Kerala’s achievement of sustaining the single digit infant mortality rate (IMR) and bringing it down from 7 to 6 in 2018 (as per the latest Sample Registration System Bulletin for 2019) is the result of the state’s single-minded initiatives and investments in the sector Is. Newborn care.
Among the larger states, Kerala is the only one with a single-digit IMR (per 1,000 live births), well ahead of other states – the nearest Delhi with an IMR of 11 – and against the national average of 30.
It is commendable that the state has managed to close the gap between IMR in rural (9) and urban areas (5) in 2018 to 7 and 5 in 2019. It was in 2018 that the state achieved the single digit distinction for the first time. IMR 7.
The “single digit IMR” was a project that the state health department and the state branch of the Indian Academy of Pediatrics had been pursuing since 2010 as scheduled, since for a long time, the state’s IMR was stagnant at 12.
About 4.7-5 lakh births take place in the state annually. A 2013 study by the state IAP found that 75% of infant deaths occurred during the neonatal period and 59% of these occurred during the first week. Premature deaths account for 35 percent of deaths, while congenital anomalies, especially severe congenital heart diseases, account for 28 percent.
The state began by strengthening infant mortality reporting and auditing; Formulate clinical guidelines and quality standards to improve antenatal, intrauterine and neonatal interventions; Huge investment in improving newborn care nurseries, ICUs and delivery points; and in the training of obstetric and neonatal nursery care personnel.
Identified issues
“Kerala’s success was in correctly identifying issues and effectively implementing focused interventions to improve newborn care. The interventions were aimed at ensuring the survival of very low birth weight babies of 1,000-1,100 g prematurely. Special attention was paid to tribal mothers. All our investments have paid off,” said PK Jameela, member, state planning board and former director of health services.
The state also launched a comprehensive newborn screening programme. All newborns are screened for visual birth defects, congenital anomalies, hearing and vision tests and metabolic disorders.
heart disease screening
This was followed in 2017 by the launch of Hridayam, a mega public-private initiative to identify and treat babies with severe congenital heart anomalies early and without delay. The project has saved the lives of hundreds of newborns and infants.
“Kerala’s consistent and concerted efforts to improve survival of infants and ensure quality of life beyond survival have been phenomenal. All our long-term strategies were supported by the government with infrastructural investments, personnel and training,” explains I. Riyaz, National Executive Member, IAP.