Prelims level : Policies Mains level : GS-II Issues relating to development and management of Social Sector or Services relating to Health, Education, Human Resources.
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Why in News?

  • According to the National Health Mission (NHM), Madhya Pradesh has recorded the highest percentage of newborn deaths of 11.5% against the total admissions to government-run sick newborn care units (SNCUs).

What is Neonatal Mortality Rate (NMR)?

  • NMR is the probability of dying during the first 28 days of life, expressed per 1,000 live births.
  • According to the Sample Registration System, neonatal deaths in India mainly occur owing to premature births and low birth weight (35.9%), pneumonia (16.9%), birth asphyxia and birth trauma (9.9%), other non-communicable diseases (7.9%), diarrhoea (6.7%), congenital anomalies (4.6%) and infections (4.2%).Under the United Nations’ Sustainable Development Goals, each country, including India, has aimed to bring down neonatal mortality to at least 12 per 1,000 live births. In 2018, it stood at 23 for India.

What does the Report Says?

  • Although admissions of neonates in the Madhya Pradesh have dropped from April 2017 to December 2019 — remaining lower than West Bengal, Rajasthan and Uttar Pradesh — the percentage of deaths at 12.2% surpassed Bihar’s last year.
  • In Bhopal, the capital city of Madhya Pradesh, one in every five children admitted to a unit died in the three years — the highest death percentage of 19.9% in the State, ten times above the NHM’s mandated key performance indicator of below 2%.

Why the Surge Happened?

  • Staff crunch, low community referrals, absence of a special neonatal transport service to health centres, and the non-availability of enough units to cater to increasing institutional deliveries had contributed to the spike in the percentage of deaths.
  • Meanwhile, West Bengal, where 34,344 neonatal deaths occurred in the period, the most in the country, the declining percentage of deaths from 9.2% in 2017 to 8.9% in 2019 coincided with a slump in admissions.
  • The health of children and mothers is not tracked in a systematic way by one platform, and services are often given randomly.

What are the Challenges Faced?

  • As the units are located at hospitals with the delivery load of more than 3,000 infants per year, mostly in District Headquarters, transporting neonates on time is crucial as they may succumb to fatal diseases within hours.
  • Although there is a dedicated service to transport pregnant women to hospitals from remote areas, there is none for neonates, who are mostly dependent on the 108 ambulance service.
  • The major challenge, however, remained community referrals, significantly aided by ASHA workers — only one in ten sick neonates born outside a hospital is taken to an SNCU. This is due to the absence of transport, inability to identify a disease by parents, and lack of awareness.

Way Forward:

  • Measures should be taken to ensure early registration of pregnancies, and for early detection of high risk cases, improving institutional deliveries, providing skill development training to health staff.
  • Education campaign should be taken up to aware the mother of the merits of antenatal care, institutional delivery, importance of exclusive breast feeding, immunization, home care for diarrhoea; all these are meant to create awareness among family members to provide support to women during pregnancies and deliveries.
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