Lok Sabha Question No. 1397 (UNSTARRED), answered on 2023-07-28
Subject: Child Mortality Rate
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Chandrani Murmu

## GOVERNMENTOFINDIA MINISTRYOF HEALTH AND FAMILY WELFARE DEPARTMENTOFHEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION No. 1397 TO BE ANSWERED ON 28 th July 2023

## CHILD MORTALITY RATE

## 1397: MS. CHANDRANI MURMU:

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

- (a) The details of the mortality rate of children under five years of age in the country, yearwise during the last five years, State/UT-wise;
- (b) The steps taken/proposed to be taken by the Government to bring down the mortality rate in the said age group of children; and
- (c) The biggest hurdle faced by the Government in this regard so far along with the details of the areas badly affected by child mortality rate in Odisha?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (DR. BHARATI PRAVIN PAWAR)

(a) to (c):

As per Sample Registration System (SRS) Report of Registrar General of India, the Under 5 Mortality Rate at National level and State/ UT wise for the period of 2016 to 2020 is placed at Annexure I.

In order to bring down Under 5 mortality all across the country including Odisha, the Ministry of Health and Family Welfare (MoHFW) supports all States/UTs in implementation of Reproductive, Maternal, New-born, Child, Adolescent Health and Nutrition (RMNCAH+N) strategy under National Health Mission (NHM) based on the Annual Program Implementation Plan (APIP) submitted by States/ UTs. The details of interventions are placed at Annexure II.

As per the Cause of Death Statistics 2017-19 released by Office of the Registrar General & Census Commissioner, India; major causes of child mortality in India are - Prematurity & low birth weight (31.2%), Pneumonia (17.5%), Birth asphyxia & birth trauma (9.9%), Other noncommunicable diseases (9.6%), Diarrheal diseases (5.8%), Congenital anomalies (5.7%), Injuries (4.9%), Ill-defined or cause unknown (4.3%), Fever of unknown origin (4.1%), Acute bacterial sepsis and severe infections (3.8%) and All other remaining causes (3.3%).

As reported by State of Odisha, Bolangir, Deograh, Kalahandi, Kandhamal and Sonepur District are identified as high newborn mortality districts.

## Annexure I

| Status of Under 5 Mortality Rate (SRS) in India and Bigger States/ UTs   |   Status of Under 5 Mortality Rate (SRS) in India and Bigger States/ UTs |   Status of Under 5 Mortality Rate (SRS) in India and Bigger States/ UTs |   Status of Under 5 Mortality Rate (SRS) in India and Bigger States/ UTs |   Status of Under 5 Mortality Rate (SRS) in India and Bigger States/ UTs |   Status of Under 5 Mortality Rate (SRS) in India and Bigger States/ UTs |
|--------------------------------------------------------------------------|--------------------------------------------------------------------------|--------------------------------------------------------------------------|--------------------------------------------------------------------------|--------------------------------------------------------------------------|--------------------------------------------------------------------------|
|                                                                          |                                                                     2016 |                                                                     2017 |                                                                     2018 |                                                                     2019 |                                                                     2020 |
| India                                                                    |                                                                       39 |                                                                       37 |                                                                       36 |                                                                       35 |                                                                       32 |
| Andhra Pradesh                                                           |                                                                       37 |                                                                       35 |                                                                       33 |                                                                       31 |                                                                       27 |
| Assam                                                                    |                                                                       52 |                                                                       48 |                                                                       47 |                                                                       43 |                                                                       40 |
| Bihar                                                                    |                                                                       43 |                                                                       41 |                                                                       37 |                                                                       34 |                                                                       30 |
| Chhattisgarh                                                             |                                                                       49 |                                                                       47 |                                                                       45 |                                                                       44 |                                                                       41 |
| Delhi                                                                    |                                                                       22 |                                                                       21 |                                                                       19 |                                                                       13 |                                                                       14 |
| Gujarat                                                                  |                                                                       33 |                                                                       33 |                                                                       31 |                                                                       28 |                                                                       24 |
| Haryana                                                                  |                                                                       37 |                                                                       35 |                                                                       36 |                                                                       31 |                                                                       33 |
| Himachal Pradesh                                                         |                                                                       27 |                                                                       25 |                                                                       23 |                                                                       23 |                                                                       24 |
| Jammu &Kashmir                                                           |                                                                       26 |                                                                       24 |                                                                       23 |                                                                       21 |                                                                       17 |
| Jharkhand                                                                |                                                                       33 |                                                                       34 |                                                                       34 |                                                                       31 |                                                                       27 |
| Karnataka                                                                |                                                                       29 |                                                                       28 |                                                                       28 |                                                                       26 |                                                                       21 |
| Kerala                                                                   |                                                                       11 |                                                                       12 |                                                                       10 |                                                                        9 |                                                                        8 |
| Madhya Pradesh                                                           |                                                                       55 |                                                                       55 |                                                                       56 |                                                                       53 |                                                                       51 |
| Maharashtra                                                              |                                                                       21 |                                                                       21 |                                                                       22 |                                                                       21 |                                                                       18 |
| Odisha                                                                   |                                                                       50 |                                                                       47 |                                                                       44 |                                                                       43 |                                                                       39 |
| Punjab                                                                   |                                                                       24 |                                                                       24 |                                                                       23 |                                                                       21 |                                                                       22 |
| Rajasthan                                                                |                                                                       45 |                                                                       43 |                                                                       40 |                                                                       41 |                                                                       40 |
| Tamil Nadu                                                               |                                                                       19 |                                                                       19 |                                                                       17 |                                                                       16 |                                                                       13 |
| Telangana                                                                |                                                                       34 |                                                                       32 |                                                                       30 |                                                                       26 |                                                                       23 |
| Uttar Pradesh                                                            |                                                                       47 |                                                                       46 |                                                                       47 |                                                                       48 |                                                                       43 |
| Uttarakhand                                                              |                                                                       41 |                                                                       35 |                                                                       33 |                                                                       30 |                                                                       26 |
| West Bengal                                                              |                                                                       27 |                                                                       26 |                                                                       26 |                                                                       24 |                                                                       22 |

Source: Sample Registration System Report of Registrar General of India https://censusindia.gov.in/census.website/data/SRSSTAT

## Interventions for improving Under 5 Mortality Rate (U5MR):

-  Facility Based New-born Care: Sick New-born Care Units (SNCUs) are established at District Hospital and Medical College level, New-born Stabilization Units (NBSUs) are established at First Referral Units (FRUs)/ Community Health Centres (CHCs) for care of sick and small babies.
-  Community Based care of New-born and Young Children: 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 practices and to identify sick new-born and young children in the community.
-  Mothers' Absolute Affection (MAA): Early initiation and exclusive breastfeeding for first six months and appropriate Infant and Young Child Feeding (IYCF) practices are promoted under Mothers' Absolute Affection (MAA).
-  Social Awareness and Actions to Neutralize Pneumonia Successfully (SAANS) initiative implemented since 2019 for reduction of childhood morbidity and mortality due to Pneumonia.
-  Universal Immunization Programme (UIP) is implemented to provide vaccination to children against life threatening diseases such as Tuberculosis, Diphtheria, Pertussis, Polio, Tetanus, Hepatitis B, Measles, Rubella, Pneumonia and Meningitis caused by Haemophilus Influenzae B. The Rotavirus vaccination is rolled out in the country for prevention of Rota-viral diarrhoea. Pneumococcal Conjugate Vaccine (PCV) is introduced in all the States and UTs.
-  Rashtriya Bal Swasthya Karyakaram (RBSK): Children from 0 to 18 years of age are screened for 32 health conditions (i.e. Diseases, Deficiencies, Defects and Developmental delay) under Rashtriya Bal Swasthya Karyakaram (RBSK) to improve child survival. District Early Intervention Centres (DEICs) at district health facility level are established for confirmation and management of children screened under RBSK.
-  Nutrition Rehabilitation Centres (NRCs) are set up at public health facilities to treat and manage the children with Severe Acute Malnutrition (SAM) admitted with medical complications.
-  Intensified Diarrhoea Control Fortnight / Defeat Diarrhoea (D2) initiative is implemented 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 testing & treatment of anaemia in school going adolescents & pregnant women, addressing non-nutritional causes of anaemia and a comprehensive communication strategy.
-  Capacity Building: Several capacity building programs of health care providers are taken up for improving maternal and child survival and health outcomes.