Steps Taken to Reduce IMR and MMR



Steps Taken to Reduce IMR and MMR

As per Sample Registration System (SRS), 2013 reports published by Registrar General of India the Infant Mortality Rate (IMR) of India is 40 per 1000 live births and as per Sample Registration System (SRS), 2011-13 reports Maternal Mortality Ratio (MMR) is 167 per 1,00,000 live births in the Country
.


Under the Millennium Development Goal (MDG) 4 target is to reduce Child Mortality by two-third between 1990 and 2015. In case of India, it translates into a goal of reducing Infant mortality rate from 88 per thousand live births in 1990 to 29 in 2015.


Under the Millennium Development Goal (MDG) 5, the target is to reduce Maternal Mortality Ratio (MMR) by three quarters between 1990 & 2015. This translates to reducing the MMR from 560 in 1990 to 140 in 2015.


State/UT-wise infant mortality rate and maternal mortality ratio is given below:-

States/UTs-wise status of infant mortality rate (IMR) and
maternal mortality ratio (MMR) in India




Source: Sample registration System (SRS), RGI office, 2013 & 2011-13 reports

Under National Health Mission, the following interventions are being implemented to reduce infant mortality rate and maternal mortality ratio in the Country:

Promotion of institutional deliveries through JananiSurakshaYojana.
Operationalization of sub-centres, Primary Health Centres, Community Health Centres and District Hospitals for providing 24x7 basic and comprehensive obstetric care services.
Name Based Web enabled Tracking of Pregnant Women to ensure antenatal, intranatal and postnatal care.
Mother and Child Protection Card in collaboration with the Ministry of Women and Child Development to monitor service delivery for mothers and children.
Antenatal, intranatal and postnatal care including Iron and Folic Acid supplementation to pregnant & lactating women for prevention and treatment of anaemia.
Engagement of more than 8.9 lakhs Accredited Social Health Activists (ASHAs) to generate demand and facilitate accessing of health care services by the community.
Village Health and Nutrition Days in rural areas as an outreach activity, for provision of maternal and child health services.
Adolescent Reproductive Sexual Health Programme (ARSH) – Especially for adolescents to have better access to family planning, prevention of sexually transmitted Infections, Provision of counselling and peer education.
Health and nutrition education to promote dietary diversification, inclusion of iron and folate rich food as well as food items that promote iron absorption.
10.  JananiShishuSurakshaKaryakaram (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.
11.  Universal Immunization Programme (UIP): Vaccination protects children against many life threatening diseases such as Tuberculosis, Diphtheria, Pertussis, Polio, Tetanus, Hepatitis B and Measles. Infants are thus immunized against seven vaccine preventable diseases every year. The Government of India supports the vaccine programme by supply of vaccines and syringes, cold chain equipment and provision of operational costs.
12.  Strengthening Facility based newborn care: Newborn care corners (NBCC) are being set up at all health facilities where deliveries take place; Special New Born Care Units (SNCUs) and New Born Stabilization Units (NBSUs) are also being set up at appropriate facilities for the care of sick newborn including preterm babies.
13.  Home Based Newborn Care (HBNC):  Home based newborn care through ASHA has been initiated to improve new born practices at the community level and early detection and referral of sick new born babies
14.  Capacity building of health care providers: Various trainings are being conducted under National Health Mission (NHM) to build and upgrade the skills of health care providers in basic and comprehensive obstetric care of mother during pregnancy, delivery and essential newborn care.
15.  Management of Malnutrition: Nutritional Rehabilitation Centres (NRCs) have been established for management of severe acute malnutrition in children.
16.  India Newborn Action Plan (INAP) has been launched to reduce neonatal mortality and stillbirths.
17.  Newer interventions to reduce newborn mortality- Vitamin K injection at birth, Antenatal corticosteroids for preterm labour, kangaroo mother care and injection gentamicin for possible serious bacillary infection.
18.  Intensified Diarrhoea Control Fortnight was observed in August 2014 focusing on ORS and Zinc distribution for management of diarrhoea and feeding practices.
19.  Integrated Action Plan for Pneumonia and Diarrhoea (IAPPD) launched in four states with highest infant mortality (UP, MP, Bihar and Rajasthan).

State/UT-wise allocation of funds and expenditure during each of the last three years and current year is given below:-





States/UTs-wise SPIP Approval and Expenditure under Child Health for F.Y. 2011-12 to 2014-15


SPIP- State Programme Implementation Plan

Based on the UN Inter–Agency Expert Group’s MMR estimates in the publication “Trends in Maternal Mortality: 1990 to 2013", the target for MMR is estimated to be 140 per 1,00,000 live births by the year 2015  taking a baseline of 560 per 100,000 live births in 1990. If the MMR declines at the same pace, India will achieve an MMR of 140 per 100,000 live births by 2015 and achieve the MDG target.


As per the information provided in the same report, 52 countries have MMR higher than that of India. Details are given below:-

International comparison of Maternal Mortality Ratio (MMR)

Sl. No.
Country
MMR per 1,00,000 live births
1
Sierra Leone
1100
2
Chad                      
980
3
Central African Republic                 
880
4
Somalia
850
5
Burundi
740
6
Democratic Republic of the Congo
730
7
South Sudan
730
8
Côte d’Ivoire          
720
9
Guinea
650
10
Liberia
640
11
Niger
630
12
Cameroon            
590
13
Guinea-Bissau
560
14
Nigeria
560
15
Mali
550
16
Malawi
510
17
Lesotho
490
18
Mozambique
480
19
Zimbabwe
470
20
Angola
460
21
Togo
450
22
Madagascar
440
23
Gambia
430
24
Ethiopia
420
25
Congo                     
410
26
United Republic of Tanzania
410
27
Afghanistan
400
28
Burkina Faso
400
29
Kenya
400
30
Eritrea
380
31
Ghana
380
32
Haiti
380
33
Sudan
360
34
Uganda
360
35
Comoros                 
350
36
Benin
340
37
Mauritania
320
38
Rwanda
320
39
Senegal
320
40
Swaziland
310
41
Equatorial Guinea
290
42
Zambia
280
43
Timor-Leste
270
44
Yemen
270
45
Guyana
250
46
Gabon
240
47
Dijibouti
230
48
Lao People’s Democratic Republic
220
49
Papua  making Guinea  
220
50
Sao Tome and Principe
210
51
Bolivia (Plurinational)
200
52
Myanmar
200
53
India
190
54
Indonesia
190
55
Nepal
190
56
Bangladesh
170
57
Botswana
170
58
Cambodia             
170
59
Pakistan
170
60
Guatemala
140
61
South Africa
140
62
Kiribati
130
63
Namibia
130
64
Solomon Islands
130
65
Suriname
130
66
Bhutan
120
67
Honduras
120
68
Morocco
120
69
Philippines
120
70
Tonga
120
71
Paraguay
110
72
Venezuela (Bolivarian Republic of )
110
73
Dominican Republic
100
74
Nicaragua
100
75
Micronesia (Federated States of )
96
76
Algeria
89
77
Peru
89
78
Democratic People’s Republic of Korea
87
79
Ecuador
87
80
Vanuatu
86
81
Panama
85
82
Trinidad and Tobago
84
83
Colombia                
83
84
Cuba                          
80
85
Jamaica
80
86
Kyrgyzstan
75
87
Mauritius
73
88
Argentina
69
89
Brazil
69
90
El Salvador
69
91
Mongolia
68
92
Iraq
67
93
Turkmenistan
61
94
Fiji
59
95
Samoa
58
96
Cabo Verde             
53
97
Barbados
52
98
Jordan
50
99
Mexico
49
100
Syrian Arab Republic
49
101
Viet Nam
49
102
Occupied Palestinian Territory
47
103
Tunisia
46
104
Belize
45
105
Egypt
45
106
Saint Vincent and the Grenadines
45
107
Tajikistan
44
108
Georgia
41
109
Costa Rica              
38
110
Bahamas
37
111
Uzbekistan
36
112
Saint Lucia
34
113
Romania
33
114
China                        
32
115
Maldives
31
116
Armenia
29
117
Malaysia
29
118
Sri Lanka
29
119
United States of America
28
120
Brunei Darussalam
27
121
Republic of Korea
27
122
Azerbaijan
26
123
Kazakhstan
26
124
Thailand
26
125
Russian Federation
24
126
Grenada
23
127
Iran (Islamic Republic of)             
23
128
Ukraine
23
129
Bahrain
22
130
Chile                        
22
131
Albania
21
132
Republic of Moldova
21
133
Puerto Rico
20
134
Turkey
20
135
Lebanon
16
136
Saudi Arabia
16
137
Serbia
16
138
Libya
15
139
Hungary
14
140
Kuwait
14
141
Uruguay
14
142
Croatia                      
13
143
Latvia
13
144
Canada                                       
11
145
Estonia
11
146
Lithuania
11
147
Luxembourg
11
148
Oman
11
149
Cyprus                     
10
150
France
9
151
Ireland
9
152
Malta
9
153
Bosnia and Herzegovina               
8
154
New Zealand
8
155
Portugal
8
156
United Arab Emirates
8
157
United Kingdom
8
158
Germany
7
159
Montenegro
7
160
Slovakia
7
161
Slovenia
7
162
The former Yugoslav Republic of Macedonia
7
163
Australia
6
164
Belgium
6
165
Japan
6
166
Netherlands
6
167
Qatar
6
168
Singapore
6
169
Switzerland
6
170
Bulgaria
5
171
Czech Republic      
5
172
Denmark                  
5
173
Greece
5
174
Austria
4
175
Finland
4
176
Iceland
4
177
Italy
4
178
Norway
4
179
Spain
4
180
Sweden
4
181
Poland
3
182
Israel
2
183
Belarus
1


Source: UN Inter–Agency “Trends in Maternal Mortality: 1990 to 2013".
 
The Government of India has not undertaken any study to assess the ongoing programme/schemes to reduce the IMR and MMR. However, regular supportive supervision visits and Common Review Mission (CRM) have been conducted to assess the progress of ongoing interventions for improvement of infant and maternal health outcomes annually in the States/UTs.
 
Based on these assessments, States/UTs are guided to prepare Annual Program Implementation Plan (PIP) to focus on priority interventions to improve infant and maternal health outcomes in each State/UT.   
 
To sharpen the focus on the low performing districts, 184 High Priority Districts (HPDs) have been identified for implementation of Reproductive Maternal Newborn Child Health+ Adolescent (RMNCH+A) interventions for achieving improved maternal and child health outcomes.
 
The Health Minister, Shri J P Nadda stated this in a written reply in the LokSabha here today.

 

Steps Taken to Reduce IMR and MMR Steps Taken to Reduce IMR and MMR Reviewed by Ajit Kumar on 10:26 PM Rating: 5

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