Suggested health services research action to achieve reduction of neonatal mortality in India

Manoj Kumar,Haresh M Kirpalani

doi:10.4236/ojpm.2011.12009

Manoj Kumar, Haresh M Kirpalani

Open Access

https://doi.org/10.4236/ojpm.2011.12009

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Abstract

Despite several national programs to reduce infant mortality, India had repeatedly failed to achieve its set targets for infant mortality. There are approximately one million neonatal deaths in India each year which accounts for nearly two-thirds of the infant deaths in India. India’s current trajectories of neonatal and infant mortality rates make it unlikely that it will achieve its targets for infant mortality rate for 2015 set under the Millennium Development Goals. Since two-thirds of infant deaths in India are neonatal deaths, implementation of effective neonatal care strategies would be essential to reduce infant mortality considerably. The history of child health services in India suggests an inattention to qualitative parameters, hindering a reversal of its failures. We discuss a format of mixed-methods participatory research, integrated with routine district level household surveys (DLHS), as a model of health services research which would better delineate the problems encountered in delivering effective newborn care at the primary care level.

Highlights

India is signatory to the United Nations’ declaration of the Millennium Development Goals (MDGs); it is expected to decrease childhood mortality by two-third by year 2015 from its level in 1990 (MDG4)
In last two decades, it has launched several large public programs targeted to the reduction of neonatal and infant mortality, namely Child Survival and Safe Motherhood (CSSM) Program in 1992 [8], Reproductive and Child Health (RCH) program in 1997 [9], followed by its second phase in 2005
Planning of services at the primary care level based on a process of community needs assessment (CNA) was included in the 2nd phase of the RCH program, this process is focussed on generating routine requirements of existing services for the year at each level rather than making structural changes

Summary

INTRODUCTION

India is signatory to the United Nations’ declaration of the Millennium Development Goals (MDGs); it is expected to decrease childhood mortality by two-third by year 2015 from its level in 1990 (MDG4). In last two decades, it has launched several large public programs targeted to the reduction of neonatal and infant mortality, namely Child Survival and Safe Motherhood (CSSM) Program in 1992 [8], Reproductive and Child Health (RCH) program in 1997 [9], followed by its second phase in 2005. It has launched a program of conditional cash transfers, Janani Suraksha Yojana(JSY), to encourage in-facility deliveries [10]. India will not able to achieve its MDG target for infant mortality [12]

REASONS FOR PROGRAMMATIC FAILURES

WHAT MORE CAN BE DONE TO ACHIEVE DESIRED REDUCTION IN NMR IN INDIA?

Findings

DISCUSSION