infant mortalit in india

8/3/2019 Infant Mortalit in India

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Infant MortalitySocial Entrepreneurship Project

2/18/2012

Institute of Management Nirma University

Group 14


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Table of ContentsMini Case .................................................................................................................3

Three Reasons for selecting the sector: ......................................................................5

What is Infant Mortality? ..........................................................................................6

Statistics ..................................................................................................................7

India vs. World Status ...........................................................................................7

Indias Infant Mortality over the Years .................................................................. 10

State-wise data ................................................................................................... 11

Stage-wise Infant Mortality Rates ......................................................................... 13

Role of Government ................................................................................................ 14

National Rural Health Mission ............................................................................. 14

Anganwadi .......................................................................................................... 15

Home Based New Born Scheme ............................................................................ 16

Role of NGOs .......................................................................................................... 18

AYAUSKAM ......................................................................................................... 19

Care in Bihar ...................................................................................................... 19

Bihar Family Health Initiatives.......................................................................... 19

Laxmi ................................................................................................................. 20

Corporate Role ....................................................................................................... 21

DHL in Maharashtra ........................................................................................... 21Glenmark Foundation ......................................................................................... 22

Jindal Steel & Power............................................................................................ 23

Ranbaxy Laboratories .......................................................................................... 24

Vedanta Aluminum ............................................................................................. 25

International Organizations in India ........................................................................ 26

UNICEF .............................................................................................................. 26

Impact ................................................................................................................... 27

Our View on the Impact .......................................................................................... 29

ReferencesExhaustive ......................................................................................... 30


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Mini Case

Is Shining India turning a Blind Eye towards its Infants?

Badal Das had come with his one-and-a-half-year-old son Anik, who was

admitted on January 28. Doctors said he needed to be under observation.

Doctors had conducted a blood test and said my son needed to be admitted

because of some deficiency in his cells. They made us sign a bond that the

baby was admitted in critical condition in spite of the fact that he showed no

sign of ailment and one of the nurses, after having a look at the blood report,

said the baby was perfectly fine, Das said, adding that his sons condition had

been deteriorating since then and that he wanted to take his son to some other

place. My childs condition has grown worse. Now I want him out of here. The

news of rampant death of kids is petrifying, he said.

A father of another two-month-old, on condition of anonymity, said his baby

did not show any visible signs of a serious ailment and that the medical officer

in Nadia, where he had come from, said the child had lost body fluid and saline

water needed to be administered. He had had an upset stomach and was

suffering from loose motions. I was made to sign a bond that my child was

brought in a serious condition, he said, adding that it was probably done to

save them from a lot of disgrace and embarrassment since the number of cribdeath cases was mounting.

Negligence in duty and rude behaviour of nurses were also alleged. Rina

Singhs 34-day-old daughter Jaya, from Gaighata, 24 Parganas North, was

admitted on Sunday. While Jaya was having problem in breathing, Rina alleged

that the nurse on duty did not pay any attention to her. I kept on asking her

to have a look at my child last night when she was gasping for breath but she

did not. My daughter died this morning, she said.

The father of Mahrufa Khatoon, who gave birth to twins, said, We have comefrom Nadia. I am staying here in open air, within the hospital premises. Nurses

here have very bad behaviour. They behave as if we are unwanted creatures.

Besides, the OPD is a scene of filth and squalor. Dogs and cats roam freely

here and often lick babies, he said.


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Lack of security at the hospital campus was clearly visible in spite of the recent

case of child thefts in Chittaranjan Hospital. All it takes to reach the wards,

beyond visiting hours, is a pink card, a tiffin carrier and Rs 30. This

correspondent borrowed a visitors card from a patients family member, a tiffin

carrier from another and went through the side gate which had no policepersonnel at the gate. One uniformed guard stopped him near the stairs. I will

go up to the second floor, give the food to my sister and rush back in 5

minutess, he said and shoved three 10-rupee notes in his hand. The guard

was too busy counting his money, and therefore let him go without further

hassle.

The correspondent went into every ward, including the emergency ward, talked

to patients and even took pictures. No one, including the nurses in the wards,

bothered to ask him anything. At most they gave him a cold stare. Each of the

beds, meant for one child, was occupied by four persons - two kids and their

mothers. We sleep on these beds, half hanging. I have grown a severe pain in

my waist and legs, said the mother of an ailing child in Ward 6.

One of the mothers was holding the oxygen pipe in place because it wouldnt

stay steady or the child sleeping next, on the same bed, would pull it off. I not

only have to keep the other child away from this pipe, but also hold it steady,

for as long as it is administered, she said.

None of the hospital authorities, wanted to comment.

(Article adapted from Indian Express)1

Note by the report writers:

Behind the glistening steel and glass structures of a growing Kolkata, the rot in

the our system shines through with the recent report of the multitude deaths of

infants within days. An estimated 34 infants died in West Bengal in a single

week of heavy winter due to negligence on part of the hospitals as well as a

complete lack of proper healthcare. This very case describes the problem in itsdeepest sense for India. We are not being responsible towards our infants.


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Three Reasons for selecting the sector:a. India is one of the most affected countries in the world in area of infantmortality & deaths during various natal stages. Due to lack of various

healthcare facilities and other reasons, countless innocent lives are lost

without reason. So much so that sometimes our healthcare system, or

lack thereof, is the cause of the death of hundreds of babies born every

year.

b. A poor family incurs a lot of expense in child bearing and rearing. And when this results into complication, the family is further pushed into

poverty by way of spending on private hospitals.

c. A society is defined by the way in which it treats its weak. And Indiaspoor healthcare system is not exactly designed to suit the needs of its

poor. More needs to be done and this report can help to identify the

source of this problem and target the same accordingly.


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What is Infant Mortality?In the field of public health, infant mortality is a commonly used statistical

measure that is defined as the ratio of infant deaths to live births. The most

widely used definition of Infant mortality rate (IMR) is the number of deaths of

babies under one year of age per 1,000 live births. The rate in a given region,

therefore, is the total number of newborns dying under one year of age divided

by the total number of live births during the year, then all multiplied by 1,000.

The infant mortality rate is also called the infant death rate (per 1,000 live

births).2

General Nature of the Problem

For the world, and for both Less Developed Countries (LDCs) and MoreDeveloped Countries (MDCs), IMR declined significantly between 1960 and2001. According to the Save the Children State of the World's Mothers report,the world infant mortality rate declined from 126 in 1960 to 57 in 2001.However, IMR was, and remains, higher in LDCs. In 2001, the Infant MortalityRate for Less Developed Countries (91) was about 10 times as large as it wasfor More Developed Countries (8). For Least Developed Countries, the InfantMortality Rate is 17 times as high as it is for More Developed Countries. Also, while both LDCs and MDCs made dramatic reductions in infant mortality

rates, reductions among less developed countries are, on average, much lessthan those among the more developed countries.2


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Statistics

India vs. World Status

The infant mortality rate of the world is 49.4 according to the United Nations

and 42.09 according to the CIA World Factbook. India has an infant mortality

rate of 60.82 which is way above average according to the UN study.3

The top 10 countries in the world with respect to lowest infant mortality3 are:

Rank Country or territory

Infant mortality rate

(deaths/1,000 live births)

1 Singapore 2.31

2 Bermuda 2.46

3 Sweden 2.75

4 Japan 2.79

5 Hong Kong 2.92

6 Macau 3.22

7 Iceland 3.23

8 France 3.33
http://en.wikipedia.org/wiki/Singaporehttp://en.wikipedia.org/wiki/Singaporehttp://en.wikipedia.org/wiki/Bermudahttp://en.wikipedia.org/wiki/Bermudahttp://en.wikipedia.org/wiki/Swedenhttp://en.wikipedia.org/wiki/Swedenhttp://en.wikipedia.org/wiki/Japanhttp://en.wikipedia.org/wiki/Japanhttp://en.wikipedia.org/wiki/Hong_Konghttp://en.wikipedia.org/wiki/Hong_Konghttp://en.wikipedia.org/wiki/Macauhttp://en.wikipedia.org/wiki/Macauhttp://en.wikipedia.org/wiki/Icelandhttp://en.wikipedia.org/wiki/Icelandhttp://en.wikipedia.org/wiki/Francehttp://en.wikipedia.org/wiki/Francehttp://en.wikipedia.org/wiki/Francehttp://en.wikipedia.org/wiki/Icelandhttp://en.wikipedia.org/wiki/Macauhttp://en.wikipedia.org/wiki/Hong_Konghttp://en.wikipedia.org/wiki/Japanhttp://en.wikipedia.org/wiki/Swedenhttp://en.wikipedia.org/wiki/Bermudahttp://en.wikipedia.org/wiki/Singapore


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Rank Country or territoryInfant mortality rate

(deaths/1,000 live births)

9 Finland 3.47

10 Anguilla 3.52

Whereas the bottom 103 are given by:

215 Guinea-Bissau 99.82

216 Zambia 101.20

217 Mali 102.05

218 Mozambique 105.80

219 Somalia 109.19

220 Niger 116.66

221 Liberia 138.24

222 Afghanistan 151.95

223 Sierra Leone 154.43

224 Angola 180.21
http://en.wikipedia.org/wiki/Finlandhttp://en.wikipedia.org/wiki/Finlandhttp://en.wikipedia.org/wiki/Anguillahttp://en.wikipedia.org/wiki/Anguillahttp://en.wikipedia.org/wiki/Guinea-Bissauhttp://en.wikipedia.org/wiki/Guinea-Bissauhttp://en.wikipedia.org/wiki/Zambiahttp://en.wikipedia.org/wiki/Zambiahttp://en.wikipedia.org/wiki/Malihttp://en.wikipedia.org/wiki/Malihttp://en.wikipedia.org/wiki/Mozambiquehttp://en.wikipedia.org/wiki/Mozambiquehttp://en.wikipedia.org/wiki/Somaliahttp://en.wikipedia.org/wiki/Somaliahttp://en.wikipedia.org/wiki/Nigerhttp://en.wikipedia.org/wiki/Nigerhttp://en.wikipedia.org/wiki/Liberiahttp://en.wikipedia.org/wiki/Liberiahttp://en.wikipedia.org/wiki/Afghanistanhttp://en.wikipedia.org/wiki/Afghanistanhttp://en.wikipedia.org/wiki/Sierra_Leonehttp://en.wikipedia.org/wiki/Sierra_Leonehttp://en.wikipedia.org/wiki/Angolahttp://en.wikipedia.org/wiki/Angolahttp://en.wikipedia.org/wiki/Angolahttp://en.wikipedia.org/wiki/Sierra_Leonehttp://en.wikipedia.org/wiki/Afghanistanhttp://en.wikipedia.org/wiki/Liberiahttp://en.wikipedia.org/wiki/Nigerhttp://en.wikipedia.org/wiki/Somaliahttp://en.wikipedia.org/wiki/Mozambiquehttp://en.wikipedia.org/wiki/Malihttp://en.wikipedia.org/wiki/Zambiahttp://en.wikipedia.org/wiki/Guinea-Bissauhttp://en.wikipedia.org/wiki/Anguillahttp://en.wikipedia.org/wiki/Finland


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It is no surprise that majority of poor-infant mortality record nations are third

world countries with poor healthcare and infrastructure. The following picture3

proves this fact:

India comes in the lower half of the table of world infant mortality rank.

147 Peru 28.62

148 Maldives 29.53

149 Guyana 29.65

150 Trinidad and Tobago 29.93

151 Indonesia 29.97

152 India 30.15
http://en.wikipedia.org/wiki/Peruhttp://en.wikipedia.org/wiki/Peruhttp://en.wikipedia.org/wiki/Maldiveshttp://en.wikipedia.org/wiki/Maldiveshttp://en.wikipedia.org/wiki/Guyanahttp://en.wikipedia.org/wiki/Guyanahttp://en.wikipedia.org/wiki/Trinidad_and_Tobagohttp://en.wikipedia.org/wiki/Trinidad_and_Tobagohttp://en.wikipedia.org/wiki/Indonesiahttp://en.wikipedia.org/wiki/Indonesiahttp://en.wikipedia.org/wiki/Indiahttp://en.wikipedia.org/wiki/Indiahttp://en.wikipedia.org/wiki/Indiahttp://en.wikipedia.org/wiki/Indonesiahttp://en.wikipedia.org/wiki/Trinidad_and_Tobagohttp://en.wikipedia.org/wiki/Guyanahttp://en.wikipedia.org/wiki/Maldiveshttp://en.wikipedia.org/wiki/Peru


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153 Kyrgyzstan 31.26

154 Zimbabwe 32.31

As shown above, India ranks below countries such as Peru, Indonesia and

Maldives.

All world statistics source Wikipedia page.2

Indias Infant Mortality over the Years

The following brief table gives an overview of infant mortality in India4:

The following graph5 shows the position of India over the years from 1950s to

the present situation.

Year Infant Mortality Rate (IMR)

2001-2005 61.3

2006-2010 54.3

2011-2015 49.2

2016-2020 44

2021-2025 40

Source : Ministry of Health & Family Welfare, Govt. of India. (11

Projected Infant Mortality Rate (IMR) in India

(2001-2005, 2006-2010, 2011-2015, 2016-2020 and 2021-2025)
http://en.wikipedia.org/wiki/Kyrgyzstanhttp://en.wikipedia.org/wiki/Kyrgyzstanhttp://en.wikipedia.org/wiki/Zimbabwehttp://en.wikipedia.org/wiki/Zimbabwehttp://en.wikipedia.org/wiki/Zimbabwehttp://en.wikipedia.org/wiki/Kyrgyzstan


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This shows that from the 60s when mortality was as high as 160 per 1000 it

has come down significantly to about 50 due to progress in healthcare, better

technology and communications. But still compared to first world countries

where infant mortality is a ridiculous 2 per 1000 births, we still have a long

way to go.

State-wise data

Infant mortality can be directly linked to education as well as a progressive

society. So unsurprisingly, Kerala has the lowest infant mortality in India. Even

rural areas of Kerala state have an IMR of 12 which is at par with first world

countries.

The following table gives a state wise picture4 of the infant mortality statistic:


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As said above, literacy is negatively correlated to infant mortality. Similarly,states which are traditionally known as masculine oriented (such as Himachal

Pradesh) have a higher infant mortality rate of females; whereas this figure is

insignificant for states like Kerala. 4

Total Rural Urban Total Rural Urban Total Rural Urban Total Rural Urban

Bigger States

Andhra Pradesh 54 60 37 52 58 36 49 54 35 46 51 33

Assam 66 68 41 64 66 39 61 64 37 58 60 36

Bihar 58 59 44 56 57 42 52 53 40 48 49 38

Chhattisgarh 59 61 49 57 59 48 54 55 47 51 52 44

Delhi 36 41 35 35 40 34 33 40 31 30 37 29

Gujarat 52 60 36 50 58 35 48 55 33 44 51 30

Haryana 55 60 44 54 58 43 51 54 41 48 51 38

Jammu & Kashmir 51 53 38 49 51 37 45 48 34 43 45 32

Jharkhand 48 51 31 46 49 32 44 46 30 42 44 30

Karnataka 47 52 35 45 50 33 41 47 31 38 43 28

Kerala 13 14 10 12 12 10 12 12 11 13 14 10

Madhya Pradesh 72 77 50 70 75 48 67 72 45 62 67 42

Maharashtra 34 41 24 33 40 23 31 37 22 28 34 20

Orissa 71 73 52 69 71 49 65 68 46 61 63 43

Punjab 43 47 35 41 45 33 38 42 31 34 37 28

Rajasthan 65 72 40 63 69 38 59 65 35 55 61 31

Tamil Nadu 35 38 31 31 34 28 28 30 26 24 25 22

Uttar Pradesh 69 72 51 67 70 49 63 66 47 61 64 44

West Bengal 37 39 29 35 37 29 33 34 27 31 32 25

Smaller States

Arunachal Pradesh 37 41 15 32 34 19 32 35 14 31 34 12

Goa 13 11 13 10 10 11 11 11 10 10 10 10

Himachal Pradesh 47 49 25 44 45 27 45 46 28 40 41 29

Manipur 12 13 9 14 16 8 16 18 11 14 15 9

Meghalaya 56 57 46 58 60 43 59 61 40 55 58 37

Mizoram 23 27 16 37 45 24 36 45 19 37 47 21

Nagaland 21 18 29 26 25 28 26 27 23 23 24 20

Sikkim 34 36 20 33 35 19 34 36 21 30 31 19

Tripura 39 40 32 34 36 26 31 33 20 27 29 19

Uttarakhand 48 52 25 44 48 24 41 44 27 38 41 25

Union Territories

Andaman & Nicobar Islands 34 38 23 31 35 23 27 31 20 25 29 18

Chandigarh 27 25 28 28 22 29 25 25 25 22 20 23

Dadra & Nagar Haveli 34 38 18 34 38 20 37 41 24 38 43 22

Daman & Diu 27 29 23 31 29 36 24 21 30 23 19 29

Lakshadweep 24 25 23 31 28 35 25 22 28 25 23 27

Puducherry 25 31 22 25 31 22 22 28 19 22 25 21

India 55 61 37 53 58 36 50 55 34 47 51 31

Note : Infant mortality rates for smaller States and Union Territories

are based on three-years period 2008-10.

Source : Ministry of Health & Family Welfare, Govt. of India.

State-wise Estimated Infant Mortality Rate by Residence in India

(2007 to 2010)

States/UTs

2007 2008 2009 2010


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Stage-wise Infant Mortality Rates

The stage at which death of the infant occurs is also an important factor in the

nature of infrastructure lack in the country. For example, more deaths in pre-

maternal stage indicate lack of testing and mother protection, whereas deathsduring the 1st year indicate lack of vaccination. 4

2001 2006 2011 2016 2001 2006 2011 2016

Andhra

Pradesh 65 59 53 48 56 50 44 39

Assam 64 53 44 36 61 51 43 36

Bihar 54 43 35 28 55 44 35 28

Gujarat 46 34 26 21 44 33 25 19

Haryana 54 46 39 34 57 46 38 31

Karnataka 76 76 76 75 67 66 65 64

Kerala 13 10 9 9 9 8 8 8

Ma ya

Pradesh 99 91 83 76 101 94 88 83

Maharashtra 46 39 33 29 46 40 34 30

Orissa 106 97 89 81 105 98 93 87

Punjab 44 39 34 30 51 45 40 36

Rajasthan 64 53 44 37 65 52 43 35

Tamil Nadu 46 38 31 26 43 34 28 23

Uttar Pradesh 64 49 37 29 74 57 45 36West Bengal 54 46 40 35 56 51 47 43

India (Pooled) 60 50 42 35 61 51 43 36

India 63 53 45 38 64 54 45 39

Source : Population Projection for India and States 1996-2016, Registrar

General, Ministry of Home Affairs.

Projected Levels of Infant Mortality Rate

(1996-2016)

States

Males Females

Indicators Total Rural Urban

Child (below 5 years) mortality rate 20 23 12

Infant mortality rate 70 75 44

Neo-natal mortality rate 45 49 28

Early neo-natal mortality rate 34 37 22

Late neo-natal mortality rate 11 12 6

Post neo-natal mortality rate 24 26 16

Peri-natal mortality rate 44 47 30

Still birth rate 10 11 8

Source : Registrar General of India.

Child and Infant Mortality Indicators in India

-1999


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Role of Government

National Rural Health Mission

National Rural Health Mission of India (NRHM) is a program and scheme runby the ministry of health under government of India. The mission was launchedon 5 April 2005 for period of 7 years (20052012). The mission helps and seeksto improve thehealth care deliverysystem. This mission is operational in wholeof India with special focus on 18 statesArunachal Pradesh,Assam,Bihar,Chhattisgarh,Himachal Pradesh,Jharkhand,Jammu andKashmir,Manipur,Mizoram,Meghalaya,MadhyaPradesh,Nagaland,Orissa,Rajasthan,Sikkim,Tripura,UttarkhandandUttarPradesh. It is undoubtedly the most ambitious rural health initiative ever beenimplemented in the country focusing on the above states which are poor andpopulous.

The primary aim of this mission is to provide accessible, accountable,

affordable, effective and reliable health care service to the people of Indiaresiding in villages. It also aims properhygieneandsanitationsystem and tomake a synergistic approach by integrating other health programs and otherIndian system of medicine. The creation of a Village health worker known asAccredited Social Health Activist(ASHA) to bring the primary health care andbasic health care to the people.

A diverse set of factors are thought to be associated with maternal mortality:

factors that influence delays in deciding to seek medical care, in reaching a

place where care is available, and in receiving appropriate care. The tenth plan

document of India has targeted to reduce the IMR to 45 per 1000 live births by

2007 and 28 per 1000 live births by 2012. The main causes of high MMR being

socioeconomic status of women, inadequateantenatal care, the low proportion

of institutional deliveries|birth, and the non-availability of skilledbirth

attendantsin two-thirds of cases.6

The goals of the NHRM include:7

Reduction in Infant Mortality Rate (IMR) and Maternal Mortality Ratio (MMR)

Universal access to public health services such as Womens health,

child health, water, sanitation & hygiene, immunization, and Nutrition.

Prevention and control of communicable and non-communicable

diseases, including locally endemic diseases

Access to integrated comprehensive primary healthcare
http://en.wikipedia.org/wiki/Health_care_deliveryhttp://en.wikipedia.org/wiki/Health_care_deliveryhttp://en.wikipedia.org/wiki/Health_care_deliveryhttp://en.wikipedia.org/wiki/Arunachal_Pradeshhttp://en.wikipedia.org/wiki/Arunachal_Pradeshhttp://en.wikipedia.org/wiki/Arunachal_Pradeshhttp://en.wikipedia.org/wiki/Assamhttp://en.wikipedia.org/wiki/Assamhttp://en.wikipedia.org/wiki/Assamhttp://en.wikipedia.org/wiki/Biharhttp://en.wikipedia.org/wiki/Biharhttp://en.wikipedia.org/wiki/Chhattisgarhhttp://en.wikipedia.org/wiki/Chhattisgarhhttp://en.wikipedia.org/wiki/Chhattisgarhhttp://en.wikipedia.org/wiki/Himachal_Pradeshhttp://en.wikipedia.org/wiki/Himachal_Pradeshhttp://en.wikipedia.org/wiki/Himachal_Pradeshhttp://en.wikipedia.org/wiki/Jharkhandhttp://en.wikipedia.org/wiki/Jharkhandhttp://en.wikipedia.org/wiki/Jharkhandhttp://en.wikipedia.org/wiki/Jammu_and_Kashmirhttp://en.wikipedia.org/wiki/Jammu_and_Kashmirhttp://en.wikipedia.org/wiki/Jammu_and_Kashmirhttp://en.wikipedia.org/wiki/Manipurhttp://en.wikipedia.org/wiki/Manipurhttp://en.wikipedia.org/wiki/Manipurhttp://en.wikipedia.org/wiki/Mizoramhttp://en.wikipedia.org/wiki/Mizoramhttp://en.wikipedia.org/wiki/Mizoramhttp://en.wikipedia.org/wiki/Meghalayahttp://en.wikipedia.org/wiki/Meghalayahttp://en.wikipedia.org/wiki/Meghalayahttp://en.wikipedia.org/wiki/Madhya_Pradeshhttp://en.wikipedia.org/wiki/Madhya_Pradeshhttp://en.wikipedia.org/wiki/Madhya_Pradeshhttp://en.wikipedia.org/wiki/Madhya_Pradeshhttp://en.wikipedia.org/wiki/Nagalandhttp://en.wikipedia.org/wiki/Nagalandhttp://en.wikipedia.org/wiki/Nagalandhttp://en.wikipedia.org/wiki/Orissahttp://en.wikipedia.org/wiki/Orissahttp://en.wikipedia.org/wiki/Orissahttp://en.wikipedia.org/wiki/Rajasthanhttp://en.wikipedia.org/wiki/Rajasthanhttp://en.wikipedia.org/wiki/Sikkimhttp://en.wikipedia.org/wiki/Sikkimhttp://en.wikipedia.org/wiki/Sikkimhttp://en.wikipedia.org/wiki/Tripurahttp://en.wikipedia.org/wiki/Tripurahttp://en.wikipedia.org/wiki/Tripurahttp://en.wikipedia.org/wiki/Uttarkhandhttp://en.wikipedia.org/wiki/Uttarkhandhttp://en.wikipedia.org/wiki/Uttarkhandhttp://en.wikipedia.org/wiki/Uttar_Pradeshhttp://en.wikipedia.org/wiki/Uttar_Pradeshhttp://en.wikipedia.org/wiki/Uttar_Pradeshhttp://en.wikipedia.org/wiki/Uttar_Pradeshhttp://en.wikipedia.org/wiki/Hygienehttp://en.wikipedia.org/wiki/Hygienehttp://en.wikipedia.org/wiki/Hygienehttp://en.wikipedia.org/wiki/Sanitationhttp://en.wikipedia.org/wiki/Sanitationhttp://en.wikipedia.org/wiki/Sanitationhttp://en.wikipedia.org/wiki/Antenatal_carehttp://en.wikipedia.org/wiki/Antenatal_carehttp://en.wikipedia.org/wiki/Antenatal_carehttp://en.wikipedia.org/wiki/Birth_attendantshttp://en.wikipedia.org/wiki/Birth_attendantshttp://en.wikipedia.org/wiki/Birth_attendantshttp://en.wikipedia.org/wiki/Birth_attendantshttp://en.wikipedia.org/wiki/Birth_attendantshttp://en.wikipedia.org/wiki/Birth_attendantshttp://en.wikipedia.org/wiki/Birth_attendantshttp://en.wikipedia.org/wiki/Antenatal_carehttp://en.wikipedia.org/wiki/Sanitationhttp://en.wikipedia.org/wiki/Hygienehttp://en.wikipedia.org/wiki/Uttar_Pradeshhttp://en.wikipedia.org/wiki/Uttar_Pradeshhttp://en.wikipedia.org/wiki/Uttar_Pradeshhttp://en.wikipedia.org/wiki/Uttarkhandhttp://en.wikipedia.org/wiki/Tripurahttp://en.wikipedia.org/wiki/Sikkimhttp://en.wikipedia.org/wiki/Rajasthanhttp://en.wikipedia.org/wiki/Orissahttp://en.wikipedia.org/wiki/Nagalandhttp://en.wikipedia.org/wiki/Madhya_Pradeshhttp://en.wikipedia.org/wiki/Madhya_Pradeshhttp://en.wikipedia.org/wiki/Madhya_Pradeshhttp://en.wikipedia.org/wiki/Meghalayahttp://en.wikipedia.org/wiki/Mizoramhttp://en.wikipedia.org/wiki/Manipurhttp://en.wikipedia.org/wiki/Jammu_and_Kashmirhttp://en.wikipedia.org/wiki/Jammu_and_Kashmirhttp://en.wikipedia.org/wiki/Jammu_and_Kashmirhttp://en.wikipedia.org/wiki/Jharkhandhttp://en.wikipedia.org/wiki/Himachal_Pradeshhttp://en.wikipedia.org/wiki/Chhattisgarhhttp://en.wikipedia.org/wiki/Biharhttp://en.wikipedia.org/wiki/Assamhttp://en.wikipedia.org/wiki/Arunachal_Pradeshhttp://en.wikipedia.org/wiki/Health_care_delivery


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Population stabilization, gender and demographic balance.

Revitalize local health traditions and mainstream AYUSH

Promotion of healthy life styles

Anganwadi

The word Anganwadi is derived from the Hindi word Angan which refers to

the courtyard of a house. In rural areas an Angan is where people get together

to discuss, greet, and socialize. The angan is also used occasionally to cook

food or for household members to sleep in the open air. This part of the house

is seen as the heart of the house. It is perceived as a sacred place. Thus the

significance that this part of the house enjoys is how the worker who works in

an angan and visits other angans to perform the indispensable duty of helping

with health care issues among other things came to be known as

the Anganwadi worker. They are after all the most important link between therural poor and good healthcare.8

The basic work of Anganwadi workers is extremely important and needs to be

carried out in the most efficient manner possible.They need to provide care for

newborn babies as well as ensure that all children below the age of 6 are

immunized or in other words have received vaccinations. They are also

expected to provide antenatal care for pregnant women and ensuring that they

are immunized against tetanus. In addition to this they must also provide post

natal care to nursing mothers. Since they primarily focus on poor and

malnourished groups it becomes necessary to provide supplementary nutritionto both children below the age of 6 as well as nursing and pregnant women.

Consistently they need to ensure that regular health and medical check ups of

women who fall between the age group of 15 to 49 years take place and that all

women and children have access to these check ups. They also need to work

towards providing pre school education to children who are between 3 to 5

years old.

The Ministry of Women and Child Development has laid down certainguidelines as to what are the responsibilities of Anganwadi Workers (AWW).

Some of them are as follows. These include showing community support andactive participation in executing this programme, to conduct regular quicksurveys of all families, organize pre-school activities, provide health andnutritional education to families especially pregnant women as to how tobreastfeeding practices etc., motivating families to adopt family planning,educating parents about child growth and development, assist in theimplementation and execution of Kishori Shakti Yojana (KSY) to educate


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teenage girls and parents by organizing social awareness programmes etc.,identify disabilities in children and so on.

The Anganwadi system is mainly managed by the Anganwadi worker. She is ahealth worker chosen from the community and given 4 months training inhealth, nutrition and child-care. She is incharge of an Anganwadi which covers

a population of 1000.About 10 Anganwadi workers are supervised by aSupervisor called Mukhyasevika. 4 Mukhyasevikas are headed by a ChildDevelopment Projects Officer (CDPO).

There are an estimated 1.053 million anganwadi centers employing 1.8 millionmostly-female workers and helpers across the country. They provide outreachservices to poor families in need of immunization, healthy food, clean water,clean toilets and a learning environment for infants, toddlers and pre-schoolers. They also provide similar services for expectant and nursingmothers. According to government figures, anganwadis reach about 58.1million children and 10.23 million pregnant or lactating women.

Anganwadis are India's primary tool against the scourges of childmalnourishment, infant mortality and curbing preventable diseases such aspolio. While infant mortality has declined in recent years, India has the world'slargest population of malnourished or under-nourished children. It is estimatedthat about 47% of children aged 03 are under-nourished as per internationalstandards.

Every 10 Anganwadi workers are supervised by the Mukhya Sevika. Theyprovide on the job training to these workers. In addition to performing theresponsibilities along with the anganwadi workers they have other duties suchas keeping a check as to who are benefitting from the programme from low

economic status specifically those who belong to the malnourished category,guide the Anganwadi workers in assessing the correct age of children, weight ofchildren and how to plot their weights on charts, demonstrate to these workersas to how everything can be done using effective methods for example inproviding education to mothers regarding health and nutrition, and alsomaintain statistics of anganwadis and the workers assigned there so as todetermine what can be improved. The Mukhya Sevika then reports to the Childdevelopment Projects Officer (CDPO).

Home Based New Born SchemeIndia's pioneering "Home-based New Born Scheme" has shown the world a new

way to cut down onneonatal mortality(within 28 days of birth).9

Almost 13 years after Dr Abhay Bang demonstrated a 62% reduction in

neonatal mortality through multiple home visits in Maharashtra, theWorld
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Health Organization(WHO) has touted it as a global policy. In a neonatal health

meeting held inGenevalast week, theWHOpraised India's leadership in rolling

out the scheme and asked all countries recording high neonatal mortality to

introduce similar interventions.

For the first time, India last year rolled the home-based newborn care schemeunder the country'sNational Rural Health Mission. Under this scheme,

Accredited Social Health Activists (ASHAs) will have to visit new mothers six

times in 42 days to encourage safe newborn care practices and early detection

and free referral of sick newborn babies.

The ASHAs are being paid Rs 250 for every home visit but get the money only

after the completion of 42 days. Within this timeframe, the ASHAs will have to

record the birth weight of the child in the maternal and child protection cards

(MCP), immunize newborns with BCG vaccine and administer the first dose of

oral polio and DPT vaccine.

They will also have to register the births and both the mother and child will

have to be safe at the end of the 42nd day to get the money.
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Role of NGOs

In recent years there has been a growth of Non-Government Organisations(NGOs) in India. NGOs have been successful in reaching the poor and reducingmortality and fertility. As innovators and experimenters, NGOs have thepotential to help operationalize the reproductive amid child health (RCH)

Programme. A growing interest among government and donors in health anddevelopment initiatives of the non-government sector reflect to a considerabledegree, a growing disenchantment with the public system. A vigorous non-government sector, as is present in India, is indicative of the acknowledgementon the part of government that some social functions are outside its legitimatecontrol. Over the years, NGOs have performed several functions to fosterpluralism in India.

In the field of health, there has been a significant growth of NGOs in thecountry over the past two decades. The 1970s witnessed the emergence of anew breed of NGOs -- several of whom took on the challenge of translating the

concepts of equity, social justice, community participation, and integrateddevelopment, embodied within the primary health care concept. Throughcommunity-based, people-oriented programmes targeted to the poor, NGOswere able to demonstrate the feasibility and effectiveness of alternative healthcare models that were successful in reaching the unreached and serving theunserved.

As the government moves forward to operationalize the Reproductive and ChildHealth Programme in India, the need to work in partnership with NGOs willenhance. New modalities for working as allies must, therefore, be developed bygovernment, NGOs, and donors. NGOs have the responsibility, as innovatorsand experimenters, to field test new strategies -- an urgent need foroperationalizing reproductive health services. Maternal and child healthservices form an integral part of reproductive health programmes. In the past,several NGOs have focussed their efforts on designing services targetted towomen and children.

Although Maternal and Child Health (MCH) services form an integral part of thegovernment's Family Welfare Programme, so far efforts have focussed primarilyon improving child survival. Maternal health has suffered from relative neglectin this programme. There is, therefore, an urgent need to strengthen maternity

care services. The government's relatively recent initiative, the Child SurvivalSafe Motherhood (CSSM) Programme, an effort to redress this neglect, shouldreceive strong emphasis.

The safe motherhood programme has a three-fold focus: (1) to strengthencommunity-based maternal health care; (2) to organize referral facilities for thetreatment of complicated deliveries; and (3) to institute an alarm and transportsystem to promptly transfer women who need emergency care to a referral


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facility for effective treatment.

AYAUSKAM

Operational Area: 30 Gram Panchayats of four blocks in the district of

Nuapada.

AYAUSKAM has been working with the people of Nuapada district, which isknown for poverty, starvation, death, migration, drought and all the classicsymptoms of poverty. As a doctor heads the organization, its basic thrust ofactivities is directed at issues of infant mortality, maternal mortality, HIV/AIDSand reproductive health care. They have been trying to link these issues withthe panchayats to generate greater awareness and make the people responsibletowards solving them in the context of their social milieu. AYAUSKAM has beenaccepted as a district-level member of the NRHM. A number of their SHGleaders and traditional birth attendants (TBAs) are working as ASHA workers

at the village level. They have also taken-up leadership building activitiesamong women and linked it with the health and nutrition program. During thelast panchayat election, their organization was actively involved in the PEVACdrive. As a result of their sincere and hard application, the percentage ofwomen representation could be raised to 52 percent in Nuapada District.10

Care in Bihar

Bihar Family Health Initiatives

Location: Bihar

Bihar, one of the poorest states in India, is poised to significantly improvematernal, newborn and child health outcomes by 2015. Strong governmentleadership, movement toward integration and system strengthening throughthe Bihar Health Sector Reform Programme (BHSRP), and increased resourcescreate a unique opportunity for progress. In this context, the Family HealthInitiative in Bihar, with support from the Bill and Melinda Gates Foundation,catalyses a dynamic process of developing, testing, and scaling-up innovativesolutions that transform frontline and first level facility family health services,dramatically increasing coverage and quality of life-saving interventions,improving survival and health for women, newborns and children throughout

the state.11

Project goals include:

1) Increasing the consistent availability of high impact and cost-effectivefamily health interventions

2) Improving the quality of key family health services and deliveryprocesses


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3) Increasing utilization of key services and uptake of health promotingbehaviors

4) Facilitating identification and consistent adoption of successfulapproaches concurrently at state level and nationally.

By the end of the 5-year project period, significant reductions in maternal,neonatal and infant mortality consistent with government of Bihar targets and in malnutrition will have been achieved. This will result from improvedhealth behaviors and increased coverage of services known to be associated with mortality and nutritional impacts: increased contraceptive prevalencerate, skilled birth attendance, emergency obstetric care, immediate newborncare, asphyxia management, prevention and management of newborn sepsis,early and exclusive breastfeeding, appropriate complementary feeding, andcomplete immunization. In concert with the other Foundation grantees inBihar as well as other stakeholders, CARE will increase equity in the receipt of

health services by ensuring that all families are mapped and included byfrontline workers; equity is monitored and addressed by supervisors andmanagers; and accountability mechanisms benefit all population groups.Documentation of effectiveness of strategies, tools and innovations that canbenefit family health throughout India and globally will also be produced fromproject learnings.

Laxmi

CORE ISSUES LAXMI adopts programs that address the need for

comprehensive development of women and children, and hence its programsare focused on following nine issues that impact the development of women

and children most: 1. Environment, Hygiene and Sanitation, including Solid

Waste Management 2. Sexual and Reproductive Health 3. Child Rights 4.

HIV/AIDS 5. Gender 6. Women Empowerment 7. Non-Formal Education 8.

Tenure and Housing Rights 9. Livelihood and Economic self-reliance.12


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Corporate RoleIn India, majority of social initiatives of corporates are part of a plan to create a good

CSR paragraph in the annual shareholder statement. Traditionally Indian corporates

have left the job of social work to the NGOs and government whilst being happy by

providing funds. But there are several companies which work extensively towards

creating better societies around them.

Amongst these, some corporate social initiatives toward infant mortality are shown

below:

DHL in Maharashtra

DHL, the worlds leading express and logistics company, has a partnership with

UNICEF and the Government of India in support of efforts to reduce malnutrition and

infant mortality in the Nandurbar District of Maharashtra, India. DHLs grant will fund

a three-year UNICEF project to empower communities to improve child survival rates

in 1,000 villages in Maharashtra.

DHLs parent company Deutsche Post World Net (DPWN) supports UNICEF

projects in three regions around the world to reduce child mortality. The target

for 2009 is to raise sufficient funds to vaccinate 50,000 children against the six

major preventable child killer diseases. In India, funding by DHL will help

accelerate UNICEFs work with the Government to achieve the Millennium

Development Goals to reduce the districts under five mortality rate to 41 per

1000 live births by 2015.

Working together with the Government of India, the Government of Maharashtra,

NGOs and other partners, UNICEF will use the US$650,000 DHL grant to educatevillagers on the prevention and treatment of common communicable diseases, provide

immunizations and micronutrients to infants and young children while strengthening

the districts health infrastructure. The grant from DHL will be used jointly with

communities and government functionaries to develop and implement village health

and nutrition plans, setting up village information posts, training workers, midwives

and setting up computer equipment for staff training and support.

The programme is an extension of DHLs global partnership with UNICEF. Globally,

DHLs parent company Deutsche Post World Net (DPWN) supports UNICEF projects in

three regions around the world to reduce child mortality. The target for 2009 is toraise sufficient funds to vaccinate 50,000 children against the six major preventable

child killer diseases. In India, funding by DHL will help accelerate UNICEFs work

with the Government to achieve the Millennium Development Goals to reduce the

districts under five mortality rate to 41 per 1000 live births by 2015.

In addition to the grant, DHL will also develop an employee volunteer program to

enable staff from across the region to contribute their time and efforts to support


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UNICEFs program in the Nandurbar District. Working alongside UNICEF, a number of

volunteer programs are being planned to improve physical infrastructures or build

capacity of local groups to improve quality of life among villagers in the Nandurbar

District.13

According to the Population Foundation of India (2008), the infant mortality

rates in Nandurbar District, Maharashtra was at a high of 68/1,000 live births

in 2001. Maternal mortality is estimated to be above 300 per 100,000 live

births. UNICEF aims to reduce malnutrition among children below three years

of age from 58 percent to 30 percent. Similarly, the project aims at reducing

infant mortality to 30 per 1000 live births, while reducing maternal mortality

by 30 percent.

UNICEF, in conjunction with the Government of India, will develop community-led,

cost- effective village action plans to improve health conditions and promote child

survival. According to the Population Foundation of India (2008), the infant mortality

rates in Nandurbar District, Maharashtra was at a high of 68/1,000 live births in

2001. Maternal mortality is estimated to be above 300 per 100,000 live births. UNICEF

aims to reduce malnutrition among children below three years of age from 58 percent

to 30 percent. Similarly, the project aims at reducing infant mortality to 30 per 1000

live births, while reducing maternal mortality by 30 percent.

At the request of the Chief Minister of the State in 2003, UNICEF and the District

administration began their work in the Nandurbar District. UNICEF has initiated

communit y planning sessions around childrens issues in each of the 1,000 villagesand 1,437 hamlets of the District. About 4,000 youth volunteers have been trained on

maximizing community participation in this program.

Glenmark Foundation

Glenmark Foundation, the Corporate Social Responsibility (CSR) arm of Glenmark

Pharmaceuticals has announced the launch of its flagship programme, Project

Kavach Healthy Children, Healthier World in the state of Rajasthan. The campaign

addresses the important issue of high Infant and Child Mortality by focusing on 3 key

agendas reducing malnutrition, increasing immunization and promoting good

hygiene practices among pregnant mothers and caregivers.15

Glenmark Foundation has announced that will adopt over 150 villages near Jaipur in

the initial phase of Project Kavach. For expanding its reach, the Foundation has also

tied with a local NGO called SIDART(Society for Integrated Developmental

Activities Research and Training).
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The launch of Project Kavach in Rajasthan was preceded by the successful rollout of

this child health campaign by Glenmark Foundation in Madhya Pradesh, India in themonth of June, 2011.

About Glenmark Foundation

Instituted with the mission ofEnriching Lives; Glenmark Foundation is theCorporate Social Responsibility (CSR) arm of Glenmark. The Foundation has been

implementing several projects for the benefit of the underprivileged sections of the

society under 3 core areas:

Sustainable Livelihoods

Child Health

Employee Volunteering

Jindal Steel & Power

To make medical facilities available to the common man,

JSPL has set up many charitable clinics and hospitals in

the Raigarh district. An ICU unit at the general hospital at

Raigarh has been set up.15

World-class health facilities are provided to the people of

Raigarh at the 100-bed multi-speciality Fortis O. P. Jindal

Hospital & Research Centre. The disciplinary facilities

include: medicine, surgery, gynaecology, orthopedics and pediatrics. The hospital has

four well-equipped Operation Theatres, a Cardiac ICU, a Burn ICU and a Neo-natal

ICU. It plans to launch a comprehensive pathological and other investigation facilities

such as X-Ray lab, ECHO colour Doppler, Endoscopy, CTScan.

Health Camps

Regular and integrated medical camps with super specialisty doctors from eminent

hospitals have benefited more than 40,000 people in the district. Women welfare

programs are also organized regularly.

Regular village medical camps are organised through mobile medical van services with

specialist doctors in Patratu, Angul and Raigarh.

Population control and family welfare is one of the important aspects of community

welfare. JSPL has been organising family planning camps in the region since 1996.

This initiative has resulted in bringing couples under family welfare coverage and has
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ensured better health for the women and also contributed in controlling infant

mortality rate in the community.

Ranbaxy Laboratories

In 1978, in the wake of the grim health scenario in India, Ranbaxy realised the

urgency to reach out to the underprivileged sections of society that had little or noaccess to basic healthcare. The Company took a conscious decision to contribute

towards the national objective Health For All. Towards this end, the Ranbaxy Rural

Development Trust was set up and the first well equipped mobile healthcare van was

introduced, in certain underserved areas of Punjab. As the programme grew, the

Ranbaxy Community Healthcare Society (RCHS), an independent body, was created,

that is devoted to the health of the disadvantaged. Today, multiple well equipped

mobile healthcare vans and an urban family welfare centre, run by Ranbaxy, benefit

over 2 lakh people, in certain identified areas in the states of Punjab, Haryana,

Himachal Pradesh, Madhya Pradesh and Delhi. The programme is based on an

integrated approach of preventive, promotive and curative services, covering areas of

maternal child health, family planning, reproductive health, adolescent health, health

education including AIDS awareness.16

During 2009, maternal and infant mortality were the focus of particular attention and

efforts in these areas were intensified in RCHS serviced areas. The results of these

interventions have been most encouraging and the general health profile of the local

community has shown further improvement in terms of coverage for immunisation,

vitamin A deficiency and family planning. The problem of malnutrition has been

addressed to a large extent and birth rates and infant mortality rates have declined

substantially. Amongst women, the risk of mortality due to pregnancy or child birth

has also been reduced when compared with the prevailing level of risk, in India andother developing countries. Ranbaxy has also dovetailed its CSR efforts in a manner

that is synchronous with the larger health goals of the State and Central Government.

RCHS continued to work actively on critical issues related to HIV/AIDS, tuberculosis,

malaria, polio, noncommunicable chronic diseases and female foeticide. RCHS also

continued its partnership with the Voluntary Health Association of Punjab for the

project on Reproductive Child Health (RCH), in the districts of Nawanshahar and

Fatehgarh Sahib, in Punjab and achieved the targets set under the RCH-II plan, of the

Government of India.

Ranbaxy entered into a Public Private Partnership (PPP) with the Punjab StateGovernment, to deliver healthcare services in identified districts of Punjab. The

programme will be rolled out in a phased manner. In order to encourage scientific

endeavour in the country, Ranbaxy presented Research Awards and Ranbaxy Science

Scholar Awards to 12 outstanding Indian scientists and 9 brilliant young scholars.

Symposia and Round Table Conferences were also organised on topics related to

women's health, immunogenomics of infectious diseases and pandemic influenza.


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Vedanta Aluminum

In Lanjigarh, Vedanta has already interested more than 70 crore rupees in last 3-4

years in CSR activities. the important projects undertaken by them areopening of 42

child care centers, support to more than one thousand Anganwadi centers for

improving nutritional level of childrens, health services in more than 100 villages

through mobile health unit, electrification in 11 villages , commercial vegetablecultivation for 700 farmers, strawberry cultivation, leaf plate making for nearly 300

Dongria Kondh tribals , construction of nearly 50 Km roads and opening of a high

standard English medium school in Lanjigarh. Over and above they are taking special

projects such as integrated child development program, wadi and watershed and

cultural activities.17


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International Organizations in India

UNICEF

UNICEF has been working in India since 1949. The largest UN organisation in

the country,UNICEF is fully committed to working with the Government of

India to ensure that each child born in this vast and complex country gets the

best start in life, thrives and develops to his or her full potential. UNICEF uses

its community-level knowledge to develop innovative interventions to ensure

that women and children are able to access basic services such as clean water,

health visitors and educational facilities, and that these services are of high

quality. At the same time, UNICEF reaches out directly to families to help them

to understand what they must do to ensure their children thrive. UNICEFs

work is centred on children from neonatal stages to adolescence. There is also

a special focus on social inclusion in all these programmes, keeping in mind

the fact that the Eleventh-Five-Year Plan emphasises on inclusive growth andrecognises social exclusion and inequality as a constraint to the achievement of

MDG goals.18

In addition to reducing infant mortality rates (IMR), the Reproductive and Child

Health programme will also aim to reduce maternal mortality rates (MMR) from

301 to 100 per 100,000 live births. The main interventions will revolve around

enhancing child survival and maternal care.

Key results include:

Reduction of IMR from 58 to 28 per 1,000 live births.

Reduction of MMR from 301 to 100 per 100,000 live births.

The Child Development and Nutrition programmewill stress on the nutritional

status of the mother along with the child. UNICEF will focus on providing

technical know-how to enhance ICDS functioning and delivery by supporting

training of the field-level workers on the one hand and by conducting a

nationwide awareness campaign on the issue with the purpose of influencing

policy. Anticipated results include:

Reduction in the level of malnutrition.

Significant reduction in micronutrient deficiencies.

Child Environment improving freshwater availability, its management,

conservation and equitable allocation, as well as access to sanitation and

adoption of critical hygiene practices.


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Impact

As depicted in the chart earlier, due to the effort of the various organizations,

infant mortality rate has gone down in India but it is still significantly larger.

Comparative to some of the countries which are similar to India in terms of

socio-cultural development and recent financial success too, India is seen asstaggering.

Comparison with BRIC countries:

Over 400,000 newborns die within the first 24 hours of their birth every year,

the highest anywhere in the world, a study by an international non-government

organisation, Save the Children, has declared.

According to the NGO, despite a decade of rapid economic growth, Indias

record on child mortality at 72 per 1,000 live births is worse than that of

neighbouring Bangladesh, one of the poorest countries in the world.

Two million children under five years of age dieone every 15 secondseach

year in India, also the highest anywhere in the world, it said. Of these more

than half die in the first month of their birth.

Moreover, one-third of all malnourished children live in India, 46 per cent of

children under three are underweight in the country, and over two-thirds of


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infants die within the very first month of their birth. Ninety per cent of these

deaths occur due to easily preventable causes like pneumonia and diarrhoea.

Improved Health Care

With the recent developments in Indias financial health and a robust economy,India has been able to develop health centers across the country. With this,

programs such as Anganwadi have been able to transform rural maternal

health care in the country. It is not possible for a country as large as India to

have affordable health care everywhere. And thus programs such as Anganwadi

go a long way in improving conditions for women.

But still as the figure shows, attendance of skilled health staff is relatively less.


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Our View on the ImpactEvery child lost is an opportunity lost for the country. And we owe it to the unborn

ones that we give them everything there is to assure them of a safe entry in this world.

Clearly this is not happening. Even though there is a reasonable reduction in the

overall IMR of India, it is still way above the world average. Whereas the world average

is about 50, India hovers just above this rate. In fact, India rates below many thirdworld countries such as Haiti in the IMR. This is a matter of shame for all of us.

There are a lot of NGOs- Indian and international which do very good work for this

issue. But they can only do so much. Indias problem is its size itself. Any program is

extremely difficult to implement in a country this huge.

Addressing the Issue

As far as addressing the core of the issue, we are far off. As the problem lies not just in

the deliveries and care thereafter, but the problem also lies in the care provided to

women in the neonatal stage. Also with this the care provided in terms of vaccinationand care during the first 1 year is also important.

Initiatives of the government and NGOs have concentrated mostly on providing a safe

delivery to women. But infant care includes pre-natal as well as post-natal care. And

this is where impact is severally lacking.

It is this care that we expect to see that will see India really rising up to its citizens

and protecting them.

Although the government expects the IMR to reduce significantly by 2025, it wont go

out completely. But India would work well if we could separate the controllable anduncontrollable aspects of infant mortality, and then target the controllable ones and

get that really under control.


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References Exhaustive1. Indian Express article accessed on 16/2/2012. Link-

http://www.indianexpress.com/news/critical-hospital/905957/0

2. Information about Infant mortality and its definitions derived from Wikipedia pageaccessed on 17/2/2012. Link- http://en.wikipedia.org/wiki/Infant_mortality

3. World statistics on world infant mortality derived from Wikipedia page accessed on17/2/2012. Link-http://en.wikipedia.org/wiki/List_of_countries_by_infant_mortality_rate

4. All Indian statistics taken from India Stat organization website accessed on 17/2/2012.Link- www.indiastat.org

5. Google Public data based on statistics from World Bank accessed on 16/2/2012. Link-http://www.google.co.in/publicdata/explore?ds=d5bncppjof8f9_&met_y=sp_dyn_imrt_i

n&idim=country:IND&dl=en&hl=en&q=infant+mortality+rate+in+india

6. Wikipedia page on National Rural Health Mission accessed on 17/2/2012. Link-http://en.wikipedia.org/wiki/National_Rural_Health_Mission_of_India

7. Goals of NHRM. Link- nhrm.nic.in8. Anganwadi information on Wikipedia page accessed on 17/2/2012. Link-

http://en.wikipedia.org/wiki/Anganwadi

9. Times of India article on Home based birth scheme. Link-http://timesofindia.indiatimes.com/india/WHO-lauds-Indian-scheme-to-reduce-

neonatal-mortality/articleshow/11904619.cms

10.NGO Ayauskum Link http://www.ayaskum.org/11.www.careindia.org12.Laxmi Profile-

http://www.ngogateway.org/user_homepage/menus.php?id=392&field=profile

13.DHL corporate responsibility. Link- http://www.indiacsr.in/en/?p=210914.Glenmark. Link- http://www.indiacsr.in/en/?p=8515.Jindal Steel & Power. Link-

http://www.jindalsteelpower.com/sustainability/csr/healthcare.aspx16.Ranbaxy link- http://www.ranbaxy.com/socialresposbility/socialcommitment.aspx17.Vedanta Link- http://www.indiacsr.in/en/?p=8518.Information on UNICEF Link-http://www.unicef.org/india/resources_4691.htm

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