India may not achieve SDG targets on reducing child mortality: study

By Monika Kundu Srivastava

New Delhi: A new study has warned that over two-thirds of the districts in the country are unlikely to achieve the UN Sustainable Development Goal (SDG) target of reducing deaths to 25 or less per 1000 live births in under 5-year old children and 12 or less per 1000 live births for newborns by 2030.

The study is based on analysis of data from the 2015–2016 National Family Health Survey (NFHS).

The results of the study done by Jayanta Kumar Bora from the International Institute for Applied Systems Analysis, Austria, and Dr Nandita Saikia from Jawaharlal Nehru University (JNU), have been published in journal PLoS ONE.

The results indicate that on an average, estimated deaths of under 5 children is double the targeted figure (49.4 against targeted 25 deaths per 1000 live births) while estimated deaths of newborns is about 2.4 times greater than the targeted one (29.2 against targeted 12 deaths per 1000 live births).

Of the 613 districts considered, 9% and 14% have already achieved the target for reducing the deaths in newborns and under 5-year-old children, respectively. But nearly half the districts (315) are unlikely to achieve the target by 2030. Most of the poorly performing districts are located in Assam, Bihar, Chhattisgarh, Haryana, Madhya Pradesh, Uttar Pradesh and Uttarakhand.

About 67% of the districts are not likely to achieve the target for male newborns, whereas 46% are not likely to achieve the target for female newborns by 2030. Most of the districts unlikely to achieve the target to reduce deaths in female newborns are located in north-central and eastern belt of the country. For male newborns, north-central-west, north-east and south-east are unlikely to meet the target by 2030. This includes rich states like Andhra Pradesh, Gujarat, Haryana, Telangana. In Chhattisgarh and Uttar Pradesh, 97% of districts are unlikely to meet the targets for both reducing deaths in newborns and in children under five irrespective of gender.

The reason for the disparities, according to the researchers, could be in the level of socio-economic development in terms of female literacy rate, urbanization and safe drinking water. Disparities in the decrease in deaths in newborns vis-à-vis under 5-year-old children could be related to implementation of interventions. “The state-level mortality rate does not reflect the inter-district variation in neonatal or under-five mortality rates. While some districts of a particular state may already have achieved the SDG3 target 15 years in advance, some districts will not achieve this even by the 2030 target time,” mentioned Mr Bora.

Another finding is that female newborn deaths are lower than male newborn deaths, a much-expected finding due to female’s biological advantage observed in other countries of the world. However, this advantage reduces in older children indicating potential discrimination against girl child.

India, presently, has the highest global share of deaths among the under-fives. Although the number of deaths in children below 5 years of age has gone done by almost 50% in over 23 years, it is not enough to meet the required targets set by UN which aims at ending preventable deaths of newborns and other children under 5 years of age, reducing deaths of newborns and in under-5 children , by 2030. This is in spite of efforts to improve the infrastructure in backward districts through the National Rural Health Mission, Integrated Management of Neonatal and Childhood Illnesses, and other schemes.

“It is important to note that India experienced the highest reduction in mortality rate in the period 2005-2016. Therefore, to achieve the SDG-related mortality goals at the district level, it needs to intervene more rigorously than ever,” said Dr Saikia.