Madhya Pradesh topped the country in infant mortality rate (IMR) with 52 deaths of children less than one year of age per 1,000 live births. The state also has highest death rate in the rural areas with over 8 deaths in a year per 1,000 people, according to the 2014 sample registration system (SRS) baseline survey released recently by the registrar general of India.
State’s IMR worse than some African countries
The state’s IMR is worse than some of the African countries which are often cited for poor health indices. According to World Bank, the IMR for Rwanda for the same year was 33, Ethiopia 43 and Zambia 45.
Even as the state topped the country in IMR, there has been a marginal improvement. In the last 2013 SRS baseline survey released in 2014, the IMR in MP was 54. MP and Assam shared the country’s top rank in IMR. But this time, Assam with IMR of 49 has slipped to the second place.
IMR is the number of deaths of children less than one year of age per 1,000 live births. Death rate is the average annual number of deaths during a year per 1,000 people at mid-year, while birth rate is the number of live births per 1,000 population of a given geographical area in a year.
The data also showed that in case of IMR, the improvement has been in urban areas only, while there has been no change in the IMR of rural areas. The IMR, according to the latest 2014 SRS baseline survey, is 57 for rural areas and 35 for urban areas.
In the 2013 SRS baseline survey, the IMR for MP’s rural areas stood at 57, while in case of urban areas it was 37. So, there has been an improvement of just two points in urban areas.
In case of death rate, over the last three SRS surveys, the death rate has come down from 8.1 in 2012, to 8 in 2013 and 7.8 in the latest survey.
MP also has highest death rate in rural areas
However, when it comes to death rate in rural areas, MP topped with 8.4 followed by Chhattisgarh with 8.3. Interestingly, in last 2013 SRS survey, it was Odisha which had topped in rural death rate. Its rural death rate was 8.7.
Pankaj Shukla, deputy director health (urban), said: “Madhya Pradesh topped in IMR in previous years also but there has been an improvement over the years. Though some other states have improved a bit more, we have taken several measures for improving the scenario here.”
“Our special newborn care units have got appreciation in the country. In next couple of years, there will marked improvement in the status of IMR in our state.”
The growth rate of MP has also witnessed a gradual decline, the data showed. The overall growth rate has come down from 18.6 in 2012 to 18.4 in 2013 and 17.9 in the latest SRS survey.
‘Shortage of doctors, lack of proper primary healthcare infra plague rural areas’
According to medical experts, MP retaining the highest IMR in the country was due to health sector suffering from many issues ranging from shortage of doctors to lack of proper primary healthcare infrastructure in rural areas.
Sachin Jain, director Vikas Samvad, who has been working for the cause of healthcare in MP, said the data clearly showed there was not much change in the primarily healthcare in rural MP where the situation remain practically unchanged.
“There are two main problems with healthcare here. First you cannot see IMR in isolation. You have to take care of maternal and adolescent health. In the last few years focus on maternal and neonatal health has derailed as is evident from recent incidents in the district hospitals.
“Second, when it comes to primary healthcare and nutrition security, the government has failed to ensure multi-sectoral convergence. There has to be coordination between various departments in rural areas for ensuring better healthcare be it water supply or panchayat,” he said.
Amulya Nidhi from Jan Swasthya Abhiyan (JSA) said for last few years, the state’s health sector had in way admitted that it cannot run the basic healthcare system in the far flung areas of MP, be it due to shortage of doctors and paramedics or lack of proper health infrastructure.
“The MP government, which keeps bragging about its achievements, should be asked why it is worst when it comes to survival of newborns and pregnant mothers. Why so many mothers and infants have to die here? Why can’t we save them? This needs to be explored in detail,” he said.