The Registrar General of India implemented the study

India has avoided the deaths of about one million children under the age of five since 2005 owing to significant reductions in mortality from pneumonia, diarrhoea, neonatal infections and birth asphyxia/trauma, measles and tetanus, claims a study published in the latest issue of The Lancet.

National Health Mission

According to a release issued by the Union Health Ministry on Tuesday, the ‘India’s Million Death Study’, implemented by the Registrar General of India, is the first study to directly quantify changes in cause-specific child deaths in India, nationally and sub-nationally, from 2000-15 among randomly selected homes.

The study further illustrates that conditions prioritised under the National Health Mission saw the maximum decline.

Pneumonia and diarrhoea mortality fell by over 60% — most of the decline due to effective treatment; mortality from birth-related breathing and trauma during delivery fell by 66% — most of the decline due to more births occurring in hospital; and measles and tetanus mortality fell by 90% — mostly due to special immunisation campaigns against each.

Mortality rate

The study states that the mortality rate (per 1,000 live births) in neonates fell from 45 in 2000 to 27 in 2015 or a 3.3% annual decline, while 1-59 months’ mortality rate fell from 45.2 in 2000 to 19.6 in 2015 or a 5.4% annual decline. Further, among 1-59 months, pneumonia fell by 63%, diarrhoea by 66% and measles by more than 90%.

The decline was greater in girls, indicating that India has, remarkably, an equal number of girls and boys dying.

Pneumonia and diarrhoea mortality rates for 1-59 months declined substantially between 2010 and 2015 at an average of 8% to 10% annual decline nationally and more so in the rural areas and poorer States.

The study worked with directly monitoring the causes of deaths in over 1.3 million or 13 lakh homes. Since 2001, about 900 staff members interviewed about one lakh living members in homes that had suffered a child’s death and completed a simple two-page form with a local language half-page narrative describing the deceased’s symptoms and treatment.

Records digitised

The records have been digitised and each one uniformly coded for cause of death independently by two of about 400 trained physicians, using World Health Organization-approved procedures. This is a direct study based on face-to-face interviews with families and is not based on modelling or projections from small samples.

“The results signify that the strategic approach of the Health Ministry has started yielding dividends and the efforts of focusing on low performing States is paying off,” noted the release.