Age of Kali – One Day


[warning]TW – Death and statistics[/warning]

India has a dubious honour of having the highest number of something. It’s not something to be proud of.

309,000 babies die every year in the first 24 hours of life in India alone. India tops the world for 24 hour neo-nate moratlity deaths. Pure Neo-nate mortality is even higher with more than a 1000 children a day dying. Often from highly preventable causes.

The country accounts for 29 per cent of all such deaths — ahead even of Nigeria, Pakistan and China,

The report by Save the Children called State of the World’s Mothers also claims that 420,000 babies across South Asia die on their first day – almost one every minute. Chronic malnourishment which leads to mental or physical impairment or ‘stunting’ is particularly severe in the region.

According to the report, of the one million babies who die each year on the day they are born, almost 40 per cent are in India, Pakistan and Bangladesh.

Kerala is the leader in reducing neonatal mortality by a wide margin, while Tamil Nadu, Delhi and Maharashtra too have improved the national rate. In India when we discuss medical and social uplift, Kerala is the gold standard of achievement.

I disagree with Thomas Chandy (CEO of Save the Children). He wishes to emphasise first day mortality. But here is the thing. We must look at 7 day mortality which is a much higher number. We have to tackle that as a whole. While the “1 day mortality” statistic is shocking it isn’t medically useful. It’s great for fundraising but the risky period for new born babies is the first 3 months. We must drop mortality rates over that time as a whole if we are to reduce Infant mortality in a significant way as well as infant morbidity.

“For the first time in history, putting an end to this crisis is within our reach, but to achieve this will require unprecedented focus on saving babies in their first day of life. Save the Children recognises the immense efforts being made in India and the government’s commitment to end child mortality in a generation. Although many challenges remain, India has mobilised the most important ingredient to long term success: political will.”

Political will exists but whether the will is merely for votes or genuine we are yet to see.

Two thirds of all newborn deaths occur in 10 countries, four of which are in the region: Nigeria, DR Congo, Tanzania, Ethiopia, Pakistan, India, Afghanistan, Bangladesh, Indonesia and China. Bangladesh has reduced newborn mortality by 49 per cent since 1990. Community health workers reaching mothers and babies at home, and training birth attendants and medical staff in resuscitation devices to help babies breathe are factors in this progress. Nepal has also reduced mortality by 47 per cent since 1990.

And some statistics are equally terrifying. Afghanistan’s maternal mortality rate is 1 in 32. India’s is 1 in 170. Nepal’s is 1 in 190. By contrast Child Birth is so safe in the UK that there is a significant movement of people who insist on making it riskier.

Afghanistan’s rate is due to the abject lack of education in birth attendants and a total and complete lack of Obstetric Care and an unwilling male dominated society in acquiring those things.

So what can we do?

1. Education of Midwives. We cannot replace them with hospital deliveries, so we must ensure midwives are educated with access to modern medicine to help reduce mortality.

2. Improvement of maternal health

3. Supplementation of maternal diet

4. Cessation of the traditional eating practice of women eating “last”.

5. Improvements to sanitation

6. Tetanus vaccination

7. Increasing maternal age

8. Decreasing total births

9. Provision of more hospitals and increasing the salaries of doctors to prevent “brain drain” from government institutions

10 Sanitation

11. Value modification

12. Education

This is a pretty hefty task we got here but it can be done. India has dropped it’s Infant mortality rate from a whopping 70 per 1000 to 40 per 1000. It can drop it to 10 and then to 5. It just needs time, money, manpower and effort.

Comments

  1. Pen says

    Chronic malnourishment which leads to mental or physical impairment or ‘stunting’ is particularly severe in the region.

    I wonder if you could just confirm I’m understanding this correctly – you’re saying the most common cause of these deaths is extreme malnourishment of the mother, leading to the fact that the baby doesn’t develop well enough to withstand the birth process and get through the first few days? And that some of this is related not to absolute shortages of food but to the fact that young mothers are often last in their family’s pecking order (literally!)? So by the time of birth it would be too late or much harder to intervene? You also mentioned breathing issues, is that related or a separate thing?

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