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Burden of infant deaths in TN
TN hopes to bring down Infant Mortality Rate on a par with developed countries by 2023.
By
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Chennai
Despite the various initiatives taken by the state government to reduce infant deaths due to pneumonia, malnutrition, diarrhoea and prematurity, which are among the main causes for infant mortality in the state, the current level of Infant Mortality Rate (IMR) for the year 2015 in the state is 19 per 1000 live births.
As per the Sample System Survey (2015), Tamil Nadu ranks second lowest among major states in the country but it is still high considering international standards. The government is therefore, putting in efforts to bring the IMR in the state to below 13 per 1000 by the end of 2017 and on a par with developed nations by 2023, under a programme called ‘Vision 2023’. ’. “The state is focussing on components such as the neonatal mortality rate.
We are also creating awareness on the need to stop all preventable deaths,” said Health Minister C Vijaya Baskar.
More neonatal units: Various programmes are being introduced to tackle death of newborns. “We already have 64 neonatal units in the state and are introducing five more in Tiruttani, Rajapalayam, Vridhachalam, Tambaram and Gudiyatham,” said a Health official, adding that Government Orders (GOs) have been issued for the same. “In one year, around 1.20 lakh babies get admitted and over 10 lakh babies are delivered in the state. Out of them, 10 to 12 per cent are admitted in Government hospitals, which is the largest, when compared to any other state. All the 64 units that have Comprehensive Emergency Obstetric and Newborn Care (CEmONC) centres, so as to improve obstetrical care.
Dr K Kumaran, a paediatrician, said, “Even though the state has been seeing a fall in the number of infant deaths each year, unless serious efforts are taken both by the government and private parties, deaths will continue. Factors like malnutrition should be the focus of the government, which, if checked, will surely result in much fewer deaths.”
Stating that the state has established three nutrition rehabilitation centres in Perambur, Dharmapuri and Institute for Child Health and Children’s Hospital, Egmore (ICH), Chennai, Dr Srinivasan, head, Newborn and Infant Critical Care Unit (NICCU), ICH, said that a Vitamin A prophylaxis programme is also being implemented for six months.
Narrowing down on the killer diseases, Dr D Saminathan, former director, ICH, said, “Once the maternal and child health care is improved, the IMR and MMR are bound to come down.
The state is also going to start Rotavirus and pneumococcal vaccines shortly. The two killer diseases of IMR are basically diarrhoea and respiratory infections, which constitute two thirds of infant mortality.” Attributing a large number of deaths of premature babies due to lack of follow-ups, he added that it is one of the most common causes for postneonatal deaths, which the state must address. “Merely providing treatment in hospitals will not help check the burden of infant deaths,” he added.
Targeting single digit in maternal deaths
With the Maternal Mortality Rate (MMR) in the state being at 14 per 1000 live births, the need for increased efforts to be taken up to check the burden of deaths, is felt essential.
With this in mind, the state government is planning to bring it on a par with developed nations by 2023. “Multiple steps are being taken to achieve the same. We have made it mandatory for all pregnancies in the state to be registered.
We are strengthening the 126 Comprehensive Emergency Obstetric and New Born Care (CEmONC) centres in the state and ensuring the availability of blood round-the-clock for emergencies,” said Dr K Kolandaisamy, Director, Department of Public Health.
While the main causes for maternal deaths are hypertension during pregnancy and post-partum haemorrhage, anaemia is one of the main aspects the government is focusing on, as it is responsible for all the causes of maternal deaths. “Iron sucrose injections are being administered to check anaemia cases among women.
The government is conducting a maternal death audit at the district level to identify what can be done to prevent the same in future. We are also using the partograph to help monitor all delivery parameters,” he added.
Between 2015 and 2016 the state had reported 637 maternal deaths, amounting to MMR of 62 per 1,00,000 live births.
“Various schemes like the Dr Muthulakshmi Reddy Maternity Benefit Scheme, the Birth Companion Programme, 24x7 delivery care services in all Primary Health Cares (PHCs), birth waiting rooms, accessible blood bank and storage centres, the Menstrual Hygiene programme and the Chief Minister’s Health Insurance Scheme, have all been there for some time now and have contributed in improving the maternal and child health in the state,” said Dr Srinivasan, of the Institute of Child Health and Children’s Hospital, Egmore.
Though maternal deaths have been coming down, the rapidity of the fall, which is one or two each year, should improve. “As our aim is to reach single digit by 2018, the fall should be three to four,” he added.
IRON HAND
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