ANSWER
THE MINISTER OF HEALTH AND FAMILY WELFARE
(SHRI JAGAT PRAKASH NADDA)
(a): India has made steady progress in reduction of Under-five mortality Rate (U5MR) from 126/1000 live births in 1990 to 49/1000 live births in 2013 as per the Sample Registration System Report (SRS) of the Registrar General of India. India may achieve MDG-4 target, if the current trend of annual decline of 6.6 percent, as per SRS, is sustained.
(b), (c) & (e): Yes, according to SRS 2013, the U5MR in India is 49/1000 live births. As per UNICEF projections, if current trends of under-five mortality rate continue, by 2030, five countries will account for more than half of all under-five deaths — India (17 per cent), Nigeria (15 per cent), Pakistan (8 per cent), Democratic Republic of the Congo (7 per cent) and Angola (5 per cent).
Under National Health Mission, the following interventions are being implemented to reduce child mortality in the Country:
1. Janani Shishu Suraksha Karyakaram (JSSK) entitles all pregnant women delivering in public health institutions to absolutely free and no expense delivery including Caesarean section. The initiative stipulates free drugs, diagnostics, blood and diet, besides free transport from home to institution, between facilities in case of a referral and drop back home. Similar entitlements have been put in place for all sick infants accessing public health institutions for treatment till one year of age.
2. Facility Based Newborn Care (FBNC) at different levels to reduce child morbidity and mortality by setting up of facilities for care of sick newborn such as Special New Born Care Units (SNCUs), Newborn Stabilization Units (NBSUs) and Newborn Care Corners (NBCCs) at different levels is a thrust area under NHM.
3. Home Based Newborn Care (HBNC) through ASHAs to improve newborn practices at the community level and early detection and referral of sick newborn babies.
4. India Newborn Action Plan (INAP) has been launched with an aim to reduce neonatal mortality and stillbirths. Newer interventions to reduce newborn mortality- Vitamin K injection at birth, Antenatal corticosteroids for preterm labour, Kangaroo mother care and injection Gentamicin to young infants in cases of suspected sepsis.
5. Intensified Diarrhoea Control Fortnight (IDCF) observed in 2014 and 2015 focusing on ORS and Zinc distribution for management of diarrhoea and feeding practices.
6. Integrated Action Plan for Pneumonia and Diarrhoea (IAPPD) launched in four states with highest child mortality (UP, MP, Bihar and Rajasthan).
7. Nutritional Rehabilitation Centres (NRCs) have been established for management of severe acute malnutrition in children.
8. Appropriate Infant and Young Child Feeding practices are being promoted in convergence with Ministry of Women and Child Development.
9. Village Health and Nutrition Days (VHNDs) are organized for imparting nutritional counselling to mothers and to improve child care practices.
10. A name based Mother and Child Tracking System (MCTS) has been put in place which is web based to ensure registration and tracking of all pregnant women and newborn babies so that provision of regular and complete services to them can be ensured.
11. Rashtriya Bal Swasthya Karyakram (RBSK) for health screening and early intervention services has been operationalized to provide comprehensive care to all the children in the age group of 0-18 years in the community. The purpose of these services is to improve the overall quality of life of children through early detection of birth defects, diseases, deficiencies, development delays including disability.
12. Under National Iron Plus Initiative (NIPI), through life cycle approach, age and dose specific IFA supplementation programme is being implemented for the prevention of anaemia among the vulnerable age groups like under-5 children, children of 6 – 10 years of age group, adolescents, pregnant & lactating women and women in reproductive age along with treatment of anaemic children and pregnant mothers at health facilities.
13. National Deworming Day was observed on 10th February, 2015 in 11 States/UT – Assam, Bihar, Chhattisgarh, Delhi, Dadra & Nagar Haveli, Haryana, Karnataka, Maharashtra, Madhya Pradesh, Rajasthan, Tamil Nadu and Tripura targeting children in the age group of 1-19 years (both school enrolled and non-enrolled), recognising negative impact of worm load in children effecting their growth and development.
14. Various trainings are being conducted under NHM to train doctors, nurses and ANMs for essential newborn care, early diagnosis and case management of common ailments of children. These trainings are on Navjaat Shishu, Suraksha Karyakram (NSSK), Integrated Management of Neonatal and Childhood Illnesses (IMNCI), Facility Based Newborn Care (FBNC), Infant and Young Child Feeding practices (IYCF), etc.
15. Universal Immunization Programme (UIP): Vaccination protects children against many life threatening diseases such as Tuberculosis, Diphtheria, Pertussis, Polio, Tetanus, Hepatitis B and Measles. Infants are thus immunized against seven vaccine preventable diseases every year. The Government of India supports the vaccine programme by supply of vaccines and syringes, cold chain equipment and provision of operational costs.
16. Mission Indradhanush has been launched to fully immunize children who are either unvaccinated or partially vaccinated; those that have not been covered during the rounds of routine immunization for various reasons.
(d): The State and UT wise Under- five mortality rate since 2010 till 2013 (latest available data from the Sample Registration System Reports of the Registrar General of India) are placed at Annexure I.
The State and UT wise funds sanctioned, released and utilized towards child health for last four years are placed at Annexure II.
Annexure 1
Trend of Under-5 Mortality Rate in India (Available only for 20 bigger States)
States 2010 2011 2012 2013
India 59 55 52 49
Andhra Pradesh 48 45 43 41
Assam 83 78 75 73
Bihar 64 59 57 54
Chhattisgarh 61 57 55 53
Delhi 34 32 28 26
Gujarat 56 52 48 45
Haryana 55 51 48 45
Himachal Pradesh 49 46 43 41
Jammu & Kashmir 48 45 43 40
Jharkhand 59 54 50 48
Karnataka 45 40 37 35
Kerala 15 13 13 12
Madhya Pradesh 82 77 73 69
Maharashtra 33 28 28 26
Orissa 78 72 68 66
Punjab 43 38 34 31
Rajasthan 69 64 59 57
Tamil Nadu 27 25 24 23
Uttar Pradesh 79 73 68 64
West Bengal 37 38 38 35
Source: SRS Reports (2010-13)
Statement showing of State/UTs wise SPIP Approval & Expenditure towards Child Health under RCH Flexible Pool under NHM for F.Ys 2012-13 to 2015-16
Rs. In Lakhs
S.No. State 2012-13 2013-14 2014-15 2015-16
SPIP Approval Expenditure SPIP Approval Expenditure SPIP Approval Expenditure SPIP Approval Expenditure
1 Bihar 7994.21 1,377.22 5,393.69 2,929.51 1,240.69 859.68 1,294.97 52.29
2 Chhattisgarh 1403.11 543.47 1,053.40 612.30 1,170.49 786.29 1,467.72 396.41
3 Himachal 182.79 153.04 117.62 729.44 723.84 1,305.31 420.88 120.96
4 J & K 271.47 134.99 1,192.95 468.29 647.76 468.26 487.60 188.14
5 Jharkhand 1040.57 296.56 1,905.04 883.34 1,851.56 732.90 1,905.23 310.80
6 MP 3086.54 2,672.08 4,244.62 3,974.20 3,454.66 3,025.57 3,532.79 1,241.78
7 Orissa 1233.57 788.94 1,114.75 622.06 1,562.70 668.28 1,333.38 267.97
8 Rajasthan 3416.94 808.22 2,187.88 1,114.49 2,440.05 1,554.50 2,273.20 372.17
9 UP 1516.15 558.10 1,234.83 445.58 1,790.09 709.79 2,070.88 172.59
10 Uttarakhand 233.33 249.54 150.50 201.89 215.41 205.23 392.59 111.74
11 Arunachal Pradesh 212.70 61.87 137.83 64.80 126.49 89.00 177.32 140.12
12 Assam 1474.33 776.09 2,575.66 1,568.67 3,003.88 1,591.94 2,030.07 516.40
13 Manipur 93.76 11.80 38.13 74.84 177.08 163.51 142.71 47.49
14 Meghalaya 283.01 34.91 178.22 12.90 364.50 78.75 367.50 40.75
15 Mizoram 62.50 17.34 140.10 78.16 86.45 46.67 - 32.59
16 Nagaland 199.34 63.84 178.90 46.39 128.97 18.94 125.28 14.26
17 Sikkim 62.50 15.36 49.01 50.54 64.91 49.73 63.25 12.95
18 Tripura 221.21 56.63 58.07 88.35 255.55 185.11 166.98 50.38
Sub Total 2609.35 1037.84 3355.92 1984.66 4207.83 2223.65 3073.11 854.94
19 Andhra 4656.98 866.21 2,144.84 604.91 1,234.37 676.94 1,127.19 176.32
20 Goa 43.28 32.46 45.80 14.69 69.58 18.09 36.47 2.31
21 Gujarat 4616.99 2,521.96 2,799.58 1,658.45 2,110.41 1,678.12 1,684.89 750.25
22 Haryana 484.79 180.92 568.26 560.96 573.59 465.81 421.40 84.87
23 Karnataka 897.08 553.49 478.10 302.37 1,024.33 255.02 856.15 95.25
24 Kerala 1231.82 1,046.48 401.69 310.24 198.13 158.07 264.07 22.33
25 Maharashtra 2602.04 2,204.45 1,773.38 2,656.63 2,408.12 1,309.78 1,000.12 60.35
26 Punjab 742.00 394.24 295.35 47.73 784.41 637.57 360.85 73.50
27 Tamil Nadu 5946.94 20.15 561.50 1,062.79 656.00 4,098.09 1,063.99 603.33
28 Telangana - - - - 755.59 118.01 761.41 69.22
29 West Bengal 3593.78 919.29 1,441.89 1,119.11 3,245.09 2,412.71 2,125.84 1,259.84
30 Andaman & Nicobar 55.45 - 5.98 - 29.20 3.74 13.95 -
31 Chandigarh 14.03 0.02 0.40 0.18 3.08 0.29 3.53 0.14
32 Dadra & Nagar Haveli 21.01 3.42 10.20 3.82 23.60 1.48 27.62 0.19
33 Daman 6.60 0.33 - - 0.46 0.32 2.77 0.25
34 Delhi 409.20 24.40 86.70 19.12 152.60 16.20 97.52 1.47
35 Lakshadweep 47.00 - 4.52 - 15.20 0.27 21.10 -
36 Puducherry 3.20 3.50 14.96 5.71 15.60 8.75 24.40 0.05
Grand Total 48360.2 17391.32 32584.35 22332.48 32604.44 24398.72 28145.61 7289.46
Note:
a) SPIP- State Programme Implementation Plan.
b) Above statement comprises of Child Health activity under RCH Flexible Pool
c) Above mentioned Expenditure figures are as reported by States/UTs up to 30.09.2015
d) Above Expenditure is inclusive of previous year unspent balance
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