*State's health indicators on a downward trend *

 C. Maya

http://www.hindu.com/2007/02/12/stories/2007021209510400.htm

* Survey shows poor performance in immunisation and child nutrition Poor
show in immunisation and child nutrition *

 ------------------------------
* *
*Percentage of stunted, underweight children goes up; infant mortality in
urban areas on the rise *
*Anaemia during pregnancy up by over 10 per cent; obesity among women shoots
up *
------------------------------

 THIRUVANANTHAPURAM: It may not come as a rude surprise to many, but Kerala
no longer figures on top of the list of States which are making rapid
advancements on the health front.

If the preliminary findings in the latest National Family Health Survey
(NFHS 3) are anything to go by, all major health indicators for the State
are now sliding down, a clear indication that Kerala has been resting on the
glory of its past achievements for far too long.

The key findings for Kerala from NFHS 3 show poor performance by the State
as far as two key areas are concerned: immunisation and child nutrition.

The percentage of `totally vaccinated children' or children between 12-23
months who have received all recommended vaccines in the State is now just
75 per cent.

This is a slide by more than five per cent from the last NFHS (NFHS 2,
`98-99) figures, which was 80 per cent.

 Universal phenomenon

 However, the drop in immunisation cover seems to be a universal phenomenon,
with Tamil Nadu showing a drop from 89 per cent during NFHS 2 to 81 per cent
in NFHS 3; Maharashtra showing a drop from 78 per cent to 59 per cent and
Himachal Pradesh going from 83 per cent to 74 per cent.

As far as trends in children's nutritional status are concerned, most of the
other States seems to have made gains but in Kerala, the percentage of
children under three years of age who are too thin for their height has gone
up from 11 per cent to 16 per cent.

The percentage of children under three years who are underweight has also
gone up from 27 to 29 per cent.

Anaemia is another major problem that the State has totally failed to
tackle.

If the percentage of children in the 6-35 months age group who are anaemic
was 43.9 in the last NFHS, the figure currently stands at 55.7 per cent.

The percentage of women in the 15-49 age group who are anaemic is 32.3 per
cent as against 22.7 per cent in the last survey.

Anaemia during pregnancy can be a dangerous condition but the percentage of
pregnant women in the 15-49 age group who are anaemic in the State has also
gone up from 20.3 per cent during NFHS 2 to 33.1 per cent in NFHS 3.

NFHS 3 shows that infant mortality rate in Kerala is still the lowest in the
country at 15 (15 infant deaths per 1,000 live births). In NFHS 2, the
figure was 16.

However, infant mortality shows a slight upward trend from 16 to 18 per
1,000 live births in urban areas as per the latest survey, which should be
investigated thoroughly.

 Major implications

 Another key finding of NFHS 3, which could have major implications for the
State's morbidity pattern in future, is the rapid upward trend in the
percentage of obese or overweight men and women. Kerala now has the second
largest population of obese adults in the country, after Punjab.

The percentage of overweight or obese women in the 15-49 age group is a
whopping 34 per cent, while that of men is 24.3 per cent.

The last NFHS put the percentage of obese women in the State at 20.6 per
cent. This is the first time that base line data for men is being registered
in any NFHS.

 Shift in focus

 "The health indicators that we take so much pride in has been the result of
long years of consistent fieldwork by our health workers, who ensured
community participation in all health programmes. In the later years, the
focus on field programmes slackened and as the public health system failed
to raise itself to the expectations of people, the people's response to
public health initiatives also came down," said a public health activist.

The State still enjoys the lowest infant mortality rate (15 per 1,000 live
births), the total fertility rate is below two and institutional deliveries
are almost 100 per cent.

 No major gains

  However, what is significant from the NFHS 3 findings is that Kerala has
not made any gains on the health front in the past few years, while several
States like Andhra Pradesh, Tamil Nadu, Himachal Pradesh have been surging
ahead.

"Our health indicators have not improved but rural States like Himachal
Pradesh have gone ahead of us and now comes third if we were to rate the
health system," said a Health Department official.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
"Ours is a battle not for wealth or for power.
It is a battle for freedom. It is a battle for the reclamation of human
personality."
- Dr BR Ambedkar
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

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