India avoids 1 million child deaths, reduces infectious disease mortality
India has averted roughly a million deaths of children aged younger than 5 years since 2005 — a milestone reached partly through large reductions in deaths from infectious diseases, according to researchers.
Almost three times as many child deaths in India could have been prevented if national trends caught up with those in some individual states, they added.
Mortality rates associated with neonatal tetanus and measles were among those that plunged over the years, Prabhat Jha, MD, head of the Centre for Global Health Research (CGHR) of St. Michael’s Hospital in Toronto, and colleagues wrote in The Lancet.
Their work was part of the Million Death Study (MDS), which assesses premature deaths in India. It is there and in other low- and middle-income countries that most deaths occur in homes and without medical care, according to the CGHR.
According to a news release, hundreds of specially trained census staff in India visited more than 1.3 million homes to interview people about deaths in their household, and two physicians independently examined these “verbal autopsies” to establish the most probable cause of death.
Households that were interviewed included 100,000 in which child deaths had occurred, Jha said in the news release. In all, the researchers gathered data on 52,252 deaths in neonates (those aged younger than 1 month) and 42,057 deaths among children aged 1 to 59 months.
Jha and colleagues found that, from 2000 to 2015, neonatal mortality from infection of any kind decreased by 66%, from 11.9 per 1,000 live births to 4 per 1,000 live births.
Neonatal tetanus mortality decreased by about 93%, from 1.6 per 1,000 live births to 0.1 per 1,000 live births. Measles mortality among children aged 1 to 59 months decreased by nearly 91%, from 3.3 per 1,000 live births to 0.3 per 1,000 live births.
Also among those aged 1 to 59 months, pneumonia deaths dropped by 63%, from 11.2 per 1,000 live births to 4.2 per 1,000 live births, and diarrhea deaths decreased by 66%, from 9.4 per 1,000 live births to 3.2 per 1,000 live births.
One of the measures Indian officials took to improve outcomes included a program promoting a second dose of measles vaccine and encouraging women to give birth in hospitals, the release said.
According to the researchers, officials must continue the trend of reducing mortality among children aged younger than 5 years and neonatal death to achieve the U.N. Sustainable Development Goals, which include cutting India’s child mortality rate in half by 2030. Studies like theirs, they added, can help guide the effort.
“Forthcoming, more detailed analyses than this study of the MDS in partnership with the Indian Council of Medical Research should provide additional details of cause-specific mortality patterns in the country,” they wrote. “Direct mortality statistics are essential to planning strategies to meet the 2030 Sustainable Development Goals for child and adult health.” – by Joe Green
Disclosure: Jha reports that he is supported by the Canada Research Chair Programme and the University of Toronto.