Uttar Pradesh Has Second Highest Child Mortality Rate In India (Image Credits: iStock)
Despite improvements over the years, Uttar Pradesh continues to report one of the highest child mortality rates in India, according to the latest annual health report (2024–25) released by the Union Ministry of Health and Family Welfare. The report reveals that 43 out of every 1,000 children born in the state die before reaching the age of five. Alarmingly, 38 infants per 1,000 live births die within their first year (infant mortality rate or IMR), while 28 per 1,000 die within the first 28 days of life (neonatal mortality rate or NMR).
The numbers place Uttar Pradesh behind only Madhya Pradesh, where the IMR stands at 43 and NMR at 31. Both states are significantly above the national averages — the current IMR for India is 28, and the NMR is 20.
A closer look at the data reveals that nearly 63 per cent of all under-five deaths occur during the neonatal period, i.e., within the first 28 days of life. Of these, about 75 per cent take place during the first week, known as the early neonatal period. Medical experts point out that many of these deaths are preventable and are often linked to infections acquired during childbirth, particularly septicaemia, which is commonly caused by poor hygiene and lack of proper care at the time of delivery.
What Are Institutional Deliveries?
Institutional deliveries refer to childbirth that takes place in a healthcare facility such as a government hospital, primary health centre, or private clinic, in the presence of skilled medical professionals. These settings are equipped with sterile tools, hygienic delivery rooms, emergency care facilities, and trained staff to manage complications—factors that are crucial in reducing the risk of infections in both the mother and the newborn.
In contrast, home births without trained midwives or clean delivery practices can lead to complications, especially in remote or underserved areas where awareness and access to healthcare are limited. “Deliveries in unsanitary conditions significantly increase the risk of infections, including neonatal sepsis or septicaemia, which can be fatal if not treated promptly,” say healthcare experts.
What Is Septicaemia or Infection During Childbirth?
Septicaemia, also known as sepsis, is a severe infection that spreads through the bloodstream. In newborns, it is often caused by bacterial infections introduced during or shortly after delivery. Common causes include:
- Unclean cutting of the umbilical cord.
- Use of non-sterile delivery instruments.
- Infections in the birth canal.
- Contaminated hands or surfaces during delivery.
Once a baby’s immature immune system is exposed to bacteria, it can lead to rapid infection and life-threatening inflammation.
Symptoms of Infection or Septicaemia in Newborns
Early detection of infection is key to survival. Parents and caregivers should look out for the following warning signs:
- Lethargy or unusual sleepiness
- Poor feeding or refusal to breastfeed
- High or very low body temperature
- Rapid or difficult breathing
- Skin rashes or jaundice (yellowing of the skin)
- Swelling or redness around the umbilical stump
- Seizures or irritability
If any of these symptoms appear, immediate medical attention is critical.
Preventive Measures: How to Reduce The Risk Of Infection During Childbirth
Doctors strongly recommend institutional deliveries as the most effective preventive measure. Other key strategies include:
- Regular antenatal check-ups to monitor the mother’s health and catch complications early.
- Ensuring delivery in a clean, sterile environment, preferably in a hospital or health centre.
- Training birth attendants on hygiene practices and sterile techniques.
- Immediate postnatal care to monitor both mother and baby for any signs of infection.
- Promoting breastfeeding, which boosts the baby’s immunity.
- Proper umbilical cord care, using sterile tools and keeping the area clean and dry.
- Public awareness campaigns to educate families about the risks of home deliveries and the benefits of institutional births.
Government Strategies To Save Newborn Babies
While the health department in Uttar Pradesh has been working to improve maternal and child health through schemes like Janani Suraksha Yojana (JSY), experts explain that behavioural change, awareness, and access to quality maternal care are essential to saving newborn lives.
To combat the high neonatal and infant mortality rates, the Ministry of Health and Family Welfare has launched a series of targeted programs under its Newborn Health Strategic Interventions. These efforts aim to reduce preventable deaths and ensure better care for mothers and infants, particularly in high-risk states like Uttar Pradesh.
One major step has been the promotion of Essential Newborn Care (ENC) at the time of birth. To support this, Newborn Care Corners (NBCCs) have been set up at delivery points in healthcare facilities across the country. These dedicated spaces are equipped to provide immediate care to newborns, including resuscitation and thermal protection.
To reduce financial barriers that often delay or prevent timely care, the government launched the Janani Shishu Suraksha Karyakram (JSSK). This initiative ensures free diagnosis, treatment, and referral transport for infants up to one year of age in public health facilities. As a result, families are not burdened with out-of-pocket expenses during the critical early stages of life.
Other program is the Home-Based Newborn Care (HBNC) and Home-Based Care for Young Children (HBYC). These programs empower Accredited Social Health Activists (ASHAs) to promote essential newborn practices like exclusive breastfeeding, hygienic cord care, and prompt identification of neonatal illnesses. ASHAs receive incentives to make scheduled home visits to check on newborns and postpartum mothers during the first six weeks after birth.
According to state reports, under the HBNC program, 1.47 crore newborns were visited by ASHAs in 2023–24, and more than 71.15 lakh newborns were reached between April and September 2024. These home visits have played a vital role in the early detection of illness and timely referrals, especially in remote and underserved areas.
Diarrhoea, pneumonia, undernutrition, and poor hygiene play a major role in child survival, therefore, efforts are being made to strengthen Water, Sanitation, and Hygiene (WASH) interventions in both healthcare facilities and communities to reduce infection risks during and after childbirth.
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