Most child deaths due to pneumonia in India

Most child deaths due to pneumonia in India

News:

1. The 2018 Pneumonia and Diarrhea Progress Report, by the International Vaccine Access Center (IVAC) released on the eve of 10th World Pneumonia Day (November 12) describes progress in fighting pneumonia and diarrhoea in 15 countries.

Important Facts:

2. The report analyses how effectively countries are delivering 10 key interventions to help protect against, prevent, and treat, pneumonia and diarrhoea.
3. These ten key interventions are namely breastfeeding, vaccination, access to care, use of antibiotics, oral rehydration solution (ORS) and zinc supplementation.
4. Findings of the report:

• The 15 countries that the report looked at account for 70% of global pneumonia and diarrhoea deaths in children under five.
• The health systems in these countries are falling woefully short of ensuring that the most vulnerable children have access to prevention and treatment services.
• Globally, pneumonia and diarrhoea led to nearly one of every four deaths (36 million deaths) in children under five years of age in 2016 with over two-thirds of the global burden of pneumonia and diarrhoea mortality occurring in just 15 countries, including India.
• Nearly half a million pneumonia and diarrhoea deaths still occurred in two countries i.e., India and Nigeria despite improvements in access and use of health interventions.
• The number of deaths of children under five years due to pneumonia in 2016 was 1,58,176, while diarrhoea deaths was 1,02,813, the report said.
• The 15 nations in order with the highest number of pneumonia and diarrhoea child deaths are India, Nigeria, Pakistan, the Democratic Republic of Congo, Ethiopia, Chad, Angola, Somalia, Indonesia, Tanzania, China, Niger, Bangladesh, Uganda, and Cote d’Ivoire.
• RotaC coverage: The rotavirus vaccine had not been introduced in eight of the 15 focus countries i.e., Nigeria, DRC, Chad, Somalia, Indonesia, China, Bangladesh, and Uganda.
• Of the seven countries where rotavirus vaccine has been introduced, the median coverage of complete rotavirus vaccine is 58 per cent.
• Moreover the lowest coverage levels of rotavirus vaccine were in Pakistan (12 per cent) and India (13 per cent), both of which had recently started phased national rollouts that had not yet reached all states or provinces.
• Increasing coverage of Haemophilus Influenzae Type B (Hib) vaccine, as well as continued scale-up of rotavirus vaccines, first introduced in mid-2016, led to a bump in scoring for the 10 interventions since last year’s report.

5. Findings in India’s case:

• India has topped the list of 15 countries with the highest number of pneumonia and diarrhoea deaths in children under five in 2016.
• India’s vaccination coverage to prevent rotavirus infection was the lowest among the 15 countries which introduced it last year.
• India lost over 2.6 lakh children under five years from pneumonia and diarrhoea in 2016.
• Progress in India home to more under-five pneumonia and diarrhoea deaths than any other country in 2016 has been mixed.
• The proportion of children receiving important treatments remains dismally low, with barely 20 percent receiving ORS for diarrhoeal disease.
• In contrast, the other treatment indicators decreased i.e., ORS coverage (-13%), exclusive breastfeeding (-10%), and access to pneumonia care (-4%).
• Owing to increasing coverage of Hib vaccine, continued scale-up of rotavirus vaccines as well as zinc supplementation, India has shown progress in interventions for fighting pneumonia and diarrhoea by one percentage point.
• Introduced in 2017, the pneumococcal conjugate vaccine (PCV) has been included in only six states to-date.
• Further scale-up of the vaccine to all states should be considered,” the report, which analysed government data, said.

6. Significance of report: 

• The report can help focusing on short-comings and could help achieve the United Nations’ Sustainable Development Goal target of reducing under-five mortality to at least as low as 25 per 1,000 live births by 2030.

7. Concerns:

• The Pneumonia and Diarrhoea Progress Report, supported by the Bill & Melinda Gates Foundation, issued annually, finds that although countries are making progress in immunisation coverage, they seriously lag in efforts to treat childhood illnesses especially among populations that are remote, impoverished or otherwise left behind.

8. Way forward:

• Addressing inequities will demand greater levels of funding, strong political commitment, accountability supported by better data, and a coordinated global effort that prioritizes the most vulnerable.
• Authors at the IVAC have also called on the global community to collect better data and target communities of greatest need.