On an average, there are 1,452 neonatal deaths in one day and 60 per hour in India
The death of more than 100 children at JK Lon Hospital in Rajasthan’s Kota district and 134 at a government hospital in Gujarat’s Rajkot in December 2019 made global headlines. Children had also died en masse in Bihar’s Muzaffarpur district and Uttar Pradesh’s Gorakhpur district in the recent past.
The sensationalisation of the Kota and Rajkot episodes by media apart, the deaths of children in hospitals across India remain a concern.
Down To Earth (DTE) asked a cross-section of experts how bad was child mortality in Indian hospitals. There was no consolidated data, they said. Only a few proxy calculations could be made.
Barring 0.1 per cent, most neonatal deaths — that occur within 28 days of birth — were in hospitals, said Remesh Kumar, the secretary of Indian Academy of Pediatricians. “Even in the most trying of circumstances, parents are able to take children to a hospital. The quality of healthcare provided may vary though,” he added.
Considering the increase in India's institutional delivery rate, there is little chance that parents won't take a child who falls ill within 28 days of birth to a facility where she was born only a few days ago, an expert said.
Neonatal deaths were at 24 per thousand live births, according to a government reply to a question asked in Rajya Sabha in February 2019. Considering the 2,21,04,418 registered live births in India in 2017 (data by the Union Ministry of Health and Family Welfare), the number of neonatal deaths would be 530,506.
Excluding 0.1 per cent, 529,976 deaths would have been in hospitals. That would be 1,452 neonates dead in a day, or 60 per hour. This doesn't include children under 5, the other indicator to measure child mortality.
The Union government has put special emphasis on improving development indicators of eight Empowered Action Group (EAG) states — Madhya Pradesh, Odisha, Rajasthan, Uttar Pradesh, Chhattisgarh, Bihar, Jharkhand and Uttarakhand. Almost half of India's registered live births in 2017 were in these states.
Rajasthan witnessed a decline of 19.1 per cent in IMR from 2013 to 2017. In Madhya Pradesh, Odisha, UP, Chhattisgarh, and Bihar Uttarkahand, the decline was 12.9 per cent, 19.6 per cent, 18 per cent, 17.4 per cent, 16.7 per cent and 0 per cent, respectively.
Another reading of the data suggests that more number of live registered births does not mean more infant deaths. For instance, the highest IMR is that of Madhya Pradesh, that is 47 per 1,000 live births.
However, the registered live births that took place in the central state in the same year was 14,68,191, which is third highest in these EAG states. The highest number of registered live births in the same year among these states took place in UP, that is, 35,45,785 births. However, its IMR is third highest.
Among the EAG states, the best improvement was shown by Jharkhand. It witnessed a decline of 21.6 per cent from 2013-17.
Replying to queries from Down To Earth, Rajesh Khanna, deputy director, Health & Nutrition, at the non-profit Save the Children said, “There are three primary reasons for deaths of children in hospitals in India — delay in recognition (at household level), delay in transportation or referral and delay in treatment (at health facility). As far as specific causes are concerned, preterm births, pneumonia, intrapartum complications and others are responsible for deaths.”
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