India’s progress towards the Millennium Development Goals 4 and 5 on infant and maternal mortality
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World Health Organization. Regional Office for South-East Asia
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Background: India is in a race against time to achieve the Millennium Development Goals (MDGs)4 and 5, to reduce Infant Mortality Rate (IMR) to ‘28’ and Maternal Mortality Ratio (MMR) to ‘109’,by 2015. This study estimates the percent net contribution of the states and the periods in shapingIndia’s IMR/MMR, and predicts future levels.Methods: A standardized decomposition technique was used to estimate each state’s and period’spercent share in shaping India’s decline in IMR/MMR between two time points. Linear and exponentialregression curves were fitted for IMR/MMR values of the past two decades to predict IMR/MMRlevels for 2015 for India and for the 15 most populous states.Results: Due to favourable maternal mortality reduction efforts in Bihar/Jharkhand (19%) andMadhya Pradesh/Chhattisgarh (11%), Uttar Pradesh (33%) - India is predicted to attain the MDG-5target by 2016, assuming the pace of decline observed in MMR during 1997-2009 continues to followa linear-trend, while the wait may continue until 2023-2024 if the decline follows an exponentialtrend. Attaining MDG-4 may take until 2023-2024, due to low acceleration in IMR drop in Bihar/Jharkhand, Uttar Pradesh/Uttarakhand and Rajasthan. The maximum decline in MMR during 2004-2009 coincided with the launch and uptake of the National Rural Health Mission (NRHM).Conclusions: Even though India as a nation is not predicted to attain all the MDG 4 and 5 targets,at least four of its 15 most populous states are predicted to do so. In the past two decades, MMRreduction efforts were more effective than IMR reduction efforts.
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