Why children remain at risk

As the 2015 target for achieving millennium development goals adopted in 1990 approaches, the time has come to take stock of various countries' performances and identify areas that need more attention. The Unicef recently released a report which categorically stated that India will not be able to achieve the goal of an under-five mortality rate (U5MR) of 42 by 2015. The report further stated that only six of the 29 states — Kerala, Tamil Nadu, Maharashtra, Punjab, Himachal Pradesh and West Bengal — are likely to attain the goals of an infant mortality rate (IMR) of 26 per 1,000 live births and U5MR of 42 by 2015. The report has been greeted with despair, evident in the discussions on why India is not poised to achieve these goals.

One of the millennium goals set for India is to reduce the U5MR by two-thirds between 1990 and 2015, that is, from 109 in 1990 to 42 by 2015. According to the sample registration system (SRS) estimates available for 2010, the figure is 61, suggesting a decline of about 44 per cent in 20 years. With five years to go from 2010, unless the pace of decline accelerates substantially, India would be a long way from the goal.

It is important to put the situation in perspective. In 1990, both IMR and U5MR in the six states set to meet the goals were significantly lower than the national average. So for these states to reach the national goal was relatively easy. If the millennium goal for the U5MR is accepted, then Maharashtra, Punjab and Himachal Pradesh are nowhere near their individual goals of a two-thirds decline in child mortality. Kerala is a historical exception in the league of Indian states, with an IMR and child mortality similar to that of many developed countries. The declines in Tamil Nadu and West Bengal are impressive; the rest of India could learn from them when it comes to providing healthcare for the young.

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