Child deaths – India and the world

The recently released UN Inter-agency Group for Child Mortality Estimation (IGME) Report on child mortality shows that despite significant improvements made in this sphere, child deaths remain a major global concern and more so in the developing economies of the world. It is estimated that in 2018, 6.2 million child (under 15 years) deaths occurred globally – down 56% from 1990 estimates. 85% of these deaths (5.3 million) were of children below 5 years, of which 2.5 million occurred within the first 4 weeks of life (neo-natal), 1.5 million between months 1 and 11 and 1.3 million between years 1 and 4. As can be observed from the above figures, risks to a child’s life remains highest in the first month after birth.

The global mortality rate among children below 5 (1-4+ years) and neo-natal stage was observed to be as below:

Mortality rate = no. of deaths per 1000 live births

In 2018, 121 countries had already achieved the sustainable development goal (SDG) target rate of 25 or fewer child deaths per 1000 before the age of 5. If all countries achieve the target by 2030, 11 million lives under 5 will be saved globally – more than 1/2 of them in sub-Saharan Africa alone. Unfortunately, at current rate, 53 countries will fail to meet the target by 2030 – 2/3rd of these are in sub-Saharan Africa.

However, there are widespread regional variations in the above. In sub-Saharan Africa, under-five mortality rate in 2018 was 78/1000 live births – double of the global average. It translates 1 in every 13 child born in this region not surviving till his or her 5th birthday. Sub-Saharan Africa and central & south Asia together account for more than 80% of all below 5 deaths. Same holds true for all casualties below 15 years of age.

% of deaths by regions of the globe

Half of all the deaths under-five (1-4+ years age) in 2018 occurred in 5 countries – India, Nigeria, Pakistan, DR Congo and Ethiopia. India and Nigeria together account for about a third of all child deaths below 5.

Total no. of child deaths (in 000’s) 1-4+ years age in 2018
Figures in circle are no. of deaths per 1000 live births in same time period

In terms of infant (less than 1 year) deaths and neo-natal (28 days from birth) deaths also, these 5 countries register the maximum numbers in 2018.

Total no. of infant deaths (in 000s) in 2018
Figures in the circle are no. of deaths per 1000 live births in the same time period

Total no. of neo-natal deaths (in 000s) in 2018
Figures in the circle are no. of deaths per 1000 live births in the same time period

India has made dramatic improvements over the last 3 decades in bringing down the mortality among children below 5 years. However, the fight is far from over. The present mortality rate for below 5 years and neo-natal are both still short of the SDG targets (under 5: 37 in India against UN target of 25 or below / neo-natal: 23 in India against UN target of 12 or below).

Every child death is an unimaginable human tragedy. What makes it even sadder is that majority deaths below 5 occur due to preventable and treatable causes. India’s under 5 mortality rate came down from 126 in 1990 to 37 in 2018 – a remarkable progress. This shows that with the right commitment, concerted efforts and political will, targets that appear impossible can also be achieved. IPD sincerely hopes and prays that in the near future, child deaths are nearly eliminated not just from India but across the globe.

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