INDIA LAGS BEHIND IN PROTECTING ITS NEWBORNS

21/06/2018

The Sustainable Development Goals (SDG) are a universal call to action to end poverty, protect the planet and ensure that all people enjoy peace and prosperity. The SDGs provide guidelines and targets for all countries to adopt in accordance with their own priorities. The SDG 3 clearly states “Ensure healthy lives and promote well-being for all at all ages.” The target within SDG 3 on neonatal mortality further states “By 2030, end preventable deaths of newborns and children under five years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1000 live births and under-five mortality to at least as low as 25 per 1000 live births.”
Global status of newborns and infant mortality: The United Nations Children’s Fund (UNICEF) released a report on February 20, 2018, on infant mortality rate, according to which every year 26 lakh children die within one month of birth and about 26 lakh children are still-born. In the report, Japan was said to be the safest country for infants while Pakistan is the most unsafe country. Newborn mortality rate is less than one (0.9 per cent) per 1,000 newborns in Japan followed by Iceland 1/1000 (one per cent), Singapore 1.1 (1.1 per cent) and Finland 1/833 (1.2 per cent). According to the report, 8 of the 10 most unsafe countries are in sub-Saharan Africa. The birth of children is the most unsafe in Pakistan, where one in every 22 newborns die before completing 28 days. Similarly in Central Africa, (42.3 per cent), in Afghanistan (40.2 per cent) and in Somalia (38.8 per cent) of newborns die.
The report also says that globally, in low-income countries, the average newborn mortality rate is 27 deaths per 1,000 births. In high-income countries, that rate is three deaths per 1,000. In the list of unsafe births in 52 countries with low-income, India ranked 12th in 2017. According to the World Health Organization (WHO), of these 26 lakh infant deaths, 10 lakh died on the first day of birth and 10 lakh children died within six days of their birth.
In the report “The Story Behind the Data 2017” released by the Bill and Melinda Gates Foundation, more than 100 million children have been saved since 1990 due to immunisation and improved newborn care, and if efforts are further intensified, global mortality rate can be 11 by 2030. Eighty per cent of newborn children die due to premature birth and complex infections such as pneumonia and sepsis. Availability of quality health facilities, trained doctors, nurses, cleanliness, proper pre and post natal care, can prevent these deaths from taking place.
The WHO report, “The World Health Statistics 2017” includes statistics of life expectancy as well as data on SDGs. According to this report, newborns and infant mortality rates are declining year after year and all the countries are making efforts to further reduce it. Newborn mortality rate of 19 per 1000 live births in 2015 is 37 per cent less than it was in the year 2000. But in spite of these efforts, there are 60 countries that cannot achieve the required newborn mortality rate of 12/1000 live births by 2030, and half of these countries cannot even meet this target by 2050.
The struggle for the life of the newborn in India: Newborn infant mortality rate in India is 25.4/1000 births. Out of the total infant mortality rate globally, one fourth, ie 24 per cent deaths, are in India alone. According to the sample registration system (SRS) bulletin of the Registrar General of India, in the year 2016, there has been a three digit decline (eight per cent) in the newborn mortality rate and 90,000 fewer infants have died in 2016 compared to 2015. This decrease was recorded in Bihar, Assam, Madhya Pradesh, Uttar Pradesh, Jharkhand, Chhattisgarh, Odisha and Rajasthan. In the case of infant mortality, several inequalities are seen in India. In Kerala and Goa, the rate is 10/1000; and in Bihar and Uttarakhand, it is 44/1000. The deaths of newborn children is also higher in the States where the birth rate is high, 46 per cent of the total children born in the country are born in Madhya Pradesh, Rajasthan, Uttar Pradesh and Bihar and 57 per cent of the total number of new born infant mortality is from these States.
A look at the causes of death: Delay and complex deliveries, infections such as pneumonia, sepsis and diarrhea, congenital abnormalities are major causes of the death of the newborns. According to the Sample Registration System (SRS) of the Registrar General of India, 35.9 per cent of the total infant deaths in India are of babies born before time and the weight of children is lower at birth, 16.9 per cent pneumonia, 9.9 per cent Asphyxia and birth trauma, 7.9 per cent. Other non-communicable diseases, 6.7 per cent of diarrheal diseases and 4.6 per cent are due to birth defects and 4.2 per cent due to infections.
There is a huge lack of institutional health infrastructure and facilities. The condition of health services in villages is shabby. According to the National Family Health Survey (NFHS-IV), only 21 per cent of women can get all pre-delivery services. When the child is growing in the womb, the inability to detect any problems causes a large number of new born deaths.
Children have the highest risk of infections like pneumonia, blood infection and diarrhea. According to the WHO, diarrhea is the second largest cause of death among Indian children. According to the report of the John Hopkins Bloomberg School of Public Health 2017, if India gives more attention to pneumonia and diarrhea, lives of 90,000 children under five years of age can be saved every year. Apart from this, not having proper eating habits during adolescence, child marriage, getting pregnant before the full development of the body, not getting rest during pregnancy and subsequent hard work, mental / emotional problems, social beliefs about pregnancy, pollution, violence etc. are also causes contributing to the death of newborns.
Some efforts and strategies to achieve SDG goals: Awareness is being brought about by the Government through television, radio and newspapers about the various schemes like Navjaat Shishu Yojana, Baal aur Kishoravastha Swasthya Yojana, Pradhan Mantri Matritva Vandana Yojana. Special Neonatal Treatment and Nutrition Rehabilitation centres are also being opened across the country. If the Government wants to achieve the SDG target of the newborn infant mortality in the right way, more budget allocation will be have to be made for health services. A mass awareness campaign needs to be run at the grassroots level, in which volunteers, organisations, media; social workers and students can help.
Every citizen has been given the right to life in the Indian Constitution. This right is not available to the newborn children due to which a large number of newborns are dying. There is a need to make serious socio-economic-political efforts to reduce infant mortality.

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