Reports on Child Mortality and Stillbirths | 12 Jan 2023

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 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.

Source: TH