With 44:1000, Assam second highest in infant mortality rate among Indian states
As per a recently published report by the Sample Registration Survey (SRS), the infant mortality rate (IMR) in Assam was the second worst in the country at 44 deaths in 2017.
Among the poorest performing states, Assam was second only to Madhya Pradesh where the infant mortality rate is 47- the highest in the country. The IMR in rural areas in Assam is 46 while it is 21 in urban areas.
On the other hand, the lowest infant mortality rates were recorded in Kerala and Tamil Nadu with 10 and 16 infant deaths respectively. Among the smaller states, Nagaland and Goa had the lowest IMR with 7 and 9 deaths respectively.
Infant mortality rate is the number of deaths per 1,000 live births in a given time period and it is an important indicator of the overall health scenario of a region or community.
The SRS report revealed that Assam’s IMR is much higher than the national average which stood at 33 for 2017. The state’s IMR stood at 44 in 2016 too and it remained steady in 2017. Further, the infant mortality rate was 47 in 2015.
Further, at the national level, India has seen a consistent decline in the infant mortality rate in the past ten years. The IMR reduced from 53 in 2008 to 33 in 2017.
However, India is still lagging behind its neighbours including Bangladesh, Nepal and Sri Lanka.
Experts blame poor ante-natal care, lack of awareness about contraception, poor spacing between pregnancies and diarrhoea among infants as some of the major reasons behind the state’s poor maternal and child health indicators.
“Our peripheral healthcare system is not good enough and needs to be strengthened. The patients should be getting good healthcare services near their homes, but instead they keep getting referred to different places when they visit a healthcare facility near their homes,” informed Dr Tanma Saikia Das, a city-based gynaecologist at a government hospital.
She added that unless the peripheral healthcare roots are strong, it will be difficult to reduce the infant mortality rates.
“Unless the primary health centres (PHCs), first referral units (FRUs) in the state, do not work to their full potential, the rates cannot come down,” Das told G Plus.
Another city-based doctor informed that many doctors are reluctant to stay and work in far-flung areas.
“Till the expecting woman doesn’t receive proper care within those nine months, then it becomes a problem. The problems with her health need to be identified and treated at an initial level,” he mentioned.
Joint direct of health services for Kamrup (Metro) district, Ganesh Saikia, said that at the district level, the data was only published and available till 2013. He said that for Kamrup (Metro), the IMR stood at 39 deaths.
Speaking about the initiatives he informed that there are many programmes which are currently operational that have been initiated from the centre as well as the state government.
“We are currently implementing the government-sponsored schemes and the IMR has reduced over the years, it means that the programmes are working,” he said.
Dwelling on the reasons behind the high incidences of child and maternal deaths in Assam, Saikia said that the pattern of population is different in Assam than other states. He further informed that the population residing in the tea garden areas is the worst affected.
“The maternal and infant deaths are highest in tea garden areas. Now the state government has initiated schemes in the tea gardens to specifically target that population. For tea gardens, mobile medical units have been given in parts of upper Assam,” he mentioned.
Saikia further added that under a special scheme called wage compensation for pregnant women in tea gardens, Rs 5,000 is being given to the pregnant women of tea garden areas while Rs 6,000 is given to labourers who are pregnant and working in tea gardens.
This scheme was launched by chief minister Sarbananda Sonowal in October 2018.
Maternal deaths: a cause of concern
Apart from high infant deaths, the maternal deaths in the state, too, stand high. The maternal mortality rate (MMR) in Assam is 300 against the national average of 167 as per the National Family Health Survey (NFHS) IV.
MMR is the number of female deaths per 1 lakh live births in a year from any cause related to pregnancy or its management.
Commenting on the reasons behind high maternal mortality rates, Dr Tanma Saikia Das, a city-based gynaecologist, said that poor ante-natal care, immigrant population who stay in Char areas and are reluctant to go to health centres are the main reasons.
“A number of complications can be avoided if only the mothers deliver in a hospital with skilled staff. Even during home deliveries, we are focussing on skilled birth attendants. Also after delivery, essential newborn care plays a vital role,” informed an official at the National Health Mission (NHM).
He added that special newborn care units (SNCUs) in all district hospitals and medical colleges are playing a major role in improving newborn care. These are meant to provide intensive care to newborn babies.
In addition to SNCUs, paediatric intensive care units have also been established in different medical colleges of the state, said officials.
Authorities say that a major challenge faced by them in bringing down the mortality rates has been overcoming the geographical barriers to make health services accessible in remote areas.
“It becomes difficult for the ambulances to reach a few places due to the hilly terrain and poor condition of roads. In such cases making the services available to people become an issue,” informed a senior health official.