Resource centre on India's rural distress


India earned another dubious distinction in child mortality with the highest number of deaths of children under-five-years of age, according to a UNICEF report released in September 2012.

India's toll is higher than the deaths in Nigeria, Democratic Republic of Congo and Pakistan put together. Globally, almost 19,000 children under five years of age die every day across the world a quarter of which is in India alone. India accounted for the highest number of 16.55 lakh such deaths in 2011.

There is also good news but not from India. The rest of the world, including Bangladesh, has done much better. The global mortality rate for young children has been nearly halved in the past two decades, but Africa and South Asia have not kept pace, according to the report, titled “Committing to Child Survival: A Promise Renewed”. It is obvious that mainly India is to be blamed for the poor performance of the sub-continent.

The biggest improvement in child health has been recorded in Latin America and the Caribbean, East Asia and the Pacific, Central and Eastern Europe, the Middle East and North Africa. These regions have cut the child death rate by half since 1990.

Under-five deaths are now increasingly concentrated in sub-Saharan Africa and South Asia, which now account for 80 percent of the world total, said the UNICEF. Sub-Saharan Africa accounted for almost half (49%) of the global total in 2011. Despite rapid gains in reducing under-five mortality, South Asia’s share of global under-five deaths remains second highest, at 33% in 2011.

India (24 percent of the total), Nigeria (11 percent), Democratic Republic of Congo (seven percent), Pakistan (five percent) and China (four percent) make up half of the total number of children deaths. In contrast, the rest of the world’s regions have seen their share fall from 32% in 1990 to 18% two decades later.

UNICEF said that poverty is not the only decisive factor in deaths. Children are more likely to die early if they are born in a rural area or if their mother has not had primary education. Some poor countries have made spectacular progress on child health in recent years. Laos cut its mortality rate by 72 percent between 1990 and 2011, East Timor by 70 percent, Liberia 68 percent and Bangladesh 67 percent.

Globally, the five leading causes of deaths among children under five include pneumonia (18 per cent); pre-term birth complications (14 per cent); diarrhoea (11 per cent); intrapartum-related complications (9 per cent) and malaria (7 per cent). More than 50% of the deaths due to pneumonia and diarrhoea occurred in just four countries: India (10.7 lakh), Nigeria (7.56 lakh), Democratic Republic of Congo (4.65 lakh) and Pakistan (3.52 lakh).

The major cause for diarrhea was lack of toilets and defecating in the open. About 1.1 billion people in the world still defecate in the open. Lack of sanitation was the major cause for diarrhoea related deaths. About 2.5 billion people in the world are deprived of proper sanitation and half of them live in India and China. About 78 crore people in the world do not have access to clean drinking water.

Besides, more than a third of child deaths are attributable to undernutrition globally, the report states.
Key findings of the report: 

In India number of under-five deaths was 1.7 million in 2011, which was 24 percent of global total. 

Number of under-five deaths has declined from 30.61 lakhs in 1990 to 16.55 lakhs in 2011.  

Under Five Mortality Rate (U5MR-Probability of dying between birth and exactly 5 years of age, expressed per 1,000 live births) in India was 61 (Rank-49) in 2011 as compared to 72 (Rank-39) in Pakistan, 48 (Rank-57) in Nepal, 46 (Rank-60) in Bangladesh, 15 (Rank-115) in China, 16 (Rank-107) in Brazil and 8 (Rank-145) in the US. 

Under Five Mortality Rate (deaths per 1,000 live births) in India declined from 114 in 1990 to 88 in 2000 and further to 61 in 2011. The decline in Under Five Mortality Rate between 1990 and 2011 has been 46 percent overall.

Sex-specific under Five Mortality Rate (deaths per 1,000 live births) in India for male was 110 and female was 119 in 1990. Sex-specific under Five Mortality Rate (deaths per 1,000 live births) in India for male was 59 and female was 64 in 2011.

Neonatal causes accounted for 42 percent of deaths among India children under 5 years of age in 2010 to be followed by Pneumonia (24 percent), diarrhoea (13 percent) and injuries (3 percent).   

More than half of under-five deaths caused by pneumonia or diarrhoea occur in just four countries: India, Nigeria, the Democratic Republic of the Congo and Pakistan.  

Infant mortality rate (IMR-Probability of dying between birth and exactly 1 year of age, expressed per 1,000 live births) in India has declined from 81 in 1990 to 47 in 2011.

Number of infant deaths in India has declined from 21.74 lakhs in 1990 to 12.73 lakhs in 2011.  

Neonatal mortality rate (Probability of dying in the first month of life, expressed per 1,000 live births) in India has fallen from 47 in 1990 to 32 in 2011.

Number of neonatal deaths (of children) in India has declined from 12.88 lakhs in 1990 to 8.76 lakhs in 2011.

An estimated 2.5 billion people still lack access to improved sanitation—more than half of them in India or China—while over 780 million are not using improved drinking water sources.


Committingto Child Survival-A Promise Renewed, Progress Report 2012,

UN Doubles Down on Slashing Child Mortalityby 2015- Kim-Jenna Jurriaans, IPS News, 13 September, 2012,

UNICEFreport points to rapid progress made in reducing child deaths worldwide-ChrisNiles and Rebecca Obstler, UNICEF,