Children are considered the future of the nation therefore health concerns of children need urgentChildren are considered the future of the nation therefore health concerns of children need urgent attention. Health of children became the top priority in every country after the declaration of MDGs. Child health situation of any country described through a set of indicators, as Infant Mortality Rate (IMR), Under 5 Mortality Rate (U5MR), Child growth status (age-weight) etc. These indicators reflect the status of child health situation as well as the development status of the state. More than 50 % of child deaths are occurring due to diarrhea, acute respiratory illness, malaria and measles. Apart from the medical causes of child death there are social determinants which provide the space for the occurrence of the child diseases. Poverty and gender with all their consequences on nutrition, access to health care, environment and education are two important social determinants of Child mortality. The other social determinants caste, religion and culture also plays significant role. National Rural Health Mission was launched in 2005 in India. There has been a decreasing trend in IMR 60 (SRS 2005) to 53 (SRS 2009). Jharkhand state has also decreasing trend in IMR 51(SRS 2005) to 46 (SRS 2009).77.7 percent children and 68.4 percent pregnant women are suffering from anemia in Jharkhand (DLHS 3). The literacy rate of women is only 34.1% as against 64.9% literacy rate of men. 73.5 percent families living in kaccha house whereas 78 percent population surviving with low standard of living (DLHS 3). The data reveals that children in Jharkhand have to born and grow in unhealthy situations resulting in to the early child mortality. An integrated effort is necessary and execution of the components of convergence under NRHM needed to be strengthened along with the regular programmes to save the life of child.
Strategies for Child Health:
Infant mortality has reduced to 46 and neo-natal mortality rate of the State has stagnated at 32. For further improvement in the status of neo-natal mortality, several initiatives has been taken in the previous year’s like establishment of Sick New Born Care Units, New born stabilization corners, Scale up of Integrated Management of Neo-natal and Child Illness, control and prevention of Acute Respiratory Infections and Diarrhea.
Facility based interventions:
- Strengthening referral facilitieses.
- Operationalization of 203 new borne corners (NBC) proposed last year.
- 18 new born stabilization units (NSU) proposed for FY 11-12.
- Improved Routine immunization and Vitamin A coverage
- Integrated Management of Neonatal and Childhood Illnesses (IMNCI) up scaled to 24 districts. F-IMNCI training proposed for 240 MOs and Staff nurses.
- SNCU proposed for 5 districts in FY 11-12
- Convergence with ICDS for nutritional aspects.
Community level interventions:
- Improving Skilled Care at Birth by increasing number of SBA, Proper antenatal care to reduce perinatal mortality.
- Strengthening referral transport
- Community based Management of SAM children, based on the WHO standardized protocol, establishment of 10 new MTECs and strengthening 48 existing MTCs.
Other comprehensive programmes:
- Improving Skilled Care at Birth by increasing number of SBA, Proper antenatal care to reduce perinatal mortality.reading best practices and behaviors
- Bi-annual vitamin A round for vit A supplementation
- Child anaemia reduction programme
- Diarrhoea management
- Malaria Management
- School Health Programmes
- Child Survival training package for Sahiyyas