While its neonatal mortality rate stands at 25.4, the country has managed a 66% reduction in under-five deaths between 1990 to 2015.
New Delhi: With over six lakh children dying within the first month of their birth in 2016, India has found itself among the riskiest countries for newborns.
According to a new UNICEF report released on Tuesday, the country’s neonatal mortality rate at 25.4 deaths per 1,000 live births makes it 12th worst among 52 “lower middle-income countries” that pose risk for newborns. India is also the only major country in the world to have a higher mortality for girls than boys.
Within the country as well, disparities are highly significant. While Kerala and Goa have neonatal mortality rates of ten per 1,000 live births, the figure for Bihar and Uttarakhand stands at 44 per 1,000.
Additionally, Uttar Pradesh, Bihar, Madhya Pradesh and Rajasthan account for 46% of all births and 57% of India’s neonatal deaths.
India is currently not on track to meet the Sustainable Development Goal target for neonatal mortality of 12 by 2030, the report notes. To achieve this goal, the country will have to reduce its neonatal deaths by half in the next 12 years.
While India is ahead of Pakistan, which has a neonatal mortality rate of 45.6 with one in 22 newborns dying in the South Asian country, it is far behind the curve when compared to its other neighbours – Sri Lanka, Bangladesh, Nepal and Bhutan. India has, however, managed a 66% reduction in under-five deaths between 1990 to 2015 against the world average of 55%.
Babies born in Japan (neonatal mortality rate of 0.9), on the other hand, have the best shot at survival, followed by Iceland and Singapore and Estonia, the report found.
Worldwide, 2.6 million babies die within a month of birth every year – an average of 7,000 deaths every day. Of these, India accounts for 6,40,000 annual neonatal deaths.
A Scroll.in report notes that this is the first time that the UN group has ranked countries based on their newborn mortality rate.
According to UNICEF, newborn survival is closely linked to a country’s income level. Globally, in low-income countries, the average newborn mortality rate (NMR) is 27, while in high-income countries the figure is only three. “This gap is significant,” the UN body notes. “If every country brought its NMR to the high-income average, or below, by 2030, 16 million newborn lives could be saved.”
Under-five mortality
The UNICEF representative in India, Dr Yasmin Ali Haque, told Hindustan Times the country has fared better than others in the world in terms of reducing reducing under-five mortality, “but progress has been slower in saving babies during the neonatal period when they are the most vulnerable.”
In 2016, India’s under-five mortality fell to 39 from 43 in the previous year, resulting in close to 120,000 fewer children dying. This was in part due to the the positive impact of vaccination against diarrhoea and pneumonia, now included in the national immunisation programme, Hindustan Times notes.
Premature births counts for over 80% of newborn deaths. Complications during labour and delivery as well as infections like sepsis, meningitis and pneumonia are also major contributors.
Dilip Mavlankar, director at Indian Institute of Public Health, Gandhinagar, told the Hindustan Times that vaccinations do not reduce neonatal or infant deaths significantly, but have an impact in lowering under-five mortality.
“To lower neonatal deaths, we need to strengthen mother and newborn health services, including home-based care by health workers, institutional care for sick newborns, promoting breastfeeding, treating underweight babies, keeping the mother healthy, preventing early marriage and reducing malnutrition in adolescent girls,” Mavlankar said.