May 07, 2013
Every year, over 309,300 children (29 per cent of global share) in India don't live beyond the first day because of pre-term birth, hygiene and maternal health complications, says the latest World Mothers Report authored by US-based organization, Save the Children. This is higher than for any of the other country 176 countries ranked in the report.
Despite a higher population China ranks 4th and accounts for only 5 per cent of the global share of first-day deaths. Nearly two-thirds of all first-day deaths occur in just 10 large population countries like India, China and Indonesia. Others high up on the list are Pakistan, Afghanistan and African nations like Nigeria and Ethiopia. Predictably, just 1 per cent of the global first-day deaths occur in developed countries and US tops that list.
South Asia is particularly vulnerable because the region has only 14 doctors or nurses per 10,000 people says the report. Among the other killers are pre-term deliveries, low birth weight (28 per cent of babies in India are underweight) and the fact that in nations like Bangladesh, India and Nepal close to 13 per cent of women are stunted and, therefore, bear a higher risk for complications. Also, in these countries, 20 per cent to 40 per cent of women are acutely underweight. Early marriage and childbearing heightens the risk for babies. In India 47 per cent girls marry by the age of 18, in Bangladesh child marriage and early childbearing is most prevalent with 66 per cent of young women getting married and 40 per cent giving birth by before 18 years.
Says Dr Rajiv Tandon, senior adviser for health and nutrition at Save the Children: "We don't just lack resources but also training of frontline workers, supportive supervision and data for decision making. We need to find out whether our auxiliary nurse midwife (ANMs), Accredited Social Health Activist (ASHA) workers and anganwadi workers are motivated? In most districts they lack the supplies required and don't have the skill-sets to deal with such emergency situations."
The report recommends using simple and effective techniques by frontline workers to improve matters. For example during preterm labor attendants can administer corticosteroids injections on women to accelerate lung development of the fetus. Or, for birth asphyxia when babies don't breathe after birth (kills about 717,000 babies each year), the practice of drying the baby and gently rubbing to stimulate breathing can prevent death.
India is in the dog house with respect to maternal health as well reporting 56,000 maternal deaths per year. It is followed by Pakistan (12,000). India ranks 142 among 176 countries in this list which is topped by Finland. Congo ranks last in maternal health.