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Focus on child's first 1000 days to end malnutrition
Save the Children's report, 'State of the World's Mothers 2012' says India continues to under-perform on maternal and child health. Although figures are little better than the previous year but lot more needs to be done to address the issue of undernourishment.

SAVE THE Children’s global flagship report, State of the World’s Mothers, highlights that the best method for protecting pregnant mother and her baby from the vicious cycle of malnutrition is to focus on the child’s first 1000 days starting from pregnancy. The report reveals that in developing countries like India, breastfed infants are at least six times more likely to survive in the early months than non-breastfed children. Yet less than 40% receive the full benefits of exclusive breastfeeding.

The report has analysed the countries of the world in three categories – the least developed, the less developed and the developed. India ranks 76th among 80 “less developed countries” in the world.

The report also rates countries in their performance on maternal and child health and notes that even as some countries in Asia have made progress in the last one year in improving the conditions of their mothers, India’s mother’s index remained static. India was 76thout of 80 countries this year as against 75th in the “less developed countries” category in 2011. “Even though India has made efforts to improve maternal health by encouraging institutional deliveries and taking other measures, the benefits have not yet appeared to bring about a shift. This report shows that even now almost half of our births take place in the absence of skilled health personnel. This has a direct bearing on mothers’ health and, due to the strong dependence of children on mothers, also on children’s health,” said Thomas Chandy, Save the Children India CEO.

The Mother’ Index is based on a number of criteria such as lifetime risk of maternal death, percent of births attended by skilled health personnel, and other risk factors related to maternity.

Relative to most other Tier II countries, India underperforms (i.e. scores below average) on all indicators on the Mothers’Index apart from two – contraceptive prevalence (49%) and access to safe water (92%). On both, India scores slightly above average (which is 46% and 89%, respectively (3 percentage points above average on both measures).

However, India grossly underperforms on skilled birth attendance (which is 53%, relative to an average of 88%) and child malnutrition (underweight prevalence is 43%, relative to the 9% average). At 43% of under-five children underweight, India has the highest rate of child malnutrition (given by underweight) of all Tier II countries and the 2nd highest rate in the world (tied with Yemen), after Timor-Leste. Its rate of skilled birth attendance is the 5th lowest in all of Tier II countries.

India's poor performance on female education (girls can expect to receive 10 years of formal schooling) also places India among the bottom 10 in Tier II.In Asia, while Bangladesh and Nepal are rated in the report as ‘good’ for their practices on infant and toddler feeding, Afghanistan and India are rated as ‘fair’; Pakistan and Vietnam as ‘poor’.

Save the Children Director for Policy and Advocacy Shireen Vakil Miller said, “Exclusive breastfeeding is a critical and irreplaceable source of nutrition for a newborn. In India, only 46% percent of all newborns are exclusively breastfed till 6 months. Exclusively breastfed children are at least 6 times more likely to survive in the early months of life than non-breastfed children. Globally, exclusive breastfeeding can save one million lives in a year. We urge the government of India to take the findings into account and radically transform the health service delivery system as well as improve education and nutritional status of children in India.”

In South Asia, Sri Lanka remains exemplary with its excellent indicators on women’s and children’s health. Sri Lanka is at the 42nd rank this year among the less developed countries. Ms Miller said “India should also learn from the examples of countries like Sri Lanka that have invested so well in their public health system. China, India’s economic rival, is far ahead of India at rank 14, which is an improvement from its 18th rank last year.

This year ahead of a crucial G8 meeting, where food supply will be discussed, State of the World's Mothers focuses on nutrition as one of the key factors in determining mothers' and their children's well-being - malnutrition being the underlying cause of at least a fifth of maternal mortality and more than a third of child deaths.

West Bengal:

Save the Children’s State Programme Manager, Jatin Mondar said, “West Bengal is doing better as compared to the nation on many indicators of mother and child health, like institutional deliveries, infant mortality rate, under 5 mortality rate and vitamin A supplement etc. However, improving exclusive breastfeeding, which is at present (43.7) is lower than the national average (46.8), needs a greater focus. As the report suggests, if the state focuses on exclusive breastfeeding through 1000 days programme, it would have desired effect on child malnourishment in the state (49.6), which is again more than the national figures (48%).”

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