Lok Sabha Question No. 1029 (UNSTARRED), answered on 2020-02-07
Subject: Neonatal Mortality
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Badruddin Ajmal

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

## LOK SABHA UNSTARRED QUESTION NO. 1029 TO BE ANSWERED ON 7 th FEBRUARY, 2020

## NEONATAL MORTALITY

## 1029. SHRI M. BADRUDDIN AJMAL:

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

- (a) whether the UNICEF in its global report on neonatal mortality has revealed that in India nearly  6 lakh  newborn  die  each  year,  if  so,  the  details  thereof indicating  the  number  of newborn deaths during last five y ears, State/UT and year -wise;
- (b) whether is it a fact that more than 80 per cent die from preventable and treatable causes such  as  premature birth,  complications  during  delivery  and  infections  like sepsis  and pneumonia;
- (c)  if  so,  the  details  of preventive  remedies  taken  by the  Government  to  save  the  life  of children during the last five years; and
- (d)  the  details  of  schemes  being  implemented  to protect  the  newborns  especially  in  rural areas?

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

- (a) & (b): As per UNICEF Annual Report 2018, Nearly Six lakh new - borns die in India within  28  days  of  their  birth  every  year  and  most  of  these  deaths  are  preve ntable  and medically treatable.

However,  as  per  Sample  Registration  System  Report,  Neonatal  Mortality  Rate  a National level has reduced from 28 per 1,000 live births in 2013 to 23 per 1,000 live 2017.  As  per  Sample  Registration  System  Report (2010 - 13),  major  causes  of  new - borns deaths in India are Prematurity & low birth weight (48.1), Birth asphyxia & birth (12.9), Neonatal Pneumonia (12.0), Other noncommunicable diseases (7.1),Sepsis (5.4), -defined  or  cause  unknown  (5.0),  Congenit al  anomalies  (4.0),  Diarrhoeal  diseases  (3.1), Injuries (0.9), Tetanus (0.5), and others (1.0).

Details of State - wise Neonatal Mortality Rate in last 5 years (2013 to 2017) is placed at annexure .

(c) & (d): Government  of  India  is  implementing  Reproductiv e,  Maternal,  Newborn, Child,  Adolescent  health  and  Nutrition  (RMNC H A+N)  strategy  under  National  Health Mission to reduce the neonatal and child mortality.

The various intervention under RMNCHA+N strategy are as below:

1. Promotion  of  Institutional  deliveries  through  cash  incentive  under  Janani  Sura Yojana  (JSY)  and  Janani  Shishu  Suraksha  Karyakaram  (JSSK)  which  entitles  all pregnant  women  delivering  in  public  health  institutions  to  absolutely  free  de including Cae sarean section, post - natal care and treatment of sick infants up toone year of age. Pradhan Mantri Matru Vandana Yojana (PMMVY) is another maternity benefit programme under which cash incentive isprovided to pregnant women and lactating mothers.
2. Strengt hening  essential  newborn  care  at  all  delivery  points,  establishment  of Sick Newborn Care Units (SNCU), Newborn Stabilization Units (NBSU) and Kangaroo Mother Care (KMC) units for care of sick and small babies.
3. Home  Based  Newborn  Care  (HBNC)  and  Home - Based  Care  of  Young  Children (HBYC) by ASHAs to improve child rearing practices and to identify sick new - born.
4. Early initiation and exclusive breastfeeding for first six months and appropriat and Young Child Feeding (IYCF) practices are promoted under Mothers' Absolute Affection (MAA) in convergence with Ministry of Women and Child Development.
5. Universal Immunization Programme (UIP) is being supported to provide vaccination to  children  against  life  threatening  diseases  such  as  Tuberculosis,  Dipht Pertussis, Polio, Tetanus, Hepatitis B, Measles, Rubella, Pneumonia and Meningi caused by Haemophilus Influenzae B. The Rotavirus vaccination has also been rolled out in the country for prevention of Rota -viral  diarrhoea.  'Mission  Indradhanush  is targeted to immunize children who are either unvaccinated or partially vaccinate those  that  have  not  been covered  during  the  rounds  of  routine  immunization  for various reasons. Intensified Mission Indradhanush (IMI) 2.0 is rolled - outas per road -map for achieving 90% full immunization coverage across the country.
6. Nutrition Rehabilitation Centres (NRCs) have been set up at public health facilities to treat and manage the children with Severe Acute Malnutrition (SAM) admitted wit medical complications.
7. Defeat Diarrhoea (D2) initiative has been launched for promoting ORS and Zinc u and eliminating the diarrh oeal deaths by 2025.
8. Social  Awareness  and  Actions  to  Neutralize  Pneumonia  Successfully  (SAANS) initiative for reduction of Childhood morbidity and mortality due to Pneumonia.
9. Anaemia  Mukt  Bharat  (AMB)  strategy  as  a  part  of  Poshan  Abhiyan  aims  to strengt hen  the  existing  mechanisms  and  foster  newer  strategies  to  tackle  anaemi which include testing & treatment of anaemia in school going adolescents & pregn women,  addressing  non  nutritional  causes  of  anaemia  and  a  comprehensive communication strategy.
10. 10.All  the  children  from  0  to  18  years  of  age  are  screened  for  30  health  condi classified into 4Ds -Diseases, Deficiencies, Defects and Developmental delay under 'Rashtriya Bal Swasthya Karyakaram' (RBSK) to improve the quality of survival and to  reduc e  out  of  pocket  expenditure  of  families. District  early  intervention  centre (DEIC)  at  district  health  facility  level  are  established  for  confirmatio management of the 4D's.
11. 11.National  Deworming Day  (NDD)  is  implemented  biannually  every deworm ing of children (one to nineteen year of age).

year  for

- 12.Village Health Sanitation and Nutrition Days (VHSNDs) are observed for provisio of maternal and child health services and awareness on maternal and child Health nutrition education through mass and socia l media to improve healthy practices and to generate demand for service uptake.
- 13.Name based tracking of mothers and children till two years of age is done thr RCH portal to ensure complete antenatal, intranatal, postnatal care and immuniza as per schedule.

|                                                               |                                                               |                                                               |                                                               | ANNEXURE                                                      | ANNEXURE                                                      |
|---------------------------------------------------------------|---------------------------------------------------------------|---------------------------------------------------------------|---------------------------------------------------------------|---------------------------------------------------------------|---------------------------------------------------------------|
| State - wise trend of Neonatal Mortality Rate (NMR) in India, | State - wise trend of Neonatal Mortality Rate (NMR) in India, | State - wise trend of Neonatal Mortality Rate (NMR) in India, | State - wise trend of Neonatal Mortality Rate (NMR) in India, | State - wise trend of Neonatal Mortality Rate (NMR) in India, | State - wise trend of Neonatal Mortality Rate (NMR) in India, |
| States                                                        | 2013                                                          | 2014                                                          | 2015                                                          | 2016                                                          | 2017                                                          |
| India                                                         | 28                                                            | 26                                                            | 25                                                            | 24                                                            | 23                                                            |
| Andhra Pradesh                                                | 25                                                            | 26                                                            | 24                                                            | 23                                                            | 23                                                            |
| Assam                                                         | 27                                                            | 26                                                            | 25                                                            | 23                                                            | 22                                                            |
| Bihar                                                         | 28                                                            | 27                                                            | 28                                                            | 27                                                            | 28                                                            |
| Chhattisgarh                                                  | 31                                                            | 28                                                            | 27                                                            | 26                                                            | 26                                                            |
| Delhi                                                         | 16                                                            | 13                                                            | 14                                                            | 12                                                            | 14                                                            |
| Gujarat                                                       | 26                                                            | 24                                                            | 23                                                            | 21                                                            | 21                                                            |
| Haryana                                                       | 26                                                            | 23                                                            | 24                                                            | 22                                                            | 21                                                            |
| Himachal Pradesh                                              | 25                                                            | 25                                                            | 19                                                            | 16                                                            | 14                                                            |
| Jammu & Kashmir                                               | 29                                                            | 26                                                            | 20                                                            | 18                                                            | 17                                                            |
| Jharkhand                                                     | 26                                                            | 25                                                            | 23                                                            | 21                                                            | 20                                                            |
| Karnataka                                                     | 22                                                            | 20                                                            | 19                                                            | 18                                                            | 18                                                            |
| Kerala                                                        | 6                                                             | 6                                                             | 6                                                             | 6                                                             | 5                                                             |
| Madhya Pradesh                                                | 36                                                            | 35                                                            | 34                                                            | 32                                                            | 33                                                            |
| Maharashtra                                                   | 17                                                            | 16                                                            | 15                                                            | 13                                                            | 13                                                            |
| Orissa                                                        | 37                                                            | 36                                                            | 35                                                            | 32                                                            | 32                                                            |
| Punjab                                                        | 16                                                            | 14                                                            | 13                                                            | 13                                                            | 13                                                            |
| Rajasthan                                                     | 32                                                            | 32                                                            | 30                                                            | 28                                                            | 27                                                            |
| Tamil Nadu                                                    | 15                                                            | 14                                                            | 14                                                            | 12                                                            | 11                                                            |
| Telangana                                                     |                                                               | 25                                                            | 23                                                            | 21                                                            | 20                                                            |
| Uttar Pradesh                                                 | 35                                                            | 32                                                            | 31                                                            | 30                                                            | 30                                                            |
| Uttarakhand                                                   |                                                               | 26                                                            | 28                                                            | 30                                                            | 24                                                            |
| West Bengal                                                   | 21                                                            | 19                                                            | 18                                                            | 17                                                            | 17                                                            |