Health Policy Issues and Health Programmes in ... - Amazon S3

IEC for Health Programmes in Uttaranchalmarried women have an unmet need for spacing and, similarly, 11% for limiting. The unmetneed for spacing is 44% among women aged 15–19, which declines with age. Also, the unmetneed for limiting increases with age and is 16% among women aged 30–34. The preference forsons is also an issue among women. For example, for women with two living children,contraceptive use is only 22% if both children are daughters, 41% if there is one daughter andone son, and 58% if both children are sons.While the infant mortality rate in Uttaranchal is 38, this indicator is worse for children frompoorer and less-educated families. However, the infant mortality rate (IMR) is over 60% greateramong children born to mothers age 20 or less as compared with mothers ages 20–29 (an IMR of69 versus 43). Also, infant mortality is more than four times greater among children born lessthan 24 months after a previous birth (110 compared with 23 for children born after a gap ofmore than 24 months).Use of health services during pregnancy, delivery, and after childbirth remains low. Only 21% ofdeliveries are at medical facilities. Antenatal care (ANC) indicators, such as iron and folic acid(IFA) consumption and tetanus toxoid (TT) immunization, are also low. However, what is mostworrisome is that 41% of currently married women report some type of reproductive healthproblems; but almost 70% of these women have not sought any advice. Only 12% have soughtadvice or treatment at government facilities.NutritionThe prevalence of anaemia is particularly high among children and women. More than threequartersof children under three years are anaemic. Children whose mothers are anaemic are inturn more likely to suffer from anaemia. Similarly, more than 40% of children under age 3 aremalnourished, while one-third of women have this problem. Malnutrition of children can partlybe attributed to the fact that only 13% of children aged 6–9 months receive the recommendedcombination of breast milk and solid foods, in spite of the fact that breastfeeding is nearlyuniversal in Uttaranchal. However, due to ignorance, colostrum is not given by almost threefourthsof the women, and the median duration of exclusive breastfeeding is only 2.6 months.Burden of DiseaseAlthough the prevalence of tuberculosis (TB) is low, almost two per cent of the population at anytime is suffering from asthma, two per cent from malaria, and about one per cent from jaundice.At any given time, one-quarter of all children suffer from fever, 17% from acute respiratoryinfection (ARI), and 18% from diarrhoea. The ability of people to understand and treat thesesymptoms is poor. For instance, almost 20% of mothers believe that during a bout of diarrhoea,the child’s fluid intake needs to be reduced.88Empowerment and Service DeliveryDomestic violence is widespread. More than 10% of women have experienced beatings, and, ofthose, one-third feel that their husbands are justified in wielding the stick. Only four per cent ofwomen receive home visits from health workers, and nearly two-thirds of women of Uttaranchalhave not even heard about HIV/AIDS. Among the women who have heard about HIV/AIDS, 37%