Mathur Ritika Passi

India’s Performance vis-à-vis the
Health MDGs
Goal 4: Reduce Child Mortality
Recording a sharp decline in recent years,
the under-five mortality rate in India is
likely to drop from 152 in 1990 to 48
deaths per 1,000 live births in 2015, but
will miss the target of 42. The infant
mortality rate (IMR) has witnessed a less
noteworthy decline from 80 per 1,000 live
births in 1990 to 39 by 2015, as against the
target of 27. The most noteworthy finding
in all-India data pertaining to 2013 is the
higher level of female IMR than male IMR
in all the bigger states. Additionally, IMR is
higher in rural areas as compared to urban
areas. 1
Goal 5: Improve Maternal Health
The maternal mortality rate (MMR) in
India is likely to reach 140 maternal deaths
by 2015 2 as against the target of 109
per 100,000 live births. While the target
will be missed by a considerable margin,
the fact that the percentage of live births
attended by skilled health personnel stood
at 87.1 in 2013, as against 34.3 in 1993
and 42.4 in 1999, 3 is a positive indicator
of radical improvement in the area. 4 As
observed in the MDG country report, the
performance of four states—Uttar Pradesh,
Bihar, Madhya Pradesh and Rajasthan—
together contributes to 67% of the MMR
in the country. This, along with the child
mortality data, should be seen as an
indicator of social attitudes in these states
towards women’s health from their very
day of birth.
Goal 6: Combat HIV/AIDS, Malaria and
other Diseases
During the last decade, an overall reduction
of 57% has been estimated in annual new
HIV infections in the adult population.
Linked to it is the 20% rise in condom use
numbers during 2006-2010. 5 The number
of people with correct and comprehensive
knowledge of HIV/AIDS has also grown
steadily in recent years. 6 While tuberculosis
(TB) mortality has halved, results in the
same range have not been achieved in the
case of malaria.
Aligning the Health SDG to India’s
Priorities
The targets of SDG 3 give an impetus to
India’s health priorities and provide an
opportunity to step up the country’s efforts.
In light of India’s MDG performance and
observations therein, a target-wise analysis
of the existing and soon-to-be-launched
government initiatives is likely to give a
clearer picture of what can be expected.
Target 3.1
India’s initiatives to increase the number
of births attended by skilled health
personnel, like Janani SurakshaYojana (a
safe motherhood intervention programme)
and Janani Shishu Suraksha Karyakram
(supplements assistance given to pregnant
women), have been successful in bringing
down MMR and IMR levels. Since the
urban-rural gap is significant across the
country, just under 900,000 Accredited
Social Health Activists, known as ASHAs,
spread awareness and assist in accessing
healthcare in rural areas. 7 The government
has been steadily advancing maternal
healthcare facilities under both the
Reproductive and Child Health Programme
and National Rural Health Mission.
Apart from specialised plans and initiatives
such as these, India’s drive to end hunger
and ensure minimum nutrition is likely
to help bring down maternal mortality.
Malnutrition is another major cause of
maternal mortality that has been receiving
attention through convergence of a number
of general and specific food and nutrition
programmes.
Target 3.2
Apart from making constant efforts at
enabling people to access antenatal and
postnatal healthcare, specialised schemes
like Integrated Child Development Services
(ICDS) Scheme focus on nutritional needs.
As per 2013 data, the ICDS Scheme covers
over 100 million beneficiaries under
supplementary nutrition, making it one of
the world’s largest programmes for early
childhood care and development. 8
The Indian National Health Mission, with
its programme on child health, aims at
integrating schemes and interventions vital
for bringing down the under-five mortality
rate. Facility Based Newborn Care is one
such intervention to meet this end. Until
December 2014, there were 14,135 Newborn
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