Newsletter- Polity

CONTEXT OF THE NEWS

The United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) released its 2025 Report, highlighting a slowdown in global child survival progress, while recognizing India as a global exemplar.

BACKGROUND

Child mortality is a key indicator of:
- Public health systems
- Socio-economic development
Directly linked to:
- GS Paper 2 (Health & Governance)
- GS Paper 3 (Social Sector Development)
Aligned with SDG 3.2:
- Reduce Under-5 Mortality Rate (U5MR) to <25 per 1000
- Reduce Neonatal Mortality Rate (NMR) to <12 per 1000 by 2030

NEWS BREAKDOWN

Key Definitions (VERY IMPORTANT)

Neonatal Mortality Rate (NMR): Deaths within first 28 days per 1000 live births
Infant Mortality Rate (IMR): Deaths under 1 year per 1000 live births
Under-5 Mortality Rate (U5MR): Deaths before 5 years per 1000 live births
Maternal Mortality Ratio (MMR): Maternal deaths per 1,00,000 live births

GLOBAL HIGHLIGHTS (UN IGME 2025)

1. Global Burden of Child Deaths

4.9 million under-5 deaths in 2024
- Includes 2.3 million newborns
2.1 million deaths in age group 5–24 years

2. Regional Concentration

Sub-Saharan Africa: 58%
Southern Asia: 25%

3. Slowdown in Progress

Under-5 mortality reduced by >50% since 2000
But progress slowed by >60% after 2015

Reasons:

Reduced funding
Unequal healthcare access
Persistent poverty & inequality

4. Malnutrition – A Hidden Killer

Severe Acute Malnutrition (SAM): Extreme form of malnutrition causing severe wasting.

Directly caused ~100,000 deaths
Indirectly increases vulnerability to:
- Pneumonia
- Diarrhoea

5. Causes of Death

Age Group	Major Causes
Neonatal (0–28 days)	Preterm complications (36%), Birth complications (21%)
1–59 months	Pneumonia, Diarrhoea, Malaria

INDIA’S PERFORMANCE: A GLOBAL EXEMPLAR

Major Achievements

U5MR:
- 1990: 127 → 2024: 27 (79% decline)
NMR:
- 57 → 17 (70% decline)
IMR (2024): ~23.3

NFHS-5 DATA (Comparison)

Indicator	NFHS-4	NFHS-5
NMR	29.5	24.9
IMR	40.7	35.2
U5MR	49.7	41.9

Maternal Mortality

Declined to 97 per lakh (2018–20)
Target: <70 (SDG 2030)

DRIVERS OF INDIA’S SUCCESS

1. Institutional Deliveries

Janani Suraksha Yojana (JSY)
Janani Shishu Suraksha Karyakram (JSSK)

2. Newborn Care Systems

Special Newborn Care Units (SNCUs)
Tele-SNCU

3. Immunization Expansion

Universal Immunization Programme (UIP)
Mission Indradhanush

4. Grassroots Healthcare

IMNCI strategy
Role of:
- ASHA workers
- Anganwadi workers

5. Nutrition & Welfare

POSHAN Abhiyaan
Anaemia Mukt Bharat
NFSA 2013
ICDS Scheme
PM Matru Vandana Yojana

KEY CHALLENGES IN INDIA

1. Neonatal Mortality Burden

Majority deaths occur in first 28 days
Causes:
- Prematurity
- Birth asphyxia
- Infections

2. Malnutrition Crisis

57% women anaemic
Leads to:
- Low birth weight
- Weak immunity

3. Regional Inequalities

High Performing	Low Performing
Kerala, Tamil Nadu	Uttar Pradesh, Bihar, Madhya Pradesh

4. Healthcare Gaps

Limited SNCUs in rural areas
Delay in “golden hour” care

5. WASH Deficits

Poor:
- Water
- Sanitation
- Hygiene

Leads to:

Pneumonia
Diarrhoea

6. Quality of Care Issues

High institutional deliveries
But poor quality intrapartum care

WAY FORWARD: KEY SOLUTIONS

1. Focus on First 28 Days

Improve:
- Intrapartum care
- Immediate newborn care

2. Strengthen Newborn Systems

Promote:
- Kangaroo Mother Care (KMC)
- Early Essential Newborn Care (EENC)

3. Improve Quality of Care

Strengthen:
- LaQshya program
Train staff for:
- Neonatal resuscitation

4. Address Malnutrition (First 1000 Days)

Strengthen:
- POSHAN 2.0
Focus on:
- Micronutrients

5. Target High-Burden Areas

Focus on:
- Aspirational districts
- Tribal regions

6. Data-Driven Governance

Expand:
- U-WIN platform

7. Empower Frontline Workers

Strengthen:
- ASHA & Anganwadi systems

PRELIMS FOCUS

UN IGME Report 2025
SAM = Severe Acute Malnutrition
U5MR Target: <25 (SDG 3.2)
NMR Target: <12
India U5MR (2024): 27
Sub-Saharan Africa: Highest share (58%)

CONCLUSION

India must focus on neonatal care, nutrition, and healthcare quality to sustain gains and achieve SDG targets for child survival by 2030.

PRELIMS CHECK

Question 1

Consider the following statements:

Neonatal mortality refers to deaths within the first 28 days of life.
Severe Acute Malnutrition directly causes a small but significant proportion of child deaths.
Under-5 Mortality Rate is expressed per 1,00,000 live births.

Which of the statements given above are correct?

(a) 1 and 2 only
(b) 2 and 3 only
(c) 1 and 3 only
(d) 1, 2 and 3

Question 2

With reference to child mortality trends, consider the following:

Sub-Saharan Africa accounts for the largest share of global under-five deaths.
The pace of reduction in child mortality has accelerated after 2015.
Pneumonia and diarrhoea are major causes of post-neonatal deaths.

Which of the statements given above are correct?

(a) 1 and 3 only
(b) 1 and 2 only
(c) 2 and 3 only
(d) 1, 2 and 3

Question 3

Consider the following pairs:

Programme	Objective
1. JSY	Promote institutional deliveries
2. POSHAN Abhiyaan	Improve nutritional outcomes
3. IMNCI	Focus only on maternal mortality

How many of the pairs given above are correctly matched?

(a) Only one
(b) Only two
(c) All three
(d) None

ANSWERS WITH EXPLANATION

Answer 1: (a) 1 and 2 only