Lok Sabha Question No. 2143 (UNSTARRED), answered on 2017-07-28
Subject: Child Mortality
Ministry: HEALTH AND FAMILY WELFARE
Asked by: RAMSINH PATALYABHAI RATHWA

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

LOK SABHA UNSTARRED QUESTION NO. 2143 TO BE ANSWERED ON  28 TH JULY, 2017

## CHILD MORTALITY

## 2143. SHRI RAMSINH RATHWA:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) whether India has the highest number of child deaths in the world and if so, the detai and  comparison  of  India's  standing  with  BRICS  and  SAARC  member  nations  and  African countries;
- (b) whether India has achieved/is on track to achieve the fourth Millennium Development Goal (MDG - 4) aimed at reducing under five child mortality by twothird and if so, the details and if not, the reasons therefor and corrective action taken by the Government; and
- (c)whether the Government has identified high risk districts and if so, the details the interventions and if any taken and if not, the reasons therefor?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI FAGGAN SINGH KULASTE)

- (a ) : As per Sample Registration System, 2015 Report of Registrar General of India the Und -5 Mortality Rate of India is 43 per 1000 live births. In terms of numbers, this comes 10.8 lakhs under - 5 deaths in 2015.
- The comparisonof India's  Under  5  Mortality  Rate  (U5MR) with  BRICS  Countries,  SAARC member nations and African countries areplaced at Annexure - 1, Annexure - 2  and Annexure - 3 respectively.
- (b: As per the Sample Registration System (SRS) Reportof Registrar General of In dia (RGI) for the year of 2015 ,India has attained Under - 5  Mortality Rate (U5MR) of 43 per 1000 live births against the MDG -4 target of 42 per 1000 live births.

The Government of India is implementing the following interventions under the Natio Health M ission (NHM) all across the country to reduce child mortalit y rate :

- (1)Promotion  of  Institutional  deliveries  through  cash  incentive  under  Janani  Sura Yojana  (JSY)  and  Janani  Shishu  Suraksha  Karyakaram  (JSSK)  which  entitles  all pregnant  women  delivering  in public  health  institutions  to  absolutely  free  ante - natal check - ups,  delivery  including  Caesarean  section,  post - natal  care  and  treatment  of  sick infants till one year of age.

Contd……..

- (2)Strengthening of delivery points for providing comprehensive and quality Reproductive, Maternal,  Newborn,  Child  and  Adolescent  Health  (RMNCH+A)  Services,  ensuring essential  newborn  care  at  all  delivery  points,  establishment  of  Special  Newborn Units (SNCU), Newborn Stabilization Units (NBSU) and Kangaroo Mother Care (KMC) units for care of sick and small babies. Home Based Newborn Care (HBNC) is being provided  by  ASHAs  to  improve  child  rearing  practices.  India  Newborn  Action  Pla (IANP) was launched in 2014 to make concerted efforts towards attainment of the go of 'Single Digit Neonatal Mortality Rate' and 'Single Digit Stillbirth Rate', by 2030.
- (3)Early initiation and exclusive breastfeeding for first six months and appropriate and Young Child Feeding (IYCF) practices are promoted in convergence with Minist ry of  Women  and  Child  Development.  Village  Health  and  Nutrition  Days  (VHNDs)  are observed for provision of maternal and child health services and creating awarene maternal and child care including health and nutrition education. Ministry of Heal Family Welfare launched MAA -Mothers' Absolute Affection programme in August 2016 for improving breastfeeding practices (Initial Breastfeeding within one hour , Exclusive Breastfeeding  up  to  six  months  and  complementary  Breastfeeding  up  to  two  years through mass media and capacity building of health care providers in health facili well as in communities.
- (4)Universal Immunization Programme (UIP) is being supported to provide vaccination t children  against  many  life  threatening  diseases  such  as Tuberculosis,  Diphtheria, Pertussis,  Polio,  Tetanus,  Hepatitis  B  and  Measles.  Pentavalent  vaccine  has introduced all across the country and 'Mission Indradhanush' has been launched to fully immunize children who are either unvaccinated or partially va ccin ted; those that have not been covered during the rounds of routine immunization for various reasons.
- (5)Name based tracking of mothers and children till two years of age (Mother and Ch Tracking  System)  is  done  to  ensure  complete  antenatal,  intranata l,  postnatal  care  and complete immunization as per schedule.
- (6)Rashtriya Bal Swasthya Karyakram (RBSK) for health screening, early detection of bi defects,  diseases,  deficiencies,  development  delays  including  disability  and intervention services h as been Operationalized to provide comprehensive care to all th children in the age group of 0 - 18 years in the community.
- (7)Some other important interventions are Iron and folic acid (IFA) supplementation fo prevention  of  anaemia  among  the  vulnerable age  groups,  home  visits  by  ASHAs  to promote exclusive breast feeding and promote use of ORS and Zinc for management of diarrhoea in children.

(c ) : 209 low performing districts have been identified as High Priority Districts (HPDs) entitles  the m  to  receive  high  per  capita  funding,  relaxed  norms,  enhanced  monitoring  a focused technical supportive supervisions and encouragement to adopt innovative approache address their peculiar health challenges.

……………….

## Annexure - 1

| The Under-5 Mortality Rate (U5MR) in BRICS Countries   | The Under-5 Mortality Rate (U5MR) in BRICS Countries   | The Under-5 Mortality Rate (U5MR) in BRICS Countries   |
|--------------------------------------------------------|--------------------------------------------------------|--------------------------------------------------------|
| S. No.                                                 | Name of Country                                        | U5MR (Per 1000 births)                                 |
| 1                                                      | Brazil #                                               | 16                                                     |
| 2                                                      | Russian Federation #                                   | 10                                                     |
| 3                                                      | India *                                                | 43                                                     |
| 4                                                      | China #                                                | 11                                                     |
| 5                                                      | South Africa #                                         | 41                                                     |

## Source:

- # Level  and  Trends  in  Child  Mortality  Report,  2015  of  UN  Inter -agencyGroup for Child Mortality Estimation (UNIGME)
* Sample  Registration  System  (SRS),  2015  Report  of  Registrar General of India (RGI)

## Annexure - 2

| The Under-5 Mortality Rate (U5MR) in SAARC Member Nations   | The Under-5 Mortality Rate (U5MR) in SAARC Member Nations   | The Under-5 Mortality Rate (U5MR) in SAARC Member Nations   |
|-------------------------------------------------------------|-------------------------------------------------------------|-------------------------------------------------------------|
| S. No.                                                      | Name of Country                                             | U5MR (Per 1000 births)                                      |
| 1                                                           | Afghanistan #                                               | 91                                                          |
| 2                                                           | Bangladesh #                                                | 38                                                          |
| 3                                                           | Bhutan #                                                    | 33                                                          |
| 4                                                           | India *                                                     | 43                                                          |
| 5                                                           | Maldives #                                                  | 9                                                           |
| 6                                                           | Nepal #                                                     | 36                                                          |
| 7                                                           | Pakistan #                                                  | 81                                                          |
| 8                                                           | Sri Lanka #                                                 | 10                                                          |

## Source:

- # Level  and  Trends  in  Child  Mortality  Report,  2015  of  UN  Inter -agency Group for Child Mortality Estimation (UNIGME)
* Sample  Registration  System  (SRS),  2015  Report  of  Registrar General of India (RGI)

## Annexure - 3

| The Under-5 Mortality Rate (U5MR) in African Countries   | The Under-5 Mortality Rate (U5MR) in African Countries   | The Under-5 Mortality Rate (U5MR) in African Countries   | The Under-5 Mortality Rate (U5MR) in African Countries   |
|----------------------------------------------------------|----------------------------------------------------------|----------------------------------------------------------|----------------------------------------------------------|
| Name of Country                                          | U5MR                                                     | Name of Country                                          | U5MR                                                     |
| Name of Country                                          | (Per 1000 live births)                                   | Name of Country                                          | (Per 1000 live births)                                   |
| India *                                                  | 43                                                       |                                                          |                                                          |
| African Countries #                                      |                                                          |                                                          |                                                          |
| Algeria                                                  | 26                                                       | Libya                                                    | 13                                                       |
| Angola                                                   | 157                                                      | Madagascar                                               | 50                                                       |
| Benin                                                    | 100                                                      | Malawi                                                   | 64                                                       |
| Botswana                                                 | 44                                                       | Mali                                                     | 115                                                      |
| Burkina Faso                                             | 89                                                       | Mauritania                                               | 85                                                       |
| Burundi                                                  | 82                                                       | Mauritius                                                | 14                                                       |
| Cabo Verde                                               | 25                                                       | Morocco                                                  | 28                                                       |
| Cameroon                                                 | 88                                                       | Mozambique                                               | 79                                                       |
| Central African Republic (CAR)                           | 130                                                      | Namibia                                                  | 45                                                       |
| Chad                                                     | 139                                                      | Niger                                                    | 96                                                       |
| Comoros                                                  | 74                                                       | Nigeria                                                  | 109                                                      |
| Democratic Republic of theCongo                          | 98                                                       | Rwanda                                                   | 42                                                       |
| Republic of the Congo                                    | 45                                                       | Sao Tome and Principe                                    | 47                                                       |
| Cote d'Ivoire                                            | 93                                                       | Senegal                                                  | 47                                                       |
| Djibouti                                                 | 65                                                       | Seychelles                                               | 14                                                       |
| Egypt                                                    | 24                                                       | Sierra Leone                                             | 120                                                      |
| Equatorial Guinea                                        | 94                                                       | Somalia                                                  | 137                                                      |
| Eritrea                                                  | 47                                                       | South Africa                                             | 41                                                       |
| Ethiopia                                                 | 59                                                       | South Sudan                                              | 93                                                       |
| Gabon                                                    | 51                                                       | Sudan                                                    | 70                                                       |
| Gambia                                                   | 69                                                       | Swaziland                                                | 61                                                       |
| Ghana                                                    | 62                                                       | Tanzania                                                 | 49                                                       |
| Guinea                                                   | 94                                                       | Togo                                                     | 78                                                       |
| Guinea-Bissau                                            | 93                                                       | Tunisia                                                  | 14                                                       |
| Kenya                                                    | 49                                                       | Uganda                                                   | 55                                                       |
| Lesotho                                                  | 90                                                       | Zambia                                                   | 64                                                       |
| Liberia                                                  | 70                                                       | Zimbabwe                                                 | 71                                                       |

## Source:

# Level and Trends in Child Mortality Report, 2015 of UN Inter - agency Group for Child Mortality Estimation (UNIGME)

* Sample Registration System (SRS), 2015 Report of Registrar General of India (RGI)