Hospital deaths just the tip of the iceberg

HEALTHCARE IN UP The recent spotlight may have been on BRD Hospital but the picture in the rest of the state is far more disturbing

Child healthcare in Gorakhpur emerged in the spotlight after 70 children died in one of its biggest hospitals last week, but data suggests the eastern Uttar Pradesh district presents a better picture than the rest of the state, where facilities are among the worst in the country.

In UP, half of all children below five show signs of stunted growth, only 50% are properly immunised against diseases and nearly three-fourths of expecting mothers have not had adequate antenatal care. In comparison, the national average for incidence of stunted growth is 38.4%, child immunisations is 62%, and at least half of all expecting mothers had at least four antenatal care visits. The findings are part of the government’s National Family Health Survey-4 carried out in 2015-16 in 71 districts.

Balrampur has the lowest number of children who are immunised from serious diseases. Only 7% of children are fully immunised, which includes vaccination for measles and BCG, and three doses each of polio and DPT. Gorakhpur, by comparison, has better rates of immunisation than 62 other districts.

Poor nutrition, repeated infections and inadequate psychological stimulation is defined by WHO as factors that contribute to stunted growth in children. It is measured by calculating the percentage of children under the five who are shorter than expected for their ages. In Bahraich district, at the bottom of the rankings on this parameter, two of three children are stunted. In Gorakhpur, the figure improves to four in 10.

In 27 districts, more than 80% of mothers surveyed had less than four ANC visits. In Gorakhpur, only 35% had at least four visits, but in Bahraich, it was just 4.3%.

Anaemia in expecting mothers could indicate a threat to the health of both, the mother and the baby. Two in three women aged 15-49 in Chitrakoot —the worst in UP on this parameter — are anaemic. It is among the 43 UP districts that are worse than Gorakhpur. UP CM Adityanath attributed the deaths to dirty surroundings and open defecation. A third of the households in Gorakhpur use improved sanitation facilities. But in 31 districts, less than a quarter have improved facilities, which suggests open defecation is widespread. Shrawasti is the worst, where just one in 10 households have the facility.