::Infant Mortality Rates Improvement::
India face problems related to Infant mortality and Maternal mortality at a
large scale. India also receives highest number of deaths in many acute
diseases. There are various reasons for these problems but most important among
them is that in India expenditure on health in very less percentage of the GDP.
While in USA it is close to 14 percent in India it is close to five percent.
Among this percentage government spending of health is close to one percentage
only. This puts an added burden on the public to spent from their pocket. And in
a country where large section of population is poor this burden is
unsustainable. In last few decades economic growth of India has been very good
but resultant public spending on the health sector has not improved much. The
growth of India's economy now permits this long overdue increase in public
financing of health. Good health has implications for development of countryas
well this has been recognized by government in recent initiatives like National
Rural Health Mission (NRHM), the Rashtriya Swasthya Bima Yojana (RSBY) and a
multitude of state sponsored health insurance schemes.
The social objectives of all of these schemes would need to be merged and
their scope considerably expanded to create a valued and viable model of UHC in
India. With this objective in mind The Government is considering to roll out a
National Health Assurance Mission to reduce the hard earned money of poor
population in India. A Group has been constituted for preparing a comprehensive
background paper for this purpose.
Every human body is a stakeholder in the health sector of India. That is why
every individual must be motivated to a lead healthy life and thereby keep the
burden on the public health infrastructure to the minimum. Thankfully, we are a
young nation. With 65 percent of the population under the age of 35, it should
not be too difficult to make optimal use of every available Rupee. Public Health
is in state list, which makes it a state subject, the Central Government can
only provide a supplementing role to the efforts of the States/UTs. Under the
National Rural Health Mission (NRHM) central government provide accessible,
affordable and quality healthcare to the rural population. National Health
Mission (NHM) was approved the central government which subsumes the National
Urban Health Mission (NUHM) and the National Rural Health mission objective of
national health mission are also the same to provide universal access to
equitable, affordable and quality health care services to all the population.
India has registered a significant decline in Infant Mortality Rate (IMR).
According to the just released SRS bulletin, IMR of India has declined by three
points (8% decline), from 37 per 1000 live births in 2015 to 34 per 1000 live
births in 2016, compared to two points decline last year. Not only this, India
also recorded a major drop in birth cohort, which has for the first time come
down to below 25 million. India has registered 90000 fewer infant deaths in 2016
as compared to 2015. The total number of estimated infant deaths have come down
from 930000 (9.3 Lakhs) in 2015 to 840000 (8.4 lakhs) in 2016.
According to the SRS Bulletin the gender gap in India for child survival is
reducing steadily. The gender difference between female and male IMR has now
reduced to <10%, giving a major boost to the 'Beti Bachao Beti Padhao' scheme of
The results signify that the strategic approach of the Ministry has started
yielding dividends and the efforts of focusing on low performing States is
paying off. Among the EAG States and Assam, all States except Uttarakhand have
reported decline in IMR in comparison to 2015. The decline is reported as 4
points in Bihar, 3 points in Assam, Madhya Pradesh, Uttar Pradesh and Jharkhand
and two points decline in Chhattisgarh, Odisha and Rajasthan.
These remarkable achievements in merely one year is also the result of a
countrywide efforts to increase the health service coverage through various
initiatives of the Government that includes strengthening of service delivery;
quality assurance; RMNCH+A; human resources, community processes; information
and knowledge; drugs and diagnostics, and supply chain management, etc.
India has avoided about 1 million (10 lakh) deaths of children under age five
since 2005, owing to the significant reductions in mortality from pneumonia,
diarrhoea, neonatal infections and birth asphyxia/trauma, measles and tetanus,
according to study published in the latest issue of The Lancet.The 'India's
Million Death Study', implemented by the Registrar General of India,is the first
study to directly quantify changes in cause-specific child deaths in India,
nationally and sub-nationally, from 2000-15 among randomly selected homes.
The study further illustrates that the conditions prioritized under the
National Health Mission had the greatest declines. Pneumonia and diarrhea
mortality fell by over 60% (most of the decline due to effective treatment),
mortality from birth-related breathing and trauma during delivery fell by 66%
(most of the decline due to more births occurring in hospital), and measles and
tetanus mortality fell by 90% (mostly due to special immunization campaigns
against each). The study states that mortality rate (per 1000 live births) fell
in neonates from 45 in 2000 to 27 in 2015 (3.3% annual decline) and 1-59 month
mortality rate fell from 45.2 in 2000 to 19.6 in 2015 (5.4% annual decline).
Further, amongst 1-59 months, pneumonia fell by 63%, diarrhoea fell by 66% and
measles fell by more than 90%. These declines were greater in girls, indicating
that India has, remarkably, equal numbers of girls and boys dying, a significant
improvement from just a few years ago.Pneumonia and diarrhoea mortality rates
for 1-59 months declined substantially between 2010 and 2015 at an average of
8-10 % annual decline nationally and more so in the rural areas and poorer
The Million Death Study builds on the SRS by directly monitoring the causes
of death in over 1.3 million (13 lakh) homes. Since 2001, about 900 staff
interviewed about 100,000 (1 lakh) living members in all homes who had a child
die (about 53,000 deaths in the first month of life and 42,000 at 1-59
months)every six months and completed a simple two-page form with a local
language half-page narrative describing the deceased's symptoms and treatments.
The records have been digitized and each one uniformly coded for cause of death
independently by two of about 400 trained physicians, using World Health
Organization approved procedures. This is a direct study based on face-to-face
interviews with families, and is not based on modeling or projections from small
The results signify that the strategic approach of the Health Ministry has
started yielding dividends and the efforts of focusing on low performing States
is paying off.