The country’s under-five mortality rate has dropped from 127 deaths per 1,000 live births in 1990 to 27 in 2024. Since 2000, the rate has dropped from 92 to 26.6, a decrease of about 71%.“India has become a leading global example in reducing child mortality, with neonatal mortality down by nearly 70% and under-five mortality by 79% since 1990,” Health Minister Jagat Prasad Nadda said in an article published on X. He attributed this achievement to continued investment in maternal and child health.However, progress in reducing neonatal mortality has been slower. The neonatal mortality rate has dropped from 43.8 per 1,000 live births in 2000 to 16.7 in 2024, a decrease of approximately 62%.This gap means newborns now account for the largest proportion of child deaths. Of the total under-five mortality rate of 26.6, approximately 16.7 deaths per 1,000 live births in 2024 will occur in the first month of life, indicating that nearly two-thirds of child deaths are concentrated in this period.“Conditions such as prematurity, birth asphyxia and infection are the leading causes, and gaps in care – such as missed high-risk pregnancies, poor monitoring during delivery and lack of trained staff – further increase the risk. Improving the quality of care during pregnancy, delivery and the first few days after birth is critical to saving more lives,” said Dr Arvind Kumar, Chief Director and Head of Pediatrics, Fortis Hospital, Shalimar Bagh.In absolute terms, about 540,000 children under the age of five die in India every year, including nearly 390,000 newborns. Mortality rates in older children decline more rapidly due to improvements in immunity, nutrition, and disease management.“In newborns, prematurity, birth asphyxia and sepsis are major factors, while in older children, pneumonia, diarrhea and malnutrition are more common. With proper antenatal care, early breastfeeding, good nutrition and timely immunization, most of the deaths are preventable,” said Dr Varun Vij, senior consultant, Department of Paediatrics and Neonatology, Max Smart Super Specialty Hospital, Saket.Data show that between 1990 and 2024, the mortality rate of children under five years of age fell by an average of about 3.6% per year, and the rate of decline was faster after 2000.
