Report shifts blame for Palghar deaths from malnutrition

Barely a month after uproar over deaths due to malnutrition in Maharashtra’s Palghar district, the latest data compiled by the State’s women and child development department blames several other factors for the recent deaths as “primary” causes for the death rather than malnutrition. Going by the data, out of 315 cases of child deaths, not even one death has been attributed to just malnutrition.

As per the data,  315 children (between 0-6 years) have been reported dead till September 2016 this year, of these — 47 died from pneumonia, 45 due to birth asphyxia and a whopping 114 due to ‘other’ reasons.The report also cites prematurity as the cause of 31 deaths and attributes low-birth weight to 20 other deaths. 

However, a closer look at the data reveals another story.  “Malnutrition is never listed as the primary cause of death in a death certificate as most of the children die due to other infections,” says Dr Armida Fernandez, former dean of the civic-run Sion hospital, Mumbai and the founder trustee of NGO SNEHA that works with mothers and malnourished children in Mumbai’s Dharavi area.

“There is another column in the death certificate, though, that looks at the underlying cause of death where malnutrition could be mentioned,” she explains.

Experts say low birth weight of the infant and prematurity is linked to an under-nourished mother.

“One of the most common causes of prematurity and low birth weight among the children is a malnourished mother,” says Dr Rupal Dalal, medical director of the Foundation of Mother and Child Healthcare (FMCH). “These babies obviously have a compromised immune system so they are more likely to die of infections,” she adds. Pneumonia and diarrhoea tend to be the most common factors leading to death in babies.

Also, Palghar being a tribal area with a lot of deliveries conducted at home, there are times when families are unsure of the exact cause of death. “There is no post-mortem of the child so the cause of death is not evident. In such cases verbal autopsies, where the family members are asked questions about the health of the child, might help,” says Dr Fernandez.  

One glaring loophole in the system is that while the health department looks after the overall parameters, malnutrition is under the WCD department. With both of them passing the buck, no one takes responsibility of the 
malnourished child. However, after the recent wrath over the death the chief minister Devendra Fadnavis hurriedly restarted the Village Child Development Centre (VCDC) in all the 97,287 anganwadis in the state. At a VCDC, a malnourished child would be admitted for a month to get six nutritious meals each day. Department sources claim that centers have already been started in Palghar district.