Madhya Pradesh has topped the country in infant mortality rate (IMR) for the 12th successive time in a survey released by the central government last week. It has raised questions as to why over the years the state government has failed to check the death of infants compared to other states.
Madhya Pradesh has the highest IMR in the country with 52 deaths of children less than one year of age per 1000 live births, according to the latest sample registration system (SRS) baseline survey 2014 released by the registrar general of India.
Medical experts HT spoke to attribute four main factors for poor performance in checking IMR in the state. First factor is the acute shortage of doctors which has severely affected the healthcare delivery in rural areas.
MP requires 15,000 doctors but has only over 3,000’
“According to the laid down norms, there should be one doctor for every 5,000 people. In Madhya Pradesh, we ideally require around 15,000 doctors. But we have over 3,000 doctors. There is shortage of over 50% doctors against sanctioned 7,000 posts and 30 to 40% shortage of paramedics. This is the main factor that affects neonatal and maternal care in the state, which leads to high IMR,” said patron of Madhya Pradesh Medical Officers Association Dr Lalit Srivastava.
‘Young doctors not ready to work in rural areas’
Second factor, Srivastava said, was that young doctors were not ready to work in rural areas due to poor pay scale, no proper policy on promotion or transfer of doctors who agree to work in the remote areas, no residential facilities and safety arrangements for them in the rural areas. Third factor is the malnutrition and issues related to maternal health care, according to experts.
The Maternal Mortality Ratio in the state stands at 221 against 167 per 1,00,000 live births in the country. The National Family Health Survey-4 released earlier this year presents a grim picture of the neonatal healthcare in the state. The survey showed that 42.8% children under 5 years were underweight and over 68% children in the age bracket 6-59 months were anaemic. The survey also showed that over 54% women in the age bracket 15-49 years were anaemic in the state.
Fourth factor, according to the experts, is the negative attitude of some paramedics and doctors in the government health facilities.
Jan Swasthya Abhiyan’s Amulya Nidhi said massive health infrastructure won’t serve any purpose unless there were doctors in the rural areas. “Proper management of manpower in health department is lacking. In many health institutions across the state, the attitude of paramedics and some doctors is apathetic,” he said.
’Govt trying to address issue of shortage of doctors’
Deputy director national health mission Pankaj Shukla said the state government was trying to address the issue of the shortage of doctors and paramedical staff at the primary level.
“We have changed the quota for MD, MS courses for in-service doctors from 25% to 50%. The state government has also increased the age of retirement for doctors from 60 to 65. To improve the district hospitals, we are taking initiatives under ‘Kaya Kalp’ scheme which focuses on improving the working of government hospitals,” he said.
YEAR-WISE INFANT MORTALITY RATE IN STATE