Need to rethink approaches to infant & maternal healthcare

The figures reporting the decline in infant deaths in India is something to celebrate. Data for 2015 shows that 27 babies died for every 1,000 births, which is two better than the government’s own projected figures.

That is a drop of 53%, which is still far short of 67%, which is what India had promised to achieve under the MDGs. But it is promising in that it shows government programs to reduce baby deaths like incentivizing institutional deliveries, providing supplements to pregnant women, etc., is having some impact.

Data from states like Goa, Manipur and Punjab, which have reported a drop of over 60% in IMR is especially promising. However, compare this to the high rates in Uttarakhand and Madhya Pradesh and one gets a picture of just how patchy and uneven the quality of healthcare services remains.

This is a critical lack and needs to be addressed, as high IMR is a report card of the health of the country and an indicator of the future growth potential. Clearly policies aimed towards maternal and infant health need a rethink given the huge gaps that exist.

While widespread illiteracy, poor nutrition and sanitation, and lack of awareness are key factors that explain the high rates, the poor healthcare infrastructure on the ground is evident in the high number of deaths reported from states like Odisha, which witnessed the deaths of over 50 children in just two weeks in a state-run children’s hospital. 151 deaths were reported across hospitals in Kendrapara in Odisha in just 4 months.

There is a need to address the system on the ground and look at what the shortfalls are. Maternal and child health policies cannot work in isolation. There are important connections between these groups and there is a need to strengthen the continuum of care to ensure that an unbroken curve spans the home, community, health center, and hospital. This would help manage the maternal-newborn-child health scale of care in a more unified way.

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