Context: A Lancet paper regarding India’s child health indicators was published recently .

More about the research paper

  • The study was done by India State-Level Disease Burden Initiative.
  • It is the first comprehensive estimate of district-level trends of child mortality.

Findings of the study

  • 68% of under-five-year deaths in India can be attributed to child and maternal malnourishment.
  • 83% of neonatal deaths are due to low birth-weight and short gestation.
  • Although child mortality and child growth failure indicators have improved substantially across the country between 2000 and 2017, inequalities between districts have increased in many states.
    • The under-5 mortality rate (U5MR) and neonatal mortality rate in the first month of life (NMR) have dropped substantially in India since 2000.
    • However there is a 5-6 fold variation among these rates between the states and 8-11 fold variation between the districts of India.
  • State Wise scenario:
    • Uttar Pradesh
      • 48% of all districts fell in the highest priority category for NMR and recorded a low rate of reduction for the nationwide distribution of district-level rates.
      • The most affected districts of UP, which had the highest child mortality rate, included 
        • a cluster of eight districts in the north-central part (Bahraich, Balrampur, Barabanki, Gonda, Hardoi, Kheri, Shravasti and Sitapur), 
        • three districts in the south (Allahabad, Banda and Chitrakoot), and 
        • Lalitpur district in the south-west.
    • Assam
      • It has recorded the second-highest child mortality rate in 2017.
      • Vulnerable districts included Cachar, Dima Hasao, Hallakandi, Karbi Anglong, Karimganj, and West Karbi Anglong.
    • Bihar
      • The highest priority was found in the north-eastern parts (Kishanganj and Purnia), and in the south-west (Aurangabad and Kaimur).


  • Even as India struggles against the spread of COVID-19, the country’s structural fault lines in health continue to be a cause of concern.
  • Even though India had significant improvements in stunting, wasting, and underweight among children since 2000, there continues to be a five-fold variation in the prevalence of these child indicators between the districts.
  • The efforts targeting poorly performing districts as identified by the current district-wise analysis can potentially help hasten overall improvements in child growth failure in India
  • However according to Lancet study if the trends observed up to 2017 were to continue India will not be able to meet the Sustainable Development Goals NMR target by 2030.

SDG 3: Ensure healthy lives and promote wellbeing for all at all ages

Targets in SDG 3, related to maternal and child health are as follows

  • By 2030, reduce the global maternal mortality ratio to less than 70 per 100 000 live births
  • By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to 
    • reduce neonatal mortality to at least as low as 12 per 1000 live births and 
    • under-5 mortality to at least as low as 25 per 1000 live births.


About India State-Level Disease Burden Initiative

  • The India State-Level Disease Burden Initiative was launched in October 2015.
  • It is a collaboration between the Indian Council of Medical Research (ICMR), the Public Health Foundation of India (PHFI), Institute for Health Metrics and Evaluation (IHME), and senior experts and stakeholders currently from about 100 institutions across India.
  • The work of this Initiative is overseen by an Advisory Board consisting of eminent policymakers and involves extensive engagement of 14 domain expert groups with the estimation process.


Key Terms:

  • Infant Mortality Rate: It is the number of deaths of children under one year of age per 1000 live births.
  • Neonatal Mortality Rate: It is the number of deaths of children occurring during the first month ( 0-28 days) per 1000 live births.
  • Child Mortality Rate: It is the number of deaths of children under 5 years of age per 1000 live births.
  • Maternal Mortality Rate: The number of registered maternal deaths due to birth- or pregnancy-related complications per 100,000 registered live births.