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Government of India
Ministry of Health and Family Welfare
11-July-2014 14:52 IST
Infant, Child and Maternal Mortality Rate

 

As per Save the Children Report   2010, “A Fair Chance at life-Why Equity Matters for Child Mortality”, child mortality in the poorest quintile is almost three times higher than in the richest quintile in India.

 

Ministry of Health & family Welfare is addressing this issue of equity in relation to child mortality by intensified action in identified 184 high priority districts in the country where child health indicators are weak.

 

State/UT-wise Infant, Child mortality rate and Maternal Mortality Ratio during last three years and current year is given below:

State/UT-wise Infant mortality Rate per 1000 live births since 2009 to 2012

 

Sr. No

State/UTs

 SRS 2009

 SRS 2010

SRS 2011

SRS 2012

India

50

47

44

42

1

A & N Islands

27

25

23

24

2

Andhra Pradesh

49

46

43

41

3

Arunachal Pradesh

32

31

32

33

4

Assam

61

58

55

55

5

Bihar

52

48

44

43

6

Chandigarh

25

22

20

20

7

Chhattisgarh

54

51

48

47

8

D & N Haveli

37

38

35

33

9

Daman & Diu

24

23

22

22

10

Delhi

33

30

28

25

11

Goa

11

10

11

10

12

Gujarat

48

44

41

38

13

Haryana

51

48

44

42

14

Himachal Pradesh

45

40

38

36

15

Jammu & Kashmir

45

43

41

39

16

Jharkhand

44

42

39

38

17

Karnataka

41

38

35

32

18

Kerala

12

13

12

12

19

Lakshadweep

25

25

24

24

20

Madhya Pradesh

67

62

59

56

21

Maharashtra

31

28

25

25

22

Manipur

16

14

11

10

23

Meghalaya

59

55

52

49

24

Mizoram

36

37

34

35

25

Nagaland

26

23

21

18

26

Orissa

65

61

57

53

27

Pondicherry

22

22

19

17

28

Punjab

38

34

30

28

29

Rajasthan

59

55

52

49

30

Sikkim

34

30

26

24

31

Tamil Nadu

28

24

22

21

32

Tripura

31

27

29

28

33

Uttar Pradesh

63

61

57

53

34

Uttaranchal

41

38

36

34

35

West Bengal

33

31

32

32

 

State- wise Under-five mortality Rate per 1000 live births for the bigger States since 2009 to 2012

States

SRS 2009

SRS 2010

SRS 2011

SRS 2012

India

64

59

55

52

Andhra Pradesh  

52

48

45

43

Assam           

87

83

78

75

Bihar           

70

64

59

57

Chhattisgarh

67

61

57

55

Delhi           

37

34

32

28

Gujarat         

61

56

52

48

Haryana         

60

55

51

48

Himachal Pradesh

51

49

46

43

Jammu & Kashmir 

50

48

45

43

Jharkhand

62

59

54

50

Karnataka       

50

45

40

37

Kerala          

14

15

13

13

Madhya Pradesh  

89

82

77

73

Maharashtra     

36

33

28

28

Orissa          

84

78

72

68

Punjab          

46

43

38

34

Rajasthan       

74

69

64

59

Tamil Nadu      

33

27

25

24

Uttar Pradesh   

85

79

73

68

West Bengal     

40

37

38

38

 

Maternal Mortality Ratio (MMR) for major states per 100,000 live-births

 

States

SRS, 2007-09

SRS, 2010-12

India

212

178

Andhra Pradesh

134

110

Assam

390

328

Bihar/Jharkhand

261

219

Gujarat

148

122

Haryana

153

146

Karnataka

178

144

Kerala

81

66

Madhya Pradesh /Chhattisgarh

269

230

Maharashtra

104

87

Odisha

258

235

Punjab

172

155

Rajasthan

318

255

Tamil Nadu

97

90

Uttar Pradesh /Uttarakhand

359

292

West Bengal

145

117

(Source:  RGI-SRS, 2007-09, 2010-12)

 

As per WHO 2012 estimates, the causes of Child Mortality in the age group 0-5 years in India are Neonatal causes (52%), Pneumonia (15%), Diarrhoeal disease (11%), Measles (3%), Injuries (4%) and others (15%). The major medical causes of maternal deaths as per RGI-SRS (2001-03) are Haemorrhage (38%), Sepsis (11%), Abortion (8%), Hypertensive disorders (5%), Obstructed labour (5%), and Other causes (34%)  includes anaemia and various other causes.

Besides this, Illiteracy, low socio-economic status, early age of marriage, high parity, women’s empowerment, poor sanitation, hygiene and nutrition, poor access to health facilities are also contributing factors of Infant, Child and maternal mortality.

The following interventions under RMNCH+A Strategic approach of National Health Mission (NHM) are being implemented to reduce Infant, Child and Maternal mortality:

 

1)     Prevention and treatment of Anaemia by supplementation with Iron and Folic Acid tablets during pregnancy and lactation.

2)     To tackle the problem of anaemia due to malaria particularly in pregnant women and children, Long Lasting Insecticide Nets (LLINs) and Insecticide Treated Bed Nets (ITBNs) are being distributed in endemic areas.

3)     Name Based Tracking of Pregnant Women to ensure complete antenatal, intranatal, postnatal care and children up to 2 years of age for completing immunization as per UIP schedule.

4)     Operationalizing Community Health Centers as First Referral Units (FRUs) and Primary Health Centers (24X7) for round the clock maternal care services. )

5)     Promotion of Institutional Delivery through Janani Suraksha Yojana (JSY) and Janani Shishu Suraksha Karyakram (JSSK): Promoting Institutional delivery to ensure skilled birth attendance is key to reducing both maternal and neo-natal mortality.

6)     Strengthening Facility based newborn care: Newborn care corners (NBCC) are being set up at all health facilities where deliveries take place; Special New Born Care Units (SNCUs) and New Born Stabilization Units (NBSUs) are also being set up at appropriate facilities for the care of sick newborn including preterm babies.

7)     Home Based Newborn Care (HBNC):  Home based newborn care through ASHA has been initiated to improve new born practices at the community level and early detection and referral of sick new born babies

8)     Integrated Management of Neo-natal and Childhood Illness (IMINCI) is being implemented through skill building of ANMs, Nurses and doctors for early diagnosis and case management of common ailments such as Acute Respiratory Infection, Diarrhoea, fever etc. in children.

9)     Universal Immunization Programme covers about 13.5 crore children for vaccination against seven vaccine preventable diseases, through 90 lakh immunization sessions each year.

10)Capacity building of health care providers: Various trainings are being conducted under National Health Mission (NHM) to build and upgrade the skills of health care providers in basic and comprehensive obstetric care of mother during pregnancy, delivery and essential newborn care.

11)To overcome the shortage of specialists, Capacity building of MBBS doctors in Anesthesia (LSAS) and Obstetric Care including C-section (EmOC) skills particularly in rural areas.

12)Engagement of more than 8.9 lakhs Accredited Social Health Activists (ASHAs) to generate demand and facilitate accessing of health care services by the community.

13)Village Health and Nutrition Days in rural areas as an outreach activity, for provision of maternal and child health services and creating awareness on maternal and child care including health and nutrition education.

14)Management of Malnutrition: Emphasis is being laid on reduction of malnutrition which is an important underlying cause of child mortality. Nutritional Rehabilitation Centres are being established for management of Severe Acute Malnutrition (SAM).  National Iron Plus Initiative has been launched to prevent and control iron deficiency anaemia through introduction of IFA Supplementation for children (above six months of age), adolescents and women in the reproductive age group besides those who are pregnant or lactating. As breastfeeding reduces infant mortality, exclusive breastfeeding for first six months and appropriate infant and young child feeding practices are being promoted in convergence with Ministry of Woman and Child Development.

15)Rashtriya Bal Swasthya Karyakram (RBSK) for Child health screening and early intervention services has been launched to provide comprehensive care to all the children in the age group of 0-18 years in the community. The purpose of these services is to improve the overall quality of life of children through early detection of birth defects, diseases, deficiencies, development delays including disability.

16)To sharpen the focus on vulnerable and marginalized populations in underserved areas, 184 High Priority Districts have been identified for implementation of Reproductive Maternal Newborn Child Health+ Adolescent (RMNCH+A) interventions for achieving improved maternal and child health outcomes.  

 

 

New Initiatives

 

Rashtriya Kishor Swasthya Karyakram (RKSK), a new initiative was launched on 7th January 2014 to reach out to 253 million adolescents in the country. RKSK seeks to reach adolescents in their own spaces and introduces peer led interventions at the community level, supported by augmentation of facility based services.

 

Details of funds allocation and expenditure under RCH flexi pool of National Health Mission (NHM) for last three years and current years is given below:

 

Allocation and Expenditure under RCH Flexible Pool for 2010-11 to 2013-14

Rs. In crore

Sl. No.

States

2010-11

2011-12

2012-13

2013-14

Allocation

Exp

Allocation

Exp

Allocation

Exp

Allocation

Exp

1

Andaman & Nicobar Islands

1.00

0.47

1.18

6.03

1.16

6.80

7.67

8.57

2

Andhra Pradesh

212.55

77.37

235.74

171.65

258.76

325.51

740.93

319.42

3

Arunachal Pradesh

12.14

15.67

12.93

17.99

17.30

16.47

30.98

25.26

4

Assam

295.64

223.39

316.76

404.34

390.06

446.70

545.06

436.39

5

Bihar

302.41

431.69

333.91

470.36

412.43

614.78

1104.71

729.30

6

Chandigarh

2.53

1.73

2.76

3.39

3.22

4.79

7.16

8.52

7

Chattisgarh

87.56

90.64

96.58

138.90

117.09

167.00

354.49

175.47

8

Dadra & Nagar Haveli

0.62

1.55

0.79

2.45

1.05

3.08

4.62

4.71

9

Daman & Diu

0.44

0.32

0.40

1.56

0.74

2.86

6.68

4.18

10

Delhi

38.69

22.46

42.18

47.79

51.20

56.31

81.36

63.22

11

Goa

3.77

1.83

4.34

5.01

4.46

4.79

13.06

5.85

12

Gujarat

142.02

149.35

156.90

164.55

184.55

221.49

361.02

212.61

13

Haryana

59.18

67.91

65.44

86.99

77.49

116.19

218.00

154.74

14

Himachal Pradesh

25.59

19.66

28.38

20.16

31.43

38.27

60.72

63.78

15

Jammu & Kashmir

42.40

39.08

46.91

84.29

57.53

112.89

302.73

151.89

16

Jharkhand

113.29

114.72

124.97

150.12

151.13

166.32

574.32

215.52

17

Karnataka

148.01

159.25

163.60

182.56

186.83

205.41

297.86

218.81

18

Kerala

89.36

80.25

98.56

71.21

102.04

160.43

139.65

150.71

19

Lakshadweep

0.17

0.48

0.40

2.20

0.23

2.36

2.11

0.53

20

Madhya Pradesh

220.34

396.10

242.84

369.36

288.44

466.07

608.57

485.92

21

Maharashtra

271.56

214.58

299.61

338.73

343.44

384.10

35.99

24.57

22

Manipur

26.44

15.86

25.86

16.12

34.06

15.01

53.57

14.95

23

Meghalaya

25.58

11.12

27.71

16.83

37.09

20.50

29.49

24.44

24

Mizoram

9.97

12.48

10.62

14.86

13.65

22.37

748.07

600.37

25

Nagaland

22.11

17.17

23.55

22.19

24.79

33.54

63.19

33.89

26

Orissa

133.94

193.08

147.83

215.87

166.66

260.03

398.62

283.88

27

Pondicherry

2.73

3.88

3.15

6.05

3.80

6.42

10.07

8.52

28

Punjab

68.18

69.28

75.30

78.00

84.67

93.21

119.35

100.78

29

Rajasthan

206.06

284.73

227.07

369.45

272.64

441.66

702.80

460.25

30

Sikkim

6.07

3.97

6.46

7.14

7.61

9.04

15.81

11.46

31

Tamil Nadu

174.33

149.77

193.17

187.68

220.48

228.56

486.60

365.83

32

Tripura

35.55

15.79

37.86

21.25

45.94

21.23

36.37

23.49

33

Uttar Pradesh

605.90

655.09

668.60

563.79

792.97

674.71

1402.94

956.34

34

Uttarakhand

35.70

39.82

39.42

53.69

46.38

71.20

113.18

84.07

35

West Bengal

225.17

125.02

247.97

260.28

279.19

337.70

806.15

384.03

Grand Total

3647.00

3705.56

4012.75

4572.87

4710.51

5757.76

10483.88

6812.27

 

The Health Minister was replying to a question in the Lok Sabha here today.

 

                                                       *****

MV/BK