The government should implement measures immediately. While the high number of “852 child deaths due to malnutrition” is a matter of great worry, public health experts say that this might not actually be the case and the MLA should re-check his facts before making such sweeping statements.
“Let us assume that about 2 million children are born in Maharashtra each year. So, by the current mortality rate nearly 40,000 child deaths are expected. Hence, we’d expect about 2,000 to 2,500 deaths every month. Now, we need to understand that no baby dies from malnutrition alone. Malnutrition is always a contributing factor to a whole lot of other factors which ultimately lead to death. So if 30 per cent of children are malnourished, half of the children who die will be malnourished. And so, if every month about 2,000 to 3,000 children die in Maharashtra, then, at least half of those children would be malnourished which is about 1,500. And from that perspective, 852 deaths do not come as a surprise. It is expected, as per the current data published by the government. This is not justified of course, but at the same time, it is not alarming,” says Dr Abhay Bhang, a health activist and community health researcher working in the Gadchiroli district of Maharashtra.
With a population of 12 crores in Maharashtra, about 30,000 to 40,000 child deaths are expected to occur every year, as per the latest National Family Health Survey report. As per that report, the child mortality rate is 25 per 1000 children, that is of every 1000 children born, 20 to 25 die by the age of five years. So if about 2 million children are born each year, one would expect nearly 40,000 children to die annually in Maharashtra.
“Accordingly, one can expect that about 3000 child deaths occur in the state every month. Among these kids, in at least half of them, that is, in about 1500 of them malnutrition is a contributing factor. And so, the number quoted by MLA Patil is in fact lower than the expected figures,” adds Dr Bang.
In the year 2000, a collaboration of NGOs surveyed and studied the child mortality rate in 226 villages in Maharashtra. Based on that they published a report which shockingly said that close to 1,70,000 child deaths occur in Maharashtra each year. This report was then published by the Ministry of Health, GoI.
This number of deaths has now reduced drastically to 40,000, in the last twenty years and several programs and factors have contributed including female education.
Having said that, we need to differentiate between the terms ‘malnutrition’ and ‘child deaths’ because while child mortality has reduced, the problem of malnutrition remains the same and equally disturbing, just as it was decades back, say experts. Malnutrition, which is measured in terms of stunting, continues to decrease at a very slow rate, close to barely 1 percent a year.
So, what will it take to remedy the worrying situation of malnutrition in the state? “It actually begins with the height and weight of the mother, both of which are determined at the time of her (the mother’s) puberty. So, we now have a generation of women who were malnourished in their childhood. Hence, we have to carry this burden of feminine malnutrition into the next generation – it is going to take one generation to solve this problem.”
At present, as per data, about 30 per cent of children in India remain malnourished while only 3 per cent of children in India die. So the problem of malnutrition is about ten times bigger than that of child mortality.
Kamayani Mahabal, the health activist with the Jan Swasthya Abhiyaan in Maharashtra, states the Maharashtra state women and child development report presented in the legislative council this year, in which it is said that “as many as many as 9,459 children have died in tribal areas in 16 districts of the state between April 2022 and May 2023.”
“The report showed that despite spending crores of rupees on nutritious meals and other such schemes, 37,292 children died in the last four years in the 16 districts, including Nandurbar, Dule, Jalgaon, Nashik, Thane, Palghar, Chandrapur, Gadchiroli, Bhandara, Gondia, Nagpur, Amravati, Yavatmal, Raigad, Ahmednagar and Pune. The bigger question is, why has the health minister reduced the budget by 7% in 2023-24,” asks Mahabal.
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