Madhya Pradesh Records Highest Infant Deaths in Last 3 Years

Bhopal: About 34 km from Madhya Pradesh’s (MP) Shahdol city, at Arjhhula village, Mala Kol (25) mourns the death of her firstborn Pushpraj, who was merely four months old. Around 25 km from Arjhhula, at Bodri village, Sonu Kol (28) also mourns the death of his firstborn Raj.

As many as 13 infants died between November 27 and December 3, 2020, at Shahdol district hospital in a week due to poor infrastructure and the lack of doctors at special newborn care units (SNCUs).

Of the 13, five died of pneumonia, two suffered from meningitis, two had hypoxic ischemic encephalopathy—a condition where the brain does not receive adequate oxygen—one is suspected to have had a congenital condition and another died of cardiogenic shock. Of the remaining two, one died of severe hypothermia and the other was born premature and did not survive as the hospital lacks an incubation unit.

According to the hospital data, between April and November 2020, 262 infants out of the 1,516 admitted to the SNCU died.

Pushpraj and Raj are among the 41,551 newborns who died in SNCUs in the last three years in Bharatiya Janata Party (BJP)-ruled MP.

In the same period (2019 to 2022), West Bengal (WB) reported 40,378 infant deaths, the second highest in the country, followed by Rajasthan with 29,199 deaths and Uttar Pradesh with 26,623 deaths, according to the Union ministry of health and family welfare in Parliament.

MP which has an estimated eight crore population, reported 38 deaths a day in the last three years, as per the data while WB recorded the second highest at 36 deaths, followed by Rajasthan at 26 deaths and the country’s highest populated state UP at 24 deaths. 

Replying to a question of P Sandosh Kumar, CPI’s Rajya Sabha member from Kerala, on July 19 bout the death of newborns in government hospitals with reasons for the high death rate, the ministry said that 3.01 lakh newborns died in the last three years. To be specific, 1.03 lakh infants died in 2019, 98,299 in 2020 and 99,737 in 2021.

Charting out the reasons of deaths, the ministry further said, as per the Cause of Death Statistics, 2015-17, report of the Registrar General India, the major causes of neonatal mortality are prematurity and low birth weight (46.1%), birth asphyxia and birth trauma (13.5%), neonatal pneumonia (11.3%), other noncommunicable diseases (8.4%), sepsis (5.7%), congenital anomalies (4.3%), diarrheal diseases (2.3%), fever of unknown origin (1.4%), injuries (1.2%), ill-defined or cause unknown (5.3%) and other causes (0.6%).

According to the state health department, MP has 54 operational SNCUs in 50 districts. Each high-priority district has an SNCU. In the districts of Bhopal, Jabalpur Gwalior and Rewa, more than one SNCU is functional. Agar district does not have a functional SNCU. Three SNCUs have a bed strength of less than 20 (Singrauli, Dewas and SNCU Elgin Hospital, Jabalpur) while 43 SNCUs have 20-30 beds and eight SNCUs are reported to have more than 30 beds. 

According to the May bulletin of the Sample Registration System, the infant mortality rate (IMR) in the state is on the decline. Since the inception of the National Health Mission (NHM) in 2005, MP has shown a significant decline in IMR from 76 in 2005 to 43 per 1,000 in 2020. Yet it is still more than the national average of 28.

State medical education minister Vishwas Sarang told Newsclick that mostly, critical infants who were admitted to SNUCs succumbed to illnesses”. “Nonetheless, the recent data show improvement in Madhya Pradesh’s IMR. Owing to our efforts, the mortality rate dropped to 38 in 2021 from 43 in 2020 in just one year,” he said adding that “we are constantly strengthening our infrastructure to improve our tally”. 

Despite repeated attempts, state NHM director Priyanka Das was not available for comment.   

Amulya Nidhi, state convener, Jan Swasth Abhiyan, pointed out that the state would have improved its tally if the 2019 plan drafted by NHM to stop infant death was implemented. “In 2019, when the Congress returned to power after 15 years, CM Kamal Nath had urged the NHM to prepare a plan to improve infant mortality. Subsequently, the NHM drafted a plan and it was put before the Cabinet. But it was put on hold with the return of the BJP government. The government should follow that plan.”

Back at the Shahdol district hospital, its neonatal care unit, which was started in 2013, has 20 beds in SNCU and 10 in its paediatric intensive care unit and one doctor named Sunil Hatgale—the vacancies for eight others haven’t been filled. When the lone doctor was on leave for months, three doctors from Shahdol medical college headed one shift each.

Vijay Mahobiya, who lost his two-month-old son Riyansh like Mala, alleged that no doctor visited the SNCU for eight hours after his son was admitted. “If a doctor had attended to my child in time, he would have been alive,” he told Newsclick.

Mala alleged that no doctor attended to her son at the hospital. “When I asked the nurses what had happened to my son, one nurse told me, ‘You can give birth, but can’t take care of your child. Who all should we attend to.’”

In September 2017, 36 infants died in the SNCU at the hospital. In January 2020, six tribal children died within 15 hours. The chief medical officer was shunted out only to be reinstated in March.

Data mining by Peeyush Sharma