India riskiest place on earth for the newborn

27.8 per cent of global neonatal deaths take place in the country

As neo-natal mortality declined in all regions of the world over the past two decades, only five countries, topping with India, now remain the problem area. In 2009, more than half of all neonatal deaths took place in India, Nigeria, Pakistan, China, and Congo.

Though the global neonatal mortality rate decreased from 33.2 to 23.9 deaths per 1000 live births (a decrease of 28 per cent), neonatal mortality rate actually increased in eight countries, five of which were in Africa and three in Asia.

India is much ahead of China in this regard. In 2009, India accounted for 27.8 per cent of global neonatal deaths where- as China had a neonatal death rate of 6.4 per cent.“Throughout the period 1990-2009, India has been the country with largest number of neonatal deaths,” a team of medical researchers said in a study published in the journal PLOS Medicine on Tuesday.

Majority of neonatal deaths could be prevented with existing interventions including some that can be delivered at the community level with potential to reduce these deaths by one-third. These intervensions are in the form of improved hygiene at birth, breastfeeding, and simple approaches to keeping babies warm.

Over the past 20 years, more than four per cent of all the babies born live in India died during the first month of birth, said the team led by Mikkel Z Oestergaard, from the World Health Organisation(WHO).

In the last two decades, an estimated 79 million babies died in the first four weeks of life. Of these, the vast majority (more than 98 per cent) died in the low and middle income countries with 31 million in Southeast Asia alone.

Many of the 79 million babies who died in the neonatal period since 1990 were born with little or no access to health services, they said.

The list of top five contributors to the 4.6 million neonatal deaths in 1990 was topped by India (29.5 per cent deaths) also. But surprisingly, India was then followed by China (12.3 per cent) and Bangladesh was among the top five. In the last two decades Chinese health indicators have improved by leaps and bounds and Bangladesh is no longer in the top five.

India’s own data shows out of every 10 infant deaths, six-to seven pertains to neonatal deaths. Conducted in nine north and central Indian states with poor health infrastructure, the survey released earlier this month showed neo-natal mortality is more acute in rural areas than urban areas.

In UP, for instance, rural neo-natal mortality rate is 53 per 1000 live births as compared to 36 in urban areas. Jharkhand and Uttarakhand records NNMR under 30 whereas for Madhya Prdesh and UP, it is 44 and 50 respectively.