Lancet India՚s Million Death Study: 1 Million Children Saved

According to The Lancet India՚s Million Death Study, India avoided about 10 lakh deaths of children under age 5 since 2005 by significant reductions in mortality due to pneumonia, diarrhoea, neonatal infections, birth asphyxia, trauma, measles and tetanus.

Infant Mortality Rate in India 2016

Details of India՚s Million Death Study

Implemented by the Registrar General of India

First study to directly quantify changes in cause-specific child deaths in India, nationally and sub-nationally, from 2000 - 15 among randomly selected homes.

  • Illustrates conditions prioritized under the National Health Mission had the greatest declines. Pneumonia and diarrhea mortality fell by over 60% mainly due to effective treatment
  • Mortality from birth-related breathing and trauma during delivery fell by 66% mainly due to more births occurring in hospital
  • Measles and tetanus mortality fell by 90% mainly due to special immunization campaigns against each

The Numbers from India՚s Million Death Study

  • Mortality rate per 1000 live births fell in neonates from 45 in 2000 to 27 in 2015 (3.3% annual decline)
  • 1 - 59 month mortality rate fell from 45.2 in 2000 to 19.6 in 2015 (5.4% annual decline) .
  • Amongst 1 - 59 months, pneumonia fell by 63% , diarrhoea fell by 66% and measles fell by more than 90% .
  • Declines greater in girls- now India has equal numbers of girls and boys dying, a significant improvement from just a few years ago.
  • Pneumonia and diarrhoea mortality rates for 1 - 59 months declined substantially between 2010 and 2015 at an average of 8 - 10% annually more in the rural areas and poorer states.

The Mechanism of the Million Death Study

This is a direct study based on face-to-face interviews with families, and is not based on modeling or projections from small samples.

  • The study builds on the Sample Registration System (SRS) by directly monitoring the causes of death in over 1.3 million (13 lakh) homes.
  • Since 2001, about 900 staff interviewed about 100,000 (1 lakh) living members in all homes with 1 child dying
  • Surveyed about 53,000 deaths in the first month of life and 42,000 at 1 - 59 months every six months
  • The family completed a simple two-page form with a local language half-page narrative describing the deceased՚s symptoms and treatments.
  • Records were digitized and each one uniformly coded for cause of death independently by two of about 400 trained physicians, using World Health Organization approved procedures.

Strategic approach of the Health Ministry has started yielding dividends and the efforts of focusing on low performing States is paying off.

What is Sample Registration System?

  • To unify the civil registration activities, the Registration of Births & Deaths Act, 1969 was enacted.
  • Despite making registration of birth and death, compulsory the registration of births and deaths under the Act has continued to be far from satisfactory in several states and UTs.
  • To generate reliable and continuous data on birth and death indicators, the Office of the Registrar General initiated the scheme of sample registration of births and deaths popularly known, as Sample Registration System (SRS) in 1964 - 65 on a pilot basis and on full scale from 1969 - 70.

Examrace Team at Aug 21, 2021