Outlook English - Print Subscribers Copy Outlook English, 02 July 2018 | Page 26

COVER STORY
YASMIN ALI
HAQUE
W
OPINI ON
WHAT’S BEST
FOR THE KID?
Families need to know where to go for medical help and when
direct the sick to hospitals. They listened. Understanding
HEN we examined the Gorakhpur incident, where
people’s belief systems helps in addressing what motivates
scrub typhus is causing encephalitis and resulting in
them to make certain decisions.
death, we found a lot needed to be addressed at the
We see improvements in most indices in India and need
family and community level. Besides sanitation and
more services in decentralised facilities for a growing popu-
knowing when a child is really sick, families also
lation. What incentives do people have to serve in remote
need to be clear on where to go for medical help and
areas? The focus on aspirational districts is, in a way, trying
when. This year, the Dastak programme for prevention was
to challenge administrations to find answers. The crux is
launched in Uttar Pradesh before the encephalitis season. A
demand-­creation and recognition that even the poorest do
working group of the government, UNICEF and NGOs was
not make uninformed choices.
engaged to give communities clear knowledge of the danger
In Bangladesh, I once found parents most concerned about
signs of enc­ephalitis and what to do when they appear. A lot of
scabies in their household, while diarrhoea was a big killer and
encephalitis fatalities are preventable, but families and com-
family planning a policy priority. I asked one poor, illiterate
munities need to recognise things are under their control—a
woman what she would do if her child has diarrhoea: follow my
sense that comes if one ensures babies, male or female, are
advice and give her baby extra food and saline water, or listen
exc­lusively breastfed for six months, given complementary
to her mother-in-law who may want her to ‘starve’ the diar-
feeding and taken to the right healthcare provider without delay.
rhoea. She told me she would do what’s best for
The Sick Newborn Care Units (SNCUs) are
her child. That’s why families need information:
especially important. If help is at hand at the
Understanding
to make informed choices. In the early days of
primary facilities, there’s less burden on the
immunisation, parents of fully immunised
secondary ones and fatalities can be prevented.
people’s belief
children were our biggest advocates, who moti-
The surveillance system is expected to ring the
systems helps
vated other parents.
alert if cases go up. Cases need proper care at the
address what
Nuances of what drives communities need to
primary level in early stages. This programme
motivates their
be picked up too. India has progressed with
needs to run through the encephalitis season.
the under-five mortality, but its main chal-
Without these, we cannot reduce deaths due to
choices, also in
lenge is neonatal deaths. Eighty per cent births
Japanese Encephalitis or typhus.
healthcare.
happen in a facility that can pick up neonatal
Today, data can show which populations are
problems, but 20 per cent of UP’s 225 million
most vulnerable. For example, SNCUs have
children is still a very big number. So our focus is on how to
reduced child mortality rates, but not enough girls come to
reach this 20 per cent and examine why they don’t come. Was
them. How can we link this programme with the ‘Beti Bachao,
the woman ever mistreated in a labour room? Was it clean?
Beti Padhao’ or other programmes that promote equal value
Did it have privacy? UNICEF’s Every Child Lives programme
of boys and girls? India’s challenge is its massive numbers: to
works in these areas to drive further reductions.
decrease any metric by one percentage point, a quarter of a
Similarly, 60 per cent are fully immunised in India, but we
million children must be reached!
know that the DPT vaccine, which has a side effect, is among
The preference for private healthcare is a measure of public
the biggest reason for a break in immunisation for the rest.
confidence and aspiration, but it’s not peculiar to India. How
This has to be managed adequately. Parents have to know it
blurred the line between public and private providers is also
happens and wh