Revision as of 03:17, 10 June 2015

India tops global list of 1st-day deaths of infants

Jayashree Nandi 2013/05/07

The Times of India

More newborns die on the first day in India than in any other country, according to the latest ‘State Of The World’s Mothers ’ report. Every year, over 3,09,300 children (29% of the global share) in India don’t live beyond the first day because of complications associated with preterm birth, hygiene and maternal health, the report says.

The report by the United States-based Save the Children, which ranks 176 countries on maternal and child mortality, will release globally on Tuesday.

Despite being more populated, China ranks 4th and accounts for only 5% of the global share of first-day deaths. Nearly two-thirds of all first-day deaths occur in just 10 countries and most of these countries have very large populations like India and Indonesia.

Others high up on the list are Pakistan, Afghanistan and African nations like Nigeria and Ethiopia. Predictably, just 1% of the global first-day deaths occur in developed countries.

South Asia is particularly vulnerable because the region has only 14 doctors or nurses per 10,000 people, the report says. Other reasons include preterm deliveries, low birth weight (28% of babies in India are underweight) and stunting among women. Stunting refers to a height of less than 4ft 7. Early marriage and childbearing heightens the risk for babies further. In India 47% girls are married off by the age of 18.

India also fares very poorly in maternal health, with 56,000 maternal deaths per year. Pakistan, with 12,000 maternal deaths, is ranked right above India. Overall, India ranks 142 among 176 countries.

South Asia is particularly vulnerable because the region has only 14 doctors or nurses per 10,000 people according to the report. Other reasons include pre-term deliveries, low birth weight (28% of babies in India are underweight) and stunting among women. Stunting refers to a height of less than 145 cm. The report says that in Bangladesh, India and Nepal close to 13% of women are stunted and at a higher risk for complications of having smaller babies. In these countries, 20% to 40% of women are also very thin. Early marriage and childbearing heightens the risk for babies further. In India 47% girls marry by the age of 18, in Bangladesh child marriage and early childbearing is most prevalent with 66 % of young women getting married and 40% giving birth by before 18 years.

Dr Rajiv Tandon, senior adviser for health and nutrition at Save the Children, feels that India suffers from systemic problems. "We don't just lack resources but also training of frontline workers, supportive supervision and data for decision making. We need to find out whether our auxiliary nurse midwife (ANMs), Accredited Social Health Activist (ASHA) workers and anganwadi workers are motivated? In most districts they lack the supplies required and don't have the skill-sets to deal with such emergency situations," he says.

Tandon also points to cultural issues that most often risk the lives of both baby and mother. "In rural areas there is a culture of applying absolutely anything to the umbilical chord, from cow dung to oils. This can cause acute local infection and even neonatal sepsis. Another such misunderstanding is that in many parts of India people think that colostrum (first breast milk rich in anti-bodies) is not suitable for feeding. These have tremendous effect on the morbidity of newborns," he adds.

The report recommends using simple and effective techniques by frontline workers like when a mother is in preterm labor the attendant can administer an injection of corticosteroids to accelerate lung development of the fetus while the baby is still in the womb. Or, for birth asphyxia when babies don't breathe after birth (kills about 717,000 babies each year), the practice of drying the baby and gently rubbing to stimulate breathing can prevent death.

India is faring very poorly even in maternal health with 56,000 maternal deaths per year followed by Pakistan which has 12,000 maternal deaths per years. India ranks 142 among 176 countries where the first rank goes to Finland and the last rank to Democratic Republic of the Congo for maternal health and well-being. The index for this ranking was developed on the basis of five indicators—maternal health, children's wellbeing, educational status, economic status and political status of women in their country.

Under-5 mortality

Causes of under –five mortality; Graphic courtesy: The Times of India

The Times of India

May 18 2015

WHO: Under-5 mortality down 50% since 1990

Sushmi Dey

Almost half the child deaths worldwide are still caused due to under-nutrition despite substantial progress made to reduce under-five mortality , a new report by the World Health Organization (WHO) secretariat has said. Between 1990 and 2013, under-five mortality declined by 49%, falling from an estimated rate of 90 deaths per 1,000 live births to 46 deaths per 1,000 live births.The global rate of decline has also accelerated significantly, from 1.2% per annum between 1990 and 1995 to 4% per annum between 2005 and 2013. About 17,000 fewer children died every day in 2013 than in 1990.

“Despite the evidence of progress, the gains remain insufficient to reach the target of a two-thirds reduction from 1990 levels of mortality by the year 2015,“ the report, which will be released during the 68th World Health Assembly to be held from May 18 to 27 in Geneva, said.

The report also pointed to at the slower decline in neonatal mortality rate and its increasing proportion in total under-five deaths. In 1990, neonatal deaths accounted for 37% of the total under-five children deaths, and the share increased to 44% in 2013.

The observations are significant with 22% of the total under-five deaths occurring in India. Estimates show that in 2013, over 15 lakh underfive children died in India.

Child mortality is also high in Nigeria, Democratic Republic of the Congo, Pakistan and China.

However, the report observed India's efforts to control deaths due to diarrhoea and pneumonia, which contribute almost 24% of the total under-five deaths.

The annual Health Assembly , a supreme decisionmaking body of WHO, will be attended by delegations from 194 WHO member countries, who will review activities of WHO through the year and set priorities for the future.This year, India has assumed presidency at the global event after a gap of 19 years.

The report, titled `Monitoring of the achievement of the health-related Millennium Development Goals', lists other issues such as maternal mortality , people suffering from hunger, reproductive health as well as spread of HIV.