Infant Mortality Rate Mission

Infant Mortality Rate continues to be high in Orissa. It is recognized that about 60 % Infant deaths occur during neonatal period (first four weeks of life). Most of these deaths are due to pre-maturity, low birth weight, respiratory infections, diarrhea and malnutrition. It is also acknowledged that infant mortality is higher in lower socioeconomic groups residing in backward tribal districts of Orissa. Notwithstanding the fact that several strategic interventions are being implemented to reduce MMR and IMR, the decline has been marginal.

In the year 2001 when IMR was 97 per 1000 live births, the State Govt. decided to lunch IMR Mission to focus more on interventions addressing more proximal determinants of infant mortality. The strategy was.

• To strengthen the ongoing programmes to deliver desired output.
• New interventions to reduce neonatal deaths.

Referral Transport.

Home delivery by unskilled persons is a major cause of high infant mortality and morbility. To promote Institutional delivery cash assistance was provided to beneficiaries to reach the health facility for delivery.
After implementation of Janani Surakhya Yojana (JSY) in 2005 under NRHM which provided the same support, the cash assistance to transport of sick neonates and puerperal mothers with complications, for institutional care.This will compliment JSY and cover 3 most vital stages of maternal and neonatal care.  The outcome of the initiative can be seen after a couple of years of operation.

Chemoprophylaxis.

The upsurge of malaria in Orissa adversely influences pregnant mothers and infants “Apart from maternal and infant deaths, malaria during pregnancy also results in the birth of under-weight babies who may be disadvantages for the rest of their lives”. (WHO 2000)

Under the mission prophylactic chloroquin tablets are given to pregnant mothers after 12 weeks of pregnancy and this is continued up to 4 weeks after delivery in recommended weekly doses. UNICEF was supporting this activity so far by providing the required number of chloroquin tablets. But indications are that the support may not be available from the coming year onwards. The cost proposed for this activity can be revised if Govt. of India supplies are available.

I E C.

Lack of  awareness and traditional beliefs remain as hindrances to the access of available service. Ongoing community awareness programmes under various schemes are not enough to reach the people in far flung areas. It is proposed to use a variety of communication tools during the coming years including display boards, hoardings, telefilms, traditional media and focus group discussions. It is necessary to maintain these activities, evaluate their impact from time to time and bring about required changes in strategy.

Supervision and Monitoring.

Close and consistent monitoring is essential to get the desired output. Sector level and block level monitoring and district level supervision is in place. It is proposed to provide more inputs for the mobility of field level supervisors.

Capacity building and Motivation.

• Training of doctors and frontline workers is an important of RCH-II with focus on maternal care.
• Frequent supervisory visits will enhance the confidence of field functionaries. Focus group discussions with PRI members, SHGs and other agencies at Panchayat level will provide harmonious work environment  for grass-root workers.
• Female Health Workers and Anganwadi workers constitute the main work force. The success of any health programme largely depends upon the motivation level of these workers. It is proposed to introduce a performance linked incentive system in which one ANM and one AWW will be rewarded every year from each block based on the overall performan