Child Health & Immunization

Child Health & Immunization

In India, an estimated 26 millions of children are born every year. As per census 2011, the share of Children (0-6 years) accounts 13% of the total population in the country. An estimated 15.5 lakhs children die every year before completing 5 years of age. However, 79% of under-five child mortality takes place within one year of the birth which accounts nearly 11.6 lakhs infant deaths whereas 56% of under-five deaths take place within first one month of life accounts 8.7 lakhs neo-natal deaths every year in the country.

As a part of UN Millennium Development Goals; India is committed to reduce child mortality by 2/3rd of 1990 by year 2015. India had Infant Mortality Rate of 80 per 1000 live births in 1990 and MDG is 28. IMR has declined by 12 points in the decade 1990-2000. Thus, showing about 15% decline in IMR during the decade 1990-2000 and during 2000-1005. However, IMR decline has accelerated by 4% annually during the NHM period and thus 24% decline from 2005 to 2011. At present, IMR stands at 44 per 1000 live births. On the other hand, rural-urban differential of IMR was observed to be very wide before the NHM period. This gap has narrowed down during the period of 2005 to 2011 from 24 to 19 due to intensive programs aimed at rural populations.

Under five-mortality rate is 55 per thousand live births (SRS 2011), showing a 19 point decline since 2005-06 (NFHS III). A 14 point decline was observed in just three years between 2008 and 2011. Neonatal Mortality Rate is 31 per thousand live births (SRS 2011), showing a slow decline of 6 point since 2005.Child Health strategies under RCH II/NHM are designed to achieve the goals and objectives for child survival committed in NHM, the XIth Plan and Millennium Summit (MDGs). The Reproductive and Child Health programme (RCH) II under the National Rural Health Mission (NHM) comprehensively integrates interventions that promote child health and addresses factors contributing to Infant and Under-Five Mortality.

Causes of Child Mortality

As per WHO 2012 estimates, the causes of Child Mortality in the age group 0-5 years in India are (a) Neonatal causes (52%), (b) Pneumonia (15%), (c) Diarrhoeal disease (11%), (d) Measles (3%), (e) Injuries (4%) and (f) others (15%). However, The major causes of neonatal deaths are Infections (16%) such as Pneumonia, Septicemia and Umbilical Cord infection; Prematurity (18%) i.e birth of newborn before 37 weeks of gestation and Asphyxia (10%) i.e. inability to breathe immediately after birth and leads to lack of oxygen.

Thrust area under child mortality in India

Thrust Area 1 : Neonatal Health

Essential new born care (at every ‘delivery’ point at time of birth)

Facility based sick newborn care (at FRUs & District Hospitals)

Home Based Newborn Care

Thrust Area 2 : Nutrition

Promotion of optimal Infant and Young Child Feeding Practices

Micronutrient supplementation (Vitamin A, Iron Folic Acid)

Management of children with severe acute malnutrition

Thrust Area 3: Management of Common Child hood illnesses

Management of Childhood Diarrhoeal Diseases & Acute Respiratory Infections

Thrust Area 4: Immunisation

Intensification of Routine Immunisation

Eliminating Measles and Japanese Encephalitis related deaths

Polio Eradication

The strategies for child health intervention focus on improving skills of the health care workers, strengthening the health care infrastructure and involvement of the community through behaviour change communication.