Skip to main content

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

 
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

TRENDING

Area set aside in Ahmedabad for PM's affordable housing scheme 'has gone to big builders'

Following my article on affordable housing in Counterview, which quoted a top real estate consultant, I was informed that affordable housing—a scheme introduced by Prime Minister Narendra Modi—has deviated from its original intent. A former senior bureaucrat, whom I used to meet during my Sachivalaya days, told me that an entire area in Ahmedabad, designated for the scheme, has been used to construct costly houses instead. 

Punishing senior citizens? Flipkart, Shopsy stop Cash on Delivery in Ahmedabad!

The other day, someone close to me attempted to order some goodies on Flipkart and its subsidiary Shopsy. After preparing a long list of items, this person, as usual, opted for the Cash on Delivery (popularly known as COD) option, as this senior citizen isn't very familiar with online prepaid payment methods like UPI, credit or debit cards, or online bank transfers through websites. In fact, she is hesitant to make online payments, fearing, "I may make a mistake," she explained, adding, "I read a lot about online frauds, so I always choose COD as it's safe. I have no knowledge of how to prepay online."

Gujarat slips in India Justice Report 2025: From model state to mid-table performer

Overall ranking in IJR reports The latest India Justice Report (IJR), prepared by legal experts with the backing of several civil society organisations and aimed at ranking the capacity of states to deliver justice, has found Gujarat—considered by India's rulers as a model state for others to follow—slipping to the 11th position from fourth in 2022.

Just 5% Gujarat Dalit households 'recognise' social reformers who inspired Ambedkar

An interesting survey conducted across 22 districts and 32 villages in Gujarat sheds light on the representation of key social reformers in Dalit households. It suggests that while Dr. B.R. Ambedkar's photo was displayed in a majority of homes, images of Lord Buddha and the 19th-century reformist couple, Savitribai Phule and Jyotiba Phule, were not as commonly represented.

Whither PMAY? Affordable housing in decline as Indian real estate shifts focus to premium segments

A leading property consultant that seeks to provide comprehensive real estate services to developers, corporates, financial institutions, and the government has reported that, while housing prices have risen between 10–34% across India's top seven cities over the past year, the once-robust supply of affordable housing has "tottered and dwindled."

Of lingering shadow of Haren Pandya's murder during Modi's Gujarat days

Sunita Williams’ return to Earth has, ironically, reopened an old wound: the mysterious murder of her first cousin, the popular BJP leader Haren Pandya, in 2003. Initially a supporter of Narendra Modi, Haren turned against him, not sparing any opportunity to do things that would embarrass Modi. Social media and some online news portals, including The Wire , are abuzz with how Modi’s recent invitation to Sunita to visit India comes against the backdrop of how he, as Gujarat’s chief minister, didn’t care to offer any official protocol support during her 2007 visit to Gujarat.  

Not just Haren Pandya, even Dhirubhai Shah, youngest assembly speaker, wanted to be Gujarat CM

Dhirubhai Shah with Keshubhai Patel  When Keshubhai Patel was sought to be replaced by the BJP high command in 2001, everyone knows that Narendra Modi became the final choice. However, someone who was part of the top circles those days now tells me something I had no knowledge of—that the choice was between Modi and a Kutch MLA, Dhirubhai Shah, who served as the 16th Speaker from March 1998 to December 2002 during the 10th Assembly, the youngest to take the office.

Tracking a lost link: Soviet-era legacy of Gujarati translator Atul Sawani

The other day, I received a message from a well-known activist, Raju Dipti, who runs an NGO called Jeevan Teerth in Koba village, near Gujarat’s capital, Gandhinagar. He was seeking the contact information of Atul Sawani, a translator of Russian books—mainly political and economic—into Gujarati for Progress Publishers during the Soviet era. He wanted to collect and hand over scanned soft copies, or if possible, hard copies, of Soviet books translated into Gujarati to Arvind Gupta, who currently lives in Pune and is undertaking the herculean task of collecting and making public soft copies of Soviet books that are no longer available in the market, both in English and Indian languages.

My interaction with Jatin Sheth, who claims to come from Gandhian family

Today I was called for lunch by Jatin Sheth, who runs a citizens' organisation, seeking to address people's common issues ranging from poor roads to gutters going berserk. After I told him about my Soviet experiences on his insistence, he said, he wanted a person who could help him out with everything that he was doing -- from writing letters to authorities in English to representing before them. He said he could pay "up to Rs 50,000."