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Child Health in India, Smaller States Better Placed

By Aditi Tandon
Updated Thursday, 11 August 2011 15:08:05 - IST (UTC +5:30)

New Delhi: The country’s first-ever district-level health survey has placed smaller states, including Uttarakhand, Jharkhand and Chhattisgarh, on the top for most of the health indicators surveyed and Uttar Pradesh, Bihar and Madhya Pradesh at the bottom.
It finds neonatal mortality as the biggest challenge as seven out of every 10 infant deaths involve neonates. Here, inter-district variations are astounding.
Rudraprayag in Uttarakhand has the lowest neonatal mortality rate (NNMR) of 11 while Orissa’s Bolangir has the highest at 75. The survey proves zero correlation between people’s response to general child and maternal health and their preference for the male child.
So Uttarakhand, which tops on six of the nine health indicators studied in this largest global sample survey (18.2 million persons covered in nine biggest Indian states), stands at the bottom on sex ratio at birth (SRB) table, with Pithoragarh district posting the lowest number (764) of females born per 1,000 males as against Moradabad in UP with the highest 1,030. “This is the first time since Uttarakhand was carved out of UP that separate data is available for the two states,” said Health Secretary K Chandramauli.
Reporting a lower SRB for urban districts, the study shows active prevalence of sex selection in cities. In UP, rural SRB is 911 as against urban 873. On other indicators, urban areas are much better than rural.
Conducted by the Registrar General of India (RGI) across Assam and eight Empowered Action Group (EAG) states, Rajasthan, UP, Uttarakhand, Bihar, Jharkhand, Orissa, MP and Chhattisgarh comprising 48 per cent of India’s population, 59 per cent births and 70 per cent deaths, the first annual health survey was done at the behest of the PMO.
“It provides data for focused policy planning which was hitherto based on the sample registration system, which had smaller state-based samples,” said RGI C Chandramauli. The report lists 57 bottom-most districts; 34 in UP (where all 70 districts were surveyed); 11 in MP; seven in Assam and five in Rajasthan.
UP’s Shrawasti district is the worst in India with the highest crude birth rate (CBR is the number of live births per 1,000 persons) of 40.9; highest crude death rate (CDR is the number of deaths per 1,000 persons) of 12.6 and the highest infant mortality rate (IMR denotes the number of infant deaths less than 1 year of age per 1,000 births) of 103.
On child health, Orissa’s food crisis-hit KBK districts are the most vulnerable. Under five mortality rate is the highest - 145 - for Kandhamal. MMR (maternal mortality ratio denoting maternal deaths per 1 lakh live births) is the highest - 451 - in Faizabad Mandal of UP, where the NRHM has clearly failed as the recent scam involving three murders of CMOs has shown.
On other indicators, Uttarakhand districts outshine others - Bageshwar with the lowest CBR of 14.7; Rudraprayag with the lowest IMR of 19 and the lowest NNMR of 11; Pithoragarh with the lowest under five mortality rate of 24 and Kumaon headquarters with the lowest MMR of 183.
The CDR is the lowest (4.5) for Dhemaji district of Assam. Ironically, Uttarakhand’s Tehri Garhwal has the highest -1220 - sex ratio, which is the lowest - 818 - in Morena district of UP. Morena also has the lowest sex ratio of 787 in the 0 to 4 years’ category where Kawardha in Chhattisgarh is the best with 1,076 ratio. (Tribune News Service)

Tags: Aditi Tandon Child Health in India

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