As if being one of the biggest contributors to neo-natal and child mortality in the world was not damning enough, there is now added reason for Madhya Pradesh to hang its head in shame. While the revelation that in that state more than a lakh of children under five died between 2005 and 2009 is benumbing, what is more shocking is that crores of rupees under the Reproductive and Child Health programmes meant to reduce infant and maternal mortality rate and the total fertility rate were not used.
Undeniably, while the Madhya Pradesh government cannot be absolved, unfortunately the record of other state governments is no better. A relatively prosperous state like Punjab too recorded nearly 19,000 infant and 900 maternal mortality cases last year. Not only is India's infant mortality rate high, even safe motherhood remains a distant goal. According to a survey, no state in India will be able to achieve the UN Millennium Development Goals related to maternal mortality rate by 2010. The 13th Finance Commission's recommendation that a state's performance in reducing infant mortality rate be linked to grants from the Centre and the Union Government's acceptance of the "incentive grant" is in the right spirit. But how earnest are the state governments in using these funds is evident from Madhya Pradesh's example.
The state governments must realise their responsibilities and work sincerely to improve human development
indicators. Indeed, the reasons behind high IMR are many. Early marriage and early pregnancies too have a bearing on children's health. In Punjab with IMR of 41 per 1,000 live births the major cause is attributed to low birth weight. Yet reasons cannot be an excuse for the inaction of the state governments, especially in tackling malnourishment among small children of impoverished sections of society. The fact that the IMR in rural areas is higher than in urban areas once again points to the need to provide better care to the rural people. The NRHM's goal of reducing IMR to 30 per 1,000 live births by 2012 can only be achieved with the active cooperation of the states.
