Madhya Pradesh is unlikely to achieve the target of reducing its under-five mortality rate to less than 23 deaths per 1000 live births, claims Alok Ranjan Chaurasia, a former professor of Institute of Economic Growth in Delhi.
The goal was set out as a nationwide target in the National Health Policy 2017. This is not the first time Madhya Pradesh has fallen behind in limiting the deaths of children. The state also fell short of the Millennium Development Goal-4, which set out a target of reducing the under-five mortality rate by two thirds over the 1990 to 2015 period.
Madhya Pradesh has the highest under-five mortality rate of all states and union territories. “Despite efforts of the state government, the rank of Madhya Pradesh as compared to other states and Union territories has virtually remained unchanged over last 40 years,” said Chaurasia.
The state is also getting poorer when compared to the rest of India. In 1994,poverty levels in the state were similar to the national average. Since then, poverty levels have, on average, fallen across the country but remain high in Madhya Pradesh, falling at a far slower rate than nationwide.
Poverty seems to be at the root of India’s high rate of childhood deaths. Authors of the Million Death Study suggest low birth weight is the leading cause of neonatal death, which drives up the under-five mortality rate.Low birth weight can be caused by many factors. Foremost among these are poor diet during pregnancy, as well as a lack of healthcare before and during the birth.
In Madhya Pradesh, 24 million people, or roughly a third of the population, live under the poverty line. In regions where poverty is abundant, diets may be lacking and malnutrition may be common.
The healthcare system’s lack of accessibility is also likely to be a contributing factor the Madhya Pradesh’s issues. Targeting the 21% tribal and 17% scheduled caste population would be beneficial, claims Madhya Pradesh Principal Secretary for women and child welfare JN Kansotia.
Twenty-six million babies are born in India each year. Of these, around 730,000 die within the first month of their lives. Some claim that around 80 percent of these deaths are preventable. Greater access to healthcare in rural environments may significantly reduce these infant deaths, not just in Madhya Pradesh, but in the whole of India.
Madhya Pradesh goes to the pools in November 2018. After 14 years in power, the incumbent BJP state government is expected to face a significant anti-incumbency vote.