regular-article-logo Saturday, 30 September 2023

Some cheer: Editorial on declining infant mortality rate

Improvements in IMR cannot be independent of improvements in other parameters like malnutrition, maternal mortality ratio, inoculation of children and so on

The Editorial Board Published 10.06.22, 03:39 AM
Representational image

Representational image File photo

Reports on India’s health parameters are usually disheartening — minimal GDP investment and the poor medical infrastructure are some of the causes of this depressing picture. But there is some cause for cheer when it comes to India’s infant mortality rate. In the last decade, the country’s IMR has shown significant improvement. From 47 in 2010, it has fallen to 28 in 2020, thereby coming close to the global IMR standard of 27. Several factors are thought to have contributed to this achievement. Improved health services that prevent and timely treat causes of child mortality — complications during birth, neonatal sepsis, pneumonia, diarrhoea, low birth weight and such — have improved the count. The contribution of community caregivers such as anganwadi workers and Accredited Social Health Activists — these personnel are ignored by the incentive schemes of the government — must be acknowledged. There seems to be a gradual realisation among women about the importance of giving birth in hospitals: the last-mile coverage of hospital care must, therefore, be widened.

But the success has been uneven, as is borne out by the disparity among states: Kerala’s IMR in 2020 was 6, while Madhya Pradesh’s was 43. Expectedly, the IMR in rural areas is much higher than in urban areas — 31 and 19, respectively. There are other sobering indicators. In South Asia, the IMRs of Sri Lanka, Bangladesh, Nepal and Bhutan are lower than that of India. There is thus a case for India to learn from its smaller neighbours. Sri Lanka’s highly effective domiciliary and institutional care system for expectant mothers and children has been a success; Bangladesh has also set a milestone in terms of its public-private partnerships in the healthcare sector. These can be good examples to follow. There is also the need for policy to connect the relevant dots. Improvements in IMR cannot be independent of improvements in other parameters such as malnutrition, maternal mortality ratio, dietary needs, inoculation of children and so on. India should now work on building the momentum that it has achieved in IMR to tackle other, overlapping health challenges. Progress on this front is also contingent upon strides taken in the social, cultural and economic spheres. Issues such as vaccine hesitancy, lingering reservations towards institutional care, unequal access to hospitals on account of gender and caste discrimination and the prohibitive cost of medical treatment demand urgent attention.

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