All eyes on Gorakhpur, but these 5 maps show that it isn’t even close to how bad healthcare is in UP
HT’s analysis of NFHS data for Uttar Pradesh shows that many other districts fare worse than Gorakhpur.Updated: Aug 17, 2017 08:44 IST
Child healthcare in Gorakhpur emerged in the spotlight after 70 children died in one of its biggest hospitals last week, but official data suggests the Eastern Uttar Pradesh district presents a better picture than the rest of the state, where facilities are among the worst in the country.
In Uttar Pradesh, the country’s most populous state, half of all children below five show signs of stunted growth, only 50% are properly immunised against diseases and nearly three-fourths of expecting mothers have not had an adequate number of antenatal care.
In comparison, the national average for the incidence of stunted growth is 38.4%, child immunisations is 62%, and at least half of all expecting mothers had at least four antenatal care visits.
The findings are part of the government’s National Family Health Survey- 4 that was carried out in 2015-16 in 71 districts. HT analysed the data for five indicators, which show that many other districts fare worse than Gorakhpur when it comes to the health of children and their mothers.
Balrampur has the lowest number of children who are immunised from serious diseases. According to the NFHS-4, only 7% of children are fully immunised, which includes vaccination for measles and BCG, and 3 doses each of polio and DPT. Gorakhpur, by comparison, has better rates of immunisation than 62 other districts.
Poor nutrition, repeated infections and inadequate psychological stimulation are defined by the World Health Organisation as factors that contribute to stunted growth in children, one of the most telling signs of failing healthcare. It is measured by calculating the percentage of children under the age of five who are shorter than expected for their ages. In Bahraich district, at the bottom of the rankings on this parameter, every two of three children are stunted. In Gorakhpur, the figure improves to four in ten.
Antenatal care (ANC) refers to preventive health care checks for women during pregnancy. In 27 districts, more than 80% of mothers who were surveyed had less than four ANC visits. In Gorakhpur, only 35% of mothers had at least four ANC visits, but in Bahraich, the worst district, that figure was just 4.3%.
Anaemia in expecting mothers could indicate a threat to the health of both, the mother and the baby. Two in three women aged 15-49 in Chitrakoot district —the worst in UP on this parameter — are anaemic. It is among the forty-three UP districts that are worse than Gorakhpur.
UP chief minister Yogi Adityanath attributed the deaths in the Gorakhpur hospital to dirty surroundings and open defecation. According to NFHS data, a third of the households in Gorakhpur use improved sanitation facilities, similar to the UP average. But in 31 districts, less than a quarter of households have improved sanitation facilities, which suggests the practice of open defecation is widespread. Shrawasti is the worst, where just one in ten households has the facility.
Deepak Meena, district magistrate of Shrawasti, a district that lies at the bottom on many of the parameters, says the reason for the disparity is the lack of development. “Shrawasti is a backward area, near the border, not easy to reach, development levels are low and infrastructure lags behind,” he said.
Literacy also has an important role to play, the official said, explaining how adjacent Balrampur and Gonda show similar problems.
KK Aggarwal, national president of the Indian Medical Association, agrees that development matter for health care. “Does the district have adequate infrastructure to utilise the funds that they have been assigned? It is easy to assign new projects to places which already have good infrastructure. But where it lacks, officials say we can’t develop infrastructure here and so things don’t proceed,” he said.
The regions elected officials—MP, MLA, councillor—belong to get priority over others and funds are diverted to those places, says Aggarwal. “Neither there is accountability, nor are targets assigned.”