Child mortality rate improves, but UP 2nd highest in India: Study

Noida: UP ranked among the states with the highest child mortality rates in the country despite an year-on-year improvement, annual health report for 2024-25 released by Union ministry of health and family welfare has revealed. Forty-three out of 1,000 children born in UP die before their fifth birthday, the report said, adding the current infant mortality rate (IMR) stood at 38 per 1,000 live births, while the neonatal mortality rate (NMR) was 28.
The state stands after Madhya Pradesh, where infant mortality rate is 43 out of 1,000 live births and NMR is 31. This is much higher than the country's average IMR of 28 and MNR of 20.

Doctors attributed a significant share of infant deaths to infections during childbirth or septicaemia caused by poor hygiene, especially due to a lack of institutional deliveries.
The report also flagged that UP was among the few low-performing state (LPS) when it came to institutional childbirth. "Home births are still prevalent in UP, especially in rural areas. This is mostly due to the unavailability of institutional facilities," a senior doctor at Child PGI, Noida, said.
A Unicef India report, published in 2020, suggests that nearly 46% of all maternal deaths and 40% of neonatal deaths happen during labour or in the first 24 hours after birth.
"Pre-maturity (35%), neonatal infections (33%), birth asphyxia (20%) and congenital malformations (9%) are among the major causes of newborn deaths," the report stated.
The annual report, however, states UP and Karnataka saw the highest drop in under-five mortality rate, each by five points from 2019 when it was recorded at 48 out of 1,000 live births. In comparison, India's average decline was three points from 35 per 1,000 live births in 2019 to 32 per 1,000 live births in 2020.
However, UP continues to remain "behind the all-India average of these indicators", states a CAG report, released in Dec 2024.
Over 1k home births in Noida last year
According to the annual health report, Noida, which has several private maternity hospitals but lacks a dedicated govt women's hospital or a maternal care unit, recorded more than 5,000 home births since 2021.
While the numbers have seen a steady decline since then — 1,441 in 2021-22, 1,492 in 2022-23, 1,262 in 2023-24 and 1,055 in 2024-25 (till Feb) — it has continued to remain above 1,000 annually.
Health officials told TOI that most of these home births are recorded in the rural pockets that lack maternal care units or govt hospitals nearby.
The CAG report showed that Noida has no dedicated maternal care unit. Although the eight-floor govt combined district hospital has a woman's ward for childbirth, it does not have any dedicated child care unit.
"Of the 240 beds in the combined district hospital, pregnant women or newborns occupy nearly 60-70 beds always. However, due to the heavy rush of patients and references from CHCs and PHCs, the waitlist is too long. There is an urgent need for a dedicated women's hospital in the district," said Renu Aggarwal, chief medical superintendent of the district combined hospital.
A 50-bedded maternity and children's hospital at CHC Bhangel, which opened in 2023, currently lies in an unused condition, with tiles coming off, many of the rooms locked and equipment rusting away.
The CHC caters to Salarpur, Yakubpur and Noida Phase 2 areas.
In Jewar, the CHC has no dedicated maternal or childcare unit and barely 10 beds that are reserved for women, forcing pregnant women from nearby areas to depend on Noida district hospital, about 65km away, for delivery.
"My wife had a due date in March. But I admitted her to Noida district hospital in Feb so that we can get a bed on time. A neighbour of mine waited for her due date, and at the last minute, she did not get a bed at the CHC in Jewar. She was finally taken to a private hospital where the cost is higher," Ashok Kumar, a resident of Jewar, said.
Private hospitals charge anywhere between Rs 20,000 and Rs 1.5 lakh for childbirth. There are additional charges for medicines too.
According to Jewar community health centre (CHC) staff, average 150 deliveries take place at the centre, but it currently has just one gynaecologist to perform caesarean deliveries. Normal deliveries are majorly done by staff nurse. The CHC caters to patients from nearby Bulandshahr and Aligarh and is likely to see more cases once the flight operations start from the Noida International Airport.
Only UP dist with no women's hospital
Noida is the only UP district that does not have any dedicated maternal care unit or women's hospital, the CAG report said.
While Gorakhpur and Lucknow districts have the most maternal care facilities available, districts that lack adequate maternal care units (as of March 2022) include Bhadohi (22 beds of total 210 in two district hospitals), Kannauj (76 out of 200 beds), and Kasganj (18 out of 100 beds).
"Uttar Pradesh set a target to achieve a maternal mortality rate (MMR) of 140 per lakh live births by 2020, as per its Vision 2030 document. However, as per the Sample Registration System (SRS) 2018-20 (published by the Registrar General of India in Nov 2022), MMR was 167 per lakh live births against the current national average of 97 per lakh live births.
There was improvement from NFHS 4 (2015-16) to NFHS 5 (2019-21) under indicators such as institutional deliveries, neonatal mortality rate, infant mortality rate, and under-5 mortality rate," the CAG report stated.