Over 55,000 womendie due to child birth in India every year. Of the total children born in one year, a mind boggling 13 lakh die before they reach their first birthdays, most of them within a few weeks of entering this world. Another indicator that the world watches is how many children cannot survive beyond five years of age. In India every year, over 16 lakh under–5 years children die.

These are hairraising numbers, the highest in the world, mainly because India has the highest number of births in the world — over 2.62 crore per year. But how can one compare this with other countries with lower population or lower birth rates? That is done by expressing mother’s deaths in terms of how many per 1 lakh live births. For India this maternal mortality rate works out to 212. And for infant deaths the ratio is written as so many per 1000 live births. For India this works out to 50. Under–5 mortality in India is 63.

Although maternal mortality has fallen drastically from 570 in 1990, this should not be a matter of complacency. In highly advanced countries like in Western Europe it is below 15, and even in medium human development countries like in Russia or Brazil it is below 133. China has maternal mortality of just 38.

Death of mother during or immediately after child birth is a direct function of health infrastructure, says Dr Amit Sengupta of the People’s Health Movement. “Child birth is a natural function. Death will occur only if there is an emergency, like an obstruction. For that you need trained personnel and facilities. If people have to rush 30–40 kms in an emergency, a tragic and avoidable death results,” he explains.

Infant mortality rates too are still high in India, despite slowly reducing from about 65 in 2000. Our neighbours, though poorer, have done better — IMR is 48 in Nepal and 52 in Bangladesh. In China it is just 19.

Most infant deaths occur in the first few weeks because, again, health facilities and doctors are not easily available or cost too much. A clear indication of this comes from the wide difference between rural and urban rates. In rural areas, infant mortality is 55 while in urban areas it is much less at 34.

A revealing fact is the variations across states. Infant mortality varies from 67 in MP, 65 in Orissa and 63 in UP to just 12 in Kerala, 28 in Tamil Nadu and 33 in West Bengal.

Maternal mortality varies from 390 in Assam and 359 in Uttar Pradesh to 81 in Kerala. Obviously there are some lessons in all this: better education, better infrastructure, better nutrition. But what is perhaps most direly needed is political will across the board.