Delhi unsafe for child birth: Union health ministry

MAHABALIPURAM: The national capital may show various signs of urban development but it is not a safe place for child birth. This has been revealed in a performance score card prepared by the Union ministry of health and family welfare. Delhi has recorded a 'very low' performance against the crucial health indicator of child birth, besides scoring 'low' on indicators of pregnancy care and post-natal maternal and newborn care. Chhattisgarh, Jammu and Kashmir, Manipur, Meghalaya, Nagaland, Tripura and West Bengal are other states in the 'very low' category.

The score card was released by the ministry officials at the ongoing National Child Survival and Development Summit here on Friday.

The performance of the states was assessed on the basis of four broad categories viz reproductive age, pregnancy care, child birth and post-natal maternal and newborn care. Based on the results, the states were categorised as good, promising, low and very low.

For its unsatisfactory performance in three out of four categories, Uttar Pradesh, too, has been placed in 'low' category. As per the card, UP's performance was ranked 'very low' in the post-natal maternal and newborn care and 'low' in the pregnancy care and child birth. Reproductive age-group was the only criterion against which UP showed a redeeming performance. Other states in the 'low' category are Arunachal Pradesh, Assam, Bihar, Jharkhand, Mizoram and Rajasthan.

Goa, Gujarat, Himachal Pradesh, Kerala, Punjab, Sikkim and Tamil Nadu were ranked as the best performing states while Andhra Pradesh Haryana, Karnataka, Madhya Pradesh, Maharashtra, Odisha and Uttrakhand were grouped as promising states.

The gradings were based on 19 indicators like rate of neonatal mortality, infant mortality, and vaccination coverage among others.

The four main categories were further divided into a set of parameters. For example: the proportion of post natal (after birth) maternal and new born care includes ratio components like newborns breastfed within first hour to total live births, women discharged in less than 48 hours of delivery to total number of deliveries in the public institutions, newborns weighing less than 2.5 kg to newborns weighed at birth, infants between 0-11 months who received measles vaccine to report live births among others.

The methodology comprised analysis of data gathered through the health management and information system for a period between April and September 2012. It was retrieved in January and assessed over a period of several weeks. "All India average for respective indicator was used as a reference point. The state score has been determined keeping in mind its deviation from the national average. Positive scores were allotted to above the national average for positive indicators and to those below the national average for negative indicators. Similarly, the negative scores of -1 to -4 were awarded to those below national average (for positive indicators) and to those above the national average for negative indicators," explained Dr Ajay Khera, deputy commissioner, child health and immunisation, ministry of health and family welfare. "Points were awarded against each health parameter and in the end they were accrued to draw a final score," he added.

Managing director, National Rural Health Mission, India, Anuradha Gupta said the gradings were done to help states assess their performance so that they pull up their socks within time. The card, she said, will also instill a sense of competition among states which will rather compel them to score better the next time. "Time has come when we must think of state specific goals and targets. And states should also know that they will have to contribute their bit to improve the national picture," she said.

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