It is among India’s least developed states. Huge swathes of it are controlled by insurgents. It is densely forested and large parts of it are devilishly difficult to reach.
Yet, Chhattisgarh is also the place where infant mortality has plummeted to 59 deaths for every 1,000 children born — from 84 deaths eight years ago, when the state was carved out of 16 south eastern districts of Madhya Pradesh. The figure is still much higher than the national average of 32 per cent, a figure cited by the CIA World Factbook. And the national average itself is appallingly high compared with Japan’s 3.2 per cent, the UK’s 5 per cent and even Sri Lanka’s 22 per cent — statistics put out by the US Census Bureau.
But what is significant is that the drop is directly linked to a dramatic rise in the percentage of women in Chhattisgarh exclusively breastfeeding their children for the first six months of their lives. This figure has risen dramatically, to 82 per cent from 35 per cent in 2002, as a result of an unprecedented policy initiative undertaken jointly by Unicef, the United Nation’s international child welfare organisation, CARE, a US-based humanitarian group fighting global poverty, and the Chhattisgarh government.
Here, Chhatisgarh compares very favourably with the national average of just 46 per cent and the average for developing nations, which is 40 per cent, according to the Unicef.
This shows that infant mortality can decline even further, if this programme continues. The success of such a policy initiative is particularly impressive in Chhattisgarh, which is mineral rich but poor in terms of per capita income, and where government control is so tenuous: insurgents effectively control many districts, such as Dantewada and Bastar.
Called the Integrated Nutrition and Health Programme, the breast-feeding initiative had at its core a team of voluntary health workers, who penetrated the remotest villages to spread the virtues of exclusive breastfeeding. “The programme has succeeded because community health volunteers have done an exceptional job in creating awareness,” said Dr Pravin Khopragade, a senior project officer with the programme.
Their message may have also found particularly fertile soil: Chhattisgarh has a very high percentage of tribals, and tribal women have more autonomy and more control over shared resources than women in Hindu caste society. To cite just one example, in many tribal cultures, widows are freely allowed to remarry.
“I strictly followed the advice that my mitanin (the health volunteer) gave me,” said Hemwati Bai, who regularly visits the primary health sub-centre in Bamatela village of Rajnandgaon district. “My children, one aged three and the other five months old, are both healthy. My elder sister fed her baby other stuff, and the child developed some disease and died within a year.”
She’s just one of many who are taking their health volunteer’s words seriously. Said Prema, the sarpanch (village council head): “Exclusive breastfeeding has greatly brought down infant deaths in my area.”
In its latest report, the National Family Health Survey throws up other astonishing statistics. The percentage of mothers exclusively breastfeeding their children in rural Chhattisgarh is 84, much higher than the 69 per cent for urban areas. Also, 83 per cent of those who exclusively breastfeed their children are not educated.
The government’s National Family Health Survey is a large-scale survey conducted over many rounds across a representative sample of households throughout India.
The survey provides state and national information on, among other things, fertility, infant and child mortality, the practice of family planning, maternal and child health, reproductive health, nutrition levels.