Peer-reviewed article
District-Level Estimates of Child Mortality in Uttar Pradesh, India.
Pandey A, Sharma R ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study analyzes child mortality rates across districts in Uttar Pradesh, India using national health survey data. Neonatal mortality is the leading cause of child deaths, averaging 36 per 1,000 live births, with large variation between districts. Some districts have achieved low mortality rates near global targets, while others remain far above them. The state's under-five mortality rate of 60 per 1,000 live births is more than twice the Sustainable Development Goal target.
Key points
- Neonatal mortality averages 36 per 1,000 live births and is the largest contributor to child deaths in Uttar Pradesh
- Central and western districts like Amethi and Shahjahanpur have neonatal mortality rates above 60, while eastern districts like Ballia and Deoria have achieved rates below 12
- Post-neonatal mortality averages 15 per 1,000, with gaps in infant care and immunization coverage in districts like Agra, Hardoi, and Kheri
- Under-five mortality ranges from 25 to 111 per 1,000 across districts, more than twice the SDG 2030 target of 25
- Eight aspirational districts with targeted development initiatives show marginally better performance than the state average
Limitations
This is a descriptive analysis of mortality estimates from survey data and does not explain the causes of district-level variation or test interventions to reduce mortality. The document does not provide information on what specific interventions or policies drove successful reductions in low-mortality districts.
Abstract
The study examines district-wise variations in child mortality across Uttar Pradesh using the National Family Health Survey (NFHS)-5 dataset for Uttar Pradesh, by estimating the neonatal mortality rate (NMR), post-neonatal mortality rate (PNMR), child mortality rate (CMR), and under-five mortality rate (U5MR). Findings suggest that Uttar Pradesh continues to exhibit one of India's highest child mortality burdens, as the estimates are above the national average. Neonatal mortality, averaging about 36 deaths per 1,000 live births, remains the largest contributor to child deaths. Several central and western districts, such as Amethi, Mainpuri, and Shahjahanpur, record NMRs above 60, while some eastern districts like Ballia and Deoria have achieved rates below 12, nearing the 2030 Sustainable Development Goals (SDG). Post-neonatal mortality averages around 15 per 1,000, with high levels in Agra, Hardoi, and Kheri, indicating gaps in infant care and immunization coverage. In contrast, districts such as Kushinagar and Muzaffarnagar have PNMRs under 3, reflecting effective community-level health programs. Child mortality (ages 1-4) has declined significantly, with a state average near 10 per 1,000. Most districts report single-digit CMRs, but outliers like Fatehpur and Allahabad remain high, suggesting persistent issues related to nutrition and healthcare quality. The composite U5MR stands at nearly 60 deaths per 1,000 live births, still more than twice the SDG target. Extremes range from 111 in Amethi and 101 in Shahjahanpur to below 25 in Jaunpur, Muzaffarnagar, and Deoria. This divergence highlights both successful interventions and critical shortfalls within the state. The eight aspirational districts Bahraich, Balrampur, Chandauli, Chitrakoot, Fatehpur, Shravasti, Siddharthnagar, and Sonbhadra perform marginally better than the state average (U5MR 56.5 vs. 59.9), suggesting positive effects of targeted development initiatives. However, internal variation persists, with Siddharthnagar performing exceptionally well and Fatehpur lagging behind. Overall, Uttar Pradesh's child mortality has declined but remains uneven. Sustained improvements in neonatal care, maternal health, nutrition, and equitable healthcare delivery, especially in high-mortality districts, are crucial for meeting national and SDG by 2030.