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Attaining the Millennium Development Goals. Interventions to reduce infant and maternal mortality. Prasanna Hota Secretary Department of Family Welfare. Goal 4: Infant and Child Mortality. 2/3 rd reduction in child mortality between 1990 and 2015.
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Attaining the Millennium Development Goals Interventions to reduce infant and maternal mortality Prasanna Hota Secretary Department of Family Welfare
Goal 4:Infant and Child Mortality 2/3rd reduction in child mortality between 1990 and 2015 In India this implies reducing IMR to 27 per 1000 live births and Under 5 mortality to 32 per 1000 live births by 2015.
Key Findings • Substantial declines in IMR • Inter- and intra- state variations in levels and in rates of change • Clustering of deaths in a few states • Gender disparity in infant mortality • Maternal education and female literacy • Strong inverse association with immunization coverage • Ante-, neo-, and post-natal care improvements will help reduce IMR • The MDGs CAN be attained with some commitment
The report… • successfully demonstrates and reconfirms what many of us working in this area have intuitively believed to be true; • needs a second volume, that focuses on a “product package” that will enable us to move from from what we know and have now cogently demonstrated to the desired outcomes.
What do we need? • A Navigation System that tells me how to get to my goals most effectively. We need a road map to tell us how we should get there.
What are the problems? • Basic housekeeping is lacking in this sector; • Efficiency – converting interventions to outcomes is poor; • Data systems are inadequate and needs to be strengthened in numerous dimensions – including coverage and quality; • Accountability needs to be incentivized;
How can this be done? • Improve social service delivery. This is difficult since: • (a) it is more difficult to standardize quality across services than products, as there is people to people interaction; • (b) Quality of service can be intangible; • (c) Intimate contact between service provider and service user. Some of these concerns could be addressed through technical solutions such as e-services and through improving monitoring and evaluation.
How can this be done? • Improve management capability in the medical and health services community • In finance management • Human resource management • Product and process flows
Way Forward Identify a target to focus on – say, IMR; Let us sit with our medical, public health, infrastructure, economic, planning specialists and public officials to develop a proposal to attack IMR in a specified high IMR area in India; We then sit with financial experts, chartered and cost accountants and fully cost this intervention; We set in place the necessary personnel, M&E, and other inputs prior to initiating the IMR intervention; Implement this intervention and study the results.