New Delhi: Government think tank NITI (National Institution for Transforming India) Aayog has named the state of Maharashtra as one of the top three performers along with Kerala and Andhra Pradesh on health indicators in its annual health index which ranks states on health parameters including total fertility rate, sex ratio, healthcare facilities, and others. While Maharashtra has been recognised for its improved healthcare facilities which is evident from its reduced infant and child mortality rates, it has not been able to improve the status of malnutrition which is a major contributor to death among children under five in India. This scenario is keeping the state from achieving Sustainable Development Goal Two (SDG-2) which aims to put an end to hunger and malnutrition.
Here’s a quick look at Maharashtra’s performance in terms of health parameters:
- Maharashtra’s Infant Mortality Rate Is Substantially Lower Than The National Average: The improvement in Maharashtra’s health status, as projected by NITI Aayog’s health index, is attributed to the reduced infant mortality rate (IMR) of the state. According to the fourth and latest National Family Health Survey (NFHS 4) conducted in 2015-16, the infant mortality per 1,000 live births is 24 as opposed to 41 deaths per 1000 live births at the all India level during the same period. Maharashtra has seen an improvement of 36.84 per cent from the IMR of 38 reported in NFHS 3 conducted in 2005-06.
- The State Has Also Outpaced The Country As A Whole In Under-Five Mortality: The Under-five mortality rate (U5MR) per 1,000 live births of Maharashtra is very low compared to the national average. NFHS 4 shows that the U5MR of the state is at 29, about 38.29 per cent down from its NFHS 3 when the U5MR was 47 children per 1,000 live births. The state has not only improved its U5MR, but is also better than the national rate which was 50 deaths per 1000 live births, in NFHS 4.
- Malnutrition, Still A Massive Challenge For Maharashtra: As per experts, children under five years of age require appropriate nutrition and adequate care in order to reach their full growth and development potential. Lack of proper nutrition can make children vulnerable to poor growth and development and may even cause death. According to NFHS 4, the prevalence of stunting or low height to age among children under the age of five years has been reduced. However, the state has not been able to fight wasting or low weight for height and underweight problem among children below five years of age who were covered in the survey.
NFHS 4 shows that stunting in the state has reduced by about 12 per cent between the years 2005-06 and 2015-16. However, in the same period, wasting has seen an increase of more than nine per cent from 16.5 per cent in NFHS 3 to 25.6 per cent in NFHS 4, which is worse than the national average of 21 per cent. The prevalence of underweight in the state has been brought down by just one per cent. This indicates a failure in catering to the nutritional needs of the children in the state who were covered in the survey.
However, as per the Department of Women and Child Development, the state has been implementing Integrated Child Development Services (ICDS) for more than three decades and has been providing mid-day meals to about 82 per cent of the total number of children enrolled in public schools, to tackle malnutrition but the goals remain unfulfilled still . The state is also working towards improving the nutritional status of children through Village Health and Nutrition Day (VHND) observed once a month in every village to make people aware about the importance of nutrition and is also deploying ASHA (Accredited Social Health Activists) for this.
- Even Though There Is A Reduction, Anaemia Is Still Widely Prevalent Among Children And Women In Maharashtra: Anaemia is the deficiency of red blood cells in the blood and as per experts, it is one of the most common blood disorders in the world. Anaemia mong children can lead to several issues including increased morbidity, and development issues, as per World Health Organisation (WHO). According to NFHS 4, anaemia rate among children who are 6-59 months old in the sample surveyed is 53.8 per cent. This is just slightly better than the national average of 58.6 per cent children in the age group 6-59 months in the sample surveyed under NFHS 4. The survey shows that while there has been a reduction of about 9.6 per cent in anaemia prevalence of 63.4 per cent as reported in NFHS 3, still more than half of the children who were covered in the survey are anaemic.
The survey also shows that women in the age group 15-49 years are also widely affected by anaemia. About 48 per cent of these women are anaemic and there has been a reduction of only 0.4 per cent from NFHS 3 conducted in 2005-06, when anaemia prevalence was 48.04 per cent among women in this age group.
- With More Than 17 Per Cent Decline In Diarrhoeal Disease Cases, Maharashtra Is On The Path Of Eliminating The Disease: Maharashtra has put efforts in improving its sanitation level and this is reflected in the massive reduction in the number Diarrhoeal disease cases and deaths, says Rahul Khanadre, Swachh Bharat Mission state coordinator of Maharashtra. According to the National Health Profile (NHP) 2019 report developed by the Ministry of Health and Family Welfare of the Government of India, the cases of Diarrhoea have declined by almost 17.5 per cent from more than 7 Lakh in 2017 to 5.8 Lakh in 2018. However, the number of Diarrhoeal disease deaths has seen an increase of 14 counts in the period between 2017-18 and 2018-19. Out of the total cases of Diarrhoea in India in 2018, which was almost 1.3 crore (1,31,94,775), Maharashtra contributed only about 4.4 per cent to the national total of diarrhoea cases.
Note: For the National Family Health Survey (NFHS) 4, information for Maharashtra was gathered from a sample of over 26,890 households, which covered 29,460 women, and 4,455 men. In NFHS 3, information was collected from 8,315 households including 9,034 women and 8,867 men.
It is important also to educate the community to dispel harmful myths on nutrition of young children, adolescent girls and pregnant and lactating women. Men’s involvement is particularly crucial as the key enabler to meeting women’s nutrition needs: World Food Programme