MADHYA PRADESH TOPS IN NEONATAL DEATHS
Context: Madhya Pradesh has recorded the highest percentage of newborn deaths of 11.5% against the total admissions to government-run Sick-Newborn Care Units (SNCUs) in the past 3 years across the country.
- According to the National Health Mission (NHM), this rate of 11.5% in Madhya Pradesh is ominously spiralling since 2017.
- The country’s average for neo-natal deaths is just 7%.
- Although admissions of neonates (under 28 days) in the State have dropped from April 2017 to December 2019 — remaining lower than West Bengal, Rajasthan and Uttar Pradesh — the percentage of deaths at 12.2% surpassed Bihar’s last year.
- Meanwhile, West Bengal, where 34,344 neonatal deaths occurred in the period, the most in the country, the declining percentage of deaths from 9.2% in 2017 to 8.9% in 2019 coincided with a slump in admissions.
- Staff crunch, low community referrals, absence of a special neonatal transport service to health centres, and the non-availability of enough units to cater to increasing institutional deliveries had contributed to the spike in the percentage of deaths.
- The crunch is magnified as only one against the requisite five (82% shortfall) of surgeons, gynaecologists, physicians and paediatricians is available at hospitals.
- Madhya Pradesh has also recorded an abysmal sex-ratio in admissions. Even with a sex ratio of 931 as per the 2011 census, 663 girls were admitted against 1,000 boys in the three years, against the country average of 733.
- In Bhopal, the capital city of Madhya Pradesh, one in every five children admitted to a unit died in the three years — the highest death percentage of 19.9% in the State, ten times above the NHM’s mandated key performance indicator of below 2%.
- Urban areas report a higher death percentage as they offer tertiary care, and admit several serious cases from peripheral districts.
- The issue of under-reporting is illustrated by the NHM’s Child Health Review 2019-2020, which highlights 43 districts where government officials don’t report more than 50% of deaths of childern under 5, to falsely jack up their score.
NATIONAL HEALTH MISSION
The National Health Mission (NHM) was launched by the government of India in 2013 subsuming the National Rural Health Mission and National Urban Health Mission. It was further extended in March 2018, to continue until March 2020. It is headed by Mission Director and monitored by National Level Monitors appointed by Government of India.
The major programmatic components include Health System Strengthening, Reproductive-Maternal- Neonatal-Child and Adolescent Health (RMNCH+A), and Communicable and Non-Communicable Diseases.
PROGRESS SO FAR UNDER NHM
- Since the launch of the NRHM/NHM, a faster retardation has been noticed in the Maternal Mortality Ratio (MMR), Under Five Mortality Rate (U5MR) and the IMR.
- As per the current rate of decline, India is expected to reach its SDG target (MMR-70, U5MR-25) earlier than its due year i.e. 2030.
- With respect to bringing down the Malaria cases and deaths, India has emerged as the biggest success story amongst Malaria endemic countries in the World by reducing the deaths due to Malaria by 49.09% and 50.52% in 2013 respectively as compared to 2017.
- Strengthening and further intensification of the Revised National Tuberculosis Control Programme (RNTCP) has been done. Around 1,180 Cartridge-based nucleic acid amplification test (CBNAAT) machines have been installed across all districts which provides rapid and accurate diagnosis for TB including drug resistant TB.
- Due to these intensified efforts, there is 16% rise in identification of new cases in a single year.
- Universal drug sensitive cases has also increased by 54%.
- Newer drug regimen of Bedaquiline and Delaminide and a nutrition support for all the TB patients for the duration of the treatment has been rolled throughout the country.
- Tetanus and adult Diphtheria (Td) vaccine replaced Tetanus Toxoid (TT) vaccine amongst the new vaccines, under universal immunization programme in 2018 that ensure Diphtheria immunity among adults.
- Further, Measles-Rubella (MR) vaccination drive was conducted in 2018 across 17 additional States, which further covers 30.50 Crores children till March 2019.
- According to the latest updates, all the States/UTs are covered with Rotavirus vaccine (RVV).
- Pneumococcal Conjugated Vaccine (PCV) was further expanded to MP, Haryana and the remaining districts of Bihar, Rajasthan and Uttar Pradesh during 2018-19.
- The routine and recurring incentives which are provided to ASHAs increased from 1000 per month to 2000 per month.
- A cover of Pradhan Mantri Jevan Jyoti Beema Yojna (a premium of Rs. 330 contributed by Gol) and Pradhan Mantri Suraksha Beema Yojna (a premium of Rs.12 contributed by Gol) was provided to ASHAs and ASHA Facilitators.
- In April 2018, Anaemia Mukt Bharat (AMB) Abhiyaan was launched under POSHAN Abhiyaan.
- There has been an increment in the untied funds amount from Rs, 20,000 to Rs 50,000 for sub health Centres transformed to HWCs.
- Also, the Home Based Care for Young Child (HBYC) programme was introduced under POSHAN Abhiyaan.
- The scheme was approved for awarding States/UTs/Districts for achieving disease free status in TB/Leprosy/Malaria/Kala-Azar/Lymphatic-Filariasis/Cataract.
- Also, approval was given to the National Viral Hepatitis Control Programme that aided in the prevention, management and treatment of Hepatitis A, B, C and E.
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