Child Survival – This is How
State of the World’s Children Report 2008 released in New DelhiNew Delhi, 23 January 2008: Six women who traveled from distant and impoverished districts of Mayurbhanj in Orissa and Shivpuri in Madhya Pradesh unveiled the State of the World’s Children Report 2008 here today. Orissa and Madhya Pradesh have the highest infant mortality rates in India.
The three devis (goddesses) each from the two states did something more. They also told those present how they worked to prevent infants from dying and how they battled on for survival of the child even in the most difficult districts and communities .
Among those listening were the media and senior officials of the government and national and international development organizations.
With Child Survival as the theme for the report this year, UNICEF acknowledged the central role these front liners play in saving lives of children.
The ANM (auxiliary mid-wife nurse), ASHA (accredited social health attendant) and the AWW (anganwadi worker) - the triad forms the backbone of health and nutrition interventions for pregnant mothers and children in India.
In his opening remarks, Dr Gianni Murzi, UNICEF Representative ad-interim in India, himself an eminent pediatrician and long time champion of child survival said: “ I may be stating the obvious—but let me say it again—child survival is at the heart of human progress. Child survival is about the protection of human rights, particularly of the most vulnerable amongst us, the children.”
He said far too many young lives are lost as the global under-five mortality figure remains over 26,000 deaths a day.
“The good news is that we do know what works. The challenge is now to scale-up what works and reach the millions of children who remain excluded from affordable child survival interventions,” he added.
He echoed the words of UNICEF Executive Director Ms. Ann Veneman: “Community-level integration of essential services for mothers, newborns and young children, and sustainable improvements in national health systems can save the lives of many more children under five who die each day.”
Dr Marzio Babille, Chief Health UNICEF India dwelt on the key challenges for India and the way ahead. Neonatal deaths take a major toll in the under five deaths and malnutrition figures have stagnated over a decade.
Dr Ghanshyam Sethy from Orissa presented the experience of the Integrated Management of Neonatal and Childhood Illnesses (IMNCI) initiative in Mayurbhanj, which was followed by a lively sharing of experiences from field workers from Orissa and Madhya Pradesh.
Training as a team, following the same protocol for every child at every home visit and timely referral can radically shift the infant mortality rates, they said.
What has also helped also is the high quality treatment given at the newly established Sick Neo-Natal Care Units. “IMNCI is for us, a common language and a common strategy.” That makes all the difference.
Dr Loveleen Kacker, Joint Secretary, Women and Child Development welcomed the Report and particularly the theme.
She said allocations have dramatically increased and more money will be found if required. But the government is still working on the right formula and needs everyone’s involvement in arriving at a national strategy that truly works.
Professor (Dr.) M.K. Bhan, Secretary, Dept. of Biotechnology, a noted pediatrician who adapted IMNCI for India said high-class training, high class materials, information down the line and empowerment were needed – just commitment and money was not enough.
“India must not accept high levels of child deaths. We need to reach 90 percent child survival – not just 30% - 40%” he said. The time to act is during pregnancy and in the first two years. Anything you do after that is too little and too late, he added.
Reiterating the commitment of the Ministry of Health & Family Welfare, Amarjit Singh, the Joint Secretary, National Rural Health Mission said every health facility from the lowest to the highest needed to function at 100 percent at every level.
“NHRM is not just about medication; it is about local community empowerment, availability of knowledge, flexibility of service, a guarantee of facilities and standards.”