UN goals on MDG targets

UN Goals on Infant Mortality
The report “Infant and Child
Mortality in India”- Levels, Trends
and Determinants published by
NIMS-ICMR and UNICEF mentions
that among India’s major states, six
states namely Kerala and Tamil
Nadu in the south, Maharashtra in
the West, Punjab and Himachal
Pradesh in the North and West
Bengal in the Eastern part of India
are likely to achieve MDG-4 target
of U5MR below 39 by 2015.
However, as per the latest SRS data
on IMR and U5MR, a large number
of states are on course to meet the
UN MDG goal.
As per the above said report,
impact of key socio-economic
determinants on Infant and Child
mortality are as under:
Infant mortality rate among
children born to illiterate
mothers has been consistently
higher than those born to
mothers with any education.
The estimate showed that the
lowest mortality levels were
seen among children born to
women with more than 12
years of education and the
highest were among those born
to mothers with no education.

Children born in scheduled
caste and scheduled tribe
families have a significantly
higher risk of dying than
others.
All components of under-five
mortality have an inverse
association with economic
status as measured by Standard
of Living Index. However,
during the period covered by
the analysis, the decline in
infant mortality has been much
steeper among the children
born in low SLI households
(37.5%), as compared to those
born in high SLI households
(10.7%).
Between 1981 and 2005, IMR
and U5MR were consistently
lower among children living in
families who accessed drinking
water from a safe source as
compared to those who
accessed drinking water from
an unsafe source.
All components of Under-five
mortality are higher for
children in households that do
not have access to a flush or pit
toilet, in India as a whole.
Under National Rural Health
Mission (NRHM), higher resources
are being provided to the states and
districts with week health
indicators. Further, the following
interventions are implemented to
reduce Infant and Child mortality
rates and to achieve MDG goals in
the country:
1) Promotion of Institutional
Delivery through
JananiSurakshaYojana (JSY) and
JananiShishuSurakshaKaryakram
(JSSK): Promoting Institutional
delivery to ensure skilled birth
attendance is key to reducing both
maternal and neo-natal mortality.
JSY incentivizes pregnant women to
opt for institutional delivery and
provides for cash assistance. JSSK
entitles all pregnant women to
absolutely free and zero expense
delivery including caesarean
section operation in Government
health facilities and provides for
free to and fro transport, food,
drugs and diagnostics. Similar
entitlements have also been put in
place for sick neonates.
2) Strengthening Facility based
newborn care: Newborn care
corners (NBCC) are being set up at
all health facilities where deliveries
take place to provide essential
newborn care at birth to all new
born babies; Special New Born Care
Units (SNCUs) at District Hospitals
and New Born Stabilization Units
(NBSUs) at FRUs are being set up
for the care of sick newborn. As on
date 399 SNCUs, 1542 NBSUs and
11508 NBCCs are functional across
the country.
3) Home Based Newborn Care
(HBNC): Home based newborn care
through ASHA has recently been
initiated to improve new born care
practices at the community level
and for early detection and referral
of sick new born babies. The
schedule of home visits by ASHA
consists of at least 6 visits in case
of institutional deliveries, on days
3, 7, 14, 21, 28 & 42nd days and
one additional visit within 24 hours
of delivery in case of home
deliveries. Additional visits will be
made for babies who are pre-term,
low birth weight or ill.
4) Capacity building of health
care providers: Various trainings
are being conducted under National
Rural Health Mission (NRHM) to
build and upgrade the skills of
doctors, nurses and ANM for early
diagnosis and case management of
common ailments of children and
care of newborn at time of birth.
These trainings include Integrated
Management of Neo-natal and
Childhood Illness(IMINCI) and
NavjaatShishuSurakshtaKaryakaram
(NSSK). A total of 5.5 lakh health
care workers have been trained in
IMNCI in 471districts and 88,428
health workers trained in NSSK so
far.
5) Management of Malnutrition:
Emphasis is being laid on reduction
of malnutrition which is an
important underlying cause of child
mortality. 594 Nutritional
Rehabilitation Centres have been
established for management of
Severe Acute Malnutrition (SAM).
Iron and Folic Acid is also provided
to children for prevention of
anaemia. Recently, weekly Iron and
Folic Acid is proposed to be
initiated for adolescent population.
As breastfeeding reduces infant
mortality, exclusive breastfeeding
for first six months and appropriate
infant and young child feeding
practices are being promoted in
convergence with Ministry of
Woman and Child Development.
6) Village Health and Nutrition
Days (VHNDs) are also being
organized for imparting nutritional
counseling to mothers and to
improve child care practices.
7) Universal Immunization
Program (UIP): Vaccination against
seven diseases is provided to all
children under UIP. Government of
India supports the vaccine program
by supply of vaccines and syringes,
cold chain equipments and
provision of operational costs. UIP
targets to immunize 2.7 crore
infants against seven vaccine
preventable diseases every year. 21
states with more than 80%
coverage have incorporated second
dose of Measles in their
immunization program.
Pentavalent vaccine has been
introduced in two states of Kerala
and Tamil Nadu and proposed to be
scaled up in six more states. Year
2012-13 has been declared as ‘Year
of intensification of Routine
Immunization’.
8)Mother and Child Tracking
System: A name based Mother and
Child Tracking System has been put
in place which is web based to
enable tracking of all pregnant
women and newborns so as to
monitor and ensure that complete
services are provided to them.
States are encouraged to send SMS
alerts to beneficiaries reminding
them of the dates on which services
are due and generate beneficiary-
wise due list of services with due
dates for ANMs on a weekly basis.
Besides the above, various
programmes are being implemented
by MORD, MOUD, HUPA,
Department of school education
and literacy, MWCD to address
social and economic determinants
of health like drinking water,
sanitation, nutrition, education,
women empowerment, poverty etc
that have a bearing on reduction of
infant and child mortality .
This information was give