India Leads in Child Mortality Reduction Amid Global Slowdown

For Prelims, focus on the Under-Five Mortality Rate (U5MR) and Neonatal Mortality Rate (NMR). India's U5MR declined from 127 deaths per 1,000 live births in 1990 to 26.6 in 2024, a 79% reduction. The NMR fell from 57 in 1990 to 17 in 2024, a 70% decline.

Global gains in child mortality reduction have slowed since 2015. This period coincides with the transition from Millennium Development Goals (MDGs) to Sustainable Development Goals (SDGs). India, however, has maintained significant momentum, implying that its sustained and large-scale efforts have been effective even when global progress decelerated.

• •Global slowdown post-2015, possibly due to changing priorities or challenges in achieving the final MDG targets.
• •India's sustained efforts, including policy initiatives like the National Health Policy 2017 and programs like Ayushman Bharat, helped maintain progress.
• •This positions India as a leader and a model for other high-burden countries in Southern Asia.

India's success is attributed to sustained and large-scale efforts, particularly in improving neonatal and under-five mortality indicators. These efforts include strengthening policy commitments and improving healthcare delivery.

• •Reaffirmation of health targets through the National Health Policy 2017, aligning with SDG goals.
• •Sustained focus on improving the quality of care at public health facilities, especially for maternal and newborn health.
• •Implementation of specific initiatives and technological advancements like Tele-SNCU and Ayushman Bharat.

The National Health Policy 2017 is highly relevant as it reaffirmed the government's resolve to achieve specific health targets, including further reductions in child mortality rates, aligning with SDG targets for 2030. Additionally, programs like Ayushman Bharat and Tele-SNCU are important as practical interventions.

India's significant progress positions it as a key contributor to global efforts in reducing child mortality and a leader among high-burden countries in Southern Asia. This enhances India's soft power, demonstrates its capacity to address major public health challenges, and provides a model for other developing nations in the region.

The Under-Five Mortality Rate (U5MR) measures the probability of a child dying before reaching their fifth birthday. The Neonatal Mortality Rate (NMR) specifically measures the number of deaths among live-born infants during the first 28 completed days of life.

• •U5MR reflects broader child health issues, including nutrition, sanitation, and access to general healthcare over a longer period.
• •NMR focuses on the most vulnerable period immediately after birth, indicating the quality of maternal care, delivery practices, and immediate postnatal care.
• •Tracking both separately allows for targeted interventions, addressing specific causes of death at different stages of early childhood.

This report was released by the UN Inter-agency Group for Child Mortality Estimation (UNIGME). UNIGME is a collaborative effort involving UNICEF, WHO, the World Bank, and the United Nations Population Division.

If the global slowdown in child mortality reduction continues, it could jeopardize the achievement of the Sustainable Development Goals (SDGs) related to child health by 2030. It might also exacerbate health disparities between countries, placing a greater burden on healthcare systems in struggling nations and potentially leading to a reversal of some hard-won gains.

This focus is critical for India's public health strategy because it allows for scalable and cost-effective solutions across its vast and diverse population. Prioritizing proven, low-cost interventions ensures that limited resources are utilized efficiently to maximize impact on child survival, reaching even remote and underserved areas.

Both the Millennium Development Goals (MDGs) and the Sustainable Development Goals (SDGs) included specific targets for reducing child mortality. MDG 4 aimed to reduce the under-five mortality rate by two-thirds between 1990 and 2015. The SDGs, which succeeded the MDGs, continue this commitment under SDG 3 (Good Health and Well-being), with target 3.2 aiming to end preventable deaths of newborns and children under 5 by 2030.