New Delhi: Tackling pneumonia, diarrhea, tetanus and measles has helped India save lives of 1 million children under five since 2005, research published in medical journal Lancet said.

If the country as a whole could match the progress in child health achieved by some individual states, nearly thrice as many lives could have been saved, the study said. It was conducted by Centre for Global Health Research, St Michael’s Hospital , Dalla Lana School of Public Health, University of Toronto, Canada and Indian Council of Medical Research (ICMR).

The research is a part of Million Death Study (MDS) conducted in 1.3 million homes in more than 7,000 randomly selected areas of India. The Registrar General of India implemented the study in 2001.

The study found a 3.3% annual decline in mortality rates of neonates (infants less than one month old) and 5.4% for those ages one-month to 59 months. The declines accelerated starting in 2005 and were fastest between 2010 and 2015, and in urban areas and richer states.

Among 1,000 live births, the mortality rates among neonates fell from 45 in 2000 to 27 in 2015. The one-59 month mortality rate fell from 45.2% to 19.6%. The researchers also observed a steeper decline in the number of girls dying, narrowed a previously observed girl-boy mortality gap with almost equal number of boys and girls under age five dying in 2015.

“Hundreds of specially trained census staff in India knocked on doors of more than 1.3 million homes to interview household members about deaths. Two physicians independently examined these “verbal autopsies" to establish the most probable cause of death," said Dr Prabhat Jha, head of the Centre for Global Health Research of St. Michael’s Hospital in Toronto.

“Looking at specific causes of death, mortality rates from neonatal tetanus and measles fell by at least 90%, neonatal infection and birth trauma fell more than 66%. For children ages one to 59 months, mortality rates from pneumonia and diarrhea fell more than 60%," Dr Jha said.

The authors noted that in the last decade, the government of India has modestly increased its traditionally low level of public spending on health. The government launched a programme to encourage women to give birth in hospitals and for children to have a second dose of measles vaccine under the national immunization programme.

Though the government has launched Janani Suraksha Yojana (JSY) to reduce Maternal Mortality Rate (MMR) and Neo-natal Mortality Rate (NMR) through the promotion of institutional deliveries, researchers have indicated that continuous efforts are required to further improve the situation in India.

“To meet the United Nations’ Sustainable Development Goals of halving its child mortality rates by 2030, India must maintain its current trajectory for children ages one to 59 months and accelerate declines in neonatal mortality. Reducing the number of neonatal deaths will require efforts to reduce deaths caused by premature delivery and low birth weights, especially in poorer states," said Dr Jha.

“About 6 million children die around the world each year and progress in reducing that number depends greatly on India, which accounts for about a fifth of the deaths. About 29 million Indian children died between 2000 and 2015. Had the mortality rates of 2000 continued unchanged, about 39 million children would have died," he said.

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