III. Some Vital issues
With the exception of three cases who died in the hospital, rest of the deaths occurred at home This means that the parents have not sought medical attention during the last moments of the child’s life and the illness leading to their death. We believe that many of these deaths could have been prevented if the child was in the health care facility. Delay or denial of seeking medical attention is still an important contributory factor leading to morbidity and mortality in our country. This is a direct reflection of overall low literacy rate, ignorance, poverty and social problems.
Female Literacy is a vital contributory factor to the quality of child care and health seeking behavior of a family. To our current knowledge, there is no better tool than this. Unless female literacy improves to comfortable levels, it is difficult to expect a rapid decline in childhood mortality.
Decline in childhood mortality is parallel to socioeconomic development in the country. Presence of roads, transportation facilities and telephone coverage obviously facilitate better healthcare. A smoke filled home due to lack of electricity is a direct risk factor for a child’s health as it can contribute to Pneumonia and other respiratory illnesses.
Alcohol use is widely prevalent in our society including the female population. Alcohol directly contributes to poor maternal health, complications of pregnancy, low birth weight, child neglect, broken families and several social problems that have a direct impact of children’s health. Out of the 29 deaths stated above, at least 3 of them were associated with an alcoholic mother, who failed to bring the child for medical care!
Community Participation is indispensable in the success of any public interventions. This is surely discouraging seeing the large number of home deliveries, home deaths and failure to seek medical care. Every family is informed of the need to deliver in the health care setting or call a trained attendant and every one is informed of the presence of health facility in their locality, yet, many of our people do not come forward. Therefore, it is not appropriate to directly blame the health care delivery system alone, which in our opinion, is doing its best at the prevailing situation.
Family planning and limiting the number of children is the personnel choice of an individual couple. Such decisions are made by the clients after appropriate counseling and information from health workers. In other words, its purely informed choice. Opting for a permanent family planning method like vasectomy and tubectomy is again the choice of the family or the couple, knowing the availability of other temporary and alternative methods. No couple is forced to opt for any family planning methods by the health workers.
Declining births and declining deaths ( in older age group) is part of a demographic cycle that every nation passes through and it may best be regarded as a part of the nations over all socio-economic progress. Whether the current birth rate and the trend of decline is a concern for country’s future in terms of population size or not , is a debatable issue. We feel that that this should be left to experts in population studies to study the pattern of population growth over the last century and accordingly predict the pattern for the future.
