Infant mortalities surged by a single point in Madhya Pradesh in 2018

26 infants among 1,000 live births in the State died within the first seven days, says official

Updated - July 04, 2020 08:23 pm IST

Published - July 04, 2020 08:16 pm IST - Bhopal

Photo for representational purpose only.

Photo for representational purpose only.

The infant mortality rate (IMR) in Madhya Pradesh, recording the country’s worst rate for years now, surged by a single point over the previous year to 48 in 2018, stymying an improving annual trend for at least six years, according to the Office of the Registrar General India.

Assam pulled down the next highest rate of 44 a year before to 41, Odisha by one count to 40 and Kerala by three points to seven, the lowest among the bigger States. Even the country’s average rate has dropped single-point to 32 but the rate climbed to 43 in Uttar Pradesh, making it the second highest.

In rural Madhya Pradesh, 52 children below one died per 1,000 live births (Infant mortality rate) and 36 in urban area. The country’s average stands at 36 deaths for rural and 23 for urban areas. The IMR for boys in the State stood at 51, while for girls it was 46 in 2018, according to the Sample Registration System bulletin issued by the office.

As many as 26 infants of 1,000 live births in Madhya Pradesh died within the first seven days constituting more than half the infant deaths, explained Manish Singh, Deputy Director, State-unit of National Health Mission. “Early neo-natal deaths form the largest chunk,” he said.

Increasing premature deliveries, infections, birth asphyxiation and delay in securing treatment leading to complicated deliveries were the major causes, he said.

Birth spacing a major concern

“A major concern is birth spacing as in most cases two children were born within one-one and a half years against the advised gap of around three years. This may result in premature deliveries of low birth weight babies,” he said.

Sagar, Jabalpur and Rewa divisions witnessed higher infant mortality as did Jhabua, Alirajpur and Barwani districts where high malnutrition levels was a major cause, said Dr. Singh.

Maternal health also had a bearing on the IMR, he said. In 2015-2017, Madhya Pradesh registered a maternal mortality ratio of 188 per 1 lakh live births, against the country’s average of 122.

“Antenatal and postnatal care were important aspects in bringing down infant mortalities,” said Sachin Jain, who works for child rights. “Further, the primary health system needs to be ramped up. The entire focus, despite paucity of specialists, is on big cities like Bhopal, Indore, Gwalior and Jabalpur.”

Mr. Jain said only 11.4% mothers received full antenatal care, according to the National Family Health Survey -4 (2015-16). “Antenatal check-ups for pregnant women are very minimal. So, despite a high claimed institutional deliveries, when pregnancy is not monitored properly that may lead to complicated deliveries,” he said.

Paediatric intensive care units

To bring down the IMR, Mr. Singh said, “We are setting up paediatric intensive care units in 26 districts, available only in five districts until 2018. We are also enhancing our manpower.”

As for encouraging community referrals and ensuring timely treatment, the NHM was training workers at health and wellness centres, he said. “A facility should know who’s been referred there. So, we are developing a system wherein an ASHA worker during referral enters details of patients on an online software that can be accessed by the facility. If the patient doesn’t reach there within 24 hours, it is the facility’s responsibility to follow-up.”

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