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Amidst chequered response and reactions in tackling the global spread of COVID-19 pandemic, the state of Nagaland, particularly the Health and Family Welfare Department, could have breathe a sigh of relief with the news of the state doing well another crucial area of the health sector.
The state recently recorded the lowest Infant Mortality Rate (IMR) in India as per the Sample Registration System (SRS) bulletin, based on data collected for 2018. IMR is the number of children deaths (per per thousand live births) below one year, during a given time period.
The data released by the Office of the Registrar General & Census Commissioner, India indicated that the state has been consistently and hugely successful in bringing down the ratio over the years – from being the highest to the lowest in recent years.
Ironically, the laudable ‘achievement’ seems to have evaded the radar of the concerned authorities, who usually have acute proclivity to vaunt such feat.
Perhaps most officials, one can only conjecture, are immersed in battling the pandemic that no one bothered to share the gladdening news with the general public.
Conversely, however, it also illustrates how matters of public health concerns are normally prioritised in the state.
Besides, the improvement in the rate of IMR might simply be a reflection of the overall progress of the health status of the people, with or without government’s intervention.
As is the case, the last National Family Health Survey (NFHS) – 4, among others, has highlighted that while Nagaland had poor maternal and child healthcare status and was above national average in most variables contributing to infant mortality; its IMR was much lower.
As a result, apart from immediate health related factors, other socio-economic impact cannot be ruled out, particularly, the inherent social capital in the state. The state has been ‘successfully’ harnessing such capital in public service deliveries like education and healthcare, though monitoring and accountability factors have been concerns in terms of its functionality. As such, the authorities have a significant role to play in streamlining these measures for better health of the health system.
Accordingly, as advocated last week, the state building on the ‘opportunity’ given the COVID-19 crisis, need to revamp how it prioritises public healthcare and infrastructure, and enter into a new social contract to improve the moribund healthcare system.
In doing so, the first step is to ensure that the community health centres (CHC), the first referral units for any healthcare related emergencies for large cohorts of citizens are properly endowed with required workforce and infrastructure as per the laid down protocol. Revamping the SCs and PHCs must follow suit.
The CHCs are crucial point for most cases after rudimentary care at sub-centres (SCs) and primary health centres (PHCs). Many fatalities or deterioration of health could be prevented or reversed if those CHCs are equipped to deal with emergency situation.
Devoid of such measures, the fate of many patients, either hang in the balance or haplessly decided prematurely, particularly in the rural areas.
The Gauhati High Court (GHC), Kohima Bench direction to the Nagaland State Government to pay a sum of Rs 25 lakh as “exemplary compensation” for a health related ‘violation’ on November 15, 2019 was a wake-up call. The ongoing COVID-19 crisis is a timely admonition. The state government should take this exercise to look into the factors affecting the functionalities of the ailing health system and accordingly adopts curative actions.
