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Causes of neonatal and child mortality in India: a nationally representative mortality survey [1]
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Date: 2010-11-27
Yearly child mortality rates in India have fallen between 1·7%1 and 2·3%2 in the past two decades. Despite this decrease, the United Nations (UN) estimates that about 2·35 million children died in India in 2005. This figure corresponds to more than 20% of all deaths in children younger than 5 years worldwide, which is more than in any other country.1, 3 Large differences in overall child survival between India's diverse regions have been previously documented.4, 5 However, no direct and nationally representative measurement of the major causes of death in neonates (<1 month) and at ages 1–59 months has been done,6 and how these causes of death vary across India's regions is unknown. Social preference for boys is strong, as noted by widespread selective abortion of female fetuses7 and by lower immunisation rates in girls.8 The consequences of boy preference on child mortality remain undocumented. Understanding of the causes of child death might, therefore, help to guide the use of widely practicable interventions for neonatal and child survival.3, 9
Most deaths in India, including of children, are not medically certified since most occur at home, in rural areas, and without attention by a health-care worker.10 Thus, other sources of information are needed to help to establish the probable underlying causes of death. During the past decade the Registrar General of India (RGI) has introduced an enhanced form of verbal autopsy called RHIME—or routine, reliable, representative, re-sampled household investigation of mortality with medical evaluation11—into its nationally representative sample registration system (SRS), which covered about 6·3 million people and monitored all deaths in 1·1 million homes.5 This mortality survey is part of the Million Death Study, which seeks to assign causes to all deaths in the SRS areas during the 13 years from 2001 to 2013.11, 12, 13, 14, 15 In this report we present the results of the causes of child deaths in India, separately for the neonatal period and at ages 1–59 months, for boys and girls, and for each of six major regions of India.
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[1] Url:
https://www.sciencedirect.com/science/article/pii/S0140673610614614
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