November 19, 2020 7:01:24 am
Despite substantial progress in the reduction of maternal and under-five mortality rates, 24,583 newborns, 35,929 infants and 41,602 children below the age of five years die annually in Maharashtra due to causes which are largely preventable. Every hour, three newborns die in the state, while about 900 mothers die annually due to complications of pregnancy and childbirth — also preventable.
The information was reiterated in a joint statement released online, on Wednesday, by experts from the state health department, the Association of Maharashtra Obstetrics and Gynaecological Societies (AMOGS) and the Maharashtra chapter of the National Neonatology Forum. The organisations emphasised the need for promoting maternal and newborn health, as well as mobilising healthcare providers for providing necessary services, while simultaneously keeping in mind Covid-19 protocol.
Observed between November 15 and 21, National Newborn Week provides an opportunity for renewed commitment for promoting maternal and newborn health in the state. Highlighting the critical role of the private health sector, AMOGS president Dr Nandita Palshetkar said that various activities will be organised during the week to create a buzz around the prevention of low-birth weight (LBW) babies through preconception and antenatal care.
Promoting institutional delivery, especially among the tribal population and the urban poor; promoting essential newborn care including birth dose vaccination and Vitamin K administration after birth; promoting care of small and sick newborn through facility and home-based newborn care and Kangaroo Mother Care will also be taken up this week, said Proferssor Pramod Jog, ex-president of the Indian Academy of Pediatrics.
There has been a continuous decline of USMRs in districts of Maharashtra in the last few years, but the decline in neonatal mortality has been slow, according to noted paediatrician Professor Mrudula Phadke. The Maternal Mortality Ratio (MMR) in Maharashtra declined from 166 to 46 per 100,000 live births between 1997-’98 and 2016-’18. Between 2007 and 2018, the under five child mortality rate (U5MR) in the state declined from 42 to 22 per 1000 live births, which is fourth lowest among the large states in India, after Kerala (10) and Tamil Nadu (17) and Delhi (19). The neonatal mortality has declined from 25 to 13 per 1000 live births between 2007 and 2018.
Dr Phadke said that the Covid-19 pandemic may have slowed down and even reversed the gains in the state’s maternal and newborn health over the last few years. It is estimated that the pandemic will result in an increase of 10–45 percent in under-five deaths per month and between eight and 39 percent increase in maternal deaths per month, across 118 countries including India, due to reduced access in health services and an increase in malnutrition.
Another major challenge in Maharashtra is LBW babies, defined as a newborn with birth weight less than 2,500 g. About 20 percent of babies are born LBW every year and there has been no reduction in the proportion of such babies in the last decade, as per data from the National Family Health Surveys three and four.
LBW babies are at increased risk of under-five mortality, stunting, poor cognitive development and contracting non-communicable diseases (NCDs) in their adult lives. Even though India contributes to about 18 percent of global births every year, it also accounts for 37 percent of global low birth weight burden. Globally, LBW babies constitute only about 14 percent of children born, but they account for 60–80 percent of neonatal deaths.
Rajeshwari Chandrasekar, Chief of the Field Office, UNICEF, Maharashtra, appealed to parents, women and caregivers of newborns in the state to promote the health of women and newborns by accessing the preconception and antenatal care in the state’s health facilities.
Key highlights of the joint statement also included advice for couples to plan their pregnancy when they are healthy — when the woman is not below 18 years of age, she has a normal hemoglobin level, her body weight and body mass index is normal and she is not suffering from diseases like diabetes mellitus. Pregnant women should also have full antenatal care, take adequate diet and rest and plan for their delivery at a facility.
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