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Deaths in the 0-4 year age group account for a shocking 20% of total deaths or one in every five in Madhya Pradesh. In contrast, deaths in this age group account for just 2% or one in fifty of total deaths in Kerala.
This was revealed in the Sample Registration System (SRS) 2018 report released recently by the registrar general and census commissioner of India.
A high proportion of deaths in the 0-4 age group is not unique to MP and is the case among states with poor development indices. These include Uttar Pradesh, Rajasthan and Bihar in that order with about one in six deaths is in the 0-4 age group.

Such a high proportion of deaths in this age group is clearly because of the high under-five mortality rate (the probability of dying before 5 years of age for every 1,000 newborns) in these states. Madhya Pradesh has the highest under-five mortality rate of 56 and Kerala has the lowest of 10.
Other than Kerala, the proportion of deaths in the 0-4 age group is low in Tamil Nadu, Punjab, Himachal Pradesh and Maharashtra in that order. Again, these states also have relatively low under-five mortality rates.
In India as a whole and in most states, the deaths in the 0-4 age group constitute a higher proportion of total deaths in rural than in urban areas, except in a few states such as Uttarakhand and Punjab, where the proportion is higher in urban areas.
In some states, the difference in the proportion of deaths in the 0-4 age group between rural and urban areas is huge. The biggest gap is in Assam, where 0-4 age group deaths are just 6% of total deaths in urban areas and 16.5% in rural Assam. Similarly, in Madhya Pradesh, the proportion is just 13.4% in urban areas and 22% in rural areas. This gap could be an indication of very poor health facilities in rural areas compared to the urban centres of a state. Gujarat and Rajasthan are two other states where the gap in proportion between rural and urban areas is greater than the gap at the all-India level.

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