Quarterly Bulletin

Bal Raksha Bharat

february 2020 | ISSUE-lll

COVER STORY

Understanding Child Rights





Minister for Health and Family Welfare, Harsh Vardhan at the launch of ‘SAANS’ campaign in Gujarat



Save the Children representatives at the launch event of 'SAANS' campaign

Does decline in child mortality rate mean indicate better quality of healthcare services?

India has made a significant decline in the child mortality rate over the years, but due to recent manifestations like the one at the JK Lon Hospital in Kota (Rajasthan) during December strongly indicates the need for reflection on the quality of healthcare services, access of the marginalised people to the same and the welfare approach towards health.

Following this incident, the National Commission for Protection of Child Rights (NCPCR) conducted a probe and found a dire lack of essential medical equipment such as ventilators, a lack of staff at paediatric departments and a lack of cleanliness and basic facilities.

Among the various factors responsible for child mortality, India takes a lead with over 40 percent of the global under-five deaths due to Acute Respiratory Infections (ARIs). With close to 30 million cases of childhood Pneumonia reported every year, India tops the list of 15 countries with a high Pneumonia burden.

‘Pneumonia in India—A Situational Analysis’ developed by Save the Children launched on 26 November by Dr. Ajay Khera, Commissioner, Maternal & Child Health, Ministry of Health and Family Welfare, strongly points out the lack of current and up-to date evidence on the enablers and barriers in the response system for the disease.

As per estimates provided by Lancet, 1,40,649 under-five children died in India because of Pneumonia in 2015 which accounted for the death rate of 5.7 per 1000 live births.

The report encapsulates results from an in-depth assessment of five high-burden states of Uttar Pradesh, Rajasthan, Bihar, Madhya Pradesh and Jharkhand mapping the challenges and calling for action.

6930 children in the age group of 0-5 years were analysed. The report indicates a lack of focus on the disease compared to other childhood diseases and a huge gap in reporting. Save the Children’s report clearly points out a need for a rights based approach towards health that enables the rights holders and the duty bearers at the same time. Due to limited knowledge among healthcare providers on Prevent, Protect and Treat interventions, existing policies remain ineffective. Insufficient human resources acts as a barrier in providing adequate child health care services.

Save the Children globally has launched a major initiative to tackle Pneumonia effectively. The ‘Forgotten Killer’, initiative involves sharing of learnings on National and Global platforms. The report suggests that most of the pneumonia deaths are caused due to the popularity of home-based first-line treatment. An appropriately designed rights-based behaviour change framework will ensure a shift in the care-seeking behaviour of the community. Most of the deaths are due to delayed care-seeking or delay in initiation of treatment or due to inappropriate choice of facilities.

Save the Children suggests a need for a collaborative effort by all civil society organisations and the Government to mainstream the discourse. Their joint efforts will ensure clear commitments and resources from global and national stakeholders to address the silent killer. Recommendations for the community include a strong knowledge and information dissemination mechanism to push for effective behaviour change. Messages on the factors which can protect and prevent pneumonia, like early and exclusive breastfeeding, vaccination, hand washing and sanitation etc should be emphasised.