As per Office of Registrar General of India SRS 2010
report, Rural Under-five mortality rate is 66 per 1000 live births whereas
urban under-five mortality rate is 38 per 1000 live births.
possible reasons for higher under-five mortality rate in rural areas are lack
of awareness, poor health seeking behaviour, inappropriate child care practices
and inadequate access to quality health services.
NRHM, higher financial resources are being provided to States and districts with
weak health indicators. Further, the following
interventions under RCH progamme under National Rural Health Mission
(NRHM), are being implemented to reduce
U5 MR in rural areas:
1) Promotion of Institutional Delivery
through JananiSurakshaYojana (JSY) and JananiShishuSurakshaKaryakram (JSSK): Promoting
Institutional delivery to ensure skilled birth attendance is key
to reducing both maternal and neo-natal mortality. JSY incentivizes pregnant
women to opt for institutional delivery and provides for cash assistance. JSSK
entitles all pregnant women to absolutely free and zero expense delivery
including caesarean section operation in Government health facilities and provides
for free to and fro transport, food, drugs and diagnostics. Similar
entitlements have also been put in place for sick neonates.
2) Strengthening Facility based newborn
care: Newborn care corners (NBCC) are being set up at all health facilities where
deliveries take place to provide essential newborn care at birth to all new
born babies; Special New Born Care Units (SNCUs) at District Hospitals and New
Born Stabilization Units (NBSUs) at FRUs are being set up for the care of sick
newborn. As on date 399 SNCUs, 1542 NBSUs and 11508 NBCCs are functional across
3) Home Based Newborn Care (HBNC): Home based newborn care through ASHA has
recently been initiated to improve new born care practices at the community
level and for early detection and referral of sick new born babies. The
schedule of home visits by ASHA consists of at least 6 visits in case of
institutional deliveries, on days 3, 7, 14, 21, 28 & 42nd days and one
additional visit within 24 hours of delivery in case of home deliveries.
Additional visits will be made for babies who are pre-term, low birth weight or
4) Capacity building of health care
providers: Various trainings are being conducted to build and upgrade the
skills of doctors, nurses and ANMs for early diagnosis and case management of
common ailments of children and care of newborn at time of birth. These
trainings include Integrated Management of Neo-natal and Childhood Illness(IMINCI) and NavjaatShishuSurakshtaKaryakaram
(NSSK). A total of 5.5 lakh health care workers have
been trained in IMNCI in 471districts and 88,428 health workers trained in NSSK
of Malnutrition: Emphasis is being laid on reduction of malnutrition which is
an important underlying cause of child mortality. 594 Nutritional
Rehabilitation Centres have been established for
management of Severe Acute Malnutrition (SAM).
Iron and Folic Acid is also provided to children for prevention of anaemia. Recently, weekly Iron and Folic Acid is proposed
to be initiated for adolescent population. 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.
6) Village Health and Nutrition Days
(VHNDs) are also being organized for imparting nutritional counseling to
mothers and to improve child care practices.
7) Universal Immunization Program (UIP):
Vaccination against seven diseases is provided to all children under UIP.
Government of India supports the vaccine program by supply of vaccines and
syringes, cold chain equipments and provision of operational costs. UIP targets to immunize 2.7 crore infants
against seven vaccine preventable diseases every year. 21 states with more
than 80% coverage have incorporated second dose of Measles in their
immunization program. Pentavalent vaccine has been introduced in two states of
Kerala and Tamil Nadu and proposed to be scaled up in six more states. Year
2012-13 has been declared as ‘Year of intensification of Routine Immunization’.
8) Mother and Child Tracking
System: A name based Mother and Child Tracking System has been put in place
which is web based to enable tracking of all pregnant women and newborns so as
to monitor and ensure that complete services are provided to them. States are
encouraged to send SMS alerts to beneficiaries reminding them of the dates on
which services are due and generate beneficiary-wise due list of services with
due dates for ANMs on a weekly basis.
This information was given by Minister for Health &
Family Welfare Shri Ghulam Nabi Azad in written reply to a question in the Rajya Sabha today.