Evaluates coverage of pneumonia and diarrhea interventions in 27 states
The 2014 Pneumonia and Diarrhea Progress Report, released today by the International Vaccine Access Center (IVAC) at the Johns Hopkins Bloomberg School of Public Health, highlights India’s persisting burden of pneumonia and diarrhea, but notes marginal progress toward improving coverage of life-saving interventions to prevent child deaths and suffering from these diseases. As per the latest estimates from UNICEF, pneumonia and diarrhea collectively claimed more than 300,000 children in 2013.
According to the annual report, India ranks third lowest compared to the 15 other high burden countries for its Global Action Plan for Pneumonia and Diarrhea (GAPPD) score – a calculated average of coverage levels for the vital pneumonia and diarrhea interventions outlined in the World Health Organisation (WHO) and UNICEF’s integrated GAPPD for which data are available,including vaccination, exclusive breastfeeding, access to care, and use of antibiotics, oral rehydration solution (ORS), and zinc . However, the report also notes that India is in a position to improve its ranking following the recent commitments it has made toward access to child health interventions.
“In India, pneumonia and diarrhea have been a health challenge for very long time,” said Dr. V K Paul, Head of Pediatrics at theAll India Institute of Medical Sciences (AIIMS). “It is heartening to see that the government has started intensifying strategies to combat these diseases through various interventions. This includes the government’s decision to introduce the pentavalent vaccine against Hib pneumonia and meningitis in an additional 11 states, introduce rotavirus vaccines for diarrhea in its routine immunisation program, and step up the measles vaccination program. However, as the report suggests, we need to move faster to save many more lives of our Indian children. In particular, there is a need to raise the coverage of pneumonia treatment in the community”.
For the first time, the report also includes a subnational analysis for India. A total of 27 states in India for which data were available were ranked based on their GAPPD score. Of these, Goa performed the best and Meghalaya the worst. The analysis also revealed high levels of inequities in access to interventions between urban and rural regions within states.
“We celebrate the progress in preventing pneumonia this World Pneumonia Day, while recognizing the need to ensure ALL children have access to care and early diagnosis, vaccines, and medication,” said Kate O’Brien, Professor, Johns Hopkins Bloomberg School of Public Health and Executive Director of IVAC. “This year’s Pneumonia and Diarrhea Progress Report takes a special look within two large and high-burden countries, India and Nigeria, to identify inequities in coverage levels that exist between states. This kind of subnational analysis is important for identifying areas to focus efforts on accelerating coverage with all prevention and treatment tools.”
The Ministry of Health & Family Welfare has demonstrated its commitment to the integrated approach outlined in GAPPD through several recent efforts, including a workshop on “Integrated Approaches for Prevention and Management of Pneumonia and Diarrhea for achievement of MDG 4,” held in October with WHO in Delhi, and the Intensified Diarrhoea Control Fortnight launched in August. New scorecards are also being developed to better evaluate India’s progress on these indicators at the state- and district-level, though more and better data is needed.
“The recent decision by the Union Government to introduce three new childhood vaccines in the Universal Immunization Programme (UIP), including vaccines against rotavirus, rubella, polio (injectable), is a clear indication of the government’s commitment,” said Dr. Vijay Yewale, President, Indian Academy of Pediatrics. “
However, while the government continues to work on improving community management of pneumonia, it must also consider introducing the pneumococcal conjugate vaccine (PCV) in the Universal Immunisation Programme which is recommended by World Health Organization for all countries especially those with under-five mortality rates over 50. More than 115 countries around the world have introduced PCV vaccine including Afghanistan and Pakistan while Bangladesh plans to introduce it later this month. Global evidence has demonstrated that PCV has a dramatic impact in reducing child deaths where in use.”
EH News Bureau