Action plan soon to prevent deaths from diarrhoea, pneumonia

The Centre will soon launch an action plan against diarrhoea and pneumonia in four States, including Rajasthan. The aim is to end preventable child deaths from these two by 2025. As high as 36 per cent of all child deaths, below the age of 5, in India are caused by these two conditions.

India accounts for the highest number of diarrhoea and pneumonia deaths among children in the world with over 2 lakh children dying of diarrhoea and over 3.8 lakh children of pneumonia annually, accounting for the mortality of 4 in every 10 children under-five.

The highest burden is being borne by the poorest sections of society.

The four States where the India Action Plan for Diarrhoea and Pneumonia will be rolled out — Madhya Pradesh, Uttar Pradesh, Bihar and Rajasthan — account for half of under-five mortality in the country which stands at 62 deaths per 1,000 live births nationally. The under-five mortality rate of Rajasthan is 59 per 1,000 live births.

Launch next month

The action plan, likely to be launched next month, is a follow-up of the Global Action Plan for Diarrhoea and Pneumonia that was launched by WHO and UNICEF in April 2013 which aims to reduce pneumonia mortality to less than 3 per 1,000 live births, diarrhoea deaths to less than 1 per 1,000 live births, reduce incidence of severe pneumonia and diarrhoea by 75 per cent compared to 2010 levels and reduce by 40 per cent the global number who are stunted as compared to 2010 levels by 2025.

While India has taken several measures to reduce maternal and child mortality over the years, including launching of the National Rural Health Mission; Reproductive Maternal Neonatal Child Health plus Adolescent programme and the India Newborn Action Plan to end preventable newborn deaths, the success in reducing under-five mortality has not been uniform.

Seven States have achieved the MDG-4 target of U5MR of 38 per 1,000 live births and nine States are showing a decline of more than the national average.

While Delhi, Kerala, Karnataka, Maharashtra, Punjab, Tamil Nadu and West Bengal have achieved the MDG target, the rate of decline is 7.3 per cent in Rajasthan, 5.6 per cent in Madhya Pradesh, 7 per cent in Uttar Pradesh and 6 per cent in Bihar.

Twenty per cent districts in Rajasthan have shown an increase in U5MR between 2010-11 and 2012-13 in the annual health surveys.

Collaboration

The WHO and UNICEF have been entrusted to collaborate with the respective governments in implementing the action plan which is not a new project or a programme but a framework for strengthening coordination of existing interventions where the coverage remains low like in exclusive breastfeeding (39 per cent), vitamin A supplement (75 per cent), DTP3 immunisation (83 per cent), measles immunization (84 per cent), HiB 3 immunisation (43 per cent) and other interventions like access to antibiotics and ORS solutions, sanitation, better living condition, hand wash and clean drinking water.

Since diarrhoea and pneumonia are caused by multiple pathogens, no single intervention, including vaccine, will help in protecting children.