Sunday January 19, 2020

Dreary state of Maternal Health Care in Jharkhand

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By Prachi Salve

New Delhi: This week, as Prime Minister Narendra Modi announced – quoting the World Health Organisation (WHO) – that India was free of maternal and neo-natal tetanus, the state of maternal health in the eastern state of Jharkhand indicates the long road still ahead in the country’s dark spots.

Women_at_farmers_rally,_Bhopal,_India,_Nov_2005
Modi was speaking at the just-concluded 24-nation Call to Action Summit, which discussed how to end preventable maternal and infant deaths, particularly in high-risk areas globally, including Jharkhand.

Since its birth in March 2000, Jharkhand has seen its maternal mortality ratio (MMR), or maternal deaths per 100,000 live births, improve from 261 in 2007-09 to 219 in 2011-12 due to improved access to healthcare.

But this is 41 points higher than the national MMR average of 178 in 2011-12, worse than Myanmar and Nepal and about the same as Laos and Papua and New Guinea, according to WHO data.

Jharkhand is a part of a group of eight poor states, called the empowered action group (EAG), which includes Bihar, Chhattisgarh, Madhya Pradesh, Orissa, Rajasthan, Uttaranchal and Uttar Pradesh. The EAG was formed by the central government following the 2001 Census to contain the population explosion in these states.

The real maternal and infant-health problems in Jharkhand are revealed when we compare the state’s health indicators with other EAG states, such as Chhattisgarh and Bihar.

Jharkhand does not fare well on any of the nine key indicators including government schemes, such as the Janani Suraksha Yojana (Mothers’ Protection Programme).

The JSY is fully sponsored by the central government and provides cash incentives, including out-of-pocket expenditure incurred by pregnant women: Rs 1,400 for rural women and Rs 1,000 for urban women.

Jharkhand has the lowest ante-natal care coverage with only 60 percentof women receiving such facilities. Compare that to Bihar with 85.4 percent and Chhattisgarh with 91.8 percent.

Mothers who opted for institutional deliveries in Jharkhand were also low at 23.6 percent, compared to 39.5 percent and 29.2 percent in Bihar and Chhattisgarh, respectively. The women who do use state-run health institutions receive poor quality care.

Seen from the view of those who provide healthcare, they work at substandard facilities and there are too few of them.

The gulf between targets and reality in India’s dark areas

At the Call To Action Summit, Prime Minister Modi talked about how India had achieved 75 percent institutional deliveries nationwide, a significant factor in improving maternal and infant healthcare.

But as Video Volunteers’ ground reports reveal, absolute numbers are not enough: The quality of healthcare is an important draw for women in remote, rural areas. If infrastructure is crumbling, centres lack medical staff and patients must pay out of their pockets-apart from being treated badly-they are unlikely to use institutions.

The idea behind the JSY is to encourage women to deliver babies at health facilities by making these services free and available, especially in rural areas.

Of Jharkhand’s 24 districts, there is a significant urban bias among the bottom five districts, based on maternal-health indicators.

In general, mothers in urban areas received better maternal care in Jharkhand, including facilities under JSY, emphasising the point that poor facilities attract fewer women.

(IANS/IndiaSpend)

Next Story

Here’s How Fitbit Smartwatch May Help You Predict Flu in Real-Time

The authors identify several limitations in their study

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Fitbit
Resting heart rate tends to spike during infectious episodes and this is captured by wearable devices such as Fitbit smartwatches and fitness trackers that track heart rate. Pixabay

In a first-ever study on wearable devices to improve surveillance of infectious disease, researchers in the US have achieved real-time flu prediction in five states, using resting heart rate and sleep tracking data from Fitbit users.

Resting heart rate tends to spike during infectious episodes and this is captured by wearable devices such as smartwatches and fitness trackers that track heart rate.

Influenza results in 650,000 deaths worldwide annually. And approximately 7 per cent of working adults and 20 per cent of children aged under five years get flu each year.

“Responding more quickly to influenza outbreaks can prevent further spread and infection, and we were curious to see if sensor data could improve real-time surveillance at the state level,” said study author Dr Jennifer Radin from Scripps Research Translational Institute.

The researchers reviewed de-identified data from 200,000 users who wore a Fitbit wearable device that tracks users’ activity, heart rate and sleep for at least 60 days during the study time.

fitbit
In a first-ever study on wearable devices to improve surveillance of infectious disease, researchers in the US have achieved real-time flu prediction in five states, using resting heart rate and sleep tracking data from Fitbit users. Pixabay

From the 200,000, 47,248 users from California, Texas, New York, Illinois and Pennsylvania wore a Fitbit device consistently during the study period, resulting in a total of 13,342,651 daily measurements evaluated.

The average user was 43 years old and 60 per cent were female.

De-identified data from the users retrospectively identified weeks with elevated resting heart rate and changes to routine sleep, said the research published in The Lancet Digital Health journal.

“In the future as these devices improve, and with access to 24/7 real-time data, it may be possible to identify rates of influenza on a daily instead of weekly basis,” said Radin.

This data was compared to weekly estimates for influenza-like illness rates reported by the U.S. Centers for Disease Control (CDC).

This is the first time heart rate trackers and sleep data have been used to predict flu, or any infectious disease, in real-time.

With greater volumes of data it may be possible to apply the method to more geographically refined areas, such as county or city-level.

The authors identify several limitations in their study.

Weekly resting heart rate averages may include days when an individual is both sick and not sick, and this may result in underestimation of illness by lowering the weekly averages.

Fitbit
This is the first time heart rate trackers and sleep data have been used to predict flu, or any infectious disease, in real-time. Pixabay

Other factors may also increase resting heart rate, including stress or other infections.

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Lastly, the authors noted that previous studies of sleep measuring devices have been found to have low accuracy, though they said that accuracy will continue to improve as technology evolves. (IANS)