This year’s World Health Day brings renewed attention to maternal and newborn health, along with women’s well-being throughout the lifecycle. The focus is considered timely and welcome, particularly by those like Dr Vinod K Paul, Member, NITI Aayog, who has worked extensively in the domain of newborn care. He notes that maternal and newborn health are deeply interconnected, and views the theme as both a professional affirmation and a global call to action.
From MDGs to SDGs
Progress made during the Millennium Development Goals (MDGs) era laid a strong foundation. Between 2000 and 2015, India successfully halved under-five mortality and cut maternal mortality by three-fourths, compared to 1990 levels. These achievements, Dr Paul reflects, represent significant strides in public health. The shift to the Sustainable Development Goals (SDGs) has broadened the scope, setting absolute targets for 2030.
Clear Targets for 2030
SDG 3 outlines three key targets: reducing the maternal mortality ratio (MMR) to below 70 per 100,000 live births; bringing the under-five mortality rate to under 25 per 1,000; and lowering neonatal mortality to below 12 per 1,000 live births. India is well on track to meet each of these goals.
Maternal Mortality
India’s MMR has dropped substantially—from 556 in 1990 to 97 in the 2018–2020 estimate, marking an 83% reduction. Nine states, including Kerala, Maharashtra, Telangana and Andhra Pradesh, have already met the SDG target. Dr Paul calls this “a national success”, especially in contrast to the 42% reduction seen globally.
Under-Five Mortality
By 2020, the under-five mortality rate in India had fallen to 32 per 1,000 live births. Eleven states and union territories had already met the SDG target of 25. Since 1990, the overall reduction has been 73%—a decline that Dr Paul attributes to persistent efforts in healthcare delivery, awareness, and immunisation.
Neonatal Mortality
Neonatal mortality in India currently stands at 20 per 1,000 live births. Urban areas have already achieved the SDG target, with six states and Delhi also meeting it. The drop in under-five deaths—from 35 lakh annually in 1990 to 6–7 lakh today—is due to stronger systems, nearly universal institutional deliveries, and programmes such as Ayushman Bharat.
Tackling Stunting and Nutrition
The challenge of stunting remains, though gains are evident. From a prevalence of nearly 60% in 1990, stunting has fallen to around 35% according to recent NFHS data. Poor sanitation and repeated infections are contributing factors. Dr Paul points out that improvements under Swachh Bharat, alongside higher vaccine uptake and better treatment of diarrhoea with ORS and zinc, have played a crucial role in this decline.
Nurturing Infant and Child Health
Several critical interventions are seen as key to faster progress. Only 42% of newborns begin breastfeeding within the first hour, which must be universal. Exclusive breastfeeding, at 65%, needs to rise to 100% in the first six months. Care for small babies—including kangaroo mother care—is essential. Timely introduction of complementary feeding is another major gap.
Dr Paul underlines that a toddler’s dietary needs are surprisingly high—half that of an adult’s—and that home-cooked foods can meet these needs if given in appropriate quantity and frequency.
Maternal Health Shapes Child Outcomes
A woman’s health before and during pregnancy is pivotal to her baby’s well-being. Low maternal BMI or height can predict poorer outcomes. Nutrition support through government schemes is considered vital, and regular consumption of take-home rations is strongly encouraged. Addressing anaemia and infections is seen as central to combating stunting and wasting.
Sustaining Care Beyond Delivery
Efforts must continue after childbirth through proper nutrition, illness prevention, timely treatment, and full immunisation coverage. With increasing awareness and access, India is considered well-positioned to further reduce child undernutrition. Dr Paul reiterates the importance of national programmes such as Poshan Abhiyan and the National Health Mission in maintaining momentum.
Facing the Rise of NCDs
As communicable diseases decline, India now faces a surge in non-communicable conditions—particularly heart disease, diabetes, and cancers. Dr Paul identifies these as the “next big challenge”. Prevention, he notes, lies in maintaining a healthy weight, avoiding tobacco and alcohol, staying active, and managing stress.
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