Moving Beyond a Maternal Perspective to Child Survival.

ABSTRACT

Notwithstanding the significant improvements in child survival in recent decades [1], India accounts for the largest share of the global burden of under-five mortality with an estimated 1.2-5.9 million child deaths [2]. Consequently, scientific efforts continue to identify factors and interventions that can help improve child survival [3]. An overwhelming majority of studies are informed, almost exclusively, by a ‘maternal perspective’, such that factors and interventions have largely focused on mothers [3,4]. For instance, increasing educational attainment among women has been identified and targeted as a means to achieve rapid progress towards fourth millennium development goal (MDG-4) [4]. Other maternal specific interventions that have received considerable attention in the literature include family planning and care targeted to mothers in the pre-conception period along with micronutrient and folic acid supplementation and early initiation of breastfeeding during pregnancy and in the postnatal period [5]. In this issue, Sinha, et al. [6] consider maternal age at childbirth (hereafter referred to as maternal age) as a potentially modifiable social determinant of child survival within a large prospectively followed cohort. They report that young motherhood is associated with an increase in child mortality, leading to a conclusion that delaying age at pregnancy would confer important survival benefits in this population.