The Sample Registration Survey (SRS)-2008 puts the Infant Mortality Rate in Madhya Pradesh at 70/1000 live births. The total number of births in the State for the year 2008-09, according to the State department of public health and family welfare, was 17,51,243.
According to the IMR of 70/1000 live birth, the absolute figure for total infant deaths in the state for the year 2008-09 would stand at 1,22,587. In his written reply to Congress MLA Mahendra Singh Kalukheda, state health minister Anup Mishra put this figure at 29,274.
When a similar IMR analysis is done for the years 2005-06, 2006-07 and 2009-10, the total infant deaths in the state stand at 6,20,828, implying that 4,78,796 deaths went un-reported during these years. That’s a staggering 77 per cent of the total infant deaths in the state form 2005-06 to 2009-10.
Where are the missing children?
This can only mean two things. Either the IMR calculated by the SRS-08 is incorrect or the state government has massively under reported child deaths in its written reply in Vidhan Sabha on Monday.
What comes out clearly through this figure mismatch is the fact that not only has the state government been under-reporting child deaths in its official records, it seems to have made non-registration or improper registration of child deaths an important face-saving strategy to wash its hands off this very serious issue.
Treading on the same track of non-registration of child deaths, the Chief Medical Health Officer (CMHO) of Jhabua district (one of the high infant mortality zones in the state) recently replied to an RTI application seeking the number of infant deaths in the district for the last six months, stating that the department has no mechanism to record such data.
When asked, senior officials from the Health Department admitted to under reporting of child deaths.
Isn't it obvious that there is a case of heavy under-reporting from the district level?" asked a senior official on the condition of anonymity.
According to the monthly Health Bulletin of the Department of Public Health and Family Welfare, Madhya Pradesh, Chhindwara district registered only 36 infant deaths over the last three and a half years. If true, this would make Chhindwara one of the best performing districts in the world in terms of child health.
Interestingly, all 36 deaths were registered over a four-month period from September 2008 to January 2009. Before this period (since April 2005), not even a single death was recorded. During the same period, 2,13,597 children were born in the district, which puts the IMR for Chindwara at only around 0.16 per 1000 live births.
Similarly, in Dhar district, 1,86,847 children were born form April 2005 to January 2009. The total number of infant deaths during this period stood at 233.Interestingly again, all of these deaths were registered in the year 2005 alone. This puts the IMR for Dhar at 1.24/1000 live births.
Just to use as an example, these figures make it difficult to believe that these two districts, both with substantial tribal population, fall in a state which has the highest IMR in the country.
Conversely, the Monthly Progress Reports (MPRs) in Integrated Child Development Services of the Women and Child Development (WCD) department, show that between November 2007 to May 2008 (7 months), 469 infants in Dhar and 91 infants in Chhindwara had died.
This severe mismatch between child death records maintained by the state health department and the state women and child development department show the absolute lack of coordination between the two departments responsible for the health of children in the State.