Infant mortality goes down, neonatal deaths stagnant in Bihar

PATNA: Health policymakers of the state can cheer at the end of the year as the state’s Infant Mortality Rate (IMR) has dropped, though by one point only. Now the state’s IMR is 42, according to Union government’s latest sample registration survey (SRS)-2013 released this week. This is the sixth highest IMR across India. This translates to 1.26 lakh infant deaths annually in Bihar.
IMR is defined as the number of infants death (mortality within one year of birth) per thousand live births. The national average is 40. However, tackling neonatal deaths must become a New Year resolution because the rate has not changed and 28 kids die in per thousand live births within 28 days. This translates into 80,000 neonatal deaths annually. It is even more worrying that out of total infant deaths, 55.5% die within seven days of birth. Incidentally, Bihar CM has already declared 2015 as the year of neonates.
What should deeply worry the policymakers is the fact that the share of 0-4 age group deaths to deaths in all age groups is the highest in Bihar. Moreover, for every 1,000 live births, 54 die before attaining the age of five. This is the fifth highest under-5 mortality rate across the country. Last year, the figure was 56.
Birth asphyxia (shortness of breath), preterm births and infection are the most common causes of death. Experts lament that most of these deaths are preventable, provided proper infrastructure and manpower are provided. Every district ought to have a Special Newborn Care Centre (SNCU), but only 15 have it, most of which are not in a proper condition. A newborn care corner attached to every labour room is an elusive dream. According to health department sources, no recruitment has been made on the 700 posts of SNCUs. “People are posted on deputation. They might not even be skilled to work in newborn centres, but there is no alternative,” sources said. “Newborn care committees are supposed to meet quarterly for assessment, but no such meeting has taken place for over an year,” sources added.
A recent Unicef-National Neonatology Forum Survey said basic equipment like resuscitation unit either doesn’t exist in newborn care centres or are non-functional or the operator does not know how to use it. Lack of cleanliness leads to infection deaths. Home delivery is also an issue. “If asphyxia takes place, an ambu bag can be helpful in tackling it. But if home delivery is not assisted by skilled birth attendant (SBA), they can’t be used,” said Dr Ghanshyam Sethy, a paediatrician with Unicef.