Levels and Trends in Child Mortality

Syllabus: GS2/Health

Context

• The United Nations Inter-Agency Group for Child Mortality Estimation (UNIGME) Report 2025 was released recently.

Major Highlights

• Child Mortality: An estimated 4.9 million children died before turning 5 years old in 2024, including 2.3 million newborns.
  • Newborn deaths account for nearly half of all under-five deaths, reflecting slower progress in preventing deaths around the time of birth.
  • Most of these deaths were preventable with proven, low-cost interventions and access to quality healthcare.
• Causes of Child Mortality: 
  • Among newborns, deaths are largely caused by prematurity, complications during labour, and neonatal infections.
  • For children aged 1–59 months, pneumonia, diarrhoea and malaria remain leading killers, often intensified by malnutrition.
  • For the first time, the report estimates deaths directly caused by severe acute malnutrition (SAM), finding that more than 100,000 children aged 1-59 months died from it in 2024.

• Progress Made So Far: Since 1990, the under-five mortality rate has fallen by about 60%, and neonatal mortality by 45%. 
• Rate of Decline: Under-five deaths globally have fallen by more than half since 2000 however, since 2015, the pace of reduction in child mortality has slowed by more than 60%.
  • The current rate of decline means that 27.3 million under five deaths are projected between 2025 and 2030. 
  • These deaths remain concentrated in the same regions: sub Saharan Africa and Southern Asia.
• India Specific Findings: India is among the countries demonstrating steady progress in reducing child mortality through sustained public health efforts.
  • In 1990, India had an NMR of 57 per 1,000 lives, which fell to 17 in 2024.
  • In 1990, the Under 5 Mortality Rate (U5MR) stood at 127 per 1,000 live births, while in 2024 it declined to 27.
  • This sharp reduction is due to targeted public health interventions, improved institutional delivery systems, and expanded immunisation coverage.
• Recommendations:
  • Political commitment from high-burden countries to mobilize domestic resources, and improve access to evidence-based, quality services that are affordable for all;
  • focus on those at highest risk, especially mothers and children in sub-Saharan Africa and Southern Asia, and in conflict and fragile settings;
  • strengthen accountability for existing commitments to reduce maternal, newborn, and child deaths, and
  • invest in primary health care systems to prevent, diagnose and treat the leading causes of death in children.

Government Initiatives to Curb Child Mortality in India

• Janani Shishu Suraksha Karyakram (JSSK) entitles all pregnant women and sick infants (up to one year of age) delivering in public health institutions to have free and no-expense delivery, including cesarean section.
  • It includes free drugs, consumables, free diet during the stay, free diagnostics, free transportation, and free blood transfusion if required. 
• Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) provides pregnant women a fixed day, free of cost, assured and quality antenatal checkup by a Specialist/Medical Officer on the 9th day of every month.
• Village Health Sanitation and Nutrition Days (VHSNDs) are observed for the provision of maternal and child health services and for creating awareness on maternal and child care.
• Reproductive and Child Health (RCH) portal is a web-enabled tracking system for pregnant women and newborns to ensure seamless provision of regular and complete services to them.
• Mother and Child Protection (MCP) Cards and Safe Motherhood Booklet are distributed to pregnant women to educate them on diet, rest, danger signs of pregnancy, benefit schemes, and institutional deliveries.
• Mission Indradhanush: It was launched in 2014, aiming to achieve over 90% full immunisation coverage by strengthening routine immunisation services and targeting hard-to-reach populations.
  • Full immunisation coverage has risen from 62% in 2015 to 98.4% in 2026.
• Rashtriya Bal Swasthya Karyakram (RBSK): Children from 0 to 18 years of age are screened for 32 health conditions (i.e. Diseases, Deficiencies, Defects, and Developmental delays) under RBSK to improve child survival.
• Nutrition Rehabilitation Centres (NRCs) are established at public health facilities where children with Severe Acute Malnutrition (SAM) and medical complications are admitted for treatment.

Source: TH