Lancet, however, says more girls die than boys

The country has made a steady progress in reducing the mortality rate of children below 5 years. It declined from 2.5 million in 2001 to 1.5 million in 2012 – a fall of 3.7 per cent annually – but female child mortality continued to exceed male mortality.

A new report has shown that only one-third of the districts will achieve the Millennium Development Goal (MDG) of bringing down under-5 mortality to 38 deaths per 1,000 live births by 2015. Kerala is the only State where all districts have achieved the goals for neonates and children aged 1–59 months

The Lancet Global Health journal report says an analysis of data from 597 districts between 2001 and 2012 suggests that 222 or 37 per cent districts are on track to achieve the MDG of reducing under-5 child mortality to 38 deaths per 1,000 live births by 2015, but an equal number will achieve it only after 2020. These 222 lagging districts are home to 41 per cent of India’s live births and 56 per cent of all deaths in children younger than 5 years.

Until 2012, female mortality at ages 1–59 months exceeded male mortality by more than 25 per cent in 303 districts and by more than 50 per cent in 169 districts across the country. Excess female mortality is seen in nearly all States, including Kerala and Tamil Nadu, which otherwise have relatively low under-5 mortality.

Nationally, the 303 districts are home to more than 58 per cent of female live births and 68 per cent of female deaths at 1–59 months, totalling about 74 000 excess deaths in girls.

As many as 251 districts lag behind the relevant goal for neonatal mortality (death within a month) as against than for 1–59 month mortality. Only 81 (14 per cent) districts account for 37 per cent of deaths in children younger than 5 years nationally, according to a paper “Neonatal, 1-59 month, and U-5 mortality in 597 Indian districts, 2001-2012: estimates from national demographic and mortality surveys’’ authored by Usha Ram, Prabhat Jha and others.

At the current rates of progress, MDG- 4 on reduction of neonatal mortality will be met by India around 2020 _ rich States by 2015 and 2023 by the poorer ones, the paper says.Despite this progress, India still has the largest number of deaths in children younger than 5 years of any country in the world. Its large population and its enormous variation in social circumstances, access to health services, and other correlates of under-5 mortality mean that national statistics mask large local variation in sex-specific under-5 mortality and how this changes over time.

In 2012, nine poorer States contained nearly half of all people in India and just over half of all births, but 71 per cent of the 1·5 million deaths in children younger than 5 years. Compared with the richer States, the poorer ones have notably higher mortality per 1000 live births. Girls had higher mortality at ages 1–59 months than did boys, meaning that nationally, for every 100 deaths of boys at these ages, 131 girls died.

As many as 194 of the 222 districts lagging behind in meeting the MDG by more than 5 years are in the poorer States. Of the national totals, 12·6 million or 41 per cent live births took place in these 222 districts in 2012. By contrast, 203 or 91 per cent of the 222 districts on track to reach MDG are in the richer States.