Globally, 2.9 million newborns die within the first month of life. India, with a population totalling 17.5 percent of the global population, accounts for a startling 27 percent of the global newborn mortality rate with over 780,000 newborn deaths every year, the highest newborn mortality rate in the world. On September 17th, India launched its national Newborn Action Plan (INAP) to stop and reverse this disturbing trend.
Based on the findings and strategies promoted in The Lancet’s Every Newborn series, INAP aims to reduce India’s newborn mortality rate from its current 29 deaths per 1,000 births to under 10 deaths per 1,000 births by 2030. In order to accomplish this goal, INAP focuses on improving the following six evidence-based, effective strategies:
- Preconception and antenatal care
- Care during labor and childbirth
- Immediate newborn care
- Care of healthy newborns
- Care of small and sick newborns
- Care beyond newborn survival
Additionally, the issue of gendercide does not go ignored. Because a girl’s family traditionally must pay a dowry in order to marry, families – especially in poorer regions – favor having boys over girls. As a result, each month approximately 50,000 female fetuses are aborted or killed at birth, thrown into rivers, or simply left to die. An estimated one million girls in India “disappear” every year. With INAP, the Health Ministry takes this long-standing tradition of gender-bias into account and aims to eliminate gender-based differences in newborn health care.
“These are preventable deaths and now we have an action plan for preventing them.” – Harsh Vardhan, India Health Minister
Although India as a whole is on track to achieve Millennium Development Goals (MDGs) 4 and 5 (reducing child mortality and maternal mortality by two-thirds and three-quarters respectively), MDG success is not consistent across the country. For example, the state of Kerala already has a neonatal mortality rate of seven deaths per 1,000 births, yet the poorer states of Bihar, UP, Madhya Pradesh and Rajasthan are far behind, with a combined neonatal mortality rate amounting to 56 percent of such deaths nationwide.
“Healthy mothers and healthy children are crucial for India to realize the demographic dividend.” – Melinda Gates
It is important to emphasize that India’s efforts to reduce the newborn mortality rate are not limited to merely survival. With the launch of INAP, the Health Ministry will focus increased attention on improving the health and lives of both healthy and sick newborns. In a country where shunning those with disabilities, neuro-developmental delays, and birth defects is not uncommon, recognizing the value of all newborns, both sick and healthy, is a major step in the right direction.
With support from the Bill & Melinda Gates Foundation, the World Health Organization and UNICEF, India’s Health Ministry is confident in its ability to reduce newborn deaths nationwide – and if India’s INAP efforts echo the success of its anti-polio campaign, the future for India’s newborns looks promising.