Highest number of new born deaths in India...!!!

India records highest number of new born deaths, says a recently released World Health Organization (WHO) report

More new born babies die in India every year than in any other country, despite the number of neonatal deaths around the world witnessing a steady decline, a new study by the World Health Organisation (WHO) has said.

New born deaths decreased from 4.6 million in 1990 to 3.3 million in 2009, and fell slightly faster in the years since 2000, according to the study led by researchers from WHO, Save the Children and the London School of Hygiene and Tropical Medicine.

The study, which covers a two-decade-period and all the 193 WHO member states, found that new born deaths - characterised as deaths in the first four weeks of life (neonatal period) – account for 41 % of all child deaths before the age of five.

Almost 99 per cent of the newborn deaths occur in the developing world, with more than half taking place in the five large countries of India, Nigeria, Pakistan, China and Congo.

"India alone has more than 900,000 newborn deaths per year, nearly 28 % of the global total," WHO said, adding that India had the largest number of neonatal deaths throughout the study.

Nigeria, the world's seventh most populous country, ranked second in new born deaths – up from fifth in 1990. Three quarters of neonatal deaths around the world are caused by pre-term delivery, asphyxia and severe infections, such as sepsis and pneumonia.

WHO pointed out that two thirds or more of these deaths can be prevented with existing interventions.

Malnutrition: Reality behind Govt Health care services...!!!

When the Maharashtra government first recorded the figures of child deaths due to endemic malnutrition in the remote villages of Melghat, shocking numbers were revealed.

Almost two decades later, even though the government figures show a substantial drop in the number of malnutrition deaths, social activists and health-coordinators working in the impoverished area say that the authorities pass off such deaths as still-births.

The reality continues to bite with the data recorded just before monsoon this year, indicating 509 malnutrition induced deaths during past year, until March 2011. Every year, hundreds of children of Korku tribe in the tehsils of Melghat in the Satpura ranges fall prey to starvation and malnutrition. While the government records indicate figures ranging from 400-525 in the last five years, health activists working among the tribals tell a different story.

Madhukar Mane, Health Coordinator with NGO Maitri, which organises monsoon campaigns to prevent deaths in the precarious season, says: "The figures are certainly better than the late 90s but the numbers are still very high in the tehsils of Dharni and Chikhaldhara. Government records child deaths under two categories: still birth and neonatal. What happens is that they write off several deaths as still births so that the infant mortality rate (IMR) could be kept under check.

Maximum child deaths occur during monsoons as the tribals are not able to work and feed their children. Ironically, most government schemes are launched after the monsoons.

About 50 per cent families in Melghat are below poverty line with a high rate of unemployment. Weak mothers often deliver children in grade 1 malnutrition.

It almost instantly deteriorates to grade 2, and then 3 & 4. The nearest emergency health care is about 120 km away that too without a child specialist or medical equipment. About 39 children are suffering from grade 4 malnutrition while 442 fall under grade 3 here.

Jayashree Shidore, coordinating activist with Maitri, says: "Children with a sunken face and a bloated stomach is a common sight in Melghat." Maitri is helping such kids by imparting basic health education, especially to nursing mothers, and lessons in personal hygiene.

 
Malnutrition mars Gujarat's growth story: HDI Report: Despite a shining Gujarat story of high economic growth model applauded by a US Congressional report, the India Human Development Report 2011 points out that the state fares the worst in terms of overall hunger and malnutrition in the country. Taking a dig at the Gujarat model, Union rural development minister Jairam Ramesh, while releasing the report, said, "On nutrition, I am puzzled why the high rate of malnutrition continues to persist even in pockets high economic growth.

105 child malnutrition deaths from April-June in Melghat : AMRAVATI: The Melghat region of Vidarbha is presently a picture of despair and what sounds a discordant note is the cries of kid dying due of malnutrition. A total 105 infants have died between April and June 2009 in Melghat. Despite efforts by the government and non-government agencies and after spending a large amount of money, the infant deaths in this tribal region are unabated. Health department sources said that about 69 children are reported to be in stage IV of malnutrition in Chilkhaldhara and Dharni tehsils of Melghat region.

http://www.dnaindia.com/mumbai/report_child-malnutrition-supriya-sule-to-visit-melghat_1604058

http://articles.timesofindia.indiatimes.com/2009-07-23/india/28197788_1_malnutrition-melghat-infant-deaths

http://in.news.yahoo.com/twelve-infants-die-kolkata-childrens-hospital-123053104.html 

Child Survival in India: A Serious Issue

The level of child undernutrition remains unacceptable throughout the world, with 90 per cent of the developing world’s chronically undernourished (stunted) children living in Asia and Africa. Detrimental and often undetected until severe, undernutrition undermines the survival, growth and development of children and women, and diminishes the strength and capacity of nations. With persistently high levels of undernutrition in the developing world, vital opportunities to save millions of lives are being lost, and many more millions of children are not growing and developing to their full potential. Nutrition is a core pillar of human development and concrete, large-scale programming not only can reduce the burden of undernutrition and deprivation in countries but also can advance the progress of nations.

Fast Facts: In India 20 per cent of children under five years of age suffer from wasting due to acute undernutrition. More than one third of the world’s children who are wasted live in India. Forty three per cent of Indian children under five years are underweight and 48 per cent (i.e. 61 million children) are stunted due to chronic undernutrition, India accounts for more than 3 out of every 10 stunted children in the world. Undernutrition is substantially higher in rural than in urban areas. Short birth intervals are associated with higher levels of undernutrition. The per centage of children who are severely underweight is almost five times higher among children whose mothers have no education than among children whose mothers have 12 or more years of schooling. Undernutrition is more common for children of mothers who are undernourished themselves (i.e. body mass index below 18.5) than for children whose mothers are not undernourished. Children from scheduled tribes have the poorest nutritional status on almost every measure and the high prevalence of wasting in this group (28 per cent) is of particular concern. • India has the highest number of low birth weight babies per year at an estimated 7.4 million. • Only 25 per cent of newborns were put to the breast within one hour of birth. • Less than half of children (46 per cent) under six months of age are exclusively breastfed. • Only 20 per cent children age 6-23 months are fed appropriately according to all three recommended practices for infant and young child feeding. • 70 per cent children age 6- 59 months are anaemic. Children of mothers who are severely anaemic are seven times as likely to be severely anaemic as children of mothers who are not anaemic. • Only half (51 per cent) of households use adequately iodized salt. • Only one third (33 per cent) Indian children receive any service from an anganwadi centre; less than 25per cent receive supplementary foods through ICDS; and only 18 per cent have their weights measured in an AWC.
Source: UNICEF 

Maternal Health in India: UNICEF

India continues to contribute about a quarter of all global maternal deaths. WHO defines maternal mortality as the death of a woman during pregnancy or in the first 42 days after the birth of the child due to causes directly or indirectly linked with pregnancy. 
Fast Facts
Globally, every year over 500,000 women die of pregnancy related causes and 99 percent of these occur in developing countries.
• The Maternal Mortality Ratio (MMR) in India is 254 per 100,000 live births according to Sample Registration System (SRS) Report for 2004-2006.  This is a decline from the earlier ratio of 301 during 2001-2003.

• In the region, the MMR in China stands at 45, Sri Lanka at 58, Bangladesh at 570, Nepal at 830 and Pakistan at 320 in 2006.

• Wide disparities exist across states in India. The MMR ranges from 95 in Kerala to 480 in Assam.

• MMR has a direct impact on infant mortality Babies whose mothers die during the first 6 weeks of their lives are far more likely to die in the first two years of life than babies whose mothers survive.

• Only 47 per cent of women likely in India have an institutional delivery and 53 percent had their births assisted by a skilled birth attendant. As many as 49 percent of pregnant women still do not have three antenatal visits during pregnancy. Only 46.6 percent of mothers receive iron and folic acid for at least 100 days during pregnancy.
Key Issues
• About half of the total maternal deaths occur because of hemorrhage and sepsis. A large number of deaths are preventable through safe deliveries and adequate maternal care.
• More than half of all married women are anaemic and one-third of them are malnourished

Neonatal Health In India : UNICEF

Introduction
Child mortality is a sensitive indicator of a country’s development.  In India, the Infant Mortality Rate (IMR) (under one year) has shown a modest decline in recent years.

The average decline of IMR per year between the years 2004 to 2008 has been about 1 per cent per year.

In 2008, the IMR was 53/1,000 live births. Eight states contribute to 75 per cent of infant mortality: Uttar Pradesh, Bihar, Madhya Pradesh, Rajasthan, Andhra Pradesh, Orissa, Gujarat and Assam. 

At the current rate of decline, India will miss the XI plan goal of reduction in IMR and the Millennium Development Goal-4 on child survival.
About 70 per cent of the childhood under-five is caused by perinatal conditions (33.1 per cent), respiratory infections (22 per cent) and diarrhea (13.8 per cent). Malnutrition is an underlying cause responsible for about one third of all deaths in childhood.
Fast Facts
• Averting neonatal deaths is pivotal to reducing child mortality. The Newborn period is the period starting from birth and continues throughout 28 days of life.

• Neonatal mortality rate (mortality in the newborn period) stands at 35/1000 lives births, and contributes to 65 per cent of all deaths in the first year of life.

• Between 2004-2008, neonatal mortality has moved from 37/1000 live births to 35/1000 only.

• 56 per cent of all newborn deaths occur in five states: UP, Rajasthan, Orissa, MP and Andhra Pradesh.

• Three major causes contribute to about 60 per cent of all deaths in the newborn period: pre-maturity and low birth weight, birth asphyxia and infections.

Key Issues
• Most of the causes of deaths in the newborn period can be prevented or managed by households, communities and health facilities. But they often are unable to provide the required care.

• Inappropriate practices such as delayed initiation of breastfeeding, delayed clothing and early bathing, not seeking care when newborns are sick and applying harmful material on cord-stump increase the risk of newborn deaths.

• Health facilities are often ill equipped to provide essential newborn care to all newborn and special newborn care to sick newborns.

Gender Equity Issues in India

Gender discrimination continues to be an enormous problem within Indian society. Traditional patriarchal norms have relegated women to secondary status within the household and workplace. This drastically affects women's health, financial status, education, and political involvement. Women are commonly married young, quickly become mothers, and are then burdened by stringent domestic and financial responsibilities. They are frequently malnourished since women typically are the last member of a household to eat and the last to receive medical attention. Additionally, only 54 percent of Indian women are literate as compared to 76 percent of men. Women receive little schooling, and suffer from unfair and biased inheritance and divorce laws. These laws prevent women from accumulating substantial financial assets, making it difficult for women to establish their own security and autonomy.

In Rajasthan, all of these problems are aggravated by high levels of seasonal migration. For many men in Rajasthan, migration is required since rural parts of Rajasthan often lack a sufficient economy to provide income for a family year-round. Women are commonly left behind to care and provide for the entire household. This is increasingly difficult because it is estimated that an average woman's wage is 30 percent lower than a man's wage working in a similar position. While these mothers work, they must also tend to domestic responsibilities. This formula for supporting Rajasthani families leaves little resource for the growth and development of women's rights and education levels.

A strong "son preference" exists in the region, as it does throughout the country, and high rates of female infanticide and female feticide plague the area. In 2001, for every 1,000 males living in Rajasthan there were only 922 women (Marthur et. al., 2004). Having sons is economically advantageous to families due to cultural institutions; these institutions serve to drastically devalue the roles women play in the traditional society. Women continue to struggle to achieve equal status to men, making gender equity an issue of particular importance for Rajasthan.

In Rajasthan several NGOs that have hosted FSD participants are instrumental in providing opportunities for women. These organizations help to build networks among women to create financial self-help groups. They introduce ideas about microfinance, allowing women to participate in management activities. Other local NGOs implement projects that export the skills of women abroad to generate significant income. In 2006, Olen Crane, an FSD intern, helped nearly 400 women artisans in the Udaipur area by collecting samples of their textile products and shipping them abroad to sell to American companies. Similar projects have enormous potential to improve the financial and social status of Rajasthani women. Organizing change at a local level and planning participatory action will help to eliminate bias and stereotypes, and generate awareness of the significant gender divide that exists within Indian society.

Child and Maternal Health Issues in India

Since its independence, India has become a world leader in medical advancement due to its incredible medical education system and state-of-the-art private medical facilities. It is now a major provider of health services and contains some of the most highly skilled and qualified medical providers in the world. Quality health care, however, remains inaccessible for many undeveloped Indian regions. For example, in rural communities it is estimated that only 18 hospital beds are available per 100,000 people. Even when medical treatment is available, public hospitals are frequently understaffed and under supplied. The poor are forced to rely on overburdened, unsanitary facilities as their only source of health care.

Lack of national care has produced severe health issues throughout the nation: the highest prevalence of tuberculosis in the world; over 1.5 million children dead each year before their first birthday; and nearly 500 million lacking sufficient nutrition along with the second highest number of people living with HIV/AIDS. Growth of HIV/AIDS is a particular concern since there is not a secure infrastructure to measure the virus’s spread and impact, particularly with women in rural areas. While prevalence is not high, the country is extremely susceptible to a massive epidemic if left unchecked.

This lack of national healthcare infrastructure is having severe and lasting effects on the livelihoods of Indian citizens. In Rajasthan, about half the children suffer from malnutrition, 49 percent of women are anemic, and about one-third of children are born with a low birth weight. Additionally, only 14 percent of children between 12 and 23 months receive the necessary vaccinations to prevent diseases such as small pox and polio. Public hospitals have insufficient funds to support their communities, and since only 15 percent of Indian citizens have health insurance, quality health care remains unattainable for millions in dire need (Bhagat, 2004).

Thousands of public health NGOs are intervening to provide the necessary medical care, support, and treatment. In Udaipur and Jodhpur, FSD collaborates with local organizations that interview the local community to identify weaknesses in rural health care and then provide the underprivileged with the necessary supplies and medical advice. Additionally, FSD supports programs that host educational workshops to promote the importance of hygiene and sanitation, and assists healthcare centers that provide immunizations to at-risk children. FSD partner organizations are working within the communities with the greatest need to ensure that all citizens are guaranteed their basic right to continued health and physical well-being.