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India among six countries to report dip in maternal mortality: WHO

The Sustainable Development Goal set by the United Nations in 2015 is to reduce the global MMR to less than 70/lakh live births by 2030.

NEW DELHI: India is among six other countries that have been able to reduce maternal mortality (MMR) in the last ten years, which helped the Southeast Asia region see a steep drop in death rates, the World Health Organisation (WHO) said Tuesday. The other countries in the WHO Southeast Asia Region that were able to reduce MMR are Bangladesh, Bhutan, DPR Korea, Maldives, Sri Lanka, and Thailand. Due to this and other measures taken by other countries in the region, the newborn mortality (NMR) has almost halved, with the Region recording a 40 per cent reduction compared to a global 22 per cent drop during the same period, the WHO said.

This was announced at the four-day Regional meeting on ‘Sustain, Accelerate and Innovate strategies’ for reducing maternal, newborn, and child mortality in Colombo, Sri Lanka on Tuesday. Many women in reproductive age span die due to complications during and following pregnancy, childbirth, or abortion. Over the years, consistent Indian government efforts helped dipped MMR in the country.

MMR in India declined from 130 per lakh live births in 2014-16 to 122 in 2015-17 and dropped by nine points to 113 in 2016-18. By 2017-19, India’s MMR went down to 103, against a global MMR of 211 in 2017. The Sustainable Development Goals (SDG) set by the United Nations in 2015 is to reduce the global MMR to less than 70/lakh live births by 2030. Eight states have already achieved the SDG target. These include Kerala (19), Maharashtra (33), Telangana (43), Andhra Pradesh (45), Tamil Nadu (54), Jharkhand (56), Gujarat (57), and Karnataka (69). WHO also said India is among three other countries on track to reduce Under-5 mortality (U5MR).

The other countries of the Region are Bangladesh, Bhutan and Nepal. As per the Union Health Ministry, U5MR for the country is 32 per 1000 live births in 2020 against 35 per 1000 live births in 2019. The WHO said that India is also working to achieve a dip in newborn mortality (NMR) target by 2030. Bangladesh, Bhutan and Nepal are other countries trying to meet this target. NMR in India has registered a 2-point decline to 28 per 1000 live births in 2020 from 30 per 1000 live births in 2019.

At the regional meeting, Dr Poonam Khetrapal Singh, Regional Director of WHO Southeast Asia, said, “The Region has made significant gains in mortality reduction, but progress within countries has been uneven. We must adopt a differential approach to further reduce maternal, newborn, and child mortality based on their contextual priorities, available resources and new WHO guidelines and standards.” She said that since 2014, the Region has been focusing efforts to reduce maternal, newborn and child deaths as a flagship priority by implementing evidence-based strategies and actions. “As a result, the Region experienced a steep drop in death rates,” she said.

The SEARO region has 11 member states and houses over a quarter of the world’s population. Seven countries - Bangladesh, Bhutan, DPR Korea, India, Maldives, Sri Lanka, and Thailand - achieved the target of below 140 per 100 000 live births, while four countries - Bangladesh, Myanmar, Nepal, and Timor-Leste - are likely to attain national-level targets of a two-thirds reduction in MMR from 2010 value, she said. Under-5 mortality was reduced by 45 per cent between 2010 and 2021, compared to a 26 per cent global reduction with five countries DPR Korea, Indonesia, Maldives, Sri Lanka, and Thailand - achieving a Sustainable Development Goal (SDG) target of as low as 25 per 1000 live births.

The newborn mortality (NMR) has almost halved, with the Region recording a 40 per cent reduction compared to a global 22 per cent drop during the same period. Five countries - DPR Korea, Indonesia, Maldives, Sri Lanka, and Thailand - have achieved the SDG NMR target of neonatal mortality of 12 per 1000 live births. “We must make a strategic shift to a life-course approach that goes beyond survival to ensure that women and children thrive and achieve their full potential for health and well-being,” she said. However, some indicators have not changed over time. While 65 per cent of women access postnatal contact with a health care provider within two days after birth, less than half of newborns get breastfed within the first hours of delivery.

“There is little data on the implementation of essential newborn care practices such as skin-to-skin contact in the first hour of birth, while the coverage of life-saving oral rehydration salts for children with diarrhoea continues to be low (55 per cent), and only 64 per cent of children with suspected pneumonia are taken to a health care provider,” the WHO said. Additionally, the high burden of diseases and deaths in children due to congenital disabilities, disabilities, climate change, pandemics, etc., pose further challenges.

“It is important that while we sustain gains made in achieving high coverage of intervention packages such as skilled birth attendants and immunization, we must also explore innovative solutions to accelerate actions aimed at improving service delivery gaps and the quality and coverage of interventions such as intrapartum care, breastfeeding, care of preterm and low birth weight infants, and congenital disability prevention,” said Dr Khetrapal Singh. Countries can achieve this by adopting a universal health coverage approach by enhancing primary health care to encompass the entire continuum of essential health services and ensuring equitable, quality, safe and affordable health care when and where it is needed without financial hardship, said the Regional Director.

Recently, WHO released new guidelines and global quality standards for newborn and child health - postnatal care, quality standards for preterm and low birth weight, and Kangaroo Mother Care - aimed at strengthening national plans to improve health services at all levels of care. WHO remains committed to working with countries to support policies that reduce mother, child, and newborn mortality to ensure that every mother, everywhere, survives childbirth and they and their children can thrive and go on to lead healthy and productive lives, she said. (THE NEW INDIAN EXPRESS)