Persistent efforts, coupled with better health care systems, have made this possible, say officials
Tamil Nadu’s Infant Mortality Rate (IMR) has dropped to an all-time low of 17, dropping two points, as per the latest figures released as part of the Sample Registration Survey.
The State has dropped two points from 19 from the last survey period (2015) and stacks up very well against the national IMR of 34. IMR is counted as the number of deaths per 1,000 live births.
“It is great news for the State, actually. While the drop during the initial years of working on IMR was far more substantial, the two-point reduction at this stage of our programme is daunting, and therefore, a reason to celebrate,” according to J. Radhakrishnan, Health Secretary. Further reductions are going to be even more challenging, and the State will have to gear up to the task.
Last mile delivery
“It is the last mile that is really tough, and we are well on our way towards our own goal of achieving an IMR of 10 by 2023,” says K. Kolandaisamy, director, Public Health.
The main reasons he accounts for the fall are three-fold: Access to affordable health care at the neo natal stage; the impact of good vaccination coverage (MR and against Rota Virus); and the dip in higher order births (8 out of every 100 women have more than two children).
Efforts have been made to improve the care available to the new born through the Neonatal ICU (NICU) and comprehensive emergency obstetric care for the mothers. “We are hoping that the effort in introducing a vaccine against the rota virus will help prevent deaths due to diarrhoea, and the MR vaccine too will knock down a couple of points by reducing deaths because of congenital defects. Our target now is to improve the state of delivery care, both in the public and private sectors, since we are noticing even infants who weigh over 2.5 kg dying of various causes,” Dr. Kulandaisamy said. In government hospitals, the move is to ensure one nurse for every mother in the labour room.
Sarada Suresh, former director, Institute of Child Health, and former professor of Paediatrics, Madras Medical College, points out the significance of new born care in knocking down IMR. “Neonatal mortality accounts for 70% of the IMR, and in neonatal mortality, early neonatal mortal accounts for 70% of the deaths,” she says. This is where the sick neonatal intensive care units or NICUs have come in handy. Besides, the process for referrals to government hospitals have been simplified, and 108 emergency ambulances are available within a short time to shift women who have gone into labour or the new born.
Better system
P. Kuganantham, former health officer, Chennai Corporation, agrees that health systems in Tamil Nadu are more advanced than most states in the country. He adds that with over 99% of deliveries being institutionalised in the State, the chances for maternal and infant deaths have reduced substantially. The recent emphasis on exclusive breastfeeding for six months since birth is bound to have had an impact in improving outcomes.
Further advances in reducing the IMR can be achieved by improving maternal nutrition in order to achieve better birth weight for babies. Low birth weight continues to be a challenge and improving the mother’s nutritional intake and haemoglobin levels will be a key aspect of addressing this challenge, Dr. Suresh says.
She says the optimal weight gain for a pregnant woman would be 9 to 10 kg during her gestation period. Three periods are significant in reducing maternal and infant mortality, says Dr. Kuganantham – labour, the neo natal period (one month) and up till a year of birth. All these areas need constant attention, without any slipping up, to not only consolidate the gains, but also drop more points to reach the goal of an IMR of 10.
