Norway-India partnership to accelerate reduction of ''under-5 child mortality''

Mumbai: The governments of Norway and India today launched a multi-partner initiative aimed at accelerating progress towards ''millennium development goals'' under the National Rural Health Mission (NRHM).

The initiative will focus on the five states with the highest number of child deaths — Uttar Pradesh, Rajasthan, Madhya Pradesh, Bihar and Orissa — and involve multiple partners, including UNICEF and WHO. The partnership is the outcome of discussions on bilateral cooperation between Norway''s prime minister Jens Stoltenberg and Dr Manmohan Singh at New Delhi in December last year.

"Our belief is that this partnership will become the model to reduce infant mortality for countries across the globe," said Prassana Hota, secretary health and family welfare. "With the commitment of the two prime ministers and the support of international organisations such as UNICEF we have all the conditions to succeed," Hota added.

At the first stakeholders meeting held in Delhi today, the overview of the initiative was discussed, institutional arrangements formalised, and role of partner agencies including UNICEF and WHO were formalised. Representatives from the five target states as well as partner organisations responsible for coordination attended the meeting. Hota and Inge Tveite, councellor, Royal Norwegian Embassy chaired the meeting.

"Since the early ''90s the Government of Norway has been committed to a wide range of development issues giving almost 1 per cent of our gross national income as development assistance," Tveite said. He also said that according to the ''millennium development goals'' set out by the United Nations child mortality should be reduced by two-thirds by the year 2015. "We truly believe that if we work together we can achieve these goals thus saving millions of children, which in turn will ensure that that more countries have healthier and better educated people, healthier and stronger economies and that more countries will become safer with more equitable societies," he added.

As one of the partners responsible for implementation, UNICEF will be responsible for strengthening availability of vaccine logistics and cold chain systems, training and enabling accredited social health activists (ASHAs) for home-based newborn and child care and facilitating integrated management of neo natal and child illness (IMNCI) implementation at the district level. WHO will enhance overall programme support, strengthen surveillance and extend services on maternal health including training of birth attendants and development of accreditation systems for reproductive maternal health and newborn health facilities.

The initiative aims to achieve measurable outcomes in line with the fourth ''millennium development goals'' (MDG-4) including a sustained routine immunisation coverage rate at 80 per cent or more from 2007 onwards and saving an additional 0.5 million under-5 children each year from 2009.

Though child mortality rates have been declining over the last few decades, UNICEF''s State of the World''s Children Report 2006 projects India''s under-5 mortality rate (at the current rate of decline) at 55 per 1,000 live births, far below the MDG-4 target of 41. The five target states continue to witness the highest number of child deaths, contributing as much as 60 per cent to the total number of infant deaths reported in the country.

The Norway India Partnership Initiative will focus on four core areas in the five high-prevalence states

• Strengthening the National Rural Health Mission, by supporting an independently managed enabling network and facilitating delivery of MDG-4 related services.
• Testing and introduction of new ways of scaling up quality services by community health workers (ASHA''s) at the village level in the five states including their support needs and referral requirements.
• Involving the private sector in the delivery of MDG 4 related services at all levels
• Exploring and providing upfront catalytic financial and strategic support for new opportunities under the NRHM-MDG-4 related activities

A joint Norway-India steering committee will govern this partnership under the chairmanship of the secretary, health and family welfare. Other members of the committee would include the ambassador of Norway in India; the secretary, department of biotechnology; additional secretary and mission director, National Rural Health Mission; representatives of WHO, UNICEF.

The partnership will aim to operate at a national level with rigorous monitoring and evaluation along clearly defined milestones. The funds would be channelised through the programme partners (UNICEF and WHO)