Lok Sabha Question No. 994 (UNSTARRED), answered on 2020-02-07
Subject: Infant Deaths in Hospitals in Rajasthan
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Gajanan Chandrakant Kirtikar, Rajiv Ranjan (Lalan) Singh, Kanakmal Katara, Jaskaur Meena, Sanjay Sadashivrao Mandlik, Shrirang Appa Barne, Jual Oram, Gopal Chinayya Shetty, Nihal Chand Chauhan, Bidyut Baran Mahato, Sudheer Gupta

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

## LOK SABHA UNSTARRED QUESTION NO. 994 TO BE ANSWERED ON 07 TH FEBRUARY, 20 20

## INFANT DEATHS IN HOS PITALS IN RAJASTHAN

## 994. SHRI GAJANAN KIRTIKAR:

SHRI RAJIV RANJAN SINGH ALIAS LALAN SINGH:

SHRI KANAKMAL KATARA:

SHRIMATI JASKAUR MEENA:

SHRI SANJAY SADASHIV RAO MANDLIK:

SHRI SHRIRANG APPA BARNE:

SHRI JUAL ORAM:

SHRI GOPAL CHINNAYA SHETTY:

SHRI NIHAL CHAND:

SHRI BIDYUT BARAN MAHATO:

SHRI SUDHE ER GUPTA:

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

- (a) whether the death of more than 100 children alone in the month of December and more 1000 children in the year 2019 has been reported from hospitals in the Kota district of R if so, the details thereof and the reasons for the same;
- (b) t he action taken against the officers/Doctors responsible for this tragic incident;
- (c) whether a high level team has been set up by the Union Government including experts All India Institute of Medical Sciences, Jodhpur and other institutes to inves tigate the incident;
- (d) if so, the details thereof along with the findings of the said high level team;
- (e)  whether  the  National  Human  Rights  Commission  (NHRC)  has  issued  a  notice  to  the Rajasthan Government over the death of more than 100 children in a State run hospital in Kota and if so, the details thereof and the response of the State Government thereto;
- (f)  the  steps  taken  by  the  Government  to  curb  recurrence  of  such  incidents  and  to  p assistance to the State Government in this regard; an d
- (g)  whether  any  compensation  has  been  ordered/  extended  to  the  families  of  the  dece children, if so, the details thereof?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE

(SHRI ASHWINI KUMAR CHOUBEY)

- (a) : As per report provided by the State of Rajasthan, the J. K. Lon e hospital Kota recorded 100 deaths of children in December 2019 and more than 1000 children died in the year 2019.

The various reason of the deaths reported are -

Severe Birth Asphyxia with Hypoxic Ischemi c Encephalopathy ( HIE ) , Prematurity, Respiratory Distress Syndrome  (RDS),  Sepsis,  Congenital  Pneumonia, Congenital  Heart  Disease  ( CHD ),  Meconium Aspiratory  Syndrome  (MAS),  Aspiration  Pneumonia,  Pneumonia,  Septicaemia,  Meningoencephalitis, Thalassemia, M ult i Organ Dysfunction Syndrome etc.

(b) : As reported by State Government, the superintendent of J. K. Lone hospital has been removed in view of certain deficiencies observed in the hospital.

(c)& (d) : A central team comprising of experts from AIIMS , Jodhpur and the Ministry of Health and Family Welfare was deputed during 3 rd and 4 th January 2020 to visit J.K. Lone Hospital and Medical College in Kota district of Rajasthan.

The salient findings of the central team are as follows -

1. Out of 100 deaths r eported inJ.K. Lone Hospital, 70 deaths were in Neonatal Intensive Care  Unit  (NICU)  and  30  deaths  in  Paediatric  Intensive  Care  Unit  (PICU)/  Paediat ward.
2. Majority of neonates who died were low birth weight and 63% died in less than 24 ho of admiss ion. Majority of the death cases were referred cases from district hospital and district hospital Baran.
3. The bed occupancy rate of NICU was 125 % and of PICU was186 % resulting in sharing of beds.
4. Bed nurse ratio for NICU and PICU was 10:1 and 6:1 r espectively against the norm of 2:1.
5. Many of the equipments in the hospital were non - functional and there was no equipment maintenance policy.
6. The team recommended strengthening of infrastructure, adequate manpower and use of standard  clinical  protocol  be sides  strengthening  primary  and  secondary  health  care services at sub district level.

(e) : As  per  information received  from  Government  of  Rajasthan ,  a  notice  was  issued by National Human Rights Commission (NHRC) to S tate Government of Rajasthan on 13 th January 2020 regarding the episode of death of children in J.K Lone Government hospital, Kota, Rajasthan. The commis directed  Chief  Secretary,  Government  of  Rajasthan  for  submission  of  detailed  report  and  steps taken to address the issues.

The reply was submitted on 5 th February 2020 by state Government explaining the details of the deaths  and  various  corrective  measure  taken  immediately by  State  Government  and  ensured  the commission that State Government is committed to take all necessary ste ps to provide quality medical care to the children admitted in hospital.

(f) : Public Health and Hospitals being a State Subject, the primary responsibility of provid ng healthcare services in the state including hospitals ofKota is that of respective S tate Government. However, under National Health Mission (NHM), support is provided to the States /UTs to strengthen their heal systems including strengthening of  infrastructure, and adequate  manpowerbased  on  the  proposals received from the States i n their Programme Implementation Plans (PIPs). These PIPs are appraised in the National Programme Coordination Committee (NPCC) meetings and approvals are accorded to States/ UTs in the form of Record of Proceedings (RoPs).

Further, i n order to address child mortality and morbidity, the Government of India is supporting in  implementation  of  Reproductive,  Maternal,  Newborn,  Child,  Adolescent  health  and  Nutrit (RMNCAH+N) strategy.

The various intervention under RMNC AH +N strategy are as below:

1. Strengthening essential newborn care at all delivery points, establishment of Sick Ne Care  Units  (SNCU),  Newborn  Stabilization  Units  (NBSU)  and  Kangaroo  Mother  Care (KMC) units for care of sick and small babies.
2. Home Based Newborn Care (HBNC) and Ho me Based Care of Young Children (HBYC) by ASHAs to improve child rearing practices and to identify sick newborn.
3. Early initiation and exclusive breastfeeding for first six months and appropriate In Young  Child  Feeding  (IYCF)  practices  are  promoted under  Mothers'  Absolute  Affection (MAA) in convergence with Ministry of Women and Child Development.
4. Government  of  India  has  launched  POSHAN  (Prime  Minister  Overarching  Scheme  for Holistic Nourishment) Abhiyaan, to address malnutrition challenges in Ind ia by engaging all the important stakeholders in a convergent approach.
5. Nutrition Rehabilitation Centres (NRCs) have been set up at public health facilities and  manage  the  children  with  Severe  Acute  Malnutrition  (SAM)  admitted  with  medical complic ations.
6. Promotion of Institutional deliveries through cash incentive under Janani Suraksha Y (JSY) and Janani Shishu Suraksha Karyakaram (JSSK) which entitles all pregnant women delivering in public health institutions to absolutely free delivery inc luding Caesarea  section, post - natal  care  and  treatment of sick infants up to one year of age. Pradhan Mantri Vandana  Yojana  (PMMVY)  is  another  maternity  benefit  programme  under  which  cash incentive is provided to pregnant women and lactating mothers .
7. Besides  this  regular  reviews  and  field  visits  are  conducted  to  various  states  to supportive supervision.

(g):    No.