Nearly 2 million children under five die from lack of care in India every year, more than in any other country, said a new report released on Monday which blames poor public health spending and entrenched inequalities.
More than half of infant deaths occur in the first month after birth, said the report from Save the Children, which surveyed 14 countries including China, Pakistan and Nigeria, and ranked India 171 out of 175 countries in public health spending.
Child mortality rates have fallen in recent years in India, which ranks among the fastest growing economies, but at 72 deaths per 1,000 live births, its neonatal mortality rate is worse than its poorer neighbours Bangladesh and Sri Lanka.
India accounts for a fifth of all newborn deaths from such preventable diseases as diarrhoea and pneumonia, the report said, and will need greater political commitment and resource allocation to meet its commitment to the Millennium Development Goals (MDG), the report said.
Poor countries such as Nepal, Bangladesh, Peru and the Philippines that are on track to meet MDG explode the myth that the costs of reducing newborn and child mortality are high, said Thomas Chandy, chief executive of Save the Children.
Going by current trends, India will meet its goal only by 2020, five years after the committed date.
There is no real pressure on the government to act, largely because of public perceptions that it is too costly to change the reality. If people understood how affordable and feasible it is to prevent children dying, they'd be shocked, Chandy said.
India will need to increase public health spending to the global average of 5 percent of GDP from 1 percent by 2015, and double allocations to child health, nutrition, water and sanitation and food security schemes to cut infant mortality.
Malnutrition is the leading cause of death among children less than five years old, with nearly one-third of all malnourished children in India, the report said.
Neonatal diseases, diarrhoea and pneumonia are also leading causes of death, with gender and caste inequalities, lack of clean water and sanitation facilities also contributing. Half the women give birth without help from skilled health workers.
A crucial, overriding factor is cultural and social attitudes towards women, the report noted.
Discrimination against girls and women cuts across the whole lifecycle and is reflected in caring practices, access to nutrition, food intake and health seeking behaviours, it said.