Lok Sabha Question No. 4310 (UNSTARRED), answered on 2019-12-13
Subject: Pneumonia in Rural Areas
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Anantkumar  Hegde

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

## LOK SABHA UNSTARRED QUESTION NO. 4310 TO BE ANSWERED ON 13 TH DECEMBER, 2019

## PNEUMONIA IN RURAL A REAS

## 4310. SHRI ANANTKUMAR HEGDE:

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

- (a) the number of deaths of children reported related to pneumonia and di rrhoea during the last te in the country, State/UT -wise;
- (b) the steps being taken to create awareness about pneumonia and dia rrhoea in rural areas; and
- (c) whether the Government has set any framework to achieve 2025 Global Action Plan for pneumonia diarrhoeand if so, the details thereof and if not, the reasons therefor?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (SHRI ASHWINI KUMAR CHOUBEY)

- (a): The State/UT - wise number of deaths reported in children related to pneumonia and 2009- 2019 in Health Management Information System (HMIS) is at Annexure.
- (b): Under Reproductive, Maternal, Newborn, Child, Adolescent health and Nutrition ( program of National Health Mission, the Government of India is undertaking  followin awareness about pneumonia and diarrhea in r ural areas:
- Defeat Diarrhoea (D2) Campaign - Intensified Diarrhoea Control Fortnight (IDCF) was e upto  September  month  in  2019  as  Defeat  Diarrhoea  campaign  with  focus  on  rural purpose of this campaign is to reduce deaths due to diarrhoea t hrough mass media, social medi print & interpersonal communication activities and establishment of D2 camps in s &  non- health  locations  for  demonstrating  preparation  of  ORS  solution  and  Zinc promotion of hand washing & sanitati on.
- In  November  2019,  the  Ministry  of  Health  and  Family  Welfare  has  launched  SAANS Awareness and Actions to Neutralize Pneumonia Successfully) Initiative to accele reduce deaths due to Childhood Pneumonia. In order to trigger behavi our change for protecti and prevention from  pneumonia and to improve care seeking ,under SAANS initiative a 360 0 communication campaign has been developed with use of mass media such as televis community  radio,  social  media,  interpersonal  com munication  by  health  workers,  banners posters in community and facilities to create awareness among families and parents
- (c): The integrated Global Action Plan for the Prevention and Control of Pneumonia (GAPPD)  released  in 2013  by  World  Health  Organization  and  UNICEF  aims  to  reduce  dea pneumonia to fewer than 3 children per 1000 live births, and from diarrhea to less births by 2025.

The  Government  of  India  under  Reproductive,  Maternal,  Newborn, Child,  Adolescent  health Nutrition (RMNCHA+N) program of National Health Mission is implementing following in under Protect, Prevent and Treat framework to achieve Global Action Plan for Pneumoni by 2025.

- Defeat Diarrhoea (D2 ) initiative has been launched for reducing child deaths due to country. The initiative includes promoting use of Oral Rehydration Solution (ORS) among children by improved availability, pre - positioning of ORS to households and demonstration preparation, promoting handwashing, organizing campaigns for enhanced adv communication on prevention and control of diarrhoea, facility level strengthening dehydration,  interpersonal  activities  by  Auxiliary Nurse  Midwife  (ANM)  during  Village  He Sanitation and Nutrition Days (VHSND) and mobile health teams for urban areas and terrains for intensified diarrhoea control activities.
- SAANS  (Social  Awareness  and  Actions  to  Neutralize  Pneumonia Successfully)  Initiative  ha launched to accelerate action to reduce deaths due to Childhood Pne SAANS initiative encompasses a three tiered strategy: i) National Childhood Pneumonia Guidelines on treatment and management of Chil dhood Pneumonia; ii) Skill building and tr service  providers  for  identification  and  standardized  management  of  Pneumonia; 0 communication  SAANS  Campaign  to  ensure  greater  awareness  on  childhood  Pneumonia families and parents
- Facility based -Integrated Management of Neonatal and Childhood Illness (F -IMNCI) training to bu capacity of Medical Officer and Nurses in Primary Health Centres, First Referral Health  Centres,  and District  Hospital  on  Acute  Respiratory  I nfection  (ARI)  and  Diarrh Management.
- Universal  Immunization  Programme  (UIP)  focuses  on  Measles,  Haemophilus  Influenzae virus and Pneumococcal Vaccine for prevention of pneumonia and diarrhoea. Mission I targeted to immunize chi ldren who are either unvaccinated or partially vaccinated i.e. not been covered during the rounds of routine immunization for various reasons. In Indradhanush  (IMI)  2.0  is  being  planned  as  per  road - map f r  achieving  90%  ful l  immunizatio coverage across the country.
- Early initiation and exclusive breastfeeding for first six months and appropria Child Feeding (IYCF) practices are promoted under Mothers' Absolute Affection (MAA) initiative.

Annexure Number of  Deaths  from 2009-2019 in Under 5 Children due to Diarrhoea as reported by States/UTs in HMIS

| S.No   | States/UTs           | 2019-20(till October)   | 2018-19   | 2017-18   | 2016-17   | 2015-16   | 2014-15   | 2013-14   | 2012-13   | 2011-12   | 2010-11   | 2009-10   |
|--------|----------------------|-------------------------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|
|        | All India            | 1609                    | 2715      | 4184      | 1004      | 942       | 872       | 1632      | 2953      | 4568      | 4953      | 19612     |
| 1      | A & N Islands        | 0                       | 1         | 0         |           |           |           | 2         |           | 1         | 4         |           |
| 2      | Andhra Pradesh       | 9                       | 28        | 77        | 7         | 27        | 7         | 30        | 62        | 155       | 179       | 137       |
| 3      | Arunachal Pradesh    | 0                       | 6         | 10        | 2         | 2         | 2         |           | 8         | 8         | 2         | 3         |
| 4      | Assam                | 26                      | 53        | 60        | 39        | 41        | 34        | 49        | 79        | 34        | 38        | 36        |
| 5      | Bihar                | 66                      | 141       | 241       | 143       | 38        | 1         | 259       | 443       | 264       | 248       | 451       |
| 6      | Chandigarh           | 1                       | 4         | 8         |           |           |           | 1         | 3         | 2         | 9         | 10        |
| 7      | Chhattisgarh         | 29                      | 56        | 138       | 37        | 41        | 51        | 48        | 52        | 52        | 114       | 233       |
| 8      | Dadra & Nagar Haveli | 0                       | 0         | 2         |           | 2         |           | 6         | 3         | 5         |           | 5         |
| 9      | Daman & Diu          | 1                       | 1         | 0         | 1         | 1         |           |           |           |           |           |           |
| 10     | Delhi                | 37                      | 69        | 69        | 64        | 41        | 90        | 31        | 57        | 28        | 153       | 113       |
| 11     | Goa                  | 0                       | 0         | 1         |           |           |           |           |           |           |           |           |
| 12     | Gujarat              | 254                     | 485       | 927       | 58        | 53        | 30        | 30        | 397       | 466       | 549       | 180       |
| 13     | Haryana              | 143                     | 196       | 63        |           |           |           |           | 150       | 1175      | 21        | 36        |
| 14     | Himachal Pradesh     | 18                      | 16        | 24        | 7         | 15        | 9         | 10        | 26        | 38        | 26        | 9         |
| 15     | Jammu & Kashmir      | 4                       | 11        | 4         | 7         | 9         | 4         | 5         | 1         | 14        | 1         | 251       |
| 16     | Jharkhand            | 105                     | 77        | 92        | 32        | 17        | 25        | 14        | 20        | 13        | 12        | 15        |
| 17     | Karnataka            | 61                      | 65        | 124       | 23        | 21        | 16        | 26        | 34        | 33        | 290       | 550       |
| 18     | Kerala               | 16                      | 17        | 114       |           |           |           | 2         |           |           | 5         |           |
| 19     | Lakshadweep          | 0                       | 0         | 0         | 1         |           |           |           |           |           |           | 6         |
| 20     | Madhya Pradesh       | 183                     | 314       | 328       | 147       | 155       | 111       | 96        | 204       | 486       | 445       | 2277      |
| 21     | Maharashtra          | 98                      | 100       | 81        | 35        | 16        | 59        | 285       | 395       | 814       | 539       | 11737     |
| 22     | Manipur              | 2                       | 4         | 9         | 5         | 7         | 9         | 7         | 4         | 11        | 14        | 8         |
| 23     | Meghalaya            | 40                      | 98        | 153       | 99        | 122       | 83        | 114       | 95        | 61        | 101       | 93        |
| 24     | Mizoram              | 6                       | 2         | 11        | 13        | 11        | 17        | 19        | 19        | 11        | 23        | 24        |
| 25     | Nagaland             | 2                       | 8         | 8         | 3         | 5         | 3         | 3         | 7         | 7         |           | 16        |
| 26     | Odisha               | 37                      | 57        | 83        | 34        | 59        | 69        | 36        | 66        | 85        | 799       | 1212      |
| 27     | Puducherry           | 0                       | 2         | 0         |           | 1         |           | 2         | 1         |           | 1         | 14        |
| 28     | Punjab               | 39                      | 35        | 82        | 55        | 66        | 70        | 55        | 56        | 94        | 85        | 69        |
| 29     | Rajasthan            | 170                     | 260       | 128       | 79        | 90        | 68        | 365       | 482       | 370       | 427       | 937       |
| 30     | Sikkim               | 0                       | 1         | 2         |           |           |           |           |           |           | 3         |           |
| 31     | Tamil Nadu           | 19                      | 51        | 129       | 13        | 15        | 48        | 68        | 147       | 117       | 156       | 124       |
| 32     | Telangana            | 9                       | 166       | 116       | 5         |           | 3         | 2         | 4         | 4         | 1         | 13        |
| 33     | Tripura              | 2                       | 1         | 5         | 4         | 7         | 1         | 29        | 76        | 126       | 143       | 865       |
| 34     | Uttar Pradesh        | 198                     | 313       | 550       | 38        | 50        | 24        | 6         | 4         | 3         | 11        | 45        |
| 35     | Uttarakhand          | 16 18                   | 22 55     | 31 514    | 8 45      | 5 25      | 6 32      | 32        | 58        | 91        | 554       | 143       |

| S.No   | States/UTs           | 2019-20(till October)   | 2018-19   | 2017-18   | 2016-17   | 2015-16   | 2014-15   | 2013-14   | 2012-13   | 2011-12   | 2010-11   | 2009-10   |
|--------|----------------------|-------------------------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|-----------|
|        | All India            | 6753                    | 14949     | 16282     | 10015     | 9486      | 9672      | 7116      | 9235      | 11620     | 10764     | 13610     |
| 1      | A & N Islands        | 3                       | 0         | 10        | 4         | 4         | 4         | 6         | 7         | 20        | 15        | 15        |
| 2      | Andhra Pradesh       | 266                     | 437       | 576       | 163       | 215       | 109       | 185       | 312       | 379       | 330       | 138       |
| 3      | Arunachal Pradesh    | 9                       | 12        | 10        | 6         | 16        | 6         | 6         | 9         | 11        | 12        | 19        |
| 4      | Assam                | 359                     | 793       | 1050      | 448       | 388       | 397       | 295       | 344       | 259       | 225       | 153       |
| 5      | Bihar                | 197                     | 544       | 836       | 470       | 213       | 4         | 82        | 291       | 241       | 109       | 61        |
| 6      | Chandigarh           | 10                      | 51        | 45        | 11        | 38        | 58        | 36        | 81        | 93        | 75        | 20        |
| 7      | Chhattisgarh         | 332                     | 646       | 669       | 565       | 601       | 665       | 544       | 534       | 497       | 288       | 365       |
| 8      | Dadra & Nagar Haveli | 4                       | 17        | 26        | 11        | 6         | 13        | 15        | 23        | 22        | 20        | 33        |
| 9      | Daman & Diu          | 2                       | 2         | 0         |           |           | 1         | 1         | 1         | 1         |           |           |
| 10     | Delhi                | 304                     | 792       | 817       | 296       | 392       | 412       | 319       | 336       | 216       | 393       | 430       |
| 11     | Goa                  | 7                       | 7         | 11        | 6         | 7         | 15        | 5         | 1         |           |           |           |
| 12     | Gujarat              | 513                     | 1166      | 1337      | 520       | 312       | 373       | 211       | 225       | 466       | 553       | 629       |
| 13     | Haryana              | 190                     | 456       | 138       | 184       | 262       | 187       | 203       | 285       | 1359      | 63        | 73        |
| 14     | Himachal Pradesh     | 23                      | 68        | 52        | 56        | 57        | 63        | 64        | 85        | 110       | 83        | 57        |
| 15     | Jammu & Kashmir      | 31                      | 114       | 45        | 38        | 55        | 34        | 22        | 7         | 18        | 11        | 193       |
| 16     | Jharkhand            | 122                     | 236       | 225       | 100       | 79        | 98        | 55        | 69        | 56        | 68        | 59        |
| 17     | Karnataka            | 339                     | 625       | 691       | 372       | 388       | 351       | 349       | 286       | 322       | 563       | 1144      |
| 18     | Kerala               | 78                      | 111       | 157       | 5         | 10        | 22        | 46        | 34        | 32        | 53        | 1         |
| 19     | Lakshadweep          | 0                       | 2         | 0         | 1         | 1         |           |           |           | 1         |           | 2         |
| 20     | Madhya Pradesh       | 957                     | 1977      | 1907      | 1497      | 1405      | 1083      | 551       | 779       | 1393      | 1252      | 3205      |
| 21     | Maharashtra          | 426                     | 1015      | 980       | 781       | 770       | 1155      | 427       | 1774      | 1994      | 1635      | 1899      |
| 22     | Manipur              | 4                       | 9         | 13        | 12        | 14        | 11        | 6         | 12        | 5         | 10        | 5         |
| 23     | Meghalaya            | 242                     | 409       | 429       | 632       | 589       | 435       | 296       | 295       | 209       | 308       | 218       |
| 24     | Mizoram              | 38                      | 67        | 85        | 75        | 93        | 265       | 208       | 200       | 80        | 196       | 209       |
| 25     | Nagaland             | 17                      | 29        | 31        | 24        | 30        | 21        | 15        | 14        | 9         | 5         | 10        |
| 26     | Odisha               | 591                     | 1262      | 1125      | 1012      | 868       | 1011      | 825       | 1085      | 1386      | 1321      | 1877      |
| 27     | Puducherry           | 11                      | 42        | 52        | 4         |           | 3         | 5         | 1         |           | 2         | 19        |
| 28     | Punjab               | 71                      | 153       | 205       | 130       | 145       | 132       | 128       | 137       | 227       | 164       | 170       |
| 29     | Rajasthan            | 431                     | 1198      | 1676      | 1482      | 1285      | 1171      | 923       | 373       | 792       | 838       | 952       |
| 30     | Sikkim               | 5                       | 11        | 6         | 3         | 14        | 28        | 9         | 1         | 3         | 9         | 4         |
| 31     | Tamil Nadu           | 162                     | 267       | 396       | 89        | 125       | 389       | 350       | 571       | 281       | 524       | 524       |
| 32     | Telangana            | 97                      | 182       | 189       | 65        | 54        | 57        | 56        | 77        | 70        | 27        | 98        |
| 33     | Tripura              | 27                      | 57        |           | 98        | 112       | 126       | 36        | 159       |           | 185       | 325       |
| 34     | Uttar                |                         |           | 81        |           | 167       | 33        | 823       |           | 270       |           | 28        |
| 35     | Pradesh Uttarakhand  | 206 27                  | 568 49    | 990 32    | 118 14    | 26        | 58        | 14        | 11 816    | 17 781    | 24 1403   | 675       |

| 36   | West Bengal   | 652   | 1575   | 1390   | 723   | 745   | 882   |
|------|---------------|-------|--------|--------|-------|-------|-------|