Mother and Child Health

Mother and Child Health

This article deals with ‘ Issues relating to development and management of Social Sector/Services relating to Health- Mother and Child Health .’ This is part of our series on ‘Governance’ which is important pillar of GS-2 syllabus . For more articles , you can click here

Why Government should invest in Mother and Child Health?

Imagine government as investor . Given fiscal and capacity constraints, where would it invest to reap maximum benefits?

According to Economic Survey , low-cost maternal and early-life health and nutrition programs offer very high returns because:

  • Spending on Mother is economic option :
    • Healthy mother is more likely to give birth to a healthy baby who learns better and stays on in school longer 
    • Most rapid  physical and cognitive development occurs in the womb
  • Success of subsequent interventions—schooling and training—are influenced by early-life development. Eg Government’s investment in skills training can reap best results only if Child has developed full Cognitive & Physical Health during early age

Indices regarding Mother-Child Health

1 . Neo Natal Mortality Rate

  • Number of deaths of Children below the age of 1 month per 1000 live births
  • Neo Natal Mortality   depend upon Mother’s health 
    • Main cause of mortality during first month is different from next 11 months. It depends on in Utero Nutrition which is determined by Birth Weight of Children
  • India has high Neo Natal Mortality because
    • Indian women begin pregnancy at low weight . Along with that, they don’t gain weight during pregnancy => Result in low birth weight of child

2. Infant Mortality Rate (IMR)

  • Number of deaths of Children below the age of 1 year per 1000 live births
According to NFHS 4, IMR of India = 41
  • Note : IMR is an important indicator used for determining the socio-economic status of any country because more than any age group, survival of infants depends upon their socio-economic environment.

3. Child Mortality Rate (CMR)

  • Number of deaths of Children in age group of 0-4 year per 1000 live births

4. Under Five Mortality Rate (U5MR)

  • Number of deaths of Children in age group of 0-5 year per 1000 live births
    • According to NFHS 4, U5MR of India is  50
    • SDG Target to be achieved by India  = 25
  • U5MR is internationally accepted standard instead of Child Mortality Rate. Hence, India moving towards it.

5. Maternal Mortality Rate

  • Death of mothers during or within 42 days of child birth per 1 lakh live births
  • According to NFHS 4, Maternal Mortality Rate of India is 130

Schemes of Government to reduce MMR , IMR , CMR

1 . Pradhan Mantri Suraksheet Matritva Yojana

  • By Health Ministry in 2016
  • Ante – Natal (before birth) checkup for pregnant women on 9th of every month by specialist

2. Janani Suraksha Yojana

  • To promote Institutional delivery of the pregnant women.

3. LaQshya Program

  • Under Health Ministry since 2018
  • For Labour Room upgradations 

4. Pradhan Mantri Matru Vandana Yojana

  • ₹ 6,000 to be given to all mothers
  • To be given in Installments (6th Month pregnancy || 3 months after birth || 6 months after birth)
  • Applicable for  first  two  children.
Pradhan Mantri Matru Vandana Yojana

5. Integrated Child Development Program

  • Flagship  scheme – aims to improve nutrition ,  health status & school dropout ratio of children in age group 0-6 years 
  • 2016-17 : Other schemes like Anganwadi Services, National Crèche Scheme  brought under this

6. Promotion of Breast Feeding

  • Improving Infant and young child feeding practices including breastfeeding promotion.

7. To Combat Diseases among Pregnant Women & infants

  • Anaemia : Major problem in Pregnant women.  Iron Folic Acid Supplements are given by government
  • Diarrhoea : Large number of infants die because of this . ORS and Zinc Tablets are given

Disease Externalities  – Open Defecation

Unique source of early life disease in India is open defecation

How Open Defecation impact health of child ?

  • Open defecation spreads germs into the environment, and therefore makes growing children sick.  It can cause
    • Diarrhea: robbing growing children of food that they eat. 
    • Environmental enteropathy : chronic inflammation of the intestines => reduces ability of children’s intestines to absorb nutrients
  • Problem of child stunting is worse in villages where a higher percentage defecate in the open.

Level of Problem

  • Open defecation in India is much more common than even much poorer countries.
    • Bangladesh = Almost open defecation free
    • In 2015 , according to WHO : 61% of rural Indians defecate in open (2018 after Swachh BM : 90% Rural India now has laterine)

Behavior Issue

  • Many people in rural India who live in households with working latrines defecate in the open. 

=> These facts indicate that income constraints may not be the main determinant of open defecation.

Addressing Open Defecation

  • Swachh Bharat Mission
  • UN’s Sustainable Development Goals commit to ending open defecation worldwide by 2030.  
  • Behavioural change using ads & religious leaders   

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