Karnataka fares well in women's reproductive health; sex ratio improves

Karnataka has improved on almost all parameters in women's reproductive health and child health, shows the National Family Health Survey-5 (2019-20) released on Saturday by the Government of India.

The sex ratio has improved from 979 females per 1,000 males (in 2015-16) to 1,034. The neonatal mortality rate has also improved from 18.5% to 15.8%.

However, the burden of family planning is still on women. While female sterilisation went up from 48.6% to 57.4%, male sterilisation came to a grinding halt, and is zero. It was a dismal 0.1% in 2015-16 too.

Some worrying numbers have also emerged that is of concern to gynaecologists, obstetricians and public health professionals alike. The number of women who consumed iron and folic acid for 180 days or more when they were pregnant has come down. From 32.6% five years ago, it is 26.7% now.

This is especially important because pregnant women in the age group of 15-49 years who are anaemic (decrease in haemoglobin in blood that is improved with iron, folic acid supplements) is 45.7%.

Young women in the age group of 15-19 years who are anaemic is 49.4%. The government and the the United Nations Children's Fund (UNICEF) has a goal of 'Anaemia-Mukt Bharat'.

Dr Hema Divakar, former president, Federation of Obstetrics and Gynaecological Societies of India (FOGSI), said, "It is worrying that half the adolescent girls are anaemic. It can be tackled through proper nutrition and by giving deworming tablets once in six months and iron supplements once every week."

In private hospitals, which cater to 60% of the population, pharma companies dump iron and folic acid supplements, which are in turn given to patients. "Even in public hospitals, if not anything else, these are given free of cost," she said.

According to the WHO, folic acid should be taken all through pregnancy if the diet doesn't provide it. "Oral iron should be taken after the first trimester and during pre-pregnancy. Even during lactation, women are advised to take it as they lose blood in the delivery," Divakar said.

Epidemiologist Dr Giridhar Babu from the Pubic Health Foundation of India told DH, "I am concerned that breastfeeding practices are not improving and have dropped in initiation within one hour of birth."

Also, obesity levels are increasing in men and women, which is a dangerous sign of the shape of things to come in terms of a glaring non-communicable diseases (NCD) crisis. Besides, poor screening for cancer and a high burden of hyperglycaemia and hypertension show that NCD screening and management need to be strengthened, he said.

Children under the age of three who were breastfed within one hour of birth fell from 56.3% to 49.1%. "Breastfeeding helps in decreasing pregnancy obesity and prevents women from getting type-2 diabetes. Women who are overweight or obese has increased from 23% to 30% as per NFHS-5. There is also a far-reaching association between women who don't breastfeed and breast cancer," Dr Hema Divakar said.