Infant mortality: India
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Mortality, infant: India
Push for hospital births sees drop in infant mortality Kounteya Sinha
New Delhi: Paying women to deliver their child in a hospital is now helping India reduce its shamefully high infant mortality rate. In the first comprehensive study of the Janani Suraksha Yojana (JSY) — India’s ambitious maternal health programme, results of which were published in the British medical journal ‘Lancet’ on Thursday — researchers from the Public Health Foundation of India (PHFI) and the Institute for Health Metrics and Evaluation (IHME) at the University of Washington found that women who took part in this cash incentive scheme had 4 fewer stillbirths and deaths in the first week of life per 1,000 pregnancies and 2 fewer neonatal deaths per 1,000 live births.
The study said implementation of JSY in 2007-08 was highly variable by state — from less than 5% to 44% of women giving birth. “The poorest and least educated women did not always have the highest odds of receiving JSY payments. JSY had a significant effect on increasing antenatal care and in-facility births. In the matching analysis, JSY payment was associated with a reduction of 3.7 perinatal deaths per 1,000 pregnancies and 2.3 neonatal deaths per 1,000 live births,” the study said. “In the with-versus without comparison, the reductions were 4.1 perinatal deaths per 1,000 pregnancies and 2.4 neonatal deaths per 1,000 live births,” it added.
According to health ministry, JSY’s coverage has increased since it was launched in 2005. Beneficiaries under this scheme tripled in the last five years. While 29.3 lakh women availed of JSY in 2006-2007, the number increased to 71.1 lakh in 2007-08, 85.42 lakh in 2008-09 and 92.29 lakh in 2009-10 of the 26 million women giving birth this year in India. Prof Lalit Dandona from PHFI, who conducted the study, said, “Our analysis shows that JSY greatly improved antenatal care and the number of women who delivered in hospital. The programme is reducing perinatal and neonatal mortality.”
Mortality, Under-5
Fewer children dying in India Nearly 5% Annual Decline In Under-5 Mortality, Finds Study Kounteya Sinha
New Delhi: Nearly 20 fewer children per 1,000 live births are dying in India now, before reaching 28 days of life, than they did two decades ago. As far as post-neonatal deaths are concerned, India is now losing 15 fewer lives per 1,000 live births than it did in 1990. Among children aged 1-4 years, nearly 30 fewer children are dying now than 20 years back.
According to a new study published in medical journal ‘Lancet’ on Monday, child deaths worldwide are falling faster than earlier thought. Scientists predicted that about 7.7 million children under 5 would die in 2010, down from nearly 12 million in 1990. The deaths this year would include 3.1 million neonatals, 2.3 million post-neonatals and 2.3 million deaths of children aged between 1 and 4.
According to new research by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, under-5 mortality has reduced by 35% since 1990. The global decline during the past 20 years is 2.1% per year for overall under-5 mortality and for neonatal mortality, 2.3% for post-neonatal mortality and 2.2% for mortality in children aged between 1 and 4.
India is recording a nearly 4-5% annual decline in under-5 mortality. “We’re quite a bit further ahead than we thought,” said Christopher Murray, one of the paper’s authors and director of IHME.
Murray and colleagues assessed information from 187 countries from 1970 to 2009. They found that child deaths dropped by about 2% every year, lower than the 4.4% needed to reach the UN’s target of reducing child deaths by two-thirds by 2015.
The study said 31 developing countries were on track to meet the Millennium Development Goal by reducing child deaths by 66% between 1990 and 2015.In 1990, 12 countries had an under-5 mortality rate of more than 200 deaths per 1,000 live births. Today, no country has an under-5 mortality rate that high, according to IHME estimates.
Compared to India, Pakistan too hasn’t done a bad job. Against a neonatal rate of 54.8 per 1,000 births in 1990, it now stands at 42.7.
Infant mortality in Delhi and the other metros
Goal missed, city infant mortality capital
Even Large States Like TN And Maharashtra Score Higher
INSIGHT GROUP The Times of India 2013/09/01
New Delhi: The bad news is that Delhi has the highest infant mortality rate (IMR) among all the metros and at the current sluggish pace at which the figure is being reduced the capital would achieve its goal of reaching an IMR of 15 only in 2030. The good news is that the utilization of public health facilities is over 60%, much higher than in most states.
From an IMR—a measure of how many die within the first year for every 1,000 live births—of 33 in 2004-09, Delhi has progressed at a crawl to touch the current IMR of 28. The Delhi Human Development Report (DHDR) 2013 pointed out that much larger states like Maharashtra and Tamil Nadu had achieved IMRs of 25 and 22 respectively despite having substantial rural populations, higher levels of poverty and a less intensive network of public health infrastructure. In the Delhi Development Goals set in 2006, the target was to achieve an IMR of 15 by 2015.
Segregating infant deaths shows that most happen in the early neonatal period (up to seven days after birth). The decline in postneonatal (28 days to one year) deaths, has been cut by 62%, compared to declines in neonatal (less than one year) and early neonatal deaths of 35% and 26% respectively. The major reasons for this scenario have been identified as inadequate neonatal care in health facilities and the significant proportion of deliveries still happening at home-—about 20%—which kept women out of the coverage of essential maternal health services. The report argued for urgent efforts to ensure improved coverage of maternal and child health services in Delhi.
Yet, the Perception Survey carried out for the DHDR revealed that across different socio-economic groups a large chunk used the public health system, the proportion varying from over 75% in low income groups to 45% in high income groups.
Mortality, neonatal: reduction of/ Jharkhand
How Jharkhand’s mothers stopped their babies dying …and why the authoritative medical journal, Lancet, has praised a unique project B Sridhar
Chakradharpur (West Singbhum): Kusnopur is a hamlet in the area and it is a transformed place. As are some other villages in this mineral-rich district. Indkata, Dengsorgi and Landupoda are also in the grip of a quiet — and happy — revolution. Fewer newborn babies are dying. How has this happened?
Through an extraordinary training project for local tribal women. Prasanta Tripathy runs the NGO Ekjut, which facilitated the training. He says “there is a 45% reduction in neonatal mortality rate as well as a change in practices related to childrearing. Besides, there is a 57% reduction in postnatal depression.”
It’s been a hard slog — for the NGO and its volunteers, and the tribal women. Aantri Koda, 28, of Balundi village, was one of the early trainees. She recounts how hard it was: “When I joined the NGO for training, my husband asked me to concentrate on household chores rather than become a neta. However, my sister inlaw persuaded him to let me join, citing her own suffering during pregnancy.”
There was resistance from village elders too. Mother-of-two Kulsum Sundi, 33, recalls the gram pradhan opposing volunteers who wanted to assist her when she was pregnant. “He said that they are polluting the culture of our village by carrying semi-naked pictures of pregnant women.”
Nitima Lamay of Ekjut says lack of awareness caused the initial resistance. “Gradually, the senior members of the village started co-operating.” Tripathy says they stress on “participation, learning and action — the ingredients in the making of an empowered mother and healthy baby.”
The NGO started with 20 women in three villages around Chakradharpur six years ago. By now, it has 20,000 trained women, spread across more than a thousand villages in nine districts of Jharkhand and Orissa.
Sumitra Gagrai, Ekjut group coordinator, says the core of the revolution was the community spirit unleashed, when trained female volunteers fanned out across remote villages “to encourage adolescent girls and married women to find practical solutions for good health during the pre and post pregnancy period.”
It was a success and praised as such by ‘The Lancet’, the authoritative British medical journal.
