Children from the poorest communities are three times more likely to die before they reach the age of 5 than those from high income groups, Save the Children, a non-governmental organisation has said.
In a global report titled A Fair Chance at Life , the organisation said the policy to lower child mortality in India and elsewhere appeared to focus on children from better-off communities, leaving out those from the most disadvantaged backgrounds.
“The 41 percentage decline in child mortality over the last two decades masks a dangerous expansion of the child mortality gap between the richest and poorest families in India,” Save the Children CEO Thomas Chandy said.
Child mortality is often described as the best barometer of social and economic progress. Despite being one of the fastest growing economies, there has been no visible pattern between per capita income growth and the rate of reduction of child mortality rates. In 2008, 5.3 lakh children under 5 died in the lowest income quintile in comparison to 1.78 lakh among the wealthy quintile. The rate of decline between 2005-06 and 1997-98 among the lowest income quintile is 22.69 per cent, compared to 34.37 per cent among the high income quintile for the same period.
Of the 26 million children born in India every year, approximately 1.83 million died before their fifth birthday. “What these aggregate figures do not reveal are the huge inequities in mortality rates across the country, within States and between them, as well as between children in urban and rural areas,” Mr. Chandy said.
The under-5 mortality rate in Kerala was 14 deaths per 1000 live births. This stood at a sharp contrast to Madhya Pradesh at 92 per 1000 and 91 per 1000 for Uttar Pradesh.
“Every child has the right to survive and the Indian government has an obligation to protect them. Save the Children's research shows that prioritising marginalised and excluded communities, especially in the States lagging behind, is one of the surest ways that India can reduce the number of children dying from easily preventable causes. The National Rural Health Mission, for example, should have a clear focus on social inclusion of Dalits and adivasis in terms of access to healthcare,” he said.
Save the Children's report comes two weeks before a high-level U.N. summit in New York from September 20-22 to assess progress against the Millennium Development Goals.
By demonstrating a political will and the right policies, MDG4 could be achieved in India. The good schemes in place needed to be matched by effective implementation. And there was enough experience in India proving that low-cost interventions can make the difference between life and death for a child, the report said.
