According to the Millennium Development Goals adopted by the United Nations, India has the target of reducing the infant mortality rate (IMR) to 28 per 1,000 live births by 2015. Where do we stand today? The latest estimates for 2008 put the IMR at 53 and with five years left, it is clear that we have a long way to go to achieve the target. In fact, the UN projects an IMR of 46 in 2015, flagging the high incidence of neo-natal deaths in the heartland states as the biggest challenge to be overcome.
While the overall rate is high, there is of course significant disparity across states and across the rural-urban divide. Not only does rural India have a higher IMR of 58 compared to urban India’s 36, the states of Madhya Pradesh, Orissa and Uttar Pradesh have rural IMRs higher than 70. These states would also require more targeted intervention in the most backward districts and social groups.
Even in urban India with higher access to health care, there are six states with IMR greater than 40 — Orissa, Uttar Pradesh, Chhattisgarh, Madhya Pradesh, Haryana and Bihar. When it comes to the most rapid progress in the past decade, the star performer is Orissa, with a 19-point fall in IMR over the period 2002-2008 — the government’s Navajyoti strategy adopted in 2004 is showing results; in urban India Rajasthan stands out with the highest fall of 17 points. Both these states, however, continue to have higher-than-average IMRs, so the progress needs to be accelerated. (Click here for graph & table)
There are essentially three important aspects to reducing infant mortality: improving access to healthcare for mothers and infants, nutritional status and sanitation. One positive point to note is that there has been considerable progress since 2005 on improving access to healthcare, especially in rural areas. The recent Coverage Evaluation Survey 2009 commissioned by the UNICEF points to the success of the Janani Suraksha Yojana in raising the share of institutional deliveries, coverage of ante-natal checkups etc. There is also improvement in access to oral rehydration therapy for diarrhoea, immunisation and so on and significant changes in practices with new-borns such as cutting the umbilical cord with a sterilised/new blade, proportion of new-borns checked within 24 hours. Moreover, under the Integrated Management of Neonatal and Childhood Illness programme, there is a coordinated action plan for preventive care and managing illness. Although we can expect such programmes to continue to make their impact on reducing infant mortality, when it comes to sanitation, the picture is much bleaker, with little change expected even in the future.
Indian States Development Scorecard is a weekly feature by Indicus Analytics that focuses on the progress in India and the states across various socio-economic parameters.
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