‘Exemplar’: UN lauds India’s progress in child mortality reduction

India’s efforts and progress in reducing preventable child deaths has been lauded as “exemplar” by the United Nations, which cited the example of health initiatives such as Ayushman Bharat, and said the country has saved millions of young lives through strategic investments in its health system.

The United Nations Inter-Agency Group for Child Mortality Estimation report, released on Tuesday, cited the example of five “exemplar countries” in achieving child mortality reduction—India, Nepal, Senegal, Ghana and Burundi—highlighting diverse strategies that have accelerated progress in reducing preventable child deaths.

The report said these countries illustrate that with “political will, evidence-based strategies and sustained investments, even resource-constrained settings facing unique challenges can achieve substantial reductions in mortality, bringing the world closer to an end to preventable child deaths”.

On India, the report said the country has made gains through health system investment.

“Through strategic investments in its health system, India has already saved millions of young lives and paved the way to ensure healthy lives for millions more,” it said.

The report highlighted that since 2000, India achieved an under-five mortality reduction of 70 per cent and a neonatal mortality reduction of 61 per cent, “driven by overlapping measures to increase health coverage, enhance available interventions and develop health infrastructure and human resources”, the report said.

It cited the example of Ayushman Bharat, the world’s largest health insurance scheme which provides annual coverage of nearly USD 5,500 per family per year.

It noted that every pregnant woman is entitled to free delivery (including caesarean section), and infant care provides free transport, medications, diagnostics and dietary support in public health institutions.

To ensure comprehensive coverage and equitable access to health services, India has strengthened infrastructure via the establishment of maternity waiting homes, maternal and child health wings, newborn stabilisation units, sick newborn care units, mother care units and a dedicated programme for birth defect screening, the report said.

Further, it said that interventions like antenatal corticosteroids for preterm labour, use of continuous positive airway pressure and follow-up for vision and hearing help support newborn survival.

“This ensures millions of healthy pregnancies and thriving live births each year. India has also prioritised the training and deployment of skilled birth attendants, such as midwives and community health workers, to provide appropriate maternal and child health services,” it said.

The report noted that additionally, data systems and digital surveillance of maternal, newborn and child health indicators are continuously improved to support evidence-based decision-making.

It said that despite differing geographies, economic conditions and health system structures, Nepal, Senegal, India, Ghana and Burundi have all “outpaced” the global and their respective regional declines in child mortality through “strong governance, strategic investments in health and scale-up of evidence-based health interventions”.

“Common throughout these success stories are strengthened health systems that prioritise universal access and community-based care, data-driven decision making that ensures targeted interventions and ongoing quality improvement, expanded immunisation and maternal and newborn health programmes that prevent childhood illness and provide a continuum of care from home to hospitals, and innovative health financing models that provide sustainability and accessibility,” the report said.

The UN agency also said that several low and lower-middle-income countries have surpassed the global decline in under-five mortality since 2000.

Angola, Bhutan, Bolivia, Cabo Verde, India, Morocco, Senegal, Tanzania and Zambia have all cut their under-five mortality rate by more than two thirds since 2000.

In 2000, the country with the highest burden of under-five measles mortality was India, with only 56 per cent of infants vaccinated for measles and 189,000 deaths from measles.

By 2023, the infant measles vaccination rate had increased to 93 per cent, and under-five deaths due to the disease decreased by 97 per cent to 5,200 measles-related deaths.

The report noted that the number of children dying globally before their fifth birthday declined to 4.8 million in 2023, while stillbirths declined modestly, still remaining around 1.9 million.

Since 2000, child deaths have dropped by more than half and stillbirths by over a third, fuelled by sustained investments in child survival worldwide.

In 2022, the world reached a historic milestone when child deaths dropped slightly below 5 million for the first time. However, the progress has slowed and too many children are still being lost to preventable causes.

“Millions of children are alive today because of the global commitment to proven interventions, such as vaccines, nutrition, and access to safe water and basic sanitation,” UNICEF Executive Director Catherine Russell said.

“Bringing preventable child deaths to a record low is a remarkable achievement. But without the right policy choices and adequate investment, we risk reversing these hard-earned gains, with millions more children dying from preventable causes. We cannot allow that to happen,” Russell added.