National Health mission logo

National Health Mission

Ministry of Health and Family Welfare, Government of India

Child Health

Introduction

In India, an estimated 26 millions of children are born every year. As per Census 2011, the share of children (0-6 years) accounts 13% of the total population in the Country.The child health programme under the National Health Mission (NHM) comprehensively integrates interventions that improve child survival and addresses factors contributing to infant and under-five mortality. It is now well recognised that child survival cannot be addressed in isolation as it is intricately linked to the health of the mother, which is further determined by her health and development as an adolescent. Therefore, the concept of Continuum of Care, that emphasises on care during critical life stages in order to improve child survival, is being followed under the national programme. Another dimension of this approach is to ensure that critical services are made available at home, through community outreach and through health facilities at various levels (primary, first referral units, tertiary health care facilities). The newborn and child health are now the two key pillars of the Reproductive, maternal, newborn, child and adolescent health (RMNCH+A) strategic approach, 2013.

India has shown progress in Sample registration System indicators:

NMR (SRS)

IMR (SRS)

U5MR (SRS)

2016

2017

Point Decline

Compound Annual Change (%)

2016

2017

Point Decline

Compound Annual Change (%)

2016

2017

Point Decline

Compound Annual Change (%)

24

23

1

-4.2

34

33

1

-2.9

39

37

2

-5.1

NMR-Neonatal Mortality Rate; IMR-Infant Mortality Rate; U5MR-Under 5 Mortality Rate; SRS-Sample registration system.

 
Child Health goals under National Health Policy 2017/SDG
 

 

The Child Health programme under the Reproductive, Maternal, Newborn, Child and Adolescent (RMNCH+A) Strategy of the National Health Mission (NHM) comprehensively integrates interventions that improve child health and nutrition status and addresses factors contributing to neonatal, infant, under-five mortality and malnutrition. The National Population Policy (NPP) 2000, the National Health Policy 2002, Twelfth Five Year Plan (2007-12), National Health Mission (NRHM - 2005 – 2017), Sustainable Development Goals (2016-2030) and New National Health Policy, 2017 have laid down the goals for child health.

Child Health Indicator

Current status

NHP Target

IMR (Infant Mortality Rate)

33

28 by 2019

Neonatal Mortality rate

23

16 by 2025

Under 5 Mortality Rate

37

23 by 2025

*SRS 2017

 

Child Health Goals under SDG:

Goal 3.2: By 2030, end preventable deaths of newborn and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1000 live births and under-5 mortality to at least as low as 25 per 1000 live births.

 
Causes of Child Mortality in India
 

The major causes of child mortality in India as per the SRS reports (2010-13) are: Prematurity & low birth weight (29.8%), Pneumonia (17.1%), Diarrheal diseases (8.6%), Other non-communicable diseases (8.3%), Birth asphyxia & birth trauma (8.2%), Injuries (4.6%), Congenital anomalies (4.4%), Ill-defined or cause unknown (4.4%), Acute bacterial sepsis and severe infections (3.6%), Fever of unknown origin (2.5%), and all other remaining causes (8.4%) 

 
Causes of Infant Mortality
 

The major causes of infant mortality in India as per the SRS reports (2010-13) are: Prematurity & low birth weight (35.9%), Pneumonia (16.9%), Birth asphyxia & birth trauma (9.9%), Other noncommunicable diseases (7.9%), Diarrhoeal diseases (6.7%), Ill defined or cause unknown (4.6%), Congenital anomalies (4.6%), Acute bacterial sepsis and severe infections (4.2%), Injuries (2.1%), Fever of unknown origin (1.7%), and all other remaining causes (5.4%).

 
Causes of Neo-natal Mortality
 

The major causes of neonatal deaths as per Sample Registration System Report (2010-13) are Prematurity & low birth weight (48.1%), Birth asphyxia & birth trauma (12.9%), Neonatal Pneumonia (12.0%), Other noncommunicable diseases (7.1%), Sepsis (5.4%), Ill defined or cause unknown (5.0%), Congenital anomalies(4.0%), Diarrhoeal diseases (3.1%), Injuries (0.9%), Tetanus (0.5%) and all other remaining causes (0.9%).

 
Thrust area under Child Health programme
 

Thrust Area 1 : Neonatal and Child Health

  • Essential new born care (at every ‘delivery’ point at time of birth)
  • Facility based sick newborn care (at FRUs & District Hospitals)
  • Home Based Newborn Care and Home Based Young Care (HBYC) Programme

Thrust Area 2 : Nutrition

  • Promotion of optimal Infant and Young Child Feeding Practices under Mother’s Absolute Affection (MAA) Programme
  • Micronutrient supplementation (Vitamin A, Iron Folic Acid)
  • Management of children with severe acute malnutrition
  • National Deworming Day

Thrust Area 3: Management of Common Child hood illnesses

  • Management of Childhood Diarrhoeal Diseases & Acute Respiratory Infections

Thrust Area 4: Immunisation

  • Intensification of Routine Immunisation
  • Eliminating Measles and Japanese Encephalitis related deaths
  • Polio Eradication

The strategies for child health intervention focus on improving skills of the health care workers, strengthening the health care infrastructure and involvement of the community through behaviour change communication.

 
Child Health indicators: (SRS 2012 to 2017)
 

 

India

2012

2013

2014

2015

2016

2017

India IMR

42

40

39

37

34

33

 

Point Decline in IMR

Percentage Decline in IMR

2012/13

2013/14

2014/15

2015/16

2012/13

2013/14

2014/15

2015/16

2016/17

2

1

2

3

4.8

2.5

5.1

8.11

2.9