Lok Sabha Question No. 607 (UNSTARRED), answered on 2016-11-18
Subject: Infant Mortality
Ministry: HEALTH AND FAMILY WELFARE
Asked by: HARI NARAYAN RAJBHAR, JITENDRA CHAUDHURY, MIDHUN REDDY, RAMCHARAN BOHARA, SISIR KUMAR ADHIKARI

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED QUESTION NO. 607 TO BE ANSWERED ON 18 TH NOVEMBER, 2016

## INFANT MORTALITY

## 607. SHRI HARINARAYAN RAJBHAR: SHRI JITENDRA CHAUDHURY: SHRI P.V. MIDHUN REDDY: SHRI RAM CHARAN BOHRA: SHRI SISIR KUMAR ADHIKARI:

Will the Minister of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) whether the Government is aware that India has the highest number of cases of children who die under 5;
- (b) if so, the State - wise details thereof and the reasons therefor;
- (c)  whether  the  Government  is  aware that  multi  drugs  resistance  given  to  babies make  the ailment untreatable and if so, the details thereof;
- (d) whether World Health Organisation (WHO) h as set any target for our country upto 2020 and if so, the details of targets achieved, State - wise;
- (e) the steps taken/being taken by the Government to prevent infant mortality rate during the last three years;
- (f) whether India ranks first in the list of those countries where children die due to Pneumonia, if so, the details thereof, State/UT - wise for the last three years along with the reasons therefor; and
- (g)  the  steps  taken  by  the  Government to  check  this  disease  and  protect  children from Pneumonia?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI FAGGAN SINGH KULASTE)

- (a) &(b) : Yes.The State wise Under 5 Mortality Rate (U5MR) is annexed.

As per the Sample Registration Report (SRS) of Registrar General of India, the m causes of deaths of children (2010 - 13) are -Prematurity & low birth weight (29.8%), Pneumonia (17.1%), Diarrhoeal disease (8.6%), Other Non - Communicable Diseases (8.3%), B irth asphyxia &  birth  trauma  (8.2%),  Injuries  (4.6%),  Congenital  anomalies  (4.4%),  Ill - defined  or  cause unknown (4.4%), Acute bacterial sepsis and severe infections (3.6%), Fever of unknown or (2.5%) and All Other Remaining Causes (8.4%).

(c): Multidrug resistance in children may adversely affect treatment outcome. As per re published by Lancet in 2016 approximately 57 thousand neonatal deaths each year in India be attributable to neonatal sepsis caused by bacteria resistant to first - line  ibiotics.

(d): United Nations has recently set Sustainable Development Goals and Targets. The tar for India is to attain U5MR of 25/1000 live births by 2030.

(e) : The Government of India is implementing the following interventions under the Natio H ealth Mission (NHM) all across the country to reduce infant mortality rate:

- I. Promotion  of  Institutional  deliveries  through  cash  incentive  under  Janani  Sura Yojana  (JSY)  and  Janani  Shishu  Suraksha  Karyakaram  (JSSK)  which  entitles  all pregnant  women  deliv ering  in  public  health  institutions  to  absolutely  free  ante - natal check - ups,  delivery  including  Caesarean  section,  post - natal  care  and  treatment  of  sick infants till one year of age.
- II. Strengthening of delivery points for providing comprehensive and quality Reproductive, Maternal,  Newborn,  Child  and  Adolescent  Health  (RMNCH+A)  Services,  ensuring essential  newborn  care  at  all  delivery  points,  establishment  of  Special  Newborn Units (SNCU), Newborn Stabilization Units (NBSU) and Kangaroo Mother Care (KMC) units for care of sick and small babies. Home Based Newborn Care (HBNC) is being provided  by  ASHAs  to  improve  child  rearing  practices.  India  Newborn  Action  Pla (IANP) was launched in 2014 to make concerted efforts towards attainment of the go of 'Single Digit Neonatal Mortality Rate' and 'Single Digit Stillbirth Rate', by 2030.
- III. Early initiation and exclusive breastfeeding for first six months and appropriate and Young Child Feeding (IYCF) practices are promoted in convergence with Ministr of  Women  and  Child  Development.  Village  Health  and  Nutrition  Days  (VHNDs)  are observed for provision of maternal and child health services and creating awarene maternal and child care including health and nutrition education. Ministry of Heal FamilyWelfare launched MAA Mothers' Absolute Affection programme in August 2016 for improving  breastfeeding practices (Initial Breastfeeding within one hour, Exc Breastfeeding up to six months and complementary Breastfeeding up to two years)through  mass  m edia  and  capacity  building  of  health  care  providers  in  healt facilities as well as in communities.
- IV. Universal Immunization Programme (UIP) is being supported to provide vaccination t children  against  many  life  threatening  diseases  such  as  Tuberculosis,  D iphtheria, Pertussis,  Polio,  Tetanus,  Hepatitis  B  and  Measles.  Pentavalent  vaccine  has introduced all across the country and 'Mission Indradhanush' has been launched to fully immunize more than 89 lakh children who are either unvaccinated or partially vaccina ed; those that have not been covered during the rounds of routine immunization for var reasons.
- V. Name based tracking of mothers and children till two years of age (Mother and Ch Tracking  System)  is  done  to  ensure  complete  antenatal,  intrana tal,  postnatal  care  and complete immunization as per schedule.
- VI. Rashtriya Bal Swasthya Karyakram (RBSK) for health screening, early detection of bi defects,  diseases,  deficiencies,  development  delays  including  disability  and intervention services has been operationalized to provide comprehensive care to all th children in the age group of 0 - 18 years in the community.
- VII. Some other important interventions are Iron and folic acid (IFA) supplementation fo prevention  of  anaemia among  the  vulnerable  age  groups,  home  visits  by  ASHAs  to promote exclusive breast feeding and promote use of ORS and Zinc for management of diarrhoea in children.
- VIII. Government  of  India  has  adopted  the  Reproductive,  Maternal,  Newborn,  Child  and Adolescent  H ealth  Strategy  (RMNCH+A)  to  improve  maternal  and  child  health outcomes.  The  RMNCH+A  strategy  recognize  that  child  health  and  survival  is inextricably  linked  to  women's  health  across  all  life  stages.  Besides  this,  184  high priority districts with relatively weaker status of maternal and child health indicators have been identified, for the intensification of RMNCH+A efforts.

(f): As  per  the  Pneumonia  and  Diarrhoea  Progress  Report,  of  the  International  Vacci Access Centre (IVAC), India tops the list of 15 high burden countries in terms of deaths due to pneumonia and diarrhoea. The reasons being high prevalence of underlying under - nutrition, low birth weight and indoor air pollution.

State/UT - wise details of pneumonia deaths among children during the last t hree years are not maintained at central level.

(e): Government  of India,  under  National  Health  Mission,  is  undertaking  followin interventions for prevention and control of pneumonia among children:

- Promotion of infant and young child feeding practices t o prevent onset of malnutrition,
- Vitamin A supplementation
- Vaccination for diphtheria, pertusis, measles and Hib vaccination
- Improved case management for pneumonia at community and health facilities
- Training of health personnel on integrated management of neonatal and childhood illness including pneumonia
- Promotion of hand washing and personal hygiene through IEC activities etc.

## Government of India Ministry of Health & Family Welfare

## State wise status of Under 5 Mortality Rate in India

| States           |   2014 |
|------------------|--------|
| India            |     45 |
| Andhra Pradesh   |     40 |
| Assam            |     66 |
| Bihar            |     53 |
| Chhattisgarh     |     49 |
| Delhi            |     21 |
| Gujarat          |     41 |
| Haryana          |     40 |
| Himachal Pradesh |     36 |
| Jammu & Kashmir  |     35 |
| Jharkhand        |     44 |
| Karnataka        |     31 |
| Kerala           |     13 |
| Madhya Pradesh   |     65 |
| Maharashtra      |     23 |
| Odisha           |     60 |
| Punjab           |     27 |
| Rajasthan        |     51 |
| Tamil Nadu       |     21 |
| Telangana        |     37 |
| Uttar Pradesh    |     57 |
| Uttarakhand      |     36 |
| West Bengal      |     30 |

Source: Sample Registration System report 2014 , Registrar General of India

## Annexure