Child mortality in India: a complex situation

Background: The countdown database to track the maternal and child survival rate, as set by the Millennium Development Goal, reported recently that India's progress is not satisfactory in reducing newborn and child deaths. Data sources: Articles on neonatal and child mortality in India were accessed from PubMed/MEDLINE. Risk factors associated with neonatal and child mortality were reviewed in three crucial phases of pregnancy, childbirth and postnatal period. Results: The review revealed economic disparity acts through various avenues of cultural belief and restrictions and is indirectly associated with care seeking behavior and utilization of health care, resulting in slow decline of child mortality rate in India. Secondly, cultural norms, practices, and beliefs are strongly associated with high neonatal mortality, contributing to the sluggish decline of overall child survival rate. Proximate determinants of child mortality, i.e., income, cultural behavior and beliefs, in multiplicity of Indian cultures, are closely associated with health seeking behavior, antenatal care, delivery practices and postnatal care of infants. Conclusions: Apart from raising awareness among community leaders, family members responsible for care giving should be specially targeted for removal of hostile perceptions and barriers for improvement of child survival. Also there is need for developing new strategies for health education based on indigenous concerns, addressing socio-cultural barriers. World J Pediatr 2012;8(1):11-18