A recent article in The Lancet on the prevalence of low-birth weight (LBW) examines datasets from 148 out of 195 UN member countries. India was among the nations that didn’t figure in the study that found that there were 20.5 million LBW instances amongst all the live-births in the 148 nations. The global nutrition targets set at the World Health Assembly in 2012 is of a 30% reduction of LBWs over 2012 to 2015. The estimated prevalence of LBW was 14.6% in 2015, down from 17.5% in 2000—an average annual reduction rate (AARR) of 1.23%. But, in order to meet the global nutrition target, the AARR should be at 2.74% between 2012 and 2025. The Lancet , in an editorial, states that the weight of a new born matters a lot because of its strong relation with neonatal health and survival, growth and non-communicable diseases in adulthood. And this affects the life-stage cycle for women, as those whose height and weight remain low when they become mothers, risk another low birth weight baby.
For India, where a raft of schemes on maternal and child healthcare exist, being part of the Lancet assessment should have been important. But, India’s non-inclusion is, sadly, linked to the non-availability of updated data-sets. This mars effective monitoring and assessment of the country’s various healthcare programmes. Experts believe a top reason for the non-availability/partial availability of birth-weight and similar data is the fact that over a fifth of the births in the country are non-institutional, i.e., they don’t occur at a healthcare facility, and instead mostly occur at home. Though India has bettered its record on institutional deliveries—79% in 2015-16, up from 38.7% in 2005-06—the gap is still significant. Tackling this will need a multi-pronged approach—higher costs as well as distance and lack of transportation are cited as top reasons for non-institutional deliveries. This means the cash incentive for institutional deliveries, under one of the maternal and neonatal health programmes, is clearly not enough and there are infrastructural hurdles as well. Also, education makes a material difference to the likelihood of institutional delivery. India is estimated to have a high prevalence of LBW. Fighting this has to begin with having the relevant data, and the hurdles to that are systemic.