On Average, 17 Infants Die Every Hour In India

Twenty percent of all deaths among babies with very low birth weight are due to sepsis. (Photo Credit: AFP)

In five years to 2015-16, as many as 17 infants died every hour in India, on average, according to national health data. The death of 52 infants in Jamshedpur’s Mahatma Gandhi Memorial Medical College hospital in July 2017 and 70 in Gorakhpur’s Baba Raghav Das Medical College in August 2017 brought national attention to infant deaths across the country, but 743,464 infants died in India between 2011-12 and 2015-16.

Infant deaths fell 15%–from 172,617 in 2011-12 to 147,095 in 2015-16, according to Health Management Information System data for 2015-16.

Most common causes of death for infants aged 0-4 weeks were low birth weight, asphyxia and sepsis, while for infants aged 1-11 months, it was pneumonia.

Source: Health Management Information System

“More than two-thirds of infants die in the very first month of birth. About 90% of these deaths are due to easily preventable causes like pneumonia and diarrhoea,” according to Save the Children.

“Poorly-fed young women are married off too early, remain underweight when pregnant and get little prenatal care and nutrition,” IndiaSpend reported in September 2017.

“Babies are born underweight (less than 2.5 kg) and live in conditions where they are exposed to high risk of infection, getting inadequate nutrition that limits their ability to develop the strength to fight disease. Government-run community and primary health centres are dysfunctional, while tertiary care institutes, both private and government-run, are overburdened and mismanaged.”

Efforts to reduce child mortality must start way before a visit to the doctor, and public policy must focus on improving primary health care, our investigation shows.

Rajasthan had most deaths, Arunachal had least

In 2015-16, Rajasthan had the most infant deaths (18,269)–making up 12.4% of infant deaths across India–followed by West Bengal (15,478), Maharashtra (13,728), Madhya Pradesh (13,430) and Odisha (12,731).

Source: Health Management Information System

In the same year, Arunachal Pradesh had the least infant deaths (29), followed by Goa (38), Manipur (93), Sikkim (104) and Nagaland (125)–all five states had fewer infant deaths in 2011-12.


Source: Health Management Information System

Low birth weight, asphyxia  cause most neonatal deaths

In 2015-16, as we said, low birth weight, asphyxia and sepsis caused most neonatal deaths.

Low birth weight has three underlying reasons: Poor nutritional status before conception, short stature (mostly due to undernutrition and infections during childhood), and poor nutrition during pregnancy. All of these are traceable to the mother, IndiaSpend reported in November 2016.

Twenty percent of all deaths among babies with very low birth weight are due to sepsis, and babies with sepsis are three times more likely to die than those without.

Of infant deaths in the 1-11 month age-group, pneumonia caused 19% deaths while diarrhoea and fever-related causes led to 9% deaths.


Source: Health Management Information System

Low spending on public health = failing infrastructure

Despite poor health indicators, India had a low rate of public spending on health in 2015-16, spending 1.18% of GDP on health compared to the global average of 5.99%.

The Indian government contributed 31.3% of total spending on citizen health in 2014, 15.7 percentage points less than the median government share of 47% in BRICS countries, IndiaSpend analysis on May 8, 2017 showed.

As a result, there is a lack of basic public health infrastructure. Government guidelines say a sub-centre (first contact point between public health centres and the community) should have one Auxiliary Nurse Midwife (ANM) and one health worker, preferably male. A doctor is supposed to visit the sub-centre at least once a month.

In Rajasthan, the state with the highest number of infant deaths, 48% of positions for male health workers at sub-centres were vacant (1082 of 2241 sanctioned positions), while West Bengal, the state with the second highest infant deaths, had more than 75% of such positions vacant.

Rajasthan also had the highest number of sub-centres in the country with neither an ANM nor a male health care worker, at 1,754, according to rural health statistics.

“Poorly-fed young women are married off too early, remain underweight when pregnant and get little prenatal care and nutrition,” IndiaSpend reported in September 2017.

“Babies are born underweight (less than 2.5 kg) and live in conditions where they are exposed to high risk of infection, getting inadequate nutrition that limits their ability to develop the strength to fight disease. Government-run community and primary health centres are dysfunctional, while tertiary care institutes, both private and government-run, are overburdened and mismanaged.”

Efforts to reduce child mortality must start way before a visit to the doctor, and public policy must focus on improving primary health care, our investigation shows.

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