New Delhi, Sept. 19: India had 74,000 excess deaths among girls aged below five last year, a new study has estimated providing what public health researchers say is fresh evidence for widespread neglect of girls over boys during their vulnerable childhood years.
The study by a team of researchers in India and Canada has also found that 222 of 597 districts are on track to achieve India’s target of reducing under-five child mortality to 38 per 1,000 live births by 2015. But an equal number of districts will achieve the goal only after 2020.
Their study, described as India’s first district-specific estimate of child mortality, has also shown that nine so-called poorer states — Assam, Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Odisha, Rajasthan, Uttarakhand and Uttar Pradesh — accounted for about 1 million, or 71 per cent, of the 1.5 million deaths among children younger than five years.
The results, published yesterday in The Lancet, have also shown that one-third of all under-five mortality occurred in only 81 districts.
“These 81 districts should be considered hotspots that need very special attention,” Prabhat Jha, an epidemiologist and founding director of the Centre for Global Health at the University of Toronto in Canada, who led the study, told The Telegraph.
The study has also shown that in 2012, 251 of the 597 districts studied lagged more than five years behind the goal of pulling down neonatal deaths (deaths among children in the first month of life) of 20 per 1,000 live births.
However, it has also suggested that all districts in Bengal, Himachal Pradesh, Kerala, Maharashtra, Punjab and Tamil Nadu are on track to achieve the under-five child mortality target of less than 38 per 1,000 live births by 2015.
Jha and his colleagues from four institutions in India have also estimated that mortality among girls below five years exceeded male mortality in the same age group by 25 per cent in 303 districts in almost all states, leading to 74,000 excess deaths among girls over boys.
“We believe these excess deaths reflect widespread neglect of girls over boys in nutrition and healthcare,” said Faujdar Ram, the director of Mumbai’s International Institute of Population Science and a co-author. “In both poor and rich states, baby girls are managed worse than boys — economic development hasn’t had much impact on cultural practices.”
The study has estimated this excess mortality in girls in almost all states, including Andhra Pradesh, Bengal, Gujarat, Karnataka, Kerala, Maharashtra and Tamil Nadu — classified by the study as relatively richer states.
“There are about 700,000 deaths among boys and girls between the ages of one month and 59 months,” said Jha. “The goal should be to reduce deaths in boys and girls, as well as the 800,000 deaths in the first month of life where there is no gender gap.”
The researchers say reductions in child mortality would require goal-specific strategies. “Reducing neonatal mortality requires safe delivery and early care which means clinics and hospitals with appropriate facilities,” Jha said. “Reducing mortality between one month and 59 months requires adding vaccines against rotavirus plus more treatment facilities for pneumonia and diarrhoea.”
The study combined multiple sets of data relating to sex-specific birth and mortality, including six national mortality surveys that covered 109,000 child deaths, to estimate the neonatal and under-five child mortality in 597 of India's 640 districts.
“Until now,” Ram said, “we’ve not had child mortality estimates at the district level.”