India has the dubious distinction of recording the most first-day deaths of children. Every year, 3,09,000 children die on the day they are born in India. It accounts for 29% of all the first-day deaths globally, the highest for any country, according to the latest ‘State of the World’s Mothers’ report released by Save the Children, an NGO.

Early neonatal mortality comprises of child deaths within the first seven days of being born. Two thirds of all early newborn deaths occur in just 10 countries — Nigeria, DR Congo, Tanzania, Ethiopia, Pakistan, India, Afghanistan, Bangladesh, Indonesia and China. Four of these are in South Asia. “India, with both a large population and a high early neonatal mortality rate, is home to more than 3,09,000 first-day deaths,” the report said.

According to the government of India’s sample registration survey in 2011, for every 1,000 live births in India, 24 children die within the first seven days of birth. Madhya Pradesh surpasses the national average with the early neonatal mortality rate standing at 32. Uttar Pradesh and Orissa are next at 30. While Maharashtra has managed to duck the national average with its early neonatal mortality rate standing at 15, it still has a long way to go to reduce the burden. Kerala with 5 newborn deaths per 1,000 live births has by far the most ideal rate of early neonatal mortality.

“The main reasons for newborns dying are birth asphyxia, premature deliveries and infections. All healthcare set-ups should be well-equipped for deliveries. High-risk mothers should strictly deliver in tertiary care hospitals instead of risking their delivery in smaller set-ups,” said Dr Ashok Rathod, head of paediatric department at Sir JJ group of hospitals.

Though China is the world’s most populated country, it accounts for a minimal five per cent of all first-day deaths around the world, according to the report. It further says minnows like Bangladesh and Afghanistan in South Asia account for three and two per cent first-day deaths, respectively.