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Measures to Check Mortality Rate of Children
Jun 19, 2015

Millennium Development Goal (MDG) pertains to reduction of child mortality and sets a target of reducing mortality among children under 5 by two-third between 1990 and 2015. This translates into under 5 mortality rate goal for India as 42 per thousand live births. 

Annual rate of decline in India’s under 5 mortality rate was 4.0 % during the period 1990 to 2013, which has accelerated during 2008-13 to 6.6%. India is on track to attain the MDG goal by 2015 if the current trend of decline is sustained.

Under the National Health Mission (NHM), following interventions are being implemented to bring down mortality rate among children in all States:

 Janani Shishu Suraksha Karyakaram (JSSK) entitles all pregnant women delivering in public health institutions to absolutely free and no expense delivery including Caesarean section. The initiative stipulates free drugs, diagnostics, blood and diet, besides free transport from home to institution, between facilities in case of a referral and drop back home. Similar entitlements have been put in place for all sick infants accessing public health institutions for treatment till one year of age.

 Facility Based Newborn Care (FBNC) at different levels to reduce child morbidity and mortality: Setting up of facilities for care of sick newborn such as Special New Born Care Units (SNCUs), Newborn Stabilization Units (NBSUs) and Newborn Care Corners (NBCCs) at different levels is a thrust area under NHM.

 Home Based New Born Care (HBNC): Home based newborn care through ASHAs has been initiated to improve new born practices at the community level and early detection and referral of sick new born babies. 

♦ India Newborn Action Plan (INAP) has been launched with an aim to reduce neonatal mortality and stillbirths. 

♦ Newer interventions to reduce newborn mortality: Vitamin K injection at birth, Antenatal corticosteroids for preterm labour, kangaroo mother care and injection gentamicin to young infants in cases of suspected sepsis. 

♦ Intensified Diarrhoea Control Fortnight was observed in August 2014 focusing on ORS and Zinc distribution for management of diarrhoea and feeding practices. 

 Integrated Action Plan for Pneumonia and Diarrhoea (IAPPD) launched in four states with highest child mortality (UP, MP, Bihar and Rajasthan). 

♦ Management of Malnutrition: Nutritional Rehabilitation Centres (NRCs) have been established for management of severe acute malnutrition in children. 

♦ Appropriate Infant and Young Child Feeding practices are being promoted in convergence with Ministry of Woman and Child Development. 

♦ Village Health and Nutrition Days (VHNDs) are organized for imparting nutritional counselling to mothers and to improve child care practices. 

 Mother and Child Tracking System (MCTS): A name based Mother and Child Tracking System has been put in place which is web based to ensure registration and tracking of all pregnant women and new born babies so that provision of regular and complete services to them can be ensured. 

♦ Rashtriya Bal Swasthya Karyakram (RBSK) for health screening and early intervention services has been launched to provide comprehensive care to all the children in the age group of 0-18 years in the community. The purpose of these services is to improve the overall quality of life of children through early detection of birth defects, diseases, deficiencies, development delays including disability. 

♦ Under National Iron Plus Initiative (NIPI), through life cycle approach, age and dose specific IFA supplementation programme is being implemented for the prevention of anaemia among the vulnerable age groups like under-5 children, children of 6 – 10 years of age group, adolescents, pregnant & lactating women and women in reproductive age along with treatment of anaemic children and pregnant mothers at health facilities. 

♦ Capacity building of health care providers: Various trainings are being conducted under NHM to train doctors, nurses and ANMs for essential newborn care, early diagnosis and case management of common ailments of children. These trainings are on Navjaat Shishu, Suraksha Karyakram (NSSK), Integrated Management of Neonatal and Childhood Illnesses (IMNCI), Facility Based Newborn Care (FBNC), Infant and Young Child Feeding practices (IYCF), etc. 

 Universal Immunization Programme (UIP) covers about 13.5 crore children for vaccination against seven vaccine preventable diseases, through 90 lakh immunization sessions each year. 

♦ To sharpen the focus on vulnerable and marginalized populations in underserved areas, 184 High Priority Districts have been identified for implementation of Reproductive Maternal Newborn Child Health+ Adolescent (RMNCH+A) interventions for achieving improved maternal and child health outcomes. 


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