Skip to main content

Preventing childhood deaths: India performs worse than Bangladesh, "equals" Pakistan

By Rajiv Shah
A just-released study, “The Pneumonia and Diarrhea Progress Report 2018”, prepared by the International Vaccine Access Centre (IVAC) at the Johns Hopkins Bloomberg School of Public Health, has identified India among 15 other countries which are still far off the mark in achieving the targets of the Global Action Plan for the Prevention of Pneumonia and Diarrhea (GAPPD).
Set by the World Health Organization (WHO) and the United Nations International Children’s Emergency Fund (UNICEF), to be achieved by 2025, GAPPD is as an integrated approach to reduce the incidence of severe pneumonia and diarrhoea, and reduce the number of children under-five who are stunted, and end preventable childhood deaths from pneumonia and diarrhoea.
Calculated by averaging the indicator-specific target scores of all 10 indicators identified in GAPPD, the study finds that, as against the target of 86% coverage for various steps needed to be taken to be taken to achieve the GAPPD, India is just half way, 50%, which is equal to Pakistan but much below Bangladesh’s score of 64%.
The study focuses the world’s 15 countries with the highest number of pneumonia and diarrhea child deaths: India, Nigeria, Pakistan, the Democratic Republic of Congo (DRC), Ethiopia, Chad, Angola, Somalia, Indonesia, Tanzania, China, Niger, Bangladesh, Uganda, and Côte d’Ivoire.
India’s pneumonia prevention score is 65% as against the WHO-UNICEF target of 84% and diarrhea prevention score is 39% as against the target of 82%. Here, while Pakistan performs worse than India (63% and 33% respectively), Bangladesh scores much better (74% and 54% respectively).
Its GAPPD score is based on 10 major indicators -- exclusive breastfeeding of infants 0–5 months, 3rd dose of diphtheria-tetanus-pertussis vaccine (DTP3), 1st dose of measles-containing vaccine Hib3 (MCV1), 3rd dose of haemophilus influenzae type b (Hib) vaccine, 3rd dose of pneumococcal conjugate vaccine (PCV3), final dose of rotavirus vaccine (RotaC), children with acute respiratory infection (ARI) taken to a health facility, children under 5 with symptoms of ARI who received antibiotics, children under 5 with diarrhea receiving oral rehydration salts (ORS), and children with diarrhea who received zinc supplements.
The study regrets, “Despite significant reductions of disease in recent years with improvements in access to and use of health interventions, nearly half a million pneumonia and diarrhea deaths still occurred in two countries – India and Nigeria.”
India’s death rate among children under 5 (per 1000 live births) is 6.3 (pneumonia) and 4.1 (diarrhea). It is much higher in Pakistan, at 11.5 and 6.8 respectively, but it is lower in Bangladesh, at 5.5 and 2.3 per 1000 live births respectively.
While the that India is one of the countries where exclusive breastfeeding target of 50% has been achieved (55%), it laments, “Aside from India, of the countries that had introduced PCV, Nigeria was the only country to have PCV3 coverage below half the target, with 33% coverage.”
The study states, “Of the seven countries where rotavirus vaccine has been introduced, the median coverage of complete rotavirus vaccine is 58%. Tanzania was the only country to meet or exceed the target level, with 97% coverage. Among countries that had introduced the vaccine as of 2017, the lowest coverage levels were in Pakistan (12%) and India (13%), both of which had recently started phased national rollouts that had not yet reached all states or provinces.”
Coming to treatment indicators, the study says, while none of the 15 countries met the target, seven of them have “coverage above half the target: Uganda (80%), Indonesia (75%), India (73%), Pakistan (64%), Niger (59%), Tanzania (55%), and Angola (49%).” It adds, “The lowest coverage was reported for Nigeria (24%).”
The study says, “From 2017 to 2018, overall GAPPD scores increased in seven countries but all increases were very small (range 1-4%) – Ethiopia (+4), Pakistan (+2), Nigeria (+2), India (+1), DRC (+1), Tanzania (+1), and Niger (+1) – and scores decreased in China (-2) and Angola (-1).”
It underscores, however, “Pneumonia scores and four countries saw declines: Angola (-5), Nigeria (-3), China (-2), and India (-1).” At the time “diarrhea scores increased in six countries – Nigeria (+8), Ethiopia (+8), Pakistan (+3), Tanzania (+2), India (+1), and DRC (+1) – and decreased in China (-2), Angola (-1), and Bangladesh (-1).”
Commenting on India, the study says, “India’s overall GAPPD score increased by one point, however, this aggregate score masks the drivers of change—both positive and negative—in the individual GAPPD indicators. Coverage for Hib and rotavirus vaccines increased by 8 and 9 percentage points. Zinc coverage was recorded as 20%.”
It further states, “Although this appears to be an improvement and impacts the country's GAPPD scores, data were unavailable last year and do not necessarily reflect a 20 percentage point increase in coverage. In contrast, the other treatment indicators decreased: ORS coverage (-13 percentage points), exclusive breastfeeding (-10), and access to pneumonia care (-4).”
“Across India”, the study underscores, “There is lower vaccine coverage among female children in rural areas and in poor, urban areas. Improvements to full immunization coverage in India have not succeeded in closing the gender gap in coverage, as only 78 females were fully immunized for every 100 males fully immunized in poor areas of Delhi.”

Comments

Unknown said…
In India, health issues are not addressed to as quickly as it requires.quires either by the govt or by the people.

TRENDING

World Bank clarifies: Its 26th rank to India not for universal access to power but for ease of doing business

By Our Representative
In a major embarrassment to the Government of India, the World Bank has reportedly clarified that it has not ranked India 26th out of 130 countries for providing power to its population. The top international banker’s clarification comes following Union Power Minister Piyush Goyal’s claim that India has “improved to 26 position from 99” in access to electricity in just one year.

Mental health: India's 95% patients "deprived" of medical care, treatment gap 70%

By Moin Qazi*
Among the many challenges India faces, the most underappreciated is the ongoing mental health crisis. Mental illness is actually India’s ticking bomb. An estimated 56 million Indians suffer from depression, and 38 million from anxiety disorders. For those who suffer from mental illness, life can seem like a terrible prison from which there is no hope of escape; they are left forlorn and abandoned, stigmatized, shunned and misunderstood.

Modi model? "Refusal" to build Narmada's micro canals, keep Kutch dry; help industry

By Medha Patkar*
This is the latest photograph of the Kutch Branch Canal (KBC) of the Sardar Sarovar, as of April 8! What does it show, expose, and what memories do you recall? Is it dry or dead? Is it a canal or a carcass of the same?

Bill Gates "promoting" GMO, Bt cotton, like cartels that have roots in Hitler's Germany

By Our Representative
World-renowned environmental leader and ecologist Dr Vandana Shiva has expressed concern that Bill Gates, founder of Microsoft Corporation, has joined the bandwagon of “a poison cartel of three" – Monsanto and Bayer, Syngenta and ChemChina, Dow and DuPont – all of whom allegedly have “roots in Hitler’s Germany and finding chemicals to kill people”.

Indian talc products contain "contaminated" asbestos structures, can cause cancer: Study

Counterview Desk
A recent study, using polarizing light microscopy, transmission electron microscopy (TEM), electron diffraction, and X-ray analysis on multiple over-the-counter Indian talc products for the presence of asbestos, has concluded that large quantities of body talc products are likely to pose a public health risk for asbestos-related diseases, especially for the cancers related to asbestos exposure.

Why are you silent on discrimination against Dalit jawans? Macwan questions Modi

By Rajiv Shah
Close on the heels of releasing his book in Gujarati, "Bhed Bharat", which lists 319 cases of atrocities against Dalits and Adivasis across the country over the last five years, well-known Gujarat Dalit rights leader Martin Macwan has shot an open letter to Prime Minister Narendra Modi, telling him the reasons why he does not want vote for the BJP.

Emergence of a rare Dalit teacher in IIT-Kanpur "disturbed" certain faculty members

By PS Krishnan, IAS (Retd)*
Dr Subrahmanyam Sadrela, a faculty member in the Department of Aerospace Engineering, Indian Institute of Technology (IIT)-Kanpur since January 1, 2018, and one of the rare Dalit members of the faculty in IIT group of institutions, is facing the threat of revocation of his PhD thesis, and thereby also jeopardizing his job and career.

Investigation shows Narmada downstream "seriously" polluted. Reason: apathy, greed

By Rohit Prajapati, Krishnakant, Swati Desai*
Our investigation regarding quality of water flowing in the Narmada river downstream of the Sardar Sarovar Dam (SSD), dated April 6, 2019, between 11.00 a.m. to 4.00 p.m. reiterates, what is commonly known now, that the Sardar Sarovar Project (SSP) is planned without considering its impact on the downstream Narmada River stretch of 161 kilometres, its ecology, biodiversity and fishery, and lakhs of people living close to and dependent on the river directly or indirectly. This, in turn, has led to its present disastrous state.

RTE in remote areas? Govt of India "plans" to close down 2.4 lakh schools

By Srijita Majumder*
The Right to Education (RTE) Act, 2009, came into effect on April 1, 2010, for the first time made it obligatory on the part of the State to provide free and compulsory education to all children from 6-14 years of age in India. The Act, despite its limitations, had progressive elements like neighbourhood schools, community participation, ban on corporal punishment, no detention, continuous and comprehensive evaluation and it hence it appeared that India was not far from achieving universal elementary education.

Election Commission suffering from worst-ever "credibility crisis": Ex-bureaucrats

Counterview Desk
In an open letter to President Ram Nath Kovind, a group of ex-bureaucrats have lamented ‘weak-kneed’ responses of the Election Commission of India (ECI) in the run up to the 2019 Lok Sabha elections. Citing various violations of the model code of conduct, and pointing towards how ECI has taken little action, the letter asks the President to tell ECI to “conduct itself in a manner where its independence, fairness, impartiality and efficiency are not questioned.”