India had world's highest child mortality rate in 2015, shows Lancet study

United Nations Millennium Development Goals (MDG) set in the year 2000 was to reduce the under-five mortality rate in 2015 to one-third of the 1990 figure.

Business Standard : India had more deaths among children under five than any other country in 2015, with large disparities in the child mortality rate between richer and poorer states, a Lancet study has found.

The researchers at the Johns Hopkins Bloomberg School of Public Health in the US analysed state-level Indian data on the causes of death among children under five for the years 2000-2015.

They found that India made great progress during the period, reducing annual mortality among children under five from 2.5 million in 2000 to 1.2 million in 2015 -- which was still the highest in the world.

However, among India's states, great disparities remained: The highest mortality rate in Assam was more than seven times that in Goa. Although most under-five deaths were due to preterm complications, preventable infectious diseases featured prominently as causes of death in higher-mortality states.

"India can accelerate its reduction of under-five mortality rates by scaling up vaccine coverage and improving childbirth and neonatal care, especially in states where mortality rates remain high," said Li Liu, PhD, assistant professor at the Bloomberg School.

Using data sources from Indian government health surveys, the team assessed total mortality, mortality rates and causes of mortality for children under five in 25 states. United Nations Millennium Development Goals (MDG) set in the year 2000 was to reduce the under-five mortality rate in 2015 to one-third of the 1990 figure.

For India that would have meant reducing the under-five mortality rate to 39 deaths per 1,000 live births.

The analysis showed, however, that despite great progress since 1990 -- and even since 2000 when the under-five mortality rate was 90.5 deaths per 1,000 live births -- India in 2015 was still well above the MDG target, at 47.8 deaths per 1,000 live births. Most (57.9 per cent) of deaths among Indian children under five in 2015 occurred in the first four weeks of life -- the neonatal period.

Countrywide, the leading cause of death for children under five was preterm birth complications, which accounted for 27.5 per cent of the mortality total. However, second on the list for cause-of-death was pneumonia (15.9 per cent of deaths), and infectious illnesses were more often among the top causes in the poorer, high-mortality states.

Diarrhoea, pneumonia kill one child every two minutes in India

In 2016, almost 261,000 Indian children died before their fifth birthday due to diarrhoea or pneumonia.

In 2016, almost 261,000 Indian children died before their fifth birthday due to diarrhoea or pneumonia, both preventable diseases. This is the highest toll taken anywhere in the world by the two diseases--a fifth of their global burden--according to the 2018 Pneumonia & diarrhoea Progress Report, released on November 12, 2018, which was World Pneumonia Day. (Business Standard)

This means that about 735 Indian children died everyday of either disease in 2016--one child every two minutes. Globally, pneumonia and diarrhoea cause a quarter of deaths in children under five and fighting them together can drastically reduce child mortality across the world.

India has had mixed success in the prevention, control and treatment of diarrhoea and pneumonia in the year to 2016: Immunisation coverage improved but there was a decline in treatment indicators, said the report by the International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health.

This report analyses how effectively countries are delivering 10 key interventions to prevent and treat pneumonia and diarrhoea--breastfeeding, vaccination, access to care, use of antibiotics, oral rehydration solution (ORS) and zinc supplementation.

Since 2015, the coverage of Haemophilus influenza type b (Hib) vaccine that prevents pneumonia has increased by 8 percentage points in India, as per the report. The number of children covered by rotavirus vaccines that protect against severe diarrhoea and introduced mid-2016 has moved up by 9 percentage points since last year’s report.

In contrast, India’s other treatment indicators decreased: ORS coverage (13 percentage points), exclusive breastfeeding (10 percentage points), and access to pneumonia care (4 percentage points).

Meanwhile, there has been a steady decline in diarrhoea and pneumonia deaths in children below the age of five--almost 7.2 per cent every year for diarrhoea and 6.8 per cent for pneumonia--as per data. From 2000 to 2018, diarrhoea deaths fell by 69.7 per cent--from 339,937 to 102,813--and pneumonia deaths reduced by 67 per cent--from 485,094 to 158,176.

India prevented 1 million deaths among children under five years of age between 2005 and 2015 with interventions such as timely treatment in the case of diarrhoea, vaccinations for tetanus and measles, and increased hospital births, IndiaSpend reported in October 2017.

“India has made tremendous improvements but it needs to do much more,” said Mathu Santosham, professor, department of international health and paediatrics, Johns Hopkins University. “Currently only 20 per cent of children with diarrhoea receive zinc supplements, rotavirus vaccine is still not available across the country and PCV [pneumococcal conjugate vaccine] is rolled out only in six states.”... Read More

Pneumonia may kill over 1.7 mn children in India, 11 mn in world by 2030

As many 880,000 children, mostly under the age of two, died from the disease in 2016, the most recent year for which full data is available.

Business Standard : More than 1.7 million children in India are likely to die of pneumonia by 2030, despite the infection being easily treatable, a global study released on Monday has warned.

The study, released on the occasion of the World Pneumonia Day, found that the infectious disease is likely to kill nearly 11 million children under five by 2030.

Nigeria, India, Pakistan and the Democratic Republic of Congo (DRC) are likely to bear the highest burden of deaths, according to the report by UK-based non-profit Save the Children.

The report also shows that more than four million of these deaths -- over a third -- could be easily averted with concerted action to improve rates of vaccination, treatment and nutrition.

The disease is the biggest infectious killer for children globally, killing more than malaria, diarrhoea and measles combined.

As many 880,000 children, mostly under the age of two, died from the disease in 2016, the most recent year for which full data is available.

"It beggars belief that close to a million children are dying every year from a disease that we have the knowledge and resources to defeat," said Paul Ronalds, CEO of Save the Children.

"There is a vaccine available, and a course of antibiotics costs just 54 cents AUD," Ronalds said.

"There are no pink ribbons, global summits or marches for pneumonia. But for anyone who cares about justice for children and their access to essential healthcare, this forgotten killer should be the defining cause of our age," he said.

The agency's forecasts are based on a model developed by researchers at Johns Hopkins University in the US called the Lives Saved Tool (LiST).

They show nearly 10,865,728 children will die by 2030 on current trends, with the highest burden of deaths in Nigeria (1,730,000), India (1,710,000), Pakistan (706,000), and the Democratic Republic of Congo (635,000).

However, scaling up vaccination coverage to 90 per cent of children under the age of five could save 610,000 lives; providing cheap antibiotics could save 1.9 million; and ensuring children have good nutrition could save 2.5 million.

If all three overlapping interventions were carried out by 2030, the model suggests a total of 4.1 million deaths could be averted.

The year 2030 is the target date for the Sustainable Development Goals (SDGs), which include an ambitious global pledge to 'end preventable child deaths' and achieve Universal Health Coverage.