Childhood Pneumonia and Its Risk Factors in India

Abstract

In nearly three decades, under-five mortality in India declined from 126 (1990) to 32 (2020) per 1000 children. Despite this remarkable progress, child mortality is a key concern for a country like India as it, along with Nigeria, contributes to one-third of the global child mortality. Adding to the plight, most of the deaths occurring among children under five are due to preventable infectious diseases. Pneumonia, often referred to as the “silent killer” is one of the leading causes of death among children across the globe. In 2013, GAPPD set a global goal for reducing pneumonia deaths using a framework of protection, prevention, and treatment. Despite Global Alliance for Vaccination and Immunization (GAVI)’s mandate to vaccinate the world’s most vulnerable children, half of them did not receive all of the pneumonia-fighting vaccines as of 2019. With 11% of the global contribution of pneumonia deaths in 2019, India has the second highest burden of childhood pneumonia deaths worldwide. Higher fatality is observed among infants. Rural residents are more vulnerable to the infection of Pneumonia. Besides, impoverished and malnourished children are at a higher risk amongst all. Relentless efforts of the Indian government and organizations such as the World Health Organisation, UNICEF, Save the Children, CHAI and Every Breath Counts have certainly helped in the decline in Pneumonia in recent years. However, with just three years left to achieve the IAPPD target to reduce pneumonia deaths to lesser than 3 children per 1000 live births and the sudden outbreak of COVID-19 severely impacting the healthcare facilities and vaccination provisions, the accomplishment of the IAPPD target by 2025 and the SDG targets by 2030 may be far-fetched without any dedicated policy formulations. Thus, this study named “Situational Data Analysis of Pneumonia and Its Associated Risk Factors in India” highlights the burden of Pneumonia using the two latest rounds of the National Family Health Survey (NFHS-4 and NFHS-5). Further, the estimates of India’s burden in the global context and the population at risk in the nearby future are also analyzed. The study also identifies malnourishment among children, poverty and illiteracy of parents, and the non-availability of clean cooking fuel and hand-washing facilities as potential risk factors among children under five. Vaccinations, exclusive breastfeeding and complementary feeding practices as well as the use of clean fuel are identified as possible interventions for preventing Pneumonia among children. The study is a timely effort to add invaluable insights and draw the attention of the Indian government and policy formulators to implement strong initiatives to bring down the burden of Pneumonia in India.

Note:
Funding Information: The study was funded by Save The Children, India office.

Declaration of Interests: All authors declare ‘no competing interests’.

Keywords: Child Health, Pneumonia, ARI, India