Child survival activities in Madhya Pradesh -- past, present and future strategies and planning.

A large number of children die before they are 1 year old and many more die before they are 5 years old. Madhya Pradesh India has higher infant and child mortality rates compared with the national rate. The infant mortality rate (IMR) was 122/1000 live births in 1985. The National Health Policy of 1983 provided specific indicators for the achievement of certain basic health and family welfare goals and made a commitment to provide primary health care to all by year 2000. The government of Madhya Pradesh started the child survival program in 1987 and also opened a separate ministry for the welfare of mothers and children. To achieve the target of IMR below 60/1000 live births and for minimizing morbidity and mortality among children the following recommendations should be observed: strengthening of available antenatal care; identification of high risk mothers and their special care; proper birth spacing; correction of maternal malnutrition; conducting 100% of deliveries by trained personnel or traditional birth attendants; special health care programs for child survival in slums tribal areas and remote rural areas; identification and special care for high risk babies; complete and optimum immunization; growth monitoring and home-based records; need-based training of workers suitable to the social system; equipment and technical expertise in the delivery of neonatal care or provision of equipped nursery; control of childhood diarrheas and optimum use of oral rehydration solution; research in the field of innovative and low cost techniques; development of managerial skills among the workers at different levels; ongoing research for the identification of other major diseases in childhood and their control; and development of a feedback system.