High Under‑fve Mortality Rate in Rural Madhya Pradesh, Time to Identify High‑Risk Districts Using National Family Health Survey‑4 Data with Comparison to Low Under‑fve Mortality Rate in Rural Tamil Nadu, India

India had highest number of under‑fve deaths, 1.2 million deaths out of 5.9 million (2015). As per the results from the frst phase of National Family Health Survey (NFHS‑4), 2015–2016, under‑fve mortality rate was highest in rural area of Madhya Pradesh (MP), 69/1000 live birth as compared to urban areas, 52/1000 live birth. The objective of the study was to identify potentially high‑risk districts (HRD). This study was carried out from the secondary data of 50 districts of MP State which was available from NFHS‑4 with information from 49,164 households. Scoring method was used to identify HRD by comparing variables related to maternal and child health care of rural MP with rural Tamil Nadu. Eleven HRDs were identifed with poor maternal and child health care along with high women’s illiteracy and high percentage of child marriages in women. Indore division had 3 topmost HRD, Alirajpur, Jhabua, and Barwani followed by Rewa division with 2, Singrauli and Sidhi along with Sagar division. HRDs should be considered for targeted interventions using the strategies for reducing under‑fve mortality rate in rural MP.