UNICEF “State of the World’s Children Report 2019”

Image attribution – UNICEF/UN0321726/Mejía

As per UNICEF's State of the World's Children Report 2019, the Under 5 Mortality Rate in India is 37 per 1,000 live births against Global average of 39 per 1,000 live births in 2018, which translates to more than 8 lakhs under 5 deaths in India.

As per the Sample Registration System (SRS) 2010-13 report of Registrar General of India, major causes of child mortality in India are: Prematurity & low birth weight (29.8%), Pneumonia (17.1%), Diarrheal diseases (8.6%), Other non-communicable diseases (8.3%), Birth asphyxia & birth trauma (8.2%), Injuries (4.6%), Congenital anomalies (4.4%), Ill-defined or cause unknown (4.4%), Acute bacterial sepsis and severe infections (3.6%), Fever of unknown origin (2.5%), All Other Remaining Causes (8.4%).

As per the UNICEF 2019 report, Globalization, urbanization, inequities, humanitarian crises and climate shocks are driving unprecedented negative changes in the nutrition situation of children around the world.

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The Government of India has launched POSHAN (Prime Minister Overarching Scheme for Holistic Nourishment) Abhiyaan, to address malnutrition challenges in India by engaging all the important stakeholders in a convergent approach. The goals of POSHAN Abhiyaan are to prevent and reduce stunting, underweight and low birth weight by 2% per annum and the reduction of anemia by 3% per annum.

The Government of India has also launched several schemes under the aegis of Ministry of Women and Child Development (MWCD) to tackle malnutrition in the country including Anganwadi Services, Scheme for Adolescent Girls (SAG) and Pradhan Mantri Matru Vandana Yojna (PMMVY) to improve the nutritional and health status of children in the age-group 0-6 years. The Anganwadi Services scheme provides a package of six services i.e. Supplementary Nutrition, Pre School Non-formal Education, Nutrition and Health Education, Immunization, Health checkups, and referral services.

In order to address child mortality and morbidity, the Government of India is supporting all States/UTs under National Health Mission in implementation of Reproductive, Maternal, Newborn, Child, Adolescent health and Nutrition (RMNCAH+N) strategy, which has following interventions:

1. Strengthening essential newborn care at all delivery points, the establishment of Sick Newborn Care Units (SNCU), Newborn Stabilization Units (NBSU) and Kangaroo Mother Care (KMC) units for the care of sick and small babies.
2. Home Based Newborn Care (HBNC) and Home-Based Care of Young Children (HBYC) by ASHAs to improve child-rearing practices and to identify sick new-born and young children.
3. Early initiation and exclusive breastfeeding for the first six months and appropriate Infant and Young Child Feeding (IYCF) practices are promoted under Mothers’ Absolute Affection (MAA) in convergence with the Ministry of Women and Child Development.
4. Universal Immunization Programme (UIP) is being supported to provide vaccination to children against life-threatening diseases such as Tuberculosis, Diphtheria, Pertussis, Polio, Tetanus, Hepatitis B, Measles, Rubella, Pneumonia and Meningitis caused by Haemophilus Influenzae B. The Rotavirus vaccination has also been rolled out in the country for prevention of Rota-viral diarrhoea. Mission Indradhanush is targeted to immunize children who are either unvaccinated or partially vaccinated i.e. those that have not been covered during the rounds of routine immunization for various reasons. Intensified Mission Indradhanush (IMI) 2.0 is rolled-out as per road-map for achieving 90% full immunization coverage across the country.
5. Nutrition Rehabilitation Centres (NRCs) have been set up at public health facilities to treat and manage children with Severe Acute Malnutrition (SAM) admitted with medical complications.
6. Defeat Diarrhoea (D2) initiative has been launched for promoting ORS and Zinc use and eliminating the diarrhoeal deaths by 2025.
7. Social Awareness and Actions to Neutralize Pneumonia Successfully (SAANS) initiative for reduction of Childhood morbidity and mortality due to Pneumonia.
8. Anaemia Mukt Bharat (AMB) strategy as a part of Poshan Abhiyan aims to strengthen the existing mechanisms and foster newer strategies to tackle anaemia, which include testing & treatment of anaemia in school-going adolescents & pregnant women, addressing non-nutritional causes of anaemia and a comprehensive communication strategy. National Deworming Day (NDD) is implemented bi-annually every year for the deworming of children (one to nineteen years of age).
9. All the children from 0 to 18 years of age are screened for 30 health conditions classified into 4Ds – Diseases, Deficiencies, Defects and Developmental delay under “Rashtriya Bal Swasthya Karyakaram” (RBSK) to improve the quality of survival and to reduce out of pocket expenditure of families. District early intervention centre (DEIC) at the district health facility level is established for confirmation and management of the 4D’s.
10. Village Health Sanitation and Nutrition Days (VHSNDs) are observed for the provision of maternal and child health services and awareness on maternal and child health and nutrition education through mass and social media to improve health practices and to generate demand for service uptake.
11. Name-based tracking of mothers and children till two years of age is done through the RCH portal to ensure complete antenatal, intranatal, postnatal care and immunization as per schedule.
12. Promotion of Institutional deliveries through cash incentive under Janani SurakshaYojana (JSY) and Janani Shishu Suraksha Karyakaram (JSSK) which entitles all pregnant women delivering in public health institutions to absolutely free delivery including Caesarean section, post-natal care and treatment of sick infants up to one year of age. Pradhan Mantri Matru Vandana Yojana (PMMVY) is another maternity benefits programme under which cash incentive is provided to pregnant women and lactating mothers.

The Minister of State (Health and Family Welfare), Sh Ashwini Kumar Choubey stated this in a written reply in the Rajya Sabha.

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