As national attention was focussed on the death of 18 children over three days in Ahmedabad’s main civil hospital in October 2017, officials said most children were underweight and thus vulnerable.

That defence spotlights the fact that Gujarat--which is ranked second by industries and fifth by per capita income--is ranked 17th among 29 states on infant mortality and 25th by underweight prevalence among under-five children.

Up to 33 infants die per 1,000 live births in Gujarat, compared to Kerala (12), Tamil Nadu (19), Maharashtra (21) and Punjab (23), according to the Sample Registration System Statistical Report 2015, the latest available data.

Up to 39% of children in Gujarat are underweight--the national average is 35%--compared to 16% in Kerala, 21% in Punjab, 23% in Tamil Nadu and 36% in Maharashtra, according to the National Family Health Survey 2015-16, the latest available data.

Among 29 states, Gujarat is India’s second-most industrialised state by gross valued added, its state gross domestic product is fourth-highest in the country, and it is ranked fifth by per capita income, according to government data.

On underweight prevalence, Gujarat is ranked, as we said, 25th among 29 states--only ahead of Uttar Pradesh, Madhya Pradesh, Bihar and Jharkhand.

Smaller states such as Mizoram (11.9%) and Manipur (13.8%) and bigger states such as Kerala (16%), Punjab (21%) and Tamil Nadu (23%) have lower proportions of underweight children.

Source: National Family Health Survey 2015-16

As we said, Gujarat’s infant mortality rate (IMR, or infant deaths per 1,000 live births) is an outlier compared to its economic indicators, as is its under-five mortality rate, by which it ranks 18th, with India’s top five being Goa (13), Kerala (13), Tamil Nadu (20), Maharashtra (24) and Manipur (26).

Source: Reserve Bank of India reports here & here; Sample Registration System 2015, National Family Health Survey 2015-16 Note: Domestic product at constant prices and per capita income data are for 2015-16; Economic data for Tripura are for 2014-15, West Bengal for 2010-11

Gujarat, which is ranked fourth based on state domestic product, is ranked 17th on infant mortality, behind poorer states such as Manipur (22), Arunachal Pradesh (23) and Tripura (27).

Gujarat has a per capita income of Rs 122,502 that is almost close to Maharashtra (Rs 121,514) and Kerala (Rs 119,763). However, its child health indicators lag Maharashtra and Kerala on all three parameters--underweight children under five, infant mortality and under-five mortality.

Jammu & Kashmir, with a per capita income of Rs 60,171--50% lower than Gujarat--has lower infant mortality (26) and under-five mortality (28).

Nearly 1.08 million Indian children under the age of five years died in 2015--that is 2,959 deaths every day or two each minute--many of them of causes that were preventable and treatable, IndiaSpend reported on August 16, 2017.

India has reduced its IMR by 68% in the last 41 years from 130 in 1975 to 41 in 2015-16, data from the National Family Health Survey 2015-16 reveal, IndiaSpend reported on May 3, 2017.

India’s IMR of 41 deaths is worse than than poorer neighbours Bangladesh (31) and Nepal (29).

The deaths of infants at public hospitals is a nationwide issue, revealing the depth of the crisis in India’s public-health system, IndiaSpend reported on August 29, 2017. This year, 52 infants died over 30 days at Jamshedpur’s Mahatma Gandhi Memorial Medical College hospital in Jharkhand, two weeks after 70 children died at the Baba Raghav Das Medical College Hospital at Gorakhpur, Uttar Pradesh.

We welcome feedback. Please write to respond@indiaspend.org. We reserve the right to edit responses for language and grammar.

IndiaSpend