Passage

Passage – 4 India accounts for nearly a fifth of the world's child deaths. In terms of numbers, it is the highest in the world — nearly 16 lakhs every year. Of these, more than half die in the first month of life. Officials believe that the reason for this is the absence of steps to propagate basic health practices relating to breast feeding and immunisation. Also the large reproductive population of 2·6 crore remains bereft of care during the critical phases of pregnancy and post-delivery. Added to this is the prevalence of child marriages, anaemia among young women and lack of focus on adolescent sanitation, all of which impact child death rates.

Which is the critical inference that can be made from the above passage ?

(a) A lot of Indians are illiterate and hence do not recognize the value of basic health practices.
(b) India has a very huge population and the government alone cannot manage public health services.
(c) Universalization and integration of maternal health and child health services can effectively address the problem. ✓ UPSC's answer
(d) The nutrition of women in child bearing age does not affect child mortality rate.

Why the answer is (c)

• The passage lists two sets of causes of child deaths: child-care gaps (breastfeeding, immunisation) and maternal-care gaps (no care for 2·6 crore women during pregnancy and after delivery, child marriage, anaemia in young women, poor adolescent hygiene).

• Because the causes lie in both maternal and child health, the problem can be tackled by integrating these services and making them available to all — option (c).

• The passage does not blame illiteracy (a) or the size of the population (b), and it says anaemia in young women affects child death rates, contradicting (d).

• Hence option (c).

Why the other options are wrong

(a) A lot of Indians are illiterate and hence do not recognize the value of basic health…: The passage attributes the problem to the absence of steps to propagate health practices, not to the illiteracy of Indians.
(b) India has a very huge population and the government alone cannot manage public health…: The passage does not discuss the government's capacity to manage services or the sheer size of the population as a barrier to management.
(d) The nutrition of women in child bearing age does not affect child mortality rate.: The passage explicitly states that anaemia among young women impacts child death rates, contradicting the claim that nutrition does not affect mortality.

Asked in the CSAT Paper II of the UPSC Civil Services Preliminary Examination 2015, held on 23 August 2015. Question and answer key: Union Public Service Commission. Explanation: UPSC Answer Check.