Reports on Child Mortality and Stillbirths

• 12 Jan 2023

For Prelims: Child Mortality, Stillbirths, UNICEF, Eat Right India, Fit India Movement, International Classification of Diseases, Preterm Births

For Mains: Issue of Stillbirths and Child Mortality in India, Government Policies & Interventions

Why in News?

Recently, two global reports on child mortality (Levels and Trends in Child Mortality) and stillbirths (Never Forgotten) were released by United Nations Inter-agency Group for Child Mortality Estimation (UN IGME).

What are the Findings of the Report?

• Levels and Trends in Child Mortality:
  • Data Related to Mortality:
    • Globally, 5 million children died before their fifth birthday (under-five mortality) in 2021.
    • Over half of these (2.7 million) occurred among children aged 1-59 months, while the remainder (2.3 million) occurred in just the first month of life (neonatal deaths).
    • India’s share in these child mortalities was estimated around 7 lakhs under-five deaths; 5.8 lakhs infant deaths (death before first birthday); and 4.4 lakhs neonatal deaths.
  • Decline in Mortality Rate:
    • The global under-5 mortality rate fell by 50% since the start of the century, while mortality rates in older children and youth dropped by 36%, and the stillbirth rate decreased by 35%.
    • This can be attributed to more investments in strengthening primary health systems to benefit women, children and young people.
    • However, gains have reduced significantly since 2010, and 54 countries will fall short of meeting the Sustainable Development Goals target for under-5 mortality.
  • Region Wise Analysis:
    • Sub-Saharan Africa and southern Asia continue to have the highest rates of child mortality, with children born in sub-Saharan Africa having the lowest chances of surviving.
  • Access to Quality Health:
    • Access to and availability of quality health care continues to be a matter of life or death for children globally.
    • Most child deaths occur in the first five years, of which half are within the first month of life.
    • For these youngest babies, premature birth and complications during labour are the leading causes of death.
  • Rising Infectious Disease:
    • For children that survive past their first 28 days, infectious diseases like pneumonia, diarrhoea and malaria pose the biggest threat, the global health agency found.
• Report on Stillbirth:
  • Globally, an estimated 1.9 million stillbirths happened in 2021.
  • In 2021, the absolute estimated number of stillbirths in India (2,86,482) was greater than the death amongst children in 1-59 months of age (2,67,565).

What is the Root of Many Child Deaths?

• Preterm Births (Children born before 37 weeks of pregnancy are completed):
  • This is a challenge because these ‘preterm babies’ are two to four times at higher risk of death after birth in comparison to those born after 37 weeks of gestation.
  • Globally, one in every 10 births is preterm; in India, one in every six to seven births is preterm.
  • India has a high burden of preterm births, which means newborns in the country are at greater risk of complications and mortality.
• Stillbirths:
  • The rates and number of both preterm births and stillbirths are unacceptably high and drive the neonatal, infant and child mortalities upwards in India. Thus, they demand urgent interventions.
    • A baby who dies any time after 22 weeks of pregnancy, but before or during the birth, is classified as a stillborn.
  • One of the reasons preterm births and stillbirths do not get due attention is lack of granular and reliable data.

What are the Related Initiatives of India?

• POSHAN Abhiyaan: The government of India has launched the National Nutrition Mission (NNM) or POSHAN Abhiyaan to ensure a “Malnutrition Free India” by 2022.
• Anemia Mukt Bharat Abhiyan: Launched in 2018, the mission aims at accelerating the annual rate of decline of anaemia from one to three percentage points.
• The National Food Security Act (NFSA), 2013: It aims to ensure food and nutrition security for the most vulnerables through its associated schemes and programmes, making access to food a legal right.
• Pradhan Mantri Matru Vandana Yojana (PMMVY): Rs.6,000 is transferred directly to the bank accounts of pregnant women for availing better facilities for their delivery.
• Integrated Child Development Services (ICDS) Scheme: It was launched in 1975 and the scheme aims at providing food, preschool education, primary healthcare, immunisation, health check-up and referral services to children under 6 years of age and their mothers.
• Eat Right India and Fit India Movement are some other initiatives to promote healthy eating and healthy lifestyle.

What is UN IGME?

• UN IGME was formed in 2004 to share data on child mortality, improve methods for child mortality estimation, report on progress towards child survival goals and enhance country capacity to produce timely and properly assessed estimates of child mortality.
• UN IGME is led by United Nations Children’s Fund (UNICEF) and includes the World Health Organization, the World Bank Group and the United Nations Department of Economic and Social Affairs, Population Division.

What can be done to Prevent Stillbirths and Preterm Births?

• Scaling up Known and Proven Interventions:
  • For reducing both stillbirths and preterm births, the focus must be on:
    • Increasing access to family planning services;
    • Improving antepartum services such as health and nutrition, including the intake of iron folic acid by pregnant mothers;
    • Providing counselling on the importance of a healthy diet, and optimal nutrition;
    • Identification and management of risk factors.
• Effective Implementation of Guidelines:
  • The interventions can be best delivered if data on preterm births and stillbirths are better recorded and reported.
  • The maternal and perinatal deaths surveillance guidelines need to be effectively implemented and the International Classification of Diseases’ definition for perinatal mortality must be adopted.
    • The use of this classification will help standardise the causes of stillbirth reporting.
  • Alongside, India needs to identify the hot spot clusters of stillbirths and preterm births for local and targeted interventions.
• Allocate more Funding:
  • In the National Health Policy of 2017, the government had committed to investing 2.5% of the GDP on health by 2025.
    • Six years since then, the government’s allocation for health has increased only marginally.
  • The two recent reports are reminders that it is time for the government to allocate more funds for health, starting with the upcoming Budget.

UPSC Civil Services Examination, Previous Year Questions (PYQs)

Prelims

Q. Which of the following are the objectives of ‘National Nutrition Mission’? (2017)

1. To create awareness relating to malnutrition among pregnant women and lactating mothers.
2. To reduce the incidence of anaemia among young children, adolescent girls and women.
3. To promote the consumption of millets, coarse cereals and unpolished rice.
4. To promote the consumption of poultry eggs.

Select the correct answer using the code given below:

(a) 1 and 2 only
(b) 1, 2 and 3 only 
(c) 1, 2 and 4 only
(d) 3 and 4 only

Ans: (a)

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Mains

Q. Can the vicious cycle of gender inequality, poverty and malnutrition be broken through microfinancing of women SHGs? Explain with examples. (2021)

Source: TH