The death of 52 infants over 30 days at Jamshedpur’s Mahatma Gandhi Memorial Medical College hospital in Jharkhand, reported on 27 August 2017 by the news agency ANI, calls to attention the health of women and extent of malnutrition in India’s 10th poorest state by per capita income.

The number of deaths is not extraordinary, B Bhushan, medical superintendent of the state-run Mahatma Gandhi Memorial Medical College hospital, told IndiaSpend. “More deaths were reported this month because more children were admitted,” he said, adding that patients from Bengal too come to the hospital.

Jamshedpur, a city of 1.3 million, is the largest city in Jharkhand by population, and one of India’s oldest industrial cities, but the state’s health indicators are among India’s worst, according to an IndiaSpend analysis of 2015-16 national health data, the latest available.

“The most common reason for low weight babies is malnutrition in mothers,” he explained, saying that many mothers who come to the hospital are tribals, and from the poorest strata of society.

Jamshedpur Better off than Jharkhand but With Poor Child-Health Indicators

Wasting is one of the indicators of malnutrition.

Purbi (eastern) Singhbhum is ranked among the 10 worst in India for the proportion of wasted children, with 40.6% of children under five wasted.

Child undernutrition can not only lead to child deaths, but malnourished children also have lower cognitive abilities and are less productive members of a country’s workforce.

Jharkhand has the 6th Worst Infant Mortality Rate in India

Jharkhand’s IMR is India’s sixth worst, worse than the African nation of Ethiopia (41).

Some of the state’s districts have India’s worst health indicators, according to 2015 National Family Health Survey (NFHS) data, analysed by the International Food Policy Research Institute in New Delhi.

Three of Jharkhand’s districts are among 10 Indian districts with the highest rates of wasting in children under the age of 5 years – Purbi Singhbhum (40.6%), Dumka (41.4%) and Khunti (43%). These districts are also among the worst off when it comes to severe wasting among children.

Jharkhand spent 1.14% of their state’s gross domestic product (GDP) on health in 2015-16, less than than the average of 1.35% of GDP spent by EAG states, according to the 2017 National Health Profile.

High Proportion of Tribal Population, low Maternal Health Outcomes

One explanation for these indicators is that 62.5 percent population of Purbi Singhbhum district is tribal. In general, tribals are among India’s most disadvantaged communities, and their children among the most malnourished.

Jamshedpur, named after Sir Jamshedji Tata, the founder of Tata Steel, was founded in 1919.

There is also a direct positive correlation between the mother’s health and her child’s health as IndiaSpend reported on 5 January 2016.

Over a quarter (28%) of rural women, 15-49 years, in Purbi Singhbum had a body mass index (BMI) lower than normal, one sign of undernutrition, according to 2015-16 data from NFHS.

In Jharkhand, 31.5% of all women had a lower than normal BMI.

Two Jharkhand districts – Simdega and Saraikela Kharsawan – are the 5th and 6th worst in the country, with 78.2% and 78.8% women of reproductive age anaemic in 2015-16. Further, 62.6% of pregnant women in Jharkhand were anaemic compared to 50.3% in India.

1.08 Million Child Deaths a Year in India, but Low Government Spending on Health

Jharkhand reflects the state of India’s children and its lack of health spending.

Nearly two children under the age of five died every minute in India in 2015, many due to preventable and treatable causes, IndiaSpend reported on 16 August 2017.

In 2015, India had the highest under-five mortality rate among BRICS (an acronym for Brazil, Russia, India, China and South Africa) at 43 deaths per 1,000 live births in 2015, followed by South Africa (41), Brazil (16), China (11) and Russia (10).

Despite poor health indicators, India had one of the lowest public spending on health in the world in 2015-16, spending 1.18% of GDP on health compared to the the global average of 5.99%.

The Indian government contributed 31.3% of total citizen health spending in 2014, 15.7 percentage points less than the median government share of 47% in BRICS countries, our analysis on May 8, 2017 showed.

(Salve is an analyst & Yadavar a principal correspondent with IndiaSpend. This article was first published on IndiaSpend.)

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