Picture for representational purpose only.

LUCKNOW: Rate of children dying in the first month of life in Uttar Pradesh is over two times the rate in sub-Saharan Africa, according to a WHO coordinated study undertaken by the Alliance for Maternal and Newborn Health Improvement mortality study group.

Published in the current edition of medical journal ‘ Lancet Global Health ’, the study followed up 2.80 lakh pregnant women across 11 sites in eight countries for the entire duration of pregnancy and 42 days after delivery to assess the rates of neonatal mortality, still birth and maternal mortality.

Claimed to be the largest prospective study in the world, covering 40,000 women from UP, the research showed that while 41 out of 1000 newborn babies die in UP, only 20 / 1000 die in sub-Saharan countries including republic of Congo, Ghana, Kenya , Tanzania and Zambia.

Among the African countries, Ghana recorded the highest newborn death rate of 29 / 1000 live births which was much less than UP. The findings for UP are important as government data suggests that UP’s neonatal mortality is around 27 / 1000 live births. The extent of the problem may be gauged from the fact that 56 lakh children are born in the state every year. There is evidence to prove that if babies survive in this period, UP's infant mortality rate can be halved. This will also have a direct impact on India's IMR.

Conducted between July 2013 and February 2016, the study is important for several reasons as it provides valuable material for assessment of age patterns and causes of the problem. Important among them is that the study gives clearer picture of the health challenges before the state and its policy makers. Instead of taking the conventional route of gathering data through sample surveys and retrospective recall especially in case of deaths as in case of maternal or neonatal mortality of still births, this study took the prospective approach.

“In the old methodology, the chance of missing counts is quite high. As a result, the data gathered at the end may is usually an under-reported figure. In the prospective method, on the other hand, chances of bias as a result of missing counts is extremely low. In addition, biases due to recall are also lowered as the sample shares a first hand account,” explained Aarti and Vishwajit Kumar of social organisation Community Empowerment Lab that has been working on the issue of maternal and child health for more than a decade now.

Besides giving numbers, the study also suggests that there is need for re-assessing the way public money is spent on health targets for reproductive, maternal and newborn child health. It may be noted that UP National Health mission spends around Rs 5,000 crore each year for health programmes of which 30-35% goes for just reproductive and child health.

Haryana was the second site covered in India while its neonatal mortality was found to be 40. UP's situation was slightly better than Bangladesh where 37.8 of 1000 newborns died. In South Asian region, Pakistan fared worst. Neonatal rate for two Pakistani sites - Matiari and Karachi was found to be 46.9 and 50.1 per 1000 live births.

