The Sample Registration System Statistical Report, which was recently released by the Registrar General of India, has encouraging news on infant mortality and some related indicators of child welfare. Records show that the country has seen progressive reduction in Infant Mortality Rate (IMR). The under-five mortality rate has shown a significant decline of three points from 35 per 1,000 live births in 2019 to 32 per 1,000 live births in 2020. The IMR and the neonatal mortality rate have both declined by two points and stand at 28 per 1,000 live births and 20 per 1,000 live births, respectively. Mizoram and Nagaland have the lowest IMR of three and four deaths per 1,000 live births. Six states have attained the United Nations’ Sustainable Development Goal (SDG) of 12 for neonatal mortality rate while 11 have reached the SDG target of 25 for under-five mortality. Karnataka and UP registered the steepest fall in under-five mortality rate.
While that is an achievement, there are concerns also in some respects. Though there is a three-point increase at the national level through 2017-19, the average sex ratio at birth has declined in 10 states. Kerala has the highest sex ratio of 974 while Uttarakhand registered the lowest at 844. Sex ratio at birth is not just a medical record but an indicator of social attitudes and the gender balance which is necessary for the health of society. Experts have felt that the decline in sex ratio in some states should be seriously studied, especially because it is related to a trend that was strongly entrenched in society. This trend was a reality across the country but was particularly strong in some North Indian states like Haryana and Punjab. It is with great difficulty that such attitudes are changed and the gains that were made should not be lost.
The Pre-Conception and Pre-Natal Diagnostic Techniques Act, 1994, which banned prenatal sex-screening and selective abortion was an important step towards curbing female foeticide. But there are reports that newer ways have been found to evade the law. The decline in sex ratio may be a result of that. There is the need to promote policies that protect the girl-child and to implement them effectively. In the case of indicators like infant mortality, on which there is progress, the positive movement should be sustained. Efforts should also be made to bring down the performance gap between states and between rural and urban areas in the case of all such indicators. It is also important to improve the living conditions of the poorer sections and extend medical services to them.