Study that analysed data from the National Family Health Survey finds that most baby deaths happen in the early neonatal and post neonatal periodsÂ
India needs to prioritize policies that focus on reducing child deaths soon after birth and then during the post neonatal period – that is after 28 days of birth. An analysis that looked at data from the National Family Health Survey 5 to identify the points at which baby deaths occurred the most found that early neonatal and post neonatal periods were when newborns were the most vulnerable. The findings were published in JAMA Network Open.
The study categorised child deaths into early-neonatal mortality rate (ENMR) (the number of deaths occurring in the first 7 completed days after the child is born), late-neonatal mortality rate (LNMR) (the number of deaths occurring on days 8 to 28 completed days after the child is born per 1000 live births, postneonatal mortality rate (PNMR) (the number of deaths occurring on days 29 to 11 completed months), and childhood mortality rate (CMR) (the number of deaths occurring in months 12 to 59 completed months who are at least aged 1 year). “The share of early-neonatal deaths to total under-5 deaths increased from 29.9% in 1993 to 48.3% in 2021, while the share of late-neonatal deaths decreased from 12.6% in 1993 to 9.7% in 2021, postneonatal deaths from 27.7% in 1993 to 25.6% in 2021, and child deaths from 29.8% in 1993 to 16.4% in 2021. Except for Kerala, Goa, and Nagaland, the remaining states and UTs with available data for both time periods experienced an increase in the share of early-neonatal deaths,” the researchers noted. Early neonatal deaths are higher because of factors like low birth weight and congenital disorders but the post neonatal phase is significant because at 42 days, the community health workers stop doing routine visits to the house of a newborn baby and the care passes on completely to the family without any supervision. Weekly ASHA visits stop at 28 days.
In India of every 1000 children born, 42 die before they reach their fifth birthdays, with the country accounting for 14% of the global burden of under-5 mortality. The Sustainable Development Goals (SDGs) of the United Nations include reducing mortality in the first 5 years to 25 deaths per 1000 live births and the first 28 days to 12 deaths per 1000 live births by 2030. Extrapolating from their analysis, the researchers wrote that going by this rate of change, India may not be able to meet the SDG targets of reducing early neonatal and post neonatal mortality.
