Pneumonia is now the second leading cause of death (15 per cent) among under-five children with birth asphyxia third (11 per cent) and diarrhoea fourth place (9 per cent) followed by malaria (7 per cent), congenital anomalies (7 per cent) and neonatal infections (7 per cent).
The leading cause of death for children below five is, of course, pre-term birth complication. The Indian Academy of Paediatrics (IAP) says that more than half of the under-five deaths are due to diseases that are preventable and treatable through simple, affordable interventions.
“India is certain to miss the Millennium Development Goal of reducing infant mortality to 52 per 1,000 live births by the end of 2015,” says IAP Krishna district secretary P.S.N. Murthy. India has the highest number of child deaths in the world: an estimated 1.2 million in 2015.
Twenty per cent of the under-five child deaths in the world are from India. According to the World Health Organisation (WHO), pneumococcal disease is the world’s number one vaccine-preventable cause of death among children younger than five. With just less then two months to achieve the Millennium Goal, the current child mortality rate in India is 52.7 deaths per 1,000 live births. The paediatricians say even “simple, affordable interventions” were not being made available to the poor.
IAP official C. Mallikarjuna Rao says exclusive breast feeding of the infant for the first six months would reduce mortality 15 fold. Only 40 per cent of the babies get exclusive breast feeding. Poor awareness and not malnutrition is the cause of this, Dr Rao says. Children in better homes get less breast milk because of several misconceptions, he says.
Benzyl-penicillin, an antibiotic that is both cheap and effective against pneumococcal diseases, has not been available in Vijayawada for the last six months. The drug, which is on WHO’s List of Essential Medicines, is not being stocked by medical shops, says Krishna district Druggists and Chemists Association founder P.S. Patnaik.
“Benzyl-penicillin is an old and effective drug which is under the Drug Price Control Order. Pharmaceutical companies do not promote such drugs because they do not get good margins on them. Even retailers are not so interested because the margin they get on these drugs is low. As a result, these drugs are not available in shops,” says Sriram Razith, a wholesale drug dealer.
Besides general hygiene, household air pollution causes pneumonia in children. The use of solid fuels in households is a proxy indicator of household air pollution. Using solid fuels such as wood, charcoal and crops is associated with increased mortality from pneumonia and other acute lower respiratory diseases among children, as well as increased mortality from chronic obstructive pulmonary disease, lung cancer (where coal is used) and other diseases among adults, says Dr Rao. As many 64 per cent of the households in India use solid fuels, according to WHO.
