Concerns over infant mortality as Covid hits immunisation drives

nNEW DELHI: The involvement of accredited social health activists (Asha) and anganwadi workers in Covid-19 related activities has triggered fears that infant mortality may be adversely affected as their basic work related to immunisation and meeting nutritional requirements for children in rural areas has taken a back seat.

The work of anganwadi workers includes the supply of nutritious food to children in villages while the promotion of universal immunisation is among the key responsibilities of an Asha.

“With the immunisation drive in India coming to a standstill, and as we are diverting our resources to Covid-related activities, the fear is that this might undo any good progress...,” said an official of Niti Aayog, which is involved in the Poshan Abhiyaan to check malnutrition.

According to the 2018 Sample Registration System Bulletin released on May 9, India’s infant mortality rate has declined from 33 deaths per 1,000 live births in 2017 to 32 in 2018. The rate rose in Madhya Pradesh, Uttar Pradesh, Chhattisgarh, and Jharkhand.

National Institute of Nutrition (Hyderabad) director R Hemalatha said these numbers mean that India is missing the targets for the Sustainable Development Goals 2030, or a to-do list for tackling conflict, hunger, land degradation, gender inequality, and climate crisis. “India will miss these targets for infant mortality rate, which require us to have 12 deaths per 1,000 live births by 2030. If the trends continue, we may be able to realise the under-5 mortality rate of 25 deaths per 1,000 live births,” said Hemlatha.

Anganwadi workers and helpers under the Integrated Child Development Services (ICDS) programme visit homes to teach women about the importance of nutrition, hygiene, pregnancy care and the immunisation among other things. They help supply supplementary nutrition and collect the data needed for the delivery of services.

India faces a shortage of health workers with a doctor-population ratio of 1:1,457 against a prescribed 1:1,000 and relies heavily on the anganwadi and Asha network for public health duties.

Asha and anganwadi workers have been engaged in contact tracing of Covid-19 patients.

Rakhi Dandona, a professor at the Public Health Foundation of India, said the effect of these activities will be seen in a few years. “We had made gains in maternal care, and are we going to lose some of it? We do not know yet. But we know home deliveries would have gone up, and antenatal care and the immunisation activities have gone down.