Saving lives

Saving lives

Context:

According to the recent Unicef Report “Every Child Alive”, India, with nearly 600,000 newborn deaths each year, accounts for a quarter of the global burden of neonatal deaths. It needs political will for India to bring down its shamefully high newborn mortality rate

Highlights of the Report:

• Of the 184 countries, which the report covers, India ranks 31st with 25.4 neonatal mortality rate (per 1,000 live births)
• India ranks behind poorer countries such as Bangladesh, Nepal and Rwanda.
• Despite being ranked 12th, India has shown impressive progress in reduction of under-five mortality, nearly meeting its (Millennium Development Goal) MDG target, with a 66% reduction in under-five deaths during 1990 to 2015.
• The number of annual under-five deaths in India has gone below one million for the first time in 2016.

Chief causes of neonatal mortality rate:

• Premature birth
• Asphyxia during delivery

Suggestions to prevent newborn deaths:

• According to the report, affordable and quality healthcare solutions should be there for every mother and newborn.

It includes:

• Steady supply of clean water and electricity at health facilities,
• presence of a skilled health attendant during birth,
•  Disinfecting the umbilical cord,
• Breastfeeding within the first hour after birth
• Skin-to-skin contact between the mother and child
• Piece of cloth to keep a baby warm

What can be understood from the rankings?

• Rankings clearly indicate that financial resources are not the biggest constraint in improving this health indicator; political will is.
• According to the report while average newborn mortality in low-income nations is nine times that of high-income ones, several countries do not follow the trend
• For example, Sri Lanka and Ukraine, which like India are categorised as lower-middle income economies, had a neonatal mortality of around 5/1000 in 2016.
• In comparison, the U.S., a high-income economy, did only slightly better with a rate of 3.7/1000.
• On the other hand, Rwanda, which falls in the lowest income group of less than $1,005 per capita, has brought down its mortality rates from 41/1000 in the 1990s to 16.5 through programmes targeted at poor and vulnerable mothers.

Way ahead:

• States like Kerala and Tamil Nadu show that newborn deaths can be brought to fewer than 15 per 1000 in Indian settings.
• Programmes such as the Janani Suraksha Yojana must expand its reach in laggard States like Uttar Pradesh and Madhya Pradesh.
• Factors outside the healthcare system, like female literacy rates, have great potential to make a big difference to healthcare-seeking behaviour.