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Rural kids, girls most vulnerable in MP; under-5 deaths highest in country

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Sravani Sarkar

Bhopal: Vulnerability of rural children, especially girls of Madhya Pradesh in early years of their life has been stamped, with the latest Sample Registration System (SRS) report 2014 showing that the under-five mortality rate (U5MR) of rural children and especially girls in MP is highest in the country.

The U5MR is the number of children (out of every 1000 children born) who die before the age of five years.

The SRS-2014, a statistical report released by the Registrar General of India office on Monday, puts the figure of overall U5MR of MP at 65, while for rural MP it is 72/1000 live births. The national average is 45 and 51 respectively.

The most shocking is the figure of U5MR (females), which stands at 79, compared to national average of 55. Assam, which has slightly higher overall U5MR compared to MP (66) has a lower U5MR for girl children at 75.

Comparatively, the urban U5MR is 37 in Madhya Pradesh for both males and females - almost half of their unfortunate rural counterparts.

The rate of children’s death in any state is considered the most important health and development indicator. High rates of death reflects gaps in the health care and nutrition services system causing deaths of the most vulnerable of a state’s populace - the children.

In this context, the SRS-2014 hasn’t brought any good news for MP. In June last, the infant mortality figures were released under SRS, showing that though the rate of death of children below age of one year was decreasing over last decade, it still remains highest in country at 52/1000 live births.

On Monday, the figures for children’s deaths in other age categories were released too.

Apart from U5MR, the SRS shows that the early neonatal mortality rate (ENMR- death of children within a week of birth for every 1000 children born) is highest in Madhya Pradesh at 26/1000 live births along with Odisha.

The neonatal mortality rate (NMR- death of children within a month of birth for every 1000 live births) is second highest in country at 35, just a notch below Odisha that has recorded NMR of 36.

Sachin Jain, food rights and nutrition expert, points out the reasons according to his analysis. “The primary health care system, which is in transition phase of being privatized in MP, is showing signs of collapse and this is the impact. There is no option but to improve the outreach services and improve infrastructural and behavioural aspects of primary health care system,” he says.

Jain also emphasizes on the need of having strong community-based village level health and nutrition planning system, without which interventions might not be useful.

As for girl children’s vulnerability, Jain calls for gender and caste sensitive educational inputs that could address the issue overall.

State commissioner of health, V Kiran Gopal, while talking to said he would have to look into details of the report before responding to the situation. He however mentioned that screening of children and ensuring that low birth weight and malnourished girls get into sick newborn care units (SNCUs) and Nutrition Rehabilitation Centres (NRCs) at right time would be the right steps.

The commissioner also said that the state is now extensively focusing on pregnant women and would be ensuring at least one ante-natal check up ( ANCs) by a doctor in rural areas and at least four total checkups by frontline workers.

Also stringent monitoring and corrective steps with disincentive inputs are being taken to ensure proper ante-natal care for women. If a lady is found anaemic during childbirth, her case would be backtracked to find why she was not detected during ANCs and the Auxiliary Nurse Midwife (ANM) of the area would be called in for counseling and extensive training. If yet any case is detected at last stage, the ANM would be called at state level for training at her own cost.

He also said that the state is trying to incentivize the doctors so that they go for rural posting. Recently 700 doctors were posted in rural areas. “This however remains a challenge for us,” he conceded.


“Madhya Pradesh has high under five mortality, infant and neo natal mortality. Gender gap in these indicators, which is also evident in the recent SRS report needs attention.  State Government is taking steps to address the challenges, and we stand with them, but stronger efforts need to be further intensified, particularly on neonatal care.”

-               Michael Juma, Chief, UNICEF, Madhya Pradesh