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Plan to check child deaths

New Delhi, Feb. 4: About 130 million adolescents will receive free iron and folic acid pills every week when an initiative to prepare girls for safe motherhood and reduce India’s child mortality expands across the country later this year, Union health ministry officials said today.

The iron and folic acid supplementation is part of a multi-pronged initiative that seeks to encourage states to merge all reproductive, maternal, newborn, child and adolescent (RMNCH+A) health activities, the officials said.

They said the RMNCH+A initiative, which would also contain health education and family planning components, was a key step towards the goal of reducing India’s child mortality figures from the current 59 per 1,000 live births to 33 by 2017 and 20 by 2035.

Health officials estimate that nearly 50 per cent of girls between 15 and 20 have anaemia and need iron and folic acid supplementation. “Improving the health of adolescent girls helps reduce risks to their future babies,” said Rakesh Kumar, joint secretary in the health ministry in charge of reproductive and child health.

Around eight states, including Bengal, Odisha and Tripura, have already introduced the supplementation, and the scheme is expected to cover the entire country by April this year, Kumar said. The expanded programme will reach out to 60 million girls in government and government-aided schools, and an additional 70 million outside schools.

The ministry will later this week launch a document it is calling a “roadmap” that provides guidelines to states to implement the initiative. The document will also contain guidelines on education to encourage adolescents to curb early marriages and early pregnancies and to space children, Kumar said.

Anaemia during adolescence or early pregnancies increases the risk of low-birthweight babies who, doctors say, are at a greater risk of developing infections than babies with normal birthweight.

Since 2005, India’s decline in under-five mortality has accelerated to an average of 7.5 per cent each year, said Anuradha Gupta, additional secretary in the ministry. “Though the average mortality has been lower in urban areas, the rate of decline in rural areas has been much faster.”

International health officials believe this has been achieved through a combination of measures, from the establishment of newborn care units to encouraging deliveries in hospitals or clinics to improved community-based care of children.

For instance, in the last three years alone, newborn care units have been established across 400 district hospitals, said Satish Gupta, a Unicef health specialist.