Karnataka - Gulbarga   

Challenge of newborn babies' healthcare grows bigger

By T.V. Sivanandan

GULBARGA, JAN. 8. The challenge of protecting the health of newborn babies in India is bigger than that experienced by any other country in the world.

According to a joint study conducted by the World Health Organisation (WHO), the National Neonatology Forum and the United Nations Children's Fund (UNICEF) on the "State of newborns in India," of the 26 million newborns every year, 1.2 million die within the first four weeks.

This constitutes 30 per cent of the 3.9 million neonatal deaths worldwide.

High mortality rate

Official sources told The Hindu here today that the report pointed out that the current Neonatal Mortality Rate (NMR) of 44 deaths per 1,000 live births accounted for nearly two-thirds of the global infant mortality and half of the global child mortality (the number of deaths of children below the age of five years per 1,000 live births).

Of this, one-third of all neonatal deaths in the country occur on the first day, almost half within three days and around three fourths within the first week.

The study has also pointed out that the undivided States of Uttar Pradesh, Madhya Pradesh and Bihar together accounted for over 50 per cent of the number of neonatal deaths in India in the year 2000.

This was roughly 15 per cent of the global neonatal deaths. Neonatal mortality varies widely among the States in India. While the number of deaths was as low as 10 per 1,000 live births in Kerala, it was around 60 in Orissa and Madhya Pradesh.

Causes

Infections, birth asphyxia, and premature birth were identified as the leading causes of neonatal deaths. The study estimates the stillbirth rate in India at 30 to 35 per 1,000 births and the perinatal mortality rate was around 60 to 70 per 1,000 live births.

The study said that almost two-thirds of all deliveries took place at home and only 42 per cent of these were attended by skilled birth attendants.

Sources said that another area of concern was the high rate of maternal mortality in India, which is also said to be the highest in the world.

Of the 5.29 lakh maternal deaths each year in the world, India accounts for 1.36 lakh deaths. Hemorrhage, Anaemia, Puerperal Sepsis, obstructed labour, and abortions were the primary causes of maternal deaths in India.

Birth weight

The study has revealed that almost eight million low birth weight infants were born in India every year, accounting for around 40 per cent of low birth weight infants in the world.

It also said that 75 per cent of neonatal deaths occurred in infants with low birth weight. It said that these infants continued to suffer a higher risk of mortality beyond the neonatal period.

A growing body of evidence from the country suggests that full-term low birth weight babies are at a higher risk of developing a variety of adult-onset diseases.

Asphyxia was the second most prevalent cause of neonatal deaths. Around 4 per cent of infants suffer from significant asphyxia at birth in homes, the study revealed.

Population policy

The National Population Policy devised by the Union Government aims at reducing the infant mortality rate to less than 30 per 1,000 live births by 2010.

However, to achieve this goal it is imperative that the neonatal mortality rate is reduced to around 20 per 1,000 live births.

The policy also aims at reducing the maternal mortality rate to 100 per 1,00,00 deliveries by 2010.

At present the rate is 540 maternal deaths per 1,00,000 deliveries. Other policy goals include achieving an institutional delivery rate of 80 per cent and 100 per cent deliveries by trained persons by 2010.

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