Except Kerala, Tamil Nadu, Maharashtra, Punjab, Himachal Pradesh and West Bengal, other parts of the country are unlikely to achieve MDG 4, which aims to reduce Under-Five Mortality by two-thirds between 1990 and 2015, unless some key issues are addressed,
These observations were part of the 'The Infant and Child Mortality India Report' released by the National Institute of Medical Sciences (NIMS), Indian Council of Medical Research (ICMR) and the UNICEF India Country Office.
The report noted that India has realised impressive gains in child survival, but at the current pace, the country as a whole is unlikely to achieve MDG 4 unless related socio- economic determinants are urgently addressed.
The study highlights the impact of maternal education on child survival, as also the fact that births to adolescent mothers are at a significant risk of dying in childhood.
Even children born within two years of the previous pregnancy are unlikely to survive, while maternal malnutrition (under nutrition) as well as obesity imposes a greater mortality risk on the off-springs, the study found.
Louis-Georges Arsenault, UNICEF India Representative said, "A renewed focus on empowering women and promoting equity in access to health services will help guide actions for accelerating child survival in India, as we move towards the year 2015 and beyond."
"We require a comprehensive approach that includes coverage of key child survival interventions, improving quality of prenatal care, promoting education of girls beyond primary, delaying the age at marriage and childbirth and ensuring adequate spacing between births," he said.
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The study also found that neonatal, post-neonatal and child mortality was higher for children in households that do not have access to a flush or pit toilet.
According to Director of NIMS, Professor Arvind Pandey, the report is an important planning tool. "The results of this study underscore the need for addressing wider determinants of child mortality to achieve MDG-4 and not restrict to addressing only the direct causes."