National Health Mission (NHM) Child Health Review 2019-­2020

National Health Mission (NHM) Child Health Review 2019-­2020

• Madhya Pradesh has recorded the highest percentage of newborn deaths of 11.5% against the total admissions to government­run sick newborn care units (SNCUs) in the past three years across the country, a rate ominously spiraling since 2017, according to the National Health Mission (NHM). 
• The country’s average is 7%. 
• Although admissions of neonates (under 28 days) in the State have dropped from April 2017 to December 2019 remaining lower than West Bengal, Rajasthan, and Uttar Pradesh — the percentage of deaths at 12.2% surpassed Bihar’s last year.
• Meanwhile, West Bengal, where 34,344 neonatal deaths occurred in the period, the most in the country, the declining percentage of deaths from 9.2% in 2017 to 8.9% in 2019 coincided with a slump in admissions. 

Reason for this

• Staff crunch, low community referrals, absence of a special neonatal transport service to health centers,  and the non­availability of enough units to cater to increasing institutional deliveries had contributed to the spike in the percentage of deaths
• We have just half of the required staff nurse's strength at the units across the State. For instance, in the Jabalpur unit, there are only 14 against a required 22 nurses
• As the units are located at hospitals with the delivery load of more than 3,000 infants per year, mostly in district headquarters, transporting neonates on time is crucial. “Although there is a dedicated service to transport pregnant women to hospitals from remote areas, there is none for neonates, who are mostly dependent on the 108 ambulance service

Gender and Area wise death

• Madhya Pradesh has also recorded an abysmal sex ratio in admissions. Even with a sex ratio of 931 as per the 2011 census, 663 girls were admitted against 1,000 boys in the three years, against the country average of 733.
• In almost three-fourths of the cases relating to boys, more admissions can be attributed to the prevailing bias against the girl child in society
• In Bhopal, the capital city of Madhya Pradesh, one in every five children admitted to a unit died in the three years — the highest death percentage of 19.9% in the State, ten times above the NHM’s mandated key performance indicator of below 2%.
• Urban areas report a higher death percentage as they offer tertiary care, and admit several serious cases from peripheral districts