The latest National Family Health Survey (NFHS-5 2019-20), conducted under the aegis of the Union Ministry for Health and Family Welfare, has thrown up a mixed bag for the State.
Kerala’s infant/neonatal and under-5 mortality rates are all impressive single digits with improvement over the previous NFHS (2015-16) figures. But, the sheer drop in universal immunisation figures and nutritional parameters — an increase in anaemia across all age groups, increase in wasting and stunting in children under five years — calls for urgent measures to prevent chronic malnutrition in the State’s children.
The State’s Infant Mortality Rate, according to the latest data, is 4.4 (5.6 in NFHS-4 in 2015-16), Neonatal Mortality Rate is 3.4 (4.4), and Under-5 mortality rate is 5.2 (7.1). While the figures do not match the last Sample Resource Survey (SRS 2018) data, which are considered more reliable (SRS puts IMR at 7, NMR at 5, and U5MR at 10), senior health officials point out that the NFHS figures are not far off as these parameters are indeed dropping in the State.
The proportion of fully vaccinated children of 12-23 months in Kerala, based on information from the vaccination card, has dropped from 88.3 % to 85.2%, putting the State far behind other States in the 11th position. Health officials claim that two major floods in consequent years is one major factor which affected all outreach immunisation activities.
Early initiation of breast feeding and exclusive breast feeding up to six months have improved marginally but the percentage of children under five years who are stunted (height for age) has gone up from 19.7 in NFHS-4 to 23.4 now; wasting (weight for height) has gone up by one point to 15.8 %; children under five years who are underweight has gone up from 16.1 % to 19.7%. Interestingly, the percentage of children under five who are overweight has also gone up from 3.4 % to 4 %.
Anaemia across all age groups has increased, while anaemia in pregnant women has gone up from 22.6% to 31.4%. The State has near 100% institutional deliveries at 99.8%. However, the percentage of mothers who had at least four antenatal care visits to hospitals dropped from 90.1% to 78.6%
13,000 households
In general, NFHS-5, which covered 13,000 households in the State, indicates that Kerala’s performance has gone down in all parameters, wherein field-level activities have been the key to achieving good results . However, all those parameters where in health system infrastructure improvement and institutional care are the key – such as infant and neonatal mortality rate – the State has shown improvement.
Though the State claims to have improved access to primary care services, the indicators in the survey do not reflect this.
