Maternal mortality has been rising in Gujarat since 2014, according to a report tabled in the state assembly by the Comptroller Auditor General last week. The maternal mortality ratio, the report finds, has risen from 72 per 1,00,000 live births in 2013-’14 to 85 in 2015-’16. This report contradict the Gujarat government’s claims that its health indicators have been improving.
The CAG finds that, given this step back, it will be difficult for the state to achieve its target maternal mortality ratio of 67, which it was supposed to achieve by March 2017. Even the implementation of the Janani Shishu Suraksha Karyakram, a central government scheme, has not helped improve the maternal mortality, said the CAG.
Moreover, the report finds that 15,817 newborns died in Gujarat within the first week of birth due to lapses on the part of the health department in providing prescribed care and treatment. For instance, between the years 2013 and 2016, 56% of home deliveries were performed in the absence of skilled birth attendants. State health services have also not ensures a minimum stay of 48 hours after a normal delivery for the better care and treatment of a mother and child, the report said.
The report also finds that the state was supposed to operationalise 50% of its primary health centres as 24x7 centres by 2010 and yet, as of August 2016, only 24% PHCs functioned round the clock.
400 CRPF jawans at Kerala camp ill from food poisoning
An enquiry has been ordered into a case of suspected food poisoning at a Central Reserve Police Force force camp at Pallipuram in Kerala’s capital Thirvanathapuram on Sunday.
About 400 jawans complained of stomach pains, diarrhoea and vomiting after supposedly eating a fish curry served at the camp on Saturday evening. Of those that took ill, 109 are under observation at the Trivandrum Medical College hospital.
Newborn babies abandoned in Hyderabad
The body of a newborn male baby was found in a garbage dumping area near Hyderabad’s Gandhi Hospital last week, The News Minutereported. The baby was premature at seven months. The Hyderabad police are conducting an investigation to find out who the parents are and have registered a case of concealment of birth by secret disposal of dead body.
While the police say that this is the third complaint they have received in the last four months about a baby being dumped in the garbage, child rights activists say that there have been at least 17 cases in the last three months of newborns being abandoned. Of the 17 cases, one activist said, 14 were girl children. Activists also point out that many babies born with disabilities have been found abandoned.
Relying on the power of habits to solve India’s mammoth sanitation problem
Adopting three simple habits can help maximise the benefits of existing sanitation infrastructure.
India’s sanitation problem is well documented – the country was recently declared as having the highest number of people living without basic sanitation facilities. Sanitation encompasses all conditions relating to public health - especially sewage disposal and access to clean drinking water. Due to associated losses in productivity caused by sickness, increased healthcare costs and increased mortality, India recorded a loss of 5.2% of its GDP to poor sanitation in 2015. As tremendous as the economic losses are, the on-ground, human consequences of poor sanitation are grim - about one in 10 deaths, according to the World Bank.
Poor sanitation contributes to about 10% of the world’s disease burden and is linked to even those diseases that may not present any correlation at first. For example, while lack of nutrition is a direct cause of anaemia, poor sanitation can contribute to the problem by causing intestinal diseases which prevent people from absorbing nutrition from their food. In fact, a study found a correlation between improved sanitation and reduced prevalence of anaemia in 14 Indian states. Diarrhoeal diseases, the most well-known consequence of poor sanitation, are the third largest cause of child mortality in India. They are also linked to undernutrition and stunting in children - 38% of Indian children exhibit stunted growth. Improved sanitation can also help reduce prevalence of neglected tropical diseases (NTDs). Though not a cause of high mortality rate, NTDs impair physical and cognitive development, contribute to mother and child illness and death and affect overall productivity. NTDs caused by parasitic worms - such as hookworms, whipworms etc. - infect millions every year and spread through open defecation. Improving toilet access and access to clean drinking water can significantly boost disease control programmes for diarrhoea, NTDs and other correlated conditions.
Unfortunately, with about 732 million people who have no access to toilets, India currently accounts for more than half of the world population that defecates in the open. India also accounts for the largest rural population living without access to clean water. Only 16% of India’s rural population is currently served by piped water.
However, there is cause for optimism. In the three years of Swachh Bharat Abhiyan, the country’s sanitation coverage has risen from 39% to 65% and eight states and Union Territories have been declared open defecation free. But lasting change cannot be ensured by the proliferation of sanitation infrastructure alone. Ensuring the usage of toilets is as important as building them, more so due to the cultural preference for open defecation in rural India.
According to the World Bank, hygiene promotion is essential to realise the potential of infrastructure investments in sanitation. Behavioural intervention is most successful when it targets few behaviours with the most potential for impact. An area of public health where behavioural training has made an impact is WASH - water, sanitation and hygiene - a key issue of UN Sustainable Development Goal 6. Compliance to WASH practices has the potential to reduce illness and death, poverty and improve overall socio-economic development. The UN has even marked observance days for each - World Water Day for water (22 March), World Toilet Day for sanitation (19 November) and Global Handwashing Day for hygiene (15 October).
At its simplest, the benefits of WASH can be availed through three simple habits that safeguard against disease - washing hands before eating, drinking clean water and using a clean toilet. Handwashing and use of toilets are some of the most important behavioural interventions that keep diarrhoeal diseases from spreading, while clean drinking water is essential to prevent water-borne diseases and adverse health effects of toxic contaminants. In India, Hindustan Unilever Limited launched the Swachh Aadat Swachh Bharat initiative, a WASH behaviour change programme, to complement the Swachh Bharat Abhiyan. Through its on-ground behaviour change model, SASB seeks to promote the three basic WASH habits to create long-lasting personal hygiene compliance among the populations it serves.
This touching film made as a part of SASB’s awareness campaign shows how lack of knowledge of basic hygiene practices means children miss out on developmental milestones due to preventable diseases.
SASB created the Swachhata curriculum, a textbook to encourage adoption of personal hygiene among school going children. It makes use of conceptual learning to teach primary school students about cleanliness, germs and clean habits in an engaging manner. Swachh Basti is an extensive urban outreach programme for sensitising urban slum residents about WASH habits through demos, skits and etc. in partnership with key local stakeholders such as doctors, anganwadi workers and support groups. In Ghatkopar, Mumbai, HUL built the first-of-its-kind Suvidha Centre - an urban water, hygiene and sanitation community centre. It provides toilets, handwashing and shower facilities, safe drinking water and state-of-the-art laundry operations at an affordable cost to about 1,500 residents of the area.
HUL’s factory workers also act as Swachhata Doots, or messengers of change who teach the three habits of WASH in their own villages. This mobile-led rural behaviour change communication model also provides a volunteering opportunity to those who are busy but wish to make a difference. A toolkit especially designed for this purpose helps volunteers approach, explain and teach people in their immediate vicinity - their drivers, cooks, domestic helps etc. - about the three simple habits for better hygiene. This helps cast the net of awareness wider as regular interaction is conducive to habit formation. To learn more about their volunteering programme, click here. To learn more about the Swachh Aadat Swachh Bharat initiative, click here.
This article was produced by the Scroll marketing team on behalf of Hindustan Unilever and not by the Scroll editorial team.