Lok Sabha Question No. 4383 (UNSTARRED), answered on 2019-07-19
Subject: IMR and CMR
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Upendra Singh Rawat, Kaushal Kishore

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

LOK SABHA UNSTARRED QUESTION NO. 4383 TO BE ANSWERED ON 19 TH JULY, 2019

## IMR AND CMR

## 4383. SHRI UPENDRA SINGH RAWAT:

## SHRI KAUSHAL KISHORE:

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

(a) the percentage of national average Infant Mortality Rate (IMR) and Child Mortality (CMR) and still births for the period of 2015 - 19; and

- (b) the steps taken by the Government to lower the present IMR, CMR and still births?

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

(a)& (b): As per Sample Registration System (SRS) of Registrar General of India, the Inf Mortality Rate (IMR) is 33 per 1000 live births, The Under 5 Mortality Rate (U5MR) is 37 1000 live births and Still Birth Rate (SBR) is 5 per 1000 births at National leve l in 2017. IMR, U5MR and SBR for the year 2015, 2016 and 2017 as per SRS Report are available and placedat annexure.

Public Health is a state subject, however to reduce Child mortality and still birth programmes and schemes under National Health Mission being implemented by States/ UTs are as follows:

- (1) Promotion  of  Institutional  deliveries  through  cash  incentive  under  Janani  Sura Yojana  (JSY)  and  Janani  Shishu  Suraksha  Karyakaram  (JSSK)  which  entitles  all preg nant women (PW) delivering 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.
- (2) Strengthening of delivery points for providing comp rehensive 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 Kangar oo Mother Care (KMC) units for care of sick and small babies. India Newborn Action Plan (INAP) was launc in  2014  to  make  concerted  efforts  towards  attainment  of  the  goals  of  'Single  Digit Neonatal  Mortality  Rate'  and  'Single  Digit  Stillbirth  Rate',  by  2 030.Comprehensive

Lactation  Management  Centres  (CLMCs)  at  facilities  with  SNCU  and  Lactation Management  Units  (LMUs)  at  Sub - district  level  are  made  functional  to  ensure availability of Human  Milk for feeding small  new - borns.  Home  Based  Newborn  Care (HBNC) and  Home  Based  Care  of  Young  Children  (HBYC)  are  being  provided  by ASHAs to improve child rearing practices.

- (3) Early initiation and exclusive breastfeeding for first six months and appropriate and Young Child Feeding (IYCF) practices are promoted in convergence with Ministry 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 .  Mothers'  Absolute Affection (MAA) programme for improving breastfeeding practices (Initial Breastfeedi within one hour, Exclusive Breastfeeding up to six months and complementary feedi up  to  two  years)  through  mass  media  campaigns  and  capacity  buildi ng  of  health  care providers in health facilities as well as in communities.
- (4) Universal Immunization Programme (UIP) is being supported to provide vaccination t children  against  life  threatening  diseases  such  as  Tuberculosis,  Diphtheria,  Pe Polio,Tetanus,  Hepatitis  B,  Measles,  Rubella,  Pneumonia  and  Meningitis  caused  by Haemophilus Influenzae B. 'Mission Indradhanush and Intensified Mission Indradhanush'  was  launched  to  immunize  children  who  are  either  unvaccinated  or partially vaccinated i.e. tho s  that have not been covered during the rounds of routine immunization for various reasons.
- (5) LaQshya a Labour Room quality improvement programme is being implemented in over 2100 health facilities across the country including medical colleges.
- (6) Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) is being implemented to provide fixed - day assured, comprehensive and quality antenatal care universally to all PW on 9th of every month.
- (7) Universal screening of pregnant women including anaemic PW is carried out at all public health facilities.180 iron and folic acid (IFA) tablets are given in the ante nata IFA tablets are given in the post - natal period to all pregnant women. Of these who are found  to  be  clinically  anaemic,  are  given  double  doses  tablets  as a  part  of  treatment regimen.
- (8) Guidelines  on  standardization  of  Labour  Rooms  and  creation  of  Obstetric  HDU  and Obstetric  ICU  at  District  Hospitals  and  Medical  Colleges  has  also  been  prepared disseminated to the States for improving quality of care durin g delivery and child birth.
- (9) Name based tracking of mothers and children till two years of age (Mother and Ch Tracking  System)  is  done  to  ensure  complete  antenatal,  intranatal,  postnatal  car complete immunization as per schedule.
- (10) Rashtriya Bal Swasthya Karyakram (RBSK) for health screening, early detection of birt defects,  diseases,  deficiencies,  development  delays  and  early  intervention  servic been operationalized to provide comprehensive care to all the children in the age gr 0- 18 years in the community.
- (11) Nutrition Rehabilitation Centres (NRCs) have been set up at public health facili treat  and  manage  the  children  with  Severe  Acute  Malnutrition  (SAM)  admitted  wit medical complications.
- (12) Iron  and  folic  acid  (IFA)  supplementati on  for  the  prevention  of  anaemia  among  the vulnerable age groups, home visits by ASHAs to promote exclusive breast feeding a promote use of ORS and Zinc for management of diarrhoea in children under Intensifi Diarrhoea Control Fortnight (IDCF), adminis tration of deworm tablets to all the children in the age group of 1 - 19 years during National Deworming Day (February and August) are carried out.
- (13) Health and nutrition education through Information, Education & Communication (IEC and Behaviour Change Commu nication (BCC) to promote healthy practices and create awareness to generate demand and improve service uptake.
- (14) To  tackle  the  problem  of  anaemia  due  to  malaria  particularly  in  pregnant  women  a children,  Long  Lasting  Insecticide  Nets  (LLINs)  and  Insectici de  Treated  Bed  Nets (ITBNs) are distributed in endemic areas.
- (15) Dietary counseling to pregnant women is provided during ante - natal visits through the existing network of sub -centres and primary health centres and other health facilities well as through ou treach activities at Village Health & Nutrition Days (VHNDs).
- (16) Various  trainings  are  being  conducted  to  build  and  upgrade  the  skills  of  health providers in basic and comprehensive obstetric care of mother during pregnancy, del and essential new - born care.

…………………….

Annexure

| Infant Mortality Rate (IMR)              | Infant Mortality Rate (IMR)              | Infant Mortality Rate (IMR)              | Infant Mortality Rate (IMR)              |
|------------------------------------------|------------------------------------------|------------------------------------------|------------------------------------------|
|                                          | 2015                                     | 2016                                     | 2017                                     |
| India                                    | 37                                       | 34                                       | 33                                       |
| Source: Sample Registration System (RGI) | Source: Sample Registration System (RGI) | Source: Sample Registration System (RGI) | Source: Sample Registration System (RGI) |

| Under 5 Mortality Rate ( U5 MR)          | Under 5 Mortality Rate ( U5 MR)          | Under 5 Mortality Rate ( U5 MR)          | Under 5 Mortality Rate ( U5 MR)          |
|------------------------------------------|------------------------------------------|------------------------------------------|------------------------------------------|
|                                          | 2015                                     | 2016                                     | 2017                                     |
| India                                    | 43                                       | 39                                       | 37                                       |
| Source: Sample Registration System (RGI) | Source: Sample Registration System (RGI) | Source: Sample Registration System (RGI) | Source: Sample Registration System (RGI) |

| Still BirthRate ( SB R)                  | Still BirthRate ( SB R)                  | Still BirthRate ( SB R)                  | Still BirthRate ( SB R)                  |
|------------------------------------------|------------------------------------------|------------------------------------------|------------------------------------------|
|                                          | 2015                                     | 2016                                     | 2017                                     |
| India                                    | 4                                        | 4                                        | 5                                        |
| Source: Sample Registration System (RGI) | Source: Sample Registration System (RGI) | Source: Sample Registration System (RGI) | Source: Sample Registration System (RGI) |