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Essay On Infant Mortality Rate In India

New health centres help India battle high infant mortality rates

In the Indian State of Madhya Pradesh, the 'storm' of poverty, food insecurity and malnutrition leads to an alarming number of child deaths. UNICEF correspondent Priyanka Pruthi reports on efforts aimed at giving these children a chance at life.


Since 1990, the number of children under 5 who die every year, mainly from preventable causes, has reduced by nearly 50 per cent – from 12.6 million in 1990 to 6.6 million in 2012. Roughly 44 per cent of those deaths occur in the first 28 days of life. Although the neonatal mortality rate fell from 33 deaths per 1,000 live births in 1990 to 21 per 1,000 in 2012, still 2.9 million newborn babies died in 2012.

Reducing infant mortality is just one of the 25 achievements we are celebrating as we approach the 25th anniversary of the Convention on the Rights of the Child (CRC) in November. Learn more about the progress we’ve made and what still needs to be done.

“The high levels of child malnutrition seen in Madhya Pradesh are the result of a ‘perfect storm’ for children that associates high levels of malnutrition in mothers, poor child feeding practices in the first two years of life and high levels of infection in children’s environments; for many children, this is compounded by food insecurity and poverty in their households and limited access to basic services for them and their mothers.” -Victor Aguayo, UNICEF India Chief of Nutrition and Development

By Priyanka Pruthi

MADHYA PRADESH, India, 4 February 2013 – A baby takes sharp, rapid breaths at the Special Newborn Care Unit in the Shivpuri District Hospital. Born weak and premature, at 705 grams she weighs less than half of what she should.

It’s a tense time for her parents – left waiting for some good news at the door, they hope and pray that their daughter will make it through. 

They haven’t had the chance to name her yet.  A few hours later, we find out that they never will.

Infant mortality

Madhya Pradesh is the second largest state in India, with rich mineral resources and the largest reserves of diamonds in the country. The state is also among the main exporters of wheat in India. However, its vast expanses often remain untouched by any kind of ‘development’, and its food often doesn’t make its way to the plates of its own people. Many communities in rural areas still lack access to safe drinking water, sanitation facilities and public transport.

In a state plagued by poverty and food insecurity, the battle to save lives of low-birth-weight babies is often lost. Madhya Pradesh has the highest infant mortality rate in the country.

Making healthcare accessible 

Straining hospitals, a dearth of health centres in rural Madhya Pradesh and difficult access to the remotest regions pulled the state into a healthcare crisis. The state government and UNICEF are trying to turn things around by setting up a chain of healthcare facilities linking rural communities to district hospitals, and establishing health centres where there are none.

Shivpuri district is one of the largest in the state, which poses challenges related to access to healthcare. According to former Shivpuri district collector John Kingsly AR, “[W]e have started sub-health centres, and delivery points for pregnant women, with technical support of UNICEF. This has worked very well in interior in areas like Chharch.”

© UNICEF India/2012/Pruthi
A child sleeps by his mother in the maternity ward of the Shivpuri District Hospital, Madhya Pradesh, India. Recently, the government and UNICEF have improved facilities and created an 80-bed maternity ward with a brand new labour room.

Revamping a district hospital

The Shivpuri District Hospital, which struggled with a shortage of staff and outdated technology, has also had a recent makeover. Now, it boasts a Special Newborn Care Unit – an intensive care unit for newborns with severe complications, an 80-bed maternity ward and well-qualified nurses and doctors who have been drawn in from private hospitals through higher salaries.

The hospital also has an impressive 24/7 call centre that services remote villages through its GPS-enabled ambulances – at no cost to patients.

Since the hospital was revamped four years ago, there has been marked progress.  The Special Newborn Care Unit alone has saved more than 6,000 children.  And what has set the unit apart is its ‘follow-up’ system.

UNICEF Health Specialist Gagan Gupta describes the innovations involved in the system. “Now, with technology available, even in the remotest village you have mobile phones, so we have developed an SMS system and tracking software. The government has given us these data operators in all these [newborn care] units who make all the entries of all the patients. They send regular SMS reminders to the parents of the baby for check-ups. And the community workers make sure that they monitor the baby’s condition at home. And whenever the doctor’s examination is due, we provide free transportation for the patient to be brought here.”

© UNICEF India/2013/Gulati
A nurse examines an infant at the Special Newborn Care Unit in the Shivpuri District Hospital. Six thousand newborns have been saved since the unit was established four years ago.

A chance at life

Thirty-nine Special Newborn Care Units are now providing round-the-clock care to babies across Madhya Pradesh.

Hooked up to a myriad of tubes, the infants at the Shivpuri District Hospital’s Special Newborn Care Unit can barely move their muscles. Some were born premature. Many have low birth weight. 

With the odds stacked against them, some will not live to bear a name.

But the investment in healthcare is making a difference. Doctors tell us the quality of support being provided at the intensive care unit is critical, and the right interventions – at the right time – do bring a chance at life.



UNICEF Photography: Photo Essay

The history of population growth in India before 1921 is the history of a great fight against death. Up to 1921, population growth in this subcontinent was very often marked by the heavy toll taken by famines and epidemics.

Millions of lives were lost during these massive calamities. Despite the fact that death rates are of central importance in the study of population growth in India, it is unfortunate that the actual death rates during those early periods, when these rates were very high and fluctuating, are not available, for the death registration system was highly inadequate.

Demographers have, however, attempted to estimate the death rates and the infant mortality rates and have constructed Life Tables for India on the basis of census statistics and other available material.

The trends in mortality in India may therefore be studied with the help of these three measures. The two most striking facts about this Table are: (1) the higher level of the Indian rate prior to 1921 (that is, between 40 and 50 per thousand populations) and (2) the decline in the death rates after 1921.

It may be noted, however, that the average annual death rates tend to give a false impression as the decline in the death rates fluctuated a great deal.

During the decade 1911-1921, the disastrous influenza epidemic swept over India in 1918 and, according to the estimates of Kingsley Davis, this epidemic wiped out more than 15 million people.

That is the reason for the highest average annual death rate (48.6 per thousand populations) for that decade. It is also evident from Table 7.10 that India had made an impressive progress in her fight against death.

From 1911-1921 to 1971-1981, that is in 60 years, the average annual Indian death rate has declined from 48.6 per thousand populations to 14.9, a reduction of more than 69 per cent.

It may be observed from, which presents the estimated crude death rates from 1970 onwards, that there have been wide fluctuations in the crude death rates of India up to 1975, and that over a period of five years, a decline of only one point was achieved. In 1988, the death rate for India was 11, a decline of 3.2 points from 1978.

Two decades of the present century was very low because of poor mortality conditions. During 1911-1921, it was 19.4 years for males, 20.9 years for females and 20.1 years when both sexes were considered together.

These figures may be considered to be the lowest for the country, and one of the lowest anywhere in the world, (it may be recalled that in European countries even during the pre-Greek period in 3500 B.C., the average life span was 31 years.)

The mortality conditions in India have, however, improved over the years, and the average life expectancy has increased in each successive decade.

The main reason for the low life expectancy in India has been high infant mortality rates. During 1901-1911, these rates per thousand for males and females were 290.0 and 284.6 respectively.

In other words, one-fourth of the babies died before they completed their first year of life. Over the years, infant mortality rates in India have also declined, though they are still quite high. In 1982, this rate was 104.8 per thousand live births.

In the past, the fight against death in India was undertake in three important fields, namely, the elimination of wars and banditry, the control of famines and of epidemics.

The gains of these three points were "slow, hard and lengthy." The fight however, is not yet over, though substantial reductions in mortality have been achieved.

Although the death rate in India has been considerably reduce it still remains very high as compared to that of other developing countries of Asia.

During 1980-85, the crude death rates per thousand populations for some Asian countries were as follows: Sri Lanka: 6.6; the Philippines: 8.4; West Malaysia: 6.5; and Singapore- 5.4. This rate for India in the same period was 12.3 per thousand populations.

The average expectation of life at birth for both and females is still very low in India, as compared to that in otherdeveloping Asian countries.

For instance, the average life span formales and females in Sri Lanka during 1980-85 was 67.0 years at 70.0 years respectively. Infant mortality rates in India, as has beenpointed out earlier, are much higher than those in many developing countries of the world.

It may be concluded from this discussion that though the present mortality conditions in India are much better than they were in the past, they are far from satisfactory, and there is much scope for improvements.


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