Chandrakant Lahariya1, Vinod K Paul. 1. Department of Community Medicine, G.R. Medical College, Gwalior, India. c.lahariya@gmail.com
Abstract
OBJECTIVE: To review the current information on trends, burden, differentials, causes, and timing of under five (U5) child deaths in India. METHODS: We reviewed and analyzed data on child deaths in India from official government sources, reports, surveys, and from the published literature. The secondary analyses were carried out to provide additional insight. RESULTS: An estimated 1.84 million under 5 child deaths, including approx 1.44 million infant and 940,000 neonatal deaths occurred in India during 2007. More than 60% of these Under 5 child deaths occurred in 5 states: Uttar Pradesh (27.0%), Bihar (11.3%), Madhya Pradesh (9.9%), Rajasthan (8.0%) and Andhra Pradesh (5.7%). Approximately 41% of all Under 5 child deaths happen in the first week of life and the risk of deaths during neonatal period was at least 68 times higher than the rest of childhood. The children living in rural areas, in the central Indian states, in the lowest 20% of wealth index have the highest risk of death in India. The mortality rates in under 5, infant, neonates and early neonatal period in India declined by 43.5%, 31.2%, 32.1%, and 21.6%, respectively, between 1990 to 2007. However, the rate of reduction has slowed in last 4 years (2003-2007), with negative trend in the early neonatal mortality rate. Neonatal conditions (33%), pneumonia (22%) and diarrhea (14%) are the leading causes of under 5 deaths in India. Sepsis, pneumonia (30.4%), birth asphyxia (19.5%), and pre-maturity (16.8%) are the 3 commonest causes of neonatal deaths (0-27 days). CONCLUSIONS: The reduction in under 5 child mortality in India during 1990-2007 has been insufficient to attain Millennium Development Goal 4 (MDG4). However, there have been variable declines in early neonatal, neonatal, infant and child mortality. Despite the well known importance of neonatal survival to attain MDG4, our data suggest the early neonatal mortality rate in India may be increasing in the recent years, which is a cause for serious concern. Achievement of MDG4 in India will require further acceleration in the reduction of the under 5 mortality rate, particularly, in the 5 highest burden states: Uttar Pradesh, Bihar, Madhya Pradesh, Rajasthan and Andhra Pradesh.
OBJECTIVE: To review the current information on trends, burden, differentials, causes, and timing of under five (U5) child deaths in India. METHODS: We reviewed and analyzed data on child deaths in India from official government sources, reports, surveys, and from the published literature. The secondary analyses were carried out to provide additional insight. RESULTS: An estimated 1.84 million under 5 child deaths, including approx 1.44 million infant and 940,000 neonatal deaths occurred in India during 2007. More than 60% of these Under 5 child deaths occurred in 5 states: Uttar Pradesh (27.0%), Bihar (11.3%), Madhya Pradesh (9.9%), Rajasthan (8.0%) and Andhra Pradesh (5.7%). Approximately 41% of all Under 5 child deaths happen in the first week of life and the risk of deaths during neonatal period was at least 68 times higher than the rest of childhood. The children living in rural areas, in the central Indian states, in the lowest 20% of wealth index have the highest risk of death in India. The mortality rates in under 5, infant, neonates and early neonatal period in India declined by 43.5%, 31.2%, 32.1%, and 21.6%, respectively, between 1990 to 2007. However, the rate of reduction has slowed in last 4 years (2003-2007), with negative trend in the early neonatal mortality rate. Neonatal conditions (33%), pneumonia (22%) and diarrhea (14%) are the leading causes of under 5 deaths in India. Sepsis, pneumonia (30.4%), birth asphyxia (19.5%), and pre-maturity (16.8%) are the 3 commonest causes of neonatal deaths (0-27 days). CONCLUSIONS: The reduction in under 5 child mortality in India during 1990-2007 has been insufficient to attain Millennium Development Goal 4 (MDG4). However, there have been variable declines in early neonatal, neonatal, infant and child mortality. Despite the well known importance of neonatal survival to attain MDG4, our data suggest the early neonatal mortality rate in India may be increasing in the recent years, which is a cause for serious concern. Achievement of MDG4 in India will require further acceleration in the reduction of the under 5 mortality rate, particularly, in the 5 highest burden states: Uttar Pradesh, Bihar, Madhya Pradesh, Rajasthan and Andhra Pradesh.
Authors: Chandrakant Lahariya; Christopher R Sudfeld; Deepankar Lahariya; Shailendra S Tomar Journal: Indian J Pediatr Date: 2010-10-06 Impact factor: 1.967
Authors: Julie Knoll Rajaratnam; Jake R Marcus; Abraham D Flaxman; Haidong Wang; Alison Levin-Rector; Laura Dwyer; Megan Costa; Alan D Lopez; Christopher J L Murray Journal: Lancet Date: 2010-05-27 Impact factor: 79.321
Authors: Robert E Black; Simon Cousens; Hope L Johnson; Joy E Lawn; Igor Rudan; Diego G Bassani; Prabhat Jha; Harry Campbell; Christa Fischer Walker; Richard Cibulskis; Thomas Eisele; Li Liu; Colin Mathers Journal: Lancet Date: 2010-05-11 Impact factor: 79.321
Authors: A H Baqui; G L Darmstadt; E K Williams; V Kumar; T U Kiran; D Panwar; V K Srivastava; R Ahuja; R E Black; M Santosham Journal: Bull World Health Organ Date: 2006-09 Impact factor: 9.408
Authors: Laura M Lamberti; Sunita Taneja; Sarmila Mazumder; Amnesty LeFevre; Robert E Black; Christa L Fischer Walker Journal: J Glob Health Date: 2015-12 Impact factor: 4.413
Authors: Vaishali Deshmukh; Chandrakant Lahariya; Sriram Krishnamurthy; Manoj K Das; Ravindra M Pandey; Narendra K Arora Journal: Indian J Community Med Date: 2016 Apr-Jun