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HindustanTimes Thu,27 Nov 2014

Under-nutrition among kids in UP alarming

Pankaj Jaiswal, Hindustan Times  Lucknow, September 18, 2013
First Published: 10:50 IST(18/9/2013) | Last Updated: 10:53 IST(18/9/2013)

Rashi, 3, of Lucknow holds the national record for being the lowest birth weight baby in the country. She was born with a birth weight of a mere 620 grams and has her name in the Limca Book of Records.

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Every sixth undernourished child in India lives in Uttar Pradesh.

Every second child in UP is undernourished while only one in 14 newborns is breast fed within one hour of birth in the state, indicate statistics.

The gravity of the Uttar Pradesh scenario could be well understood when an alumnus of John Hopkins University, USA, Dr Vishwajeet Kumar puts the UP statistics in a global-historical perspective.

According to him, the annual tragedy of infant mortality equates the casualties that Hiroshima-Nagasaki atomic bomb explosions or the Indian Ocean tsunami claimed.

Vishwajeet, who is CEO and principal scientist of the Community Empowerment Lab, Lucknow-Rae Bareil, says: “The Hiroshima-Nagasaki atomic bomb explosions in World War-II claimed 240,000 lives in 1945. The tsunami from the Indian Ocean in 2004 also led to 240,000 deaths. And 240,000 babies died in UP in 2012. This tragedy is repeated in Uttar Pradesh every year. Hiroshima Nagasaki shocked the world, tsunami shocked the world, but the same number of deaths of newborn every year does not shock us.”

So, the most populous state in the country with 200 million(20 crore) people also has the worst scenario and statistics so far as under-nutrition and associated factors are concerned.

Nearly 20 districts in UP have an infant mortality rate of over 80 per 1000 births, putting them on a par with the sub-Saharan countries of Africa.

Over Rs. 9000 crore has been spent on bringing down the infant and maternal mortality rates in the state.

 Nevertheless, the overall infant mortality rate of UP is still very high. According to the latest data released by the office of the Registrar General and Census Commissioner of India on September 12, the infant mortality rate (IMR) in UP is 53 per 1000 births.

This is a marginal improvement from 2011’s IMR of 57. Nearly 20 districts have an infant mortality rate of over 80 per 1000 births, putting them on a par with the sub-Saharan countries.

Uttar Pradesh has the dubious distinction of having the top five IMR districts of India. They are Shrawasti (with the highest IMR of 103 in the country), Faizabad (98), Balrampur (93), Budaun (91) and Siddharth Nagar (91).

Experts say development of a child till the age of five years determines how he or she will perform during the rest of his or her life. “Under-nutrition during the first two years impairs both intelligence and strength. Child malnutrition occurs entirely during the first two years and is virtually irreversible after that,” says Dr Neelam Singh of Vatsalya, Lucknow.

According to the Annual Health Survey (AHS) 2010-11, in UP the under-five mortality rate is 94/1,000.

The World Health Organisation says 60% of all deaths under the age of five are related to under-nutrition.

Under-nutritioned mothers and wrong feeding practices are related to twothirds of all under-five deaths, and majority children in Uttar Pradesh unfortunately do not get proper feeding.

Out of every 100 children born in UP, 28.2 have low birth weight (below 2.5 kg), putting them at risk for inhibited growth, cognitive development, and chronic diseases in life.

Majority of the children born in big cities of the state do not suffer low birth weight (LBW), but those born in periphery districts are born with the risks associated with LBW. According to the Annual Health Survey 201011, the worst is Firozabad district where 78.2% children are born with LBW.

Following closely are Farrukhabad with 48.1% LBW children and Etah with 47.3% neonates born with low weight.

“Malnutrition and anaemia in the mother, poor quality antenatal care and complications; illnesses in pregnancy and poor spacing between two children are some reasons for babies having LBW which needs to be addressed in the state,” says Dr Vinod Jain, secretary, Lucknow College of Surgeons, and a public health expert.

“The reasons for a high IMR in many UP districts are lack of awareness about healthy food and hygiene during and after pregnancy leading to malnourishment among mothers,” says Rakesh Kapoor, medical superintendent of SGPGIMS.

He says, “Raising awareness can give wonderful results. The reason for Kerala achieving a low IMR is the high rate of institutional births there because of greater awareness when compared to UP. Today, 99.4% of births in Kerala are institutional as against 46% in UP.”

(This report has been facilitated under the OneWorld-POSHAN fellowship grant)


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