Neonatal mortality rate projection: will indian states achieve sustainable development goal 3?

Within the span of a little over a decade’s time, important steps have been taken to ameliorate the condition of children across the globe. Since the beginning of the 1990’s, India has also been actively developing health policies focussed on the good health of mothers and their children. The Millennium Development Goals which were initiated in 2000 also played an important role in streamlining efforts to reduce child mortality. Consequently a remarkable reduction in the number of child deaths was experienced in the country. However, this achievement was not commensurate for neonatal deaths. Neonatal mortality actually rose as a proportion of child mortality. Globally, India is still behind countries like Bangladesh, Ethiopia and Nepal in reducing the neonatal mortality rates. The major causes of neonatal deaths in India are mostly preventable in nature and introduction of programs which pivot around these major causes can greatly avert neonatal deaths. In light of this, the National Health Mission Scheme initiated in 2005 has within its ambit, programs like the Integrated Management of Neonatal and Childhood Illness and Navjaat Shishu Suraksha Karyakram that have stressed on providing basic as well as emergency services to sick newborns. Apart from these, initiatives like Kangaroo Mother Care, Neonatal Resuscitation Program and exclusive breastfeeding practices have also had a positive impact on the health and well being of neonates. The National Health Mission scheme has been instrumental in reducing neonatal mortality nevertheless, as a proportion of child mortality it still remains high. Therefore, the advent of the Sustainable Development Goal 3, has again set a goal for India for the next 15 years with a specific target of reducing neonatal mortality to 12 per 1000 live births. Projection of NMR for India and 56 other countries till 2030 shows that India will only reach NMR of 18 per 1000 live births and will lag behind countries like Ethiopia, Mozambique and Tajikistan. Another set of NMR projections were carried out for selected Indian states using the Lives Saved Tool (LiST) which includes the role of coverage parameters covered under NHM in reducing neonatal mortality. The study found that states like Andhra Pradesh, Assam, Karnataka, West Bengal and Uttarakhand will be able to achieve neonatal mortality rate of 12. Proper implementation and supervision of the existing neonatal health programs, national extension of state-level programs proven to reduce neonatal deaths, detailed and timely reporting of causes of death of children below the age of 29 days, proper training and sufficient and timely receipt of remuneration of grass root level health professionals to maintain motivation level and spreading awareness among populations in remote areas about such schemes are the plausible recommendations to avert neonatal deaths taking place in India and helping India in achieving the SDG3 and at providing greater survival chances to its future generation.