millennium development goals & child survival

Millennium Development Goals & Child

Survival

Dr.P.Nalini Rao, Lecturer(SG) and R.Sakthi Prabha, Lecturer , Madras School of Social Work, Chennai -8

CHILDREN OF INDIA

MILLENNIUM DEVELOPMENT GOALS AND CHILD PROTECTION

Goal 4 : Reduce child mortality

Child Mortality and Protection:

Extreme exploitation, violence or abuse can lead to child deaths, both under the age of five and throughout various phases of childhood.

Economist

According to Amartya Sen in his book “Development as Freedom” (1999) - Ability to survive is

considered a primary freedom; the ability of individuals to avoid premature mortality and persistent morbidity should be one of the most fundamental goals of development. Sound health care policies are therefore crucial in the process of development.

11th Five year Plan

•Towards Faster and More

•Inclusive Growth

India

• Live in villages- 72.00% (2001 census)

• Access to health care is tentative, safe water and adequate sanitation is almost luxury but they do influence health outcomes

• Surviving first five years of life is difficult

India

• Infant mortality rate is 62 per 1000 for Rural children and 42 per 1000 for the Urban children (NFHS-3,2007)

• Common causes of death Diarrhea diseases, Malaria, Measles, Congenital Anomalies, Malnutrition etc.

CMR and IMR in MEDIUM DEVELOPING COUNTRIES

(Based on HDI Ranking)

We have analyzed the IMR and CMR of 86 countries – ranking from 71st to 155th rank (Dominica to Gambia ) with select variables to throw some light on interesting data

Independent variables

• Adult literacy level

• Public and Private expenditure on health

• Birth attended by skilled health personnel

• Improved sanitation

• Infants with low birth weight

• Improved water resource» Contd..

Independent variables

• Undernourished Population

• Human Development index value

• GDP per capita

• Population below poverty ($2 a day)

• Gender Related Development index

Inference

• There is no association between IMR/CMR and adult literacy level, public expenditure on health, improved sanitation, undernourished population, human development index value, GDP per capita and Population below poverty line.

Inference

• There is a association between IMR and Private expenditure on health

• There is association between GDI and IMR

• There is a significant relation between CMR and Birth attended by skilled health Personnel

Inference

• There is negative correlation between IMR and Birth attended by Skilled personnel

• There is negative correlation between CMR and Improved water resources.

Indian scenario

• 80% of extremely poor live in rural areas (Purao 2000)

• Health of rural population takes a serious setbacks.

• Under nutrition more among children

TAMILNADU

Sex Ratio in the state is 987 females per 1000 males

Infant mortality rate is 35% (SRS 2001 - 03 ) (India-55%)

Tamilnadu

• 15% of women live in village with PHC

• 55% of household use Private hospitals

• 38% only use the public medical sector

• IMR is 37.0 per 1000 live births (2005)

• Higher mortality among girls (48%)

Infant Mortality Rates by State Per 1,000 live births

INDIA

Tamil Nadu

NFHS-3, Tamil Nadu, 2005-06

Early Childhood Mortality Rates, India & Tamil Nadu

Deaths per 1,000 live births

In Tamil Nadu, more than half of deaths (53%) to children who die in the first five years of life occur in the first month after birth

*For the five-year period preceding the surveyNFHS-3, Tamil Nadu, 2005-06

Childhood Mortality Rates by Sex, Tamil Nadu

Per 1,000


Girls experience lower mortality than boys in neonatal period,but they experience higher mortality in postneonatal period.

Under five mortality is also higher for girls.

Trends in Infant Mortality Rate

Per 1,000 live births

There is sharp decline in infant mortality in Tamil Nadu since from NFHS-1 to NFHS-2 and to NFHS-3.


I n f a n t M o r t a l i t y b y R e s id e n c e

3 1

4 33 8

2 4

3 8

2 8

0

1 0

2 0

3 0

4 0

5 0

6 0

7 0

8 0

U r b a n R u r a l T o t a l N o n - s lu m S lu m C it y

Tamilnadu

• Antenatal care is almost universal

• 9 out of every 10 births take place in health facility

• 89% of children were vaccinated

• 97% of children under age of six years are covered by aganwadi centers

Tamilnadu

• Upgrading PHCs- Strengthening the health delivery system

• Public private partnership model involving NGOs - satyam foundation (EMRI)- creating helpline service 108

• Vazhvoli thittam and varumun kappom thittam – a preventive model

Treatment of Childhood Diseases, Tamil Nadu

Percentage of children with childhood diseasestaken to a health facility or provider

Acute respiratory infection (ARI): 75 percent

Fever: 79 percent

Diarrhoea: 63 percent


Treatment of Diarrhoea, Tamil Nadu

55% of children under age 5 with diarrhoea in the two weeks before the survey received some kind of oral dehydration therapy (ORT)

32% were treated with a solution prepared from oral dehydration salt (ORS) packets and 32% received gruel

About one in five children (20%) did not receive any kind of treatment

9% received antibiotics, which are not normally recommended for treating childhood diarrhoea


Coverage of Full Immunization, Tamil Nadu

% Fully immunized among children age 12-23 months

Urban 78%

Rural 84%

Chennai-nonslum 74%

Chennai-slum 89%

Girls 81%

Boys 81%

With mother 10+ years of education

80%

From the highest wealth quintile

80%


Summary of Vaccination Coverage

About eight out of ten children (81%) age 12-23 months

are fully vaccinated against the six major childhood

illnesses

Tamil Nadu has highest percentage (81%) of children fully

vaccinated than any other state in the country

Coverage of full immunization decreased from 89 percent

in NFHS-2 to 81 percent in NFHS-3


Tamilnadu

• 1421 PHC- 24 hours• 246 Mobile units• 1607 Patient welfare societies at all levels• Village health and Sanitation Committees

– 13,000 villages and 540 town Panchayat• Janani Suraksha Yojana• Muthulakshmi Reddy Maternity Benefit

Scheme

Tamilnadu

• Rural water supply

• Universal Immunization programme

• 0.5 % of Population is yet to be covered for drinking water

• Empowerment of women – SHG

• NREG- Sustainable employment

Conclusion

• a self sustained economy with healthy population

• A holistic approach as suggested by MDGs is surer way to bring all into the

mainstream of development by providing equal opportunity to all.

Conclusion

• Create a level playing field for all to

• Grow

• Live

• And

• Celebrate life

Thank You

millennium development goals & child survival

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