Skip to main content

Gujarat health sector: A lurking rural-urban gap

By Rajiv Shah
Latest data of the Sample Registration System (SRS), operating under the Census of India, suggest that Gujarat suffers from a huge rural-urban divide in infant mortality rate (IMR) rate compared to most other Indian states. Statistics offered by the SRS Bulletin, finalized in September 2014, show that Gujarat’s rural IMR is 43 per 1000, as against the urban IMR of 22 per 1000, suggesting a whopping gap of 21, higher than 20 major Indian states, with the exception of Assam.
Interestingly, the gap remains high despite the fact that well-known experts have been pointing towards poor state of rural infrastructure in Gujarat for the last several years. Apparently, their voice is not being heard. The CEPT University’s Prof Darshini Mahadevia, pointed towards this in 2007, when she wrote that the main problem with Gujarat’s IMR was a very high rural IMR compared to urban IMR. “Other states have shown far better improvement in rural healthcare than Gujarat. This neglect of rural health and the rural sector in general is a reflection of the distorted development ideology being pursued by the state since a long period of time”, Prof Mahadevia had commented.
Prof Mahadevia, who co-authored “Gujarat Human Development Report 2004” – published by a Gujarat government body, Mahatma Gandhi Labour Institute, and carries a message from the then chief minister Narendra Modi – said, “The IMR improvement … in rural Gujarat has stagnated because of the continued high incidence of neo-natal mortality (NNM), which is death of infants within the first month of birth. The reasons for NNM are unsafe delivery and lack of vaccination for the newborn. These factors have to do with the primary healthcare system, which is the responsibility of the state government.” Instead of stressing on healthcare as its prime responsibility, she regretted, “Gujarat has privatised child birth facilities through the Chiranjeevi Yojana, but its success has not been seen in the tribal areas.”
In 2010, Prof Dileep Mavalankar, who was previously with the Indian Institute of Management-Ahmedabad, and is currently director, Public Health Foundation of India, Gandhinagar, noted that despite all the economic development in the state, the rural IMR remained high, and the main reason behind this seemed to be issues related with diarrhoea, which the rural health system in the state was “still not able to solve.” Then, last year, Smita Bajpai of the Centre for Health, Education, Training and Nutrition Awareness (CHETNA), Ahmedabad, which has worked in coordination with the Gujarat government on health and nutrition of women and children, said, woeful lack of medical facilities, particularly in the rural areas, was one of the reasons behind high IMR in the rural areas of Gujarat.
“Another reason”, she said, was lack of specialists. “Even if a family wants to get its new born baby girl treated they will most of the time have to travel long distance and even then there is no guarantee that a specialist doctor would be available. Most of the specialists are only available in district hospitals.”
Assam tops in the rural-urban IMR gap – it has 56 IMR per 1000 in rural areas as against 32 in urban areas, suggesting a gap of 24, and Gujarat and Rajasthan next, with a rural-urban gap of 21. While the all-India rural-urban gap is 17 (44 rural and 27 urban), much lower than Gujarat’s, the lowest gap is that of Kerala, just about four (13 rural and nine urban). Indeed, Gujarat’s poor rural IMR is pulling Gujarat away from achieving the UN Millennium Development Goal for IMR – 27 per 1000 in 2015. According to the United Nations Children’s Fund (UNICEF), only six states, “namely Kerala, Tamil Nadu, Maharashtra, Punjab, Himachal Pradesh and West Bengal, are likely to achieve the goal by 2015.” Clearly, Gujarat does not figure in the list, thanks mainly to poor rural IMR.
Gujarat officials have noted a huge success in reducing IMR during the last decade – reaching 41 (rural plus urban) in 2011 from 60 in 2001. While this improvement may be laudable, what it fails to note is the continuing rural-urban gap. Indeed, inter-state comparison suggests that Gujarat is one of the best performers as far as urban IMR is concerned, ranking fourth among 20 major states – the SRS Bulletin data show, as many as 15 other states have a higher IMR than Gujarat’s (22 per 1000). The best performing state in urban IMR, according to the SRS, is Kerala (nine), followed by Maharashtra (16), and Tamil Nadu (17). Uttarakhand equals Gujarat with 22 IMR per 1000. The worst performers are the so-called Bimaru states with Chhattisgarh, Odisha and Uttar Pradesh each having an urban IMR of 38. Clearly, urban Gujarat has already more than achieved the UN’s Millennium Development Goal.
However, it is the rural IMR which should the main concern of the state’s policy makers. While here Gujarat performs a little better than the national average (Gujarat’s rural IMR is 43 per 1000 as against the national average of 44), this should not be any consolation. Two Bimaru states, Bihar and Jharkhand, significantly, beat Gujarat showing a better performance on this score. In fact, at 43 IMR per 1000, Gujarat ranks No 11, and is placed worse than as many as 10 major states out of 20. These are Kerala (13), Tamil Nadu (24), Maharashtra (29), West Bengal (32), Karnataka (34), Uttarakhand (34), Himachal Pradesh (35), Jharkhand (38), Jammu & Kashmir (39), and Bihar (42). Thanks to poor IMR of its rural areas, the overall IMR (rural plus urban) of Gujarat is pulled down to 36 per 1000, which is worse than seven other states.
---
This article was first published HERE

Comments

TRENDING

You promised 50 lakh houses, give us one: Ahmedabad migrant women's plea to Modi

Women display letters containing rakhi for PM    By Hirabhai Solanki, Bhartiben Dantani, Ramesh Shrivastav*  Poor labouring families, including seasonal or long-term migrants of nearly 15 squatter settlements -- working as construction and casual workers and petty vendors, providing cheap but critically important labour for Ahmedabad city, living under plastic sheetings -- have reminded the Gujarat and Central Governments about the promise made by Prime Minister Narendra Modi of building 50 lakh dwellings, wherein every pavement dweller and homeless would be given a decent home by the end of 2022. Holding a meeting in Ahmedabad under the aegis of the Majur Adhikaar Manch, they also referred to the appeal of the Prime Minister to poor and labouring women, seeking his support as brother by sending rakhis to protect their humble basti dwellings and provide them with decent housing, which is secure for them and their families. So far, about 300 women have posted rakhis to the Prime Ministe

Kailash Satyarthi NGO floats new centre in Delhi to 'empower' underprivileged children

By Our Representative  A voluntary organisation linked with Nobel laureate Kailash Satyarthi-supported NGO has floated a unique children’s resource centre at Sanjay Camp, Chankyapuri, New Delhi, in order to facilitate in imparting remedial education, recreational training and holistic development of children of around 2,500 under-privileged slum-dwelling families. Virender Singh Kadian, MLA of Delhi Cantonment, inaugurated the centre, which is called Shaheed Kalu Bal Vikas Kendra. The resource centre is in memory of Kalu Kumar, who died at an young age serving and working towards the development of under-privileged children, said an NGO source. A firebrand activist, Kalu Kumar was trafficked from Bihar to the carpet manufacturing belt of Allahabad when he was six. He was rescued by the Bachpan Bachao Andolan at the age of 10. A bright student, Kalu he covered up the lost ground very quickly and grew up to become a leader fighting for the rights of other child slaves at Bal Ashram. In

A countdown to disaster: Breach in fly-ash bunds of Nagpur's thermal power plants

Fly-ash dyke, Koradi thermal power plant  By Dhwani Shah, Deepmala Patel*  Last month the residents of several villages of Nagpur district woke up to the nightmare of being inundated with fly-ash. Located in the north of Nagpur city are Koradi and Khaparkheda thermal power stations which have their ash dykes in the vicinity. On July 10, 2022 at 3 am, the ash dyke of the Khaparkheda thermal power station broke, leading to ash contaminating the Kanhan river. Though the authorities claimed to have acted quickly and the fly ash dumping in the river was stopped, the claim stood to be misleading and false. Even today, the Kanhan river continues to be polluted with fly-ash, and the water supply to the city is affected. Not only did ash dyke of the Khaparkheda power station break, on July 16, 2022, the ash bund of the Koradi thermal power plant also broke. Fly-ash and water stored in the dyke gushed downstream to six villages -- drowning houses, water bodies and farmlands. With such large-

Golwalkar's views on tricolour, martyrs, minorities, caste as per RSS archives

By Shamsul Islam*  First time in the history of independent India, the in-charge minister of the Cultural Ministry in the current Modi government, Prahlad Singh Patel, has glorified MS Golwalkar, second supremo of the RSS and the most prominent ideologue of the RSS till date, on his birth anniversary, February 19. In a tweet he wrote : “Remembering a great thinker, scholar, and remarkable leader #MSGolwalkar on his birth anniversary. His thoughts will remain a source of inspiration & continue to guide generations.”

Multi-crore NRC updation scam? Awaited: Assam media's self-cleaning mechanism

By Nava Thakuria  If some editor-journalists are allegedly involved in a financial scam, shouldn't the people get an opportunity to identify them? As the mainstream newspapers and news channels of Assam are avoiding the issue in their coverage, how come the actual picture will come to the public domain? If the mainstream media outlets intentionally kill the news, reasons best known to the editors, should the social media users take a lead? By now a number of senior journalists (with experience in print journalism for many decades) have highlighted the issue in social media. Their message is loud and clear- identify the corrupt television journalists who grabbed a huge amount of money which is actually meant for thousands of Assamese professionals. It all began when a second first information report (FIR) was filed by the outgoing State coordinator of National Register of Citizens (NRC) against his predecessor alleging corruption and money laundering while updating the 1951 NRC in A

US rights groups claim 'continued violation' of basic freedoms in J&K since August 2019

By Our Representative  Top US-based non-profit, Human Rights Watch (HRW), headquartered in New York, and the Washington DC-based Indian diaspora group, Indian American Muslim Council (IAMC), recalling the abrogation of Article 370 three years ago, have taken strong exception to "continued restrictions" on free expression, peaceful assembly, and other basic rights in Jammu and Kashmir. Claiming that after revoking the region’s special autonomous status on August 5, 2019, the government’s “repressive policies and failure to investigate and prosecute alleged security force abuses have increased insecurity among Kashmiris”, in a statement, HRW said, “The government action was accompanied by serious rights violations including arbitrary detention of hundreds of people, a total communications blackout, and severe restrictions on freedom of movement and peaceful assembly.” It added, “Since then, the authorities have released many of the detainees and restored the internet, but have

Why global recession is 'big threat' to India, despite Nirmala Sitharaman’s bravado

By Prasanna Mohanty*  It would be imprudent to assume that a global recessionary trend will bypass India. In fact, a day after Finance Minister Nirmala Sitharaman categorically ruled out the possibility of recession and stagflation (with high unemployment and high inflation India is technically witnessing stagflation) hitting India in her responses to the Parliament earlier in the week, Commerce Secretary BVR Subrahmanyam dropped a bomb shell. He released latest trade data showing fast deteriorating trends. The data showed, in July 2022, exports fell to five-month low of $35.2 billion and imports sequentially increased to $66 billion. The details revealed a fall in seven of top 10 export items: engineering goods, petroleum products, gems and jewellery, pharmaceuticals, readymade garments, cotton yarn and plastics. All this happened, Subrahmanyam acknowledged, due to the growing recessionary trends in developed countries and elevated commodity prices. The trade deficit (merchandise g

Bangladeshi women crossing borders: Demand to sensitise cops, BSF personnel

Counterview Desk  Bringing more instances of how the security personnel along the borders in West Bengal refuse to probe the human trafficking angle while arresting Bangladeshi women, human rights leader Kirity Roy has said, they are treated as accused in violation of the memorandum of understanding (MoU) between the Government of India and the Government of Bangladesh on Bilateral Cooperation for Preventing of Human Trafficking, especially trafficking in Women and Children. In a letter to the chairman, National Human Rights Commission (NHRC), Roy, secretary, Banglar Manabadhikar Suraksha Mancha (MASUM), and national convenor, Programme Against Custodial Torture & Impunity (PACTI), Hooghly, said, “The victims should be immediately repatriated to their own country and the criminal charges against them must be withdrawn at the earliest”, insisting, “The matters must be handled by the police or the BSF personnel with a human approach.” Text: I am writing this complaint regarding det

A tale of horror and fraud: Profits in trillions of dollars for vaccine manufacturers?

By Aruna Rodrigues*  John Leake is a best-selling and “experienced non-fiction, true crime author”. Having just read what must be described as an extraordinary ‘telling’ of the Covid-19 saga, his book “The Courage to Face Covid-19: Preventing Hospitalization and Death While Battling the Bio-Pharmaceutical Complex”, co-authored with Peter A McCullough, MD, MPH, is the narration of true crime on a scale that could top the list in the history of ‘man’s inhumanity to man’. The book chronicles the unique role of national governments across the world and their health agencies, led by the USA and WHO, which followed an agenda that led to completely avoidable fatalities numbering several million. The question is why? The usual culprits are money and power. But to ascribe cause to these two is woefully insufficient. The sheer magnitude of the ‘dark agenda’ – coordinated and played out by governments, health agencies, the medical establishment (hospitals, doctors and chemists) and the massive a

Draft notification: MoEF&CC should 'critically protect' eco-sensitive Western Ghats

Counterview Desk  In a detailed representation to the secretary, Ministry of Environment, Forests and Climate Change (MoEF&CC), Shankar Sharma, power and climate policy analyst, commentin on the draft gazette notification of the MoEF&CC dated July 6, 2022 on the Ecologically Sensitive Area (ESA) of the Western Ghats (WGs), has said that the political class, having vested interests in Karnataka, has been opposing such a move for many years. Stating that there is no “rational basis to do so”, and stating that the opponents do not even seem to have even read the recommendations of Dr Kasturi Rangan committee report or the actual draft notification itself, Sharma underscores, the only aim of the vested interests, who have “unauthorisedly occupied massive pieces of forest lands”, to continue to do on in near. “These vested interests are continuing to be ignorant of the fact that Western Ghats not only harbour rich biodiversity of critical importance to our people, but also support