India third lowest in pneumonia, diarrhoea intervention

In a damning indictment of its poor health services and coverage, India finds itself ranked the third lowest among 15 high-burden countries when it comes to coverage and implementing vital pneumonia and diarrhoea interventions, according to a report.

The 2014 Pneumonia and Diarrhoea Progress Report evaluates the progress of the 15 highest-burden countries -- India, Nigeria, Pakistan, the Democratic Republic of Congo, Ethiopia, Angola, China, Afghanistan, Indonesia, Kenya, Sudan, Bangladesh, Niger, Chad and Uganda.

The rankings were based on latest child mortality estimates in implementing high-impact interventions outlined in the Integrated Global Action Plan for Prevention and Control of Pneumonia and Diarrhoea (GAPPD) for which data was available.

The GAPPD is developed and issued by the World Health Organization (WHO) and the Unicef with the goal of ending preventable pneumonia and diarrhoea mortality in children by 2025.

The parameters include vaccination, exclusive breastfeeding, access to care, and use of antibiotics, oral rehydration solution (ORS), and zinc.

According to the report released Wednesday, India is third lowest while Chad is the worst performer in the GAPPD intervention scores. Nigeria ranks second lowest in the overall GAPPD score.

The findings were released by the International Vaccine Access Center (IVAC) at the Johns Hopkins Bloomberg School of Public Health.

It said that as in previous years, the burden of child pneumonia and diarrhoea mortality continues to be most heavily concentrated in just a few countries.

The 15 countries with the greatest number of under-five child deaths from pneumonia and diarrhoea in 2013 bore 71 percent of the global burden of child deaths from these two diseases in spite of accounting for only 56 percent of the world's under five-year-old population.

For the first time, the report also included a sub-national analysis for India. A total of 27 states in India for which data was available were ranked on the basis of their GAPPD score.

Goa performed the best and Meghalaya the worst. The analysis also revealed high levels of inequities in access to interventions between urban and rural regions within states.

Kate O'Brien, professor at Johns Hopkins and IVAC executive director, said: "This year's report takes a special look within two large and high-burden countries, India and Nigeria, to identify inequities in coverage levels that exist between states."

"This kind of sub-national analysis is important for identifying areas to focus efforts on accelerating coverage with all prevention and treatment tools," she said.

In September, the health and family welfare ministry, along with representatives from high pneumonia and diarrhoea burden states and districts, WHO, Unicef, and other stakeholders came together to propose and develop the Integrated Action Plan for Pneumonia and Diarrhoea (IAPPD).

This includes a framework for monitoring selected high-burden state- and district-level progress in achieving GAPPD targets via 'score cards' and ensuring accountability in the implementation of corrective actions following regular reviews of the score cards.