[iapsm_youthmembers] Under five mortality in India---a call for action

[Guest guest]

Dear Friends,

I fully agree with Dr. kansal and wish to add that we need to frame a realistic action plan for mother and child survival under the umbrella of NRHM where we have enough funds but not the will to act.

Let's all go to Director NRHM office in our respective states and contribute to the planning and implimentation preocess for schemes on mother and child health.

Thanks

Dr. Omesh Bharti

Himachal--- On Sun, 8/17/08, Dr Om Prakash Kansal <kansalop wrote:

Dr Om Prakash Kansal <kansalop[iapsm_youthmembers] Under five mortality in India---a call for action"JSA" <pha-ncc >, "DISEASE SURVEILLANCE" <diseasesurveillance >, , iapsm_youthmembers Cc: "COMMONCAUSE" <info, "dimong padung" <dimong, "Dr Paramjeet PTA" <arnejaparam, "Dr GB Singh" <guri_bs4, "Dr. Sonu Goel" <sonugoel007, "Dr Vibhour Jain" <srcmoradabad1, "Dr Tulika Goswami Mahanta" <drtulikagoswamiSunday, August 17, 2008, 9:01 PM

 

 

 

 

 

 

 

 

Dear All,

 

The recent report on child survival reinforces us to think hard. The Essential Package for Child Survival: components

1. Skilled attendance during pregnancy, childbirth and the immediate postpartum 2. Essential Care of the Newborn 3. Breastfeeding and complementary feeding 4. Micronutrient supplementation 5. Immunization of children and mothers 6. Integrated management of sick children-IMNCI 7. Use of insecticide treated bed nets ( where indicated epidemiologically)

The report does mention that India should increase its spending on Public health but the other side of the story is that the state governments are still not in a position to consume the budget available already. In a state like Bihar, about 50% of the approved NRHM budget goes unutilized and is carried forward to next year. May I call upon all our IAPSM colleauges to think and get into real action on some of the following activities: 1. Create a sense of urgency among all stakeholders 2. As a group in departments of community medicine: If we target at least 1000 newborns per year per department for all round direct health promotion , we can cover a significant population of under fives. As I understand correctly, these days many medical colleges are in rural areas or city outskirts so a variety of population settings can be covered.

3. Influence local policy makers--MLAs, Zila Parishad heads, Nagar Palika/Municipal Corporation heads and officials, District Magistrates etc. We can broaden our focus officials--- Health, ICDS, Public Health Engineering, Civil supplies and so on.

4. Engage other professional organizations like IAP, IMA, FOGSI(Gynaecologist s), Anesthesiologists( for maternal health) etc. and then jointly arrange dissemination meetings for various public health issues. In Bihar, an effort is underway for such a group.

5. Judicious use of Right to Information act( RTI) may also be tried in some situations.

Well known and documented preventive and curative services and practices are still not reaching all eligible universally. Please contribute professionally and personally to make this happen even in any small geographic area. I request you to share your suggestions and actions taken at your end.

With good wishes, Dr Om Prakash Kansal Patna--- On Sun, 17/8/08, omesh bharti <bhartiomesh@ > wrote:

omesh bharti <bhartiomesh@ >[iapsm_youthmembers ] 2.1 million children died in India in 2006 before they turned five- TEHELKA STORY"JSA" <pha-ncc@ .com>, "DISEASE SURVEILLANCE" <diseasesurveillance >, Cc: "IAPSM" <iapsm_youthmembers>, "COMMONCAUSE" <info@commoncauseind ia.org>Sunday, 17 August, 2008, 10:27 AM

 

 

http://www.tehelka. com/story_ main40.asp? filename= Ws230808borntodi e.aspBorn To DieUNICEF says 2.1 million children died in India in 2006 before they turned fiveBETWA SHARMAIndia needs to drastically reduce the death of children under the age of five, for the world to attain the health-related Millennium Development Goals (MDGs) by 2015, said a groundbreaking report issued by the United Nations Children’s Fund (UNICEF)“More than for any other single nation, India’s progress on child survival is pivotal to meeting the health-related MDGs,” the report said. The eight United Nations Millennium Development Goals range from halving extreme poverty to providing universal primary education by 2015. The health-related MDGs entail reducing child mortality, improving maternal health and

combating HIV-AIDS. Reducing child mortality, also called MDG 4, requires reducing the global rate of under-five deaths by two-thirds from 1990 level by 2015. India is home to 20 percent of the world’s under-fives and was responsible for 2.1 million deaths in 2006, which accounted for one-fifth of the children who died before their fifth birthday.“Global attainment of the health-related MDGs will depend, in no small part, on India’s achievements in improving health, nutrition, water and sanitation, education and child protection, gender equality and women’s empowerment in the coming years," the report stressed. Every year UNICEF releases the State of the World's Children but this year the agency also published its first report for the Asia Pacific region called 'The State of Asia-Pacific’s Children', which specifically covers East and South Asia, South-East Asia and the Pacific. While East Asia and South East

Asia are on track to meet the MDGs, South Asia and the Pacific are lagging far behind. On the whole the number of under five-deaths has fallen from 6.7 million in 1990 to around four million in 2006 in Asia Pacific. Despite this decline the absolute numbers of child deaths in the region remains high, according to the report. The data revealed this in 2006: out of the 9.7 million children who died globally before turning five, more than 40 percent were from the Asia-Pacific. While in 1990, the under-five child mortality rate in the Asia-Pacific stood at 90 deaths per 1000 live births, it came down to 59 per 1,000 live births in 2006. However, the report stated that the death rate should be 30 deaths per 1,000 live births to meet the target. “It is clear that the region as a whole will have to reduce the number of child deaths between 2007 and 2015 at a much faster rate than it has managed since 1990, to meet MDG 4,” it

said.China, India and Pakistan account for half the deaths in the region, according to the report. As mentioned earlier, India accounted for 2.1 million deaths in 2006 and 415,000 children died in China. The survey showed that since 1960, the country has managed to reduce the death rate from 236 deaths per 1000 live births to 76 per 1,000 live births, in 2006. A growing economy has enabled India to reduce the under-five mortality rate by one-third since 1990- but it isn’t enough. “Despite these gains, at its current rate of progress, India is unlikely to meet the MDGs related to enhancing nutrition (MDG 1), reducing child mortality (MDG 4), improving maternal health (MDG 5),” the report confirmed. UNICEF blamed the child-deaths mainly on poor heath-services. It highlighted that South Asia spends only 1.1 percent of its Gross Domestic Product (GDP) on public health expenditure, much below the world average of 5.1

percent. India’s budget, this year, allocated 16,534 crores to the health sector, a 15 percent increase from the year before, but it still is only one percent of the GDP. The children’s agency also pointed out that increasing privatisation of health services in the country had led to a deterioration of government facilities. Growing disparities left poor people with no access to hospitals, and health workers were moving to the greener pastures of the private sector. All this contributed to the poor health of India’s children who mostly die from malnutrition and preventable diseases like pneumonia and diarrhoea. Another key reason for their susceptibility to disease is that more than half the children between one and two years, do not receive all recommended vaccinations. “More than 50 percent of this country’s under-five deaths are associated with under-nutrition and anaemia, while another 30 per cent are caused by

pneumonia,” the data showed. Further, an estimated nine percent of children are suffering from diarrhoeal diseases.While the report attributed most of the children’s deaths to malnutrition and lack of health services in India, it also blamed the high mortality rate on wider issues of gender inequality, discrimination (in access to nutrition) and poor education. In India, this added up to one out of every three women being underweight, which leads to low-weight babies who are more likely to die in infancy. Further, the country’s 55 million underweight children account for one-third of the world's underweight children in that age group. The study also showed that South Asia is also the only region in the world where female life expectancy is lower than the male’s. The region also has a massive gender imbalance in population numbers, with around 50 million more men than women. More than 20 million girls are deprived of an

education every year in the sub-continent.The greatest cause of under-five deaths in Asia-Pacific stem from deaths occurring in the neo-natal period –the first 28 days of life. Neo-natal deaths accounted for almost 40 percent of all under-five deaths in 2000 in the world. “The largest absolute number of newborn deaths in the world occurs in South Asia. India contributes around one quarter of the global total,” the reports said.“A significant underlying cause of these deaths is poor foetal growth and low birthweight, the end result of several deficiencies, notably maternal under-nutrition and incorrect breastfeeding practices,” it added.As the world draws closer to the 2015 deadline, the report called for action to increase investment in public health services, focusing on areas where child mortality is the highest. UNICEF recommended boosting public health care spending in the region by two percent so that poor

people have access to hospitals providing sustained health care from the time they are born through to their adolescence.

 

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