Developed nation by 2047, is the fervent cry by many Indians. But the road ahead is far from easy. Incidentally, one of the big four consulting companies worldwide PwC has high hopes for India listing the green revolution, leadership in tech, developing the sectors of tomorrow, building skills for the 21st century and harnessing the potential of young people and women – as the top five springboards for the nation to achieve its target. However, they have missed out on one of the most important factors of becoming a developed nation, Health. More specifically infant mortality. The difference between a developed nation and developing nation is very evident in their infant mortality rates. And that is why it is direly important to ensure neonatal health.
The infant mortality rate is the number of deaths of children under one year of age per 1,000 live births. This rate is an important key indicator for a country’s health and standard of living; a low infant mortality rate indicates a high standard of healthcare. India is neither among the countries with the highest nor among those with the lowest infant mortality rate. Its decrease indicates an increase in medical care and hygiene, as well as a decrease in female infanticide. Increasing life expectancy at birth is another indicator that shows that the living conditions of the Indian population are improving.
The World Health Organisation makes some key points:
- Globally (in 2022), 149 million children under 5 were estimated to be stunted (too short for age), 45 million were estimated to be wasted (too thin for height), and 37 million were overweight or obese.
- Few children receive nutritionally adequate and safe complementary foods; in many countries less than a fourth of infants 6–23 months of age meet the criteria of dietary diversity and feeding frequency that are appropriate for their age.
- Undernutrition is associated with 45 per cent of child deaths.
What can India do? Strategies and Doables:
India has a robust health care community that can assist in our larger goals of healthy nutrition for a good maternal and neo natal health. Some of the more important areas are in training and capacity building of community volunteers – for example: in the Infant and Young Child Feeding Practices (IYCF), ICDS (Integrated Child Development Services scheme is the world’s largest community-based program) public health systems. Diet and nutrition in prenatal and postnatal care, care of low birth-weight babies. Kangaroo Mother Care – KMC: (Kangaroo mother care is a method of care of preterm infants. The method involves infants being carried, usually by the mother, with skin-to-skin contact. This guide is intended for health professionals responsible for the care of low-birth-weight and preterm infants.)
Auxiliary Nurse Midwife (ANM) can also be capitalised extensively to promote in urban and semi-urban areas. As can be the Accredited Social Health Activist (ASHA), works in the village and focus on promotion of MCH, including immunisations and institutional-based deliveries, for which they receive a performance-related fee.
Referral linkages with Child OPD and referrals to the Child Treatment Centre for management of malnutrition: child immunisation, management of infectious diseases, services for malnourished children: weight measurement and medicines from the public health posts, Check-up and other services for lactating mothers during postnatal period from the public health posts: Referral linkages for government schemes, ID and documentation support, Partnerships with Health and Sanitation: awareness around surface hygiene, handwash, management of community cleanliness and how it directly affects the health and well-being of infants.
Partnerships with the ICDS can yield the following:
- Services for weight measurement, joint counselling for mothers
- THR (take home ration) for lactating mothers
- Baby kit for mothers in postnatal care
Involvement of men/influencers :
Men – fathers or male guardians and influencers can help in raising a healthy infant. They can be motivated about the diet requirements of infants, support mothers in preparation of baby foods etc. Fathers can be involved in KMC care, vaccination, clinical check-up, emotional support and other support for child development. They can be made aware about hospital delivery and other services received upon birthing in hospital. The involvement of key influencers, (viz religious leaders) can be encouraged in infant and child care practices to engage men on a more active basis
We can scale our message on Infant Health and Nutrition through:
- Mass awareness and health campaigns through national and community events
- Masjid announcements
- Wall paintings on Infant Nutrition
- Leveraging Information Technology (WhatsApp Chatbot)
Through these methods, India can definitely lower the infant mortality rate and help our citizens live healthier lives. While it may take some time to achieve this, if we work in synergy across all organisations, whether it be public or private organisations, India can build a roadmap for building healthier lives across the world.