State Manages to Bring Child Mortality Rate in Check
By Sharadha Kalyanam | Published: 12th January 2014 09:18 AM |
Karnataka last week achieved the United Nations 2015 Millennium Development Goal (MDG) on an Under 5 Mortality Rate of 38 per 1,000 live births. Karnataka is now at 37.
According to the UN, under-five mortality rate (U5MR) is the probability (expressed as a rate per 1,000 live births) of a child born in a specified year dying before reaching the age of five. With this, Karnataka became the sixth state after Kerala, Tamil Nadu, Maharashtra, Punjab and Delhi to achieve the MDG 4 which requires that the Under-Five Mortality Rate be reduced by two-thirds between 1990 and 2015. This meant that India had to bring it down from 118 per 1,000 live births in 1990 to 38 per 1,000 live births in 2015. Karnataka has brought it down from 47 to 37.
The main causes of Under-Five Mortality, according to doctors, are low birth weight, malnourishment, poor immunisation, poor environmental condition in slums, high population density exposing children to diseases like asthma, tuberculosis and vector-borne diseases.
With the National Rural Health Mission and sustained efforts at making primary health care stronger and more accessible, Karnataka has achieved this figure, Madan Gopal M, Principal Secretary, Department of Health and Family Welfare, told Express here on Friday.
Karnataka, however, is still far behind Kerala that has a U5MR of 14 which it has achieved through sustained efforts, he said.
A senior official of the United Nations Children’s Fund (UNICEF) told Express that a large chunk of the U5MR consists of cases of early neonatal mortality, defined as death before the age of seven completed days following live birth.
The situation is especially grim in North Karnataka along the belt of category ‘C’ districts including Bidar, Raichur, Gulbarga, Davanagere among others.
“This is due to lack of specialist doctors and poor neonatal and antenatal care in government hospitals in those regions,” the UNICEF official said.
“People in these regions depend only on government hospitals. We don’t have specialist doctors to treat pregnant women and lactating mothers. Hence, early neonatal mortality is something we are unable to control in this region,” he admitted.
Further, a recent report by the World Health Organisation and UNICEF linked U5MR with secondary education among women. “The under-five mortality rate in the world would be 61 per cent lower if women in India completed secondary education,” it said.
“Child marriages are also a huge reason for U5MR and high Infant Mortality Rate (IMR) in Karnataka,” said the UNICEF child health consultant.
Madan Gopal attributed the achievement to a combination of programmes like the ‘Madilu’ scheme and ‘Thayi’ card given to pregnant women under which the health of pregnant women and nursing mothers are monitored.
“The 108 scheme also played a large part. About 43 per cent of all emergencies are maternal emergencies. Using the Mother and Child Tracking System, Auxiliary Nurse Midwives monitor women right from pregnancy till delivery,” he said, and added that the Universal Immunisation Programme also did the trick.
How State Plans to Reduce its U5MR
The department plans to impart training to ASHA workers on conducting deliveries. “Our strategy now is to bring down early neonatal mortality. Asphyxia and sepsis have to be addressed,” he said. Strengthening Neonatal Intensive Care Units (NICU) in PHCs is also essential. “There is a lot of demand for NICU care and the system is unable to cope with it. We require cooperation from the Women and Child Welfare Department to improve care for malnourished kids,” he said.