System (SRS) Statistical Report 2020 released on 22nd September 2022by Registrar General of India (RGI), the country has been witnessing a progressive reduction in IMR, U5MR and NMR since 2014 towards achieving the Sustainable Development Goals (SDG) targets by 2030.
• Under 5 Mortality Rate (U5MR) for the country has shown a significant decline of 3 points from 2019 (32 per 1000 live births in 2020 against 35 per 1000 live births in 2019).

• • It varies from 36 in rural areas to 21 in urban areas and U5MR for females is higher (33) than male (31).

• Infant Mortality Rate (IMR)has also registered a 2-point decline to 28 per 1000 live births in 2020 from 30 per 1000 live births in 2019 (Annual Decline Rate: 6.7%).
• The Rural-Urban difference has narrowed to 12 points (Urban 19, Rural-31).
• Neonatal Mortality Ratehas also declined by 2 points from 22 per 1000 live births in 2019 to 20 per 1000 live births in 2020 (Annual Decline Rate: 9.1%).

• • It ranges from 12 in urban areas to 23 in rural areas.

Major Causes of Child Mortality in India

• Preterm Birth Complications:Low birth weight, respiratory problems due to underdeveloped lungs.
• Birth Asphyxia:Lack of oxygen during delivery, leading to brain damage or death.
• Neonatal Infections:Sepsis, pneumonia can overwhelm a newborn’s weak immune system.
• Pneumonia:The leading cause, often linked to malnutrition and air pollution.
• Diarrhoea:Dehydration caused by infectious diseases like rotavirus.
• Malnutrition:Stunting and wasting weaken a child’s immune system and increase vulnerability to infections.

Measures to Reduce Child Mortality

Improving Maternal Health

• Prenatal Care:Regular checkups, proper nutrition for pregnant women to prevent complications and low birth weight.
• Skilled Birth Attendance:Deliveries by trained midwives or doctors to ensure safe childbirth.
• Postnatal Care:Monitoring the well-being of mothers and newborns after delivery.

Combating Childhood Illnesses

• Immunization Programs:Ensure universal access to vaccinations for preventable diseases like measles, pneumonia, and diarrhea.
• Improved Sanitation and Hygiene:Promote handwashing with soap, access to clean drinking water, and proper sanitation facilities.
• Pneumonia Control:Early diagnosis and treatment with antibiotics.
• Diarrhoea Management:Oral rehydration therapy (ORT) with clean water and electrolytes to prevent dehydration.

Addressing Malnutrition

• Nutritional Programs:Promote breastfeeding for newborns, provide access to nutritious food for mothers and children, especially during the crucial first 1000 days of life.

Public Awareness

• Educate families:Importance of good hygiene, breastfeeding, timely medical care for children, and recognizing danger signs of illness.

Additional Measures

• Invest in Healthcare Infrastructure:Equip health facilities, especially in rural areas, with necessary supplies and train healthcare workers.
• Address Social Determinants:Poverty, lack of education, and gender inequality significantly contribute to child mortality.
• Empowering Women:Education and economic empowerment of women lead to better health outcomes for themselves and their children.

Way Ahead

• By tackling causes behind the child mortality and implementing required measures, India can significantly reduce child mortality and ensure a healthier future for its young generation.