The state has been able to bring down the Infant Mortality Rate (IMR) by eight points from 34 to 26 in a single year which is highest among all states, Health Department officials said here. Total Fertility Rate (TFR) has also come down from 1.7 to 1.6 in 2016-17. Early Neonatal Mortality Rate has dipped from 22 in 2014 to 18 in 2015. Neonatal Mortality Rate has declined from 26 in 2014 to 20 in 2015. Under-five mortality rate reduced from 35 in 2014 to 28 in 2015,” they said, adding that the national average of TFR is 2.3.
The officials said the Crude Death Rate (CDR) as well as the IMR in the state was lower than the national average. “While the Crude Birth Rate (CBR) is 17.6, which is lower than the national average Birth Rate of 21.8, the Crude Death Rate of 5.4 is lower than the national average death rate of 7.1. Infant Mortality rate of 26/1000 lives births is also lower than the National Infant Mortality rate of 37/1000 live birth, the officials said.
Average population covered per health institution has decreased from 3,285 souls to 2,267 souls, while the decadal population growth rate of the state has declined from 29.43 per cent (1991-2001) to 23.71 per cent (2001-2011),” they added. The officials said as per the National Family Health Survey (NFHS), mother and child health indicators in the state have improved in 2016-17 and are relatively better than the national average.
They said improvement of health care facilities in far flung and inaccessible areas of the state has been achieved by providing additional manpower of doctors and paramedicals under the National Health Mission, financial incentives to the doctors serving in far-flung or difficult areas and deployment of high end Medical Mobile Units (MMU) to provide basic health care facilities to people residing in difficult areas.
At present there are 5,534 health institutions in the state (4,433 government and 1,101 private). The bed capacity at tertiary care hospitals has risen to 5,083 beds. At secondary level, the bed strength has risen to 9,339 by way of constructing new building infrastructure and additional accommodation over or adjacent to the existing infrastructure,” they said. The officials, however, said the patient load on the public health institutions has increased tremendously over the years.
“The doctor patient ratio in our state is 1:1658 as against the recommended norm of 1:1000 of World Health Organization (WHO). To address the shortage of manpower, additional manpower in health sector has been hired on contractual basis under the National Health Mission.
“Special New Born Care Units (SNCUs) have been set up in SKIMS Soura, 20 district hospitals and three community health centres (CHCs). New Born Stabilization Units (NBSUs) in 76 CHCs and New Born Care Corners (NBCCs) in 281 Delivery Points — all these have led to marked improvement in healthcare in the state,” the officials said. They said during the current financial year, the department has formulated a proposal for establishment of 87 new model health centres – one in each assembly constituency of the state – involving financial implication of Rs 544.98 crore.
Meanwhile, Director Health Services, Kashmir, Saleem-Ur-Rehman said several factors have contributed to the improvement in the healthcare in the state. He also said, “Over two years there has been a remarkable improvement in the infrastructure, equipments, operation theatres, blood banks, etc in the peripheral health setup. Specific interventions in the form of establishment of special newborn care units and their functionalisation along with establishment of newborn stabilisation units and newborn care corners have improved the intranatal and the major perinatal component of IMR.”
Rehman said there has been a progressive increase in the number of institutional deliveries particularly in the Kashmir division and it stands at around 95 per cent of all deliveries. In addition, better prenatal care delivery at the level of the institutions has contributed to this decline in IMR, he said. The director said, “Very important, but often unreported and unappreciated, reason for the outcomes is the improved administration which emphasises on continuous monitoring of activities at the level of the institutions”. “Also the better availability of tertiary care facilities and easier and prompt referrals have been the reason for this reduction in the IMR.
“Among other reasons which could have influenced this reduction in IMR are the social factors which have been operational in our state. There are lesser adolescent marriages, housing situation has improved, the per capita income has grown, there are lesser waterborne and other infectious disease outbreaks which contribute to the survivor of the infant during the first year,” he said.