Lok Sabha Question No. 882 (UNSTARRED), answered on 2021-02-05
Subject: Child Mortality Rate
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Saikia Dilip, Ramesh Chander Kaushik

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

## LOK SABHA UNSTARRED QUESTION NO. 882 TO BE ANSWERED ON 5 TH FEBRUARY, 2021

## CHILD MORTALITY RATE

## 882. SHRI DILIP SAIKIA:

## SHRI RAMESH CHANDER KAUSHIK:

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

(a) whether it is a fact that mortality rate in children under five years of age in rural areas is 2.4 times  higher than  the  urban  children  in  the  country,  if  so,  the  details ther of,  Stat e/UT- wise including Assam;

- (b) the strategy chalked out by the Government to tackle this situation;
- (c) whether the Government has fixed any accountability at any level in this regard; and
- (d) if so, the details thereof and if not, the reasons therefor?

## ANSWER

## THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI ASHWINI KUMAR CHOUBEY)

(a) & (b):  As per Sample Registration System (SRS) Statistical Report of Registrar Gene India (2018), mortality rate in children under five years of ag (Under 5 Mortality Rate) in rural India is 40 per 1000 live births and in urban India it is 24 per 1000 live births. The ov 5 Mortality Rate is 36 per 1000 live birth at national level in 2018.

The differential Under 5 Mortality Rate in Rural and urban areas varies from state to state. The details of Under 5 Mortality Rate in larger States/ UTs including Assam covered under is placed at Annexure.

In order to bring down the mortality among children, the Government of India is suppo g all States/UTs including North - Eastern States under National Health Mission in implementation of  Reproductive,  Maternal,  Newborn,  Child,  Adolescent  health  and  Nutrition  (RMNCAH+N) strategies. The major interventions include the following:

- In order to im prove pregnancy outcome and reduce newborn/ child mortality due to home delivery, Institutional deliveries are promoted under Janani Suraksha Yojana (JSY) th cash incentive. Women delivering in public health institutions are entitled for free including  Caesarean  section,  post - natal  care  under  Janani  Shishu  Suraksha  Karyakaram (JSSK).  Treatment of sick infants up to one year of age is also covered under JSSK.
- Sick Newborn Care Units (SNCU) are established at District Hospital and Medical Colle ge level, Newborn Stabilization Units (NBSU) are established at First Referral Units (F Community Health Centres (CHC) for care of sick and small babies. India Newborn Actio Plan (INAP) was launched in 2014 to make concerted efforts to reduce neonata l mortality.
- Under  Home  Based  Newborn  Care  (HBNC)  and  Home - Based  Care  of  Young  Children (HBYC) program, home visits are performed by ASHAs to improve child rearing practice and to identify sick new -born and young children in the community.
- Early initiati on and exclusive breastfeeding for first six months and appropriate Infant Young  Child  Feeding  (IYCF)  practices  are  promoted  under  Mothers'  Absolute  Affection (MAA).
- Social Awareness and Actions to Neutralize Pneumonia Successfully (SAANS) initiative has been launched for reduction of Childhood morbidity and mortality due to Pneumonia.
- Universal  Immunization  Programme  (UIP)  is  being  supported  to  provide  vaccination  t children against life threatening diseases such as Tuberculosis, Diphtheria, Pertuss is, Polio, Tetanus, Hepatitis B, Measles, Rubella, Pneumonia and Meningitis caused by Haemophilu Influenzae  B.  The  Rotavirus  vaccination  has  also  been  rolled  out  in  the  countr prevention of Rota - viral diarrhoea.
- Children  from  0  to  18  years  of  age  ar e  screened  for  30  health  conditions  (i.e. Diseases, Deficiencies, Defects and Developmental delay) under 'Rashtriya Bal Swasthya Karyakaram' (RBSK) to improve child survival. District early intervention center (DEIC) at district  health  facility  level  are  e stablished  for  confirmation  and  management  of  children screened under RBSK.
- Nutrition Rehabilitation Centres (NRCs) have been set up at public health facilities and  manage  the  children  with  Severe  Acute  Malnutrition  (SAM)  admitted  with  medical com plications.
- Intensified Diarrhoea Control Fortnight / Defeat Diarrhoea (D2) initiative has been la for promoting ORS and Zinc use and for reducing diarrhoeal deaths.
- Anaemia Mukt Bharat (AMB) strategy as a part of Poshan Abhiyan aims to strengthen the existing mechanisms and foster newer strategies to tackle anaemia which include testi treatment  of  anaemia  in  school  going  adolescents  &  pregnant  women,  addressing  no nutritional causes of anaemia and a comprehensive communicat ion strategy.
- Name based tracking of mothers and children till two years of age is done through portal  to  ensure  complete  antenatal,  intranatal,  postnatal  care  and  immunization schedule.
- Several capacity building programs of health care provide rs are undertaken for improving maternal and child survival and health outcomes.

(c) & (d):Health being a State subject, the day to day monitoring and reporting lies domain of State/ UT governments. To strengthen public health system, under Natio nal Health Mission  (NHM)  technical  and  financial  support  is  provided  for  establishment  of  monito mechanisms  and  grievance  redressal  system.  Besides  this,  routine  monitoring  through  He Management Information System (HMIS) and periodic monitoring thr ough state reviews are also carried out. Regular advisories/ guidance are issued to States/ UTs in this regard.

| Status of Under 5 Mortality Rate at National level Larger States/ UTs in 2018   | Status of Under 5 Mortality Rate at National level Larger States/ UTs in 2018   | Status of Under 5 Mortality Rate at National level Larger States/ UTs in 2018   | Status of Under 5 Mortality Rate at National level Larger States/ UTs in 2018   |
|---------------------------------------------------------------------------------|---------------------------------------------------------------------------------|---------------------------------------------------------------------------------|---------------------------------------------------------------------------------|
|                                                                                 | Total                                                                           | Rural                                                                           | Urban                                                                           |
| India                                                                           | 36                                                                              | 40                                                                              | 26                                                                              |
| Andhra Pradesh                                                                  | 33                                                                              | 37                                                                              | 24                                                                              |
| Assam                                                                           | 47                                                                              | 50                                                                              | 23                                                                              |
| Bihar                                                                           | 37                                                                              | 37                                                                              | 32                                                                              |
| Chhattisgarh                                                                    | 45                                                                              | 47                                                                              | 38                                                                              |
| Delhi                                                                           | 19                                                                              | 17                                                                              | 19                                                                              |
| Gujarat                                                                         | 31                                                                              | 37                                                                              | 21                                                                              |
| Haryana                                                                         | 36                                                                              | 39                                                                              | 30                                                                              |
| Himachal Pradesh                                                                | 23                                                                              | 23                                                                              | 17                                                                              |
| Jammu & Kashmir                                                                 | 23                                                                              | 24                                                                              | 20                                                                              |
| Jharkhand                                                                       | 34                                                                              | 36                                                                              | 29                                                                              |
| Karnataka                                                                       | 28                                                                              | 30                                                                              | 24                                                                              |
| Kerala                                                                          | 10                                                                              | 11                                                                              | 9                                                                               |
| Madhya Pradesh                                                                  | 56                                                                              | 60                                                                              | 39                                                                              |
| Maharashtra                                                                     | 22                                                                              | 27                                                                              | 15                                                                              |
| Orissa                                                                          | 44                                                                              | 45                                                                              | 35                                                                              |
| Punjab                                                                          | 23                                                                              | 23                                                                              | 22                                                                              |
| Rajasthan                                                                       | 40                                                                              | 43                                                                              | 31                                                                              |
| Tamil Nadu                                                                      | 17                                                                              | 22                                                                              | 14                                                                              |
| Telangana                                                                       | 30                                                                              | 35                                                                              | 23                                                                              |
| Uttar Pradesh                                                                   | 47                                                                              | 49                                                                              | 38                                                                              |
| Uttarakhand                                                                     | 33                                                                              | 33                                                                              | 33                                                                              |
| West Bengal                                                                     | 26                                                                              | 27                                                                              | 25                                                                              |