Southern States
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Karnataka
Registration of births, deaths a `must', says Task force
By R. Vijaya Kumar
BANGALORE, DEC. 8. The final report of the Task Force on Health and Family Welfare, headed by Dr. H. Sudarshan, has recommended that steps be taken for achieving complete registration of births and deaths in all communities as early as possible.
Compulsory registration of births and deaths is necessary for improving quality in primary health care and public health, the report has said.
In an of information technology, collecting, storing, and analyzing data are of primary importance, and a decentralised administration is an ideal set-up for completing these procedures, according to the report.
The task force has studied the child health scenario, and made suggestions for improving it. A major issue of concern is survival. Early childhood, mainly the neonatal stage (up to 28 days after birth), the infancy stage, and pre-school-age are vulnerable periods, and many illness that may damage growth, maturation, and development may affect a child, the report has said.
Infant mortality: According to statistics given by the task force, only 10 children among 1,000 infants are lost during the first five years of life in the developed countries, compared with more than 100 in India. Seventy to 75 deaths occur in the first year of life (infant mortality). The infant mortality rate (IMR) has fallen reasonably steadily since 1947 -- from about 140 deaths for every 1,000 live births, to about 75 deaths at present. However, the IMR has not declined in the past five years. It is estimated that the IMR in the State was 74 in 1991, and 81 in 1981. As per the National Family Health Survey-2 (NFHS-2), the IMR in Karnataka is now 51 (in Kerala, it is 14). The rural and urban IMRs are 70 and 25, respectively.
The task force report has said that compulsory registration of births and deaths will go a long way in making a correct assessment of the IMR.
In the State, 50 per cent of cases of infant mortality occur in the first four weeks of life (neonatal mortality) -- a clear indication of inadequate access to health care, especially in rural areas.
Measles immunisation: According to the report, though a number of child survival interventions have been applied in the State, not much progress has been made in the coverage of the measles immunisation programme. Although the official report says that 100 per cent coverage for all vaccines has been achieved, independent assessment shows that the coverage is only 52 per cent.
Another major negative factor in child health is the lack of nutritious food. To overcome this, the task force has suggested exclusive breast feeding up to six months; complementary feeding with fresh low-cost weaning food at six months, along with breast feeding, and thereafter up to two years; personal hygiene; safe drinking water, good sanitation, use of oral dehydration solutions, and, training for mothers to recognise danger signs in children.
The task force has also suggested a number of methods to reduce neonatal mortality (up to 28 days after birth) in the State where it is high. As the neonatal mortality rate is ``dangerously'' high in rural Karnataka, the task force has suggested imparting proper training to birth attendants in rural areas through the gram sabhas.
`Introduce new vaccines': The report has urged the Government to step up immunisation programmes and introduce new vaccines by bulk purchase, as they are very expensive and beyond the reach of the poor. As the prices of new vaccines are high, the ``Government sees this price structure, and shies away from considering them for routine use. The prices are likely to crash if the Government directly purchases them, or obtains them through global tender purchase through UNICEF'', the report has said.
The task force has stressed the need to include the Hepatitis `B' vaccine in the routine schedule, as the viral infection is common. It has appealed to the Government to evolve a policy to introduce Hepatitis B vaccination in the universal immunisation programme.
The task force has made an elaborate study of child labour, and sought concerted efforts to improve the quality of life of children in difficult circumstances and hazardous situations.
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