Will National Rural Health Mission (NRHM) achieve its target in respect of Infant Mortality Rate (IMR)?

One of the flag scheme of Government of India is National Rural Health Mission (NRHM).  One of the main objective of this scheme was to bring down the Infant Mortality Rate (IMR) to the level of 30 by the terminal year of the mission i.e. by 2012.  Looking at the Government of India official data on IMR for the years (2003 – 2010), one may predict, by assuming that whatever has been done or is being done continues this year as well, one can’t achieve the required target in case of All-India.  Rather it falls quite short at the level of 45 and the same is due to most of the major states of India.  Major hurdle states are eight EAG states and Andhra Pradesh, Assam, Gujarat, Haryana and to some extent Karnataka, Punjab and Himachal Pradesh states.  If this rate continues, the target for all-India may be achieved by the year 2020.  The state of Assam, Uttar Pradesh, Madhya Pradesh and Odisha would achieve much latter in the year 2027, 2025, 2023 and 2021 respectively.  Following table gives out some more details in which one may be interested in.

Sl.No.	States	IMR	IMR = 30
		Prediction for 2012	Prediction  Year
	ALL INDIA	45	2020
1	Andhra Pradesh	44	2019
2	Assam	58	2027
3	Bihar	47	2019
4	Chhattisgarh	47	2018
5	Gujarat	43	2019
6	Haryana	46	2020
7	Jharkhand	41	2019
8	Karnataka	36	2015
9	Kerala	13	@
10	Madhya Pradesh	58	2023
11	Maharashtra	26	@
12	Odisha	56	2021
13	Punjab	32	2013
14	Rajasthan	52	2020
15	Tamil Nadu	20	@
16	Uttar Pradesh	58	2025
17	W. Bengal	27	@
18	Arunachal Pradesh	31	@
19	Delhi	34	**
20	Goa	7	@
21	Himachal Pradesh	40	2016
22	J & K	46	**
23	Manipur	14	@
24	Meghalaya	58	**
25	Mizoram	45	@
26	Nagaland	29	@
27	Sikkim	32	@
28	Tripura	31	@
29	Uttarakhand	41	**
30	A&N Islands	33	@
31	Chandigarh	28	@
32	D&N Haveli	28	**
33	Daman & Diu	19	@
34	Lakshadweep	26	@
35	Puducherry	22	@
@ : Already Achieved
**:  Prediction not done due to Erratic trend

Front page headlines in a esteemed daily news paper of India : “No fertile men in 50 years as sperm counts slide?”

This has been reported by Times of India recently.  The main reasons cited are growing levels of stress, obesity or pollutants in the air.  And it further adds that the sperm counts of are falling and causing mega concern across the globe and one estimate holds that it has fallen by as much as 50% in the last 50 years.

It has quoted further that “Dr P M Bhargava, who worked out the Indian guidelines for assisted reproductive techniques (which are soon expected to become the law), said the trend of falling sperm counts was noticed in the mid-90s in the West. "Some doctors in India believe that sperm counts are falling locally too," he said, adding that the western studies show that counts have been falling by 2% every year. "At this rate, there would be no fertile men left in the next 40-50 years," added the Hyderabad-based Bhargava, who is counted among India's foremost scientists.”

But such adverse news may create alarms among many.  Are these well established?  Are the results arrived at are well tested statistically? 

        

It is also stated that “A couple of years back, a study from Scotland of 7,500 men who attended the Aberdeen Fertility Centre between 1989 and 2002 showed that average sperm concentrations fell by nearly 30%. Another study from Copenhagen found a newer reason apart from alcohol abuse, smoking and obesity for this decline -endocrine disrupters. "Many everyday substances such as plastic buckets (or milk bottles) emit chemicals that are similar to estrogen, the female hormone,'' said Bhargava. It is exposure to the female hormone-like chemicals that could be reducing the sperm count in men, believe a school of scientists. Commonly used pesticides such as DDT and dioxins have been named as culprits.

Many disagree. Infertility specialist Dr Aniruddha Malpani said endocrine disrupters are just one of the unproven theories floating around to explain falling sperm counts. "It is the most famous theory, but it hasn't been proven yet,'' he said. Rising infertility is a problem for both men and women due to late marriages and delayed child-bearing, he added.”

Answer to the above questions is simply “No”.  No well thought statistically sound sample study has ever been undertaken in India in order to arrive at the alarming conclusion mentioned in the headlines of the very important daily in India.

GT Karnal road saw fatal accidents rise 59% in 2011 from 2010. Does it mean that this road is bloodiest of all Delhi Roads?

This analysis has been presented by the Times of India, a prominent daily newapaper of India.

As per the data published by the Times of India on 5th January, 2012, the change reported for number of accidents for the Delhi roads is as below.  It has been highlighted that The GT Karnal road is bloodiest.  Probably, this has been reported because the percent change for this road had been highest from 2010 to 2011.  Following this data analysis, GT Road would have been the next bloodies road in Delhi as the percentage change is 22.9, whereas for others it is not even positive. 

Road	2010*	2011*	% Change
Ring Road	210	198	-5.7
Outer Ring Road	125	123	-1.6
GT Karnal Road (NH-1)	70	111	+58.6
Rohtak Road	90	74	-17.8
Mathura Road	68	48	-29.4
GT Road	35	43	+22.9
NH-8	45	37	-17.8
MB Road	42	32	-23.8
Najafgarh Road	42	27	-35.7
Wazirabad Road	33	26	-21.2

* Number of Fatal Accidents.

 As could be seen from the table above, that in 2011, it is the Ring Road which has reported to have  198 fatal accidents, whereas GT Karnal Road (NH-1) had 111 (much less) fatal accidents comparatively. How can the GT Karnal road be bloodiest?  It may be mentioned that as per the given data, the most accident prone roads in Delhi are Ring Road followed by Outer Ring Road.   It may be worth mentioning that the ratio of number of fatal accidents and the length of the road is important to consider for making such an comparative analysis. In the absence of these, one can not conclude the one which has been highlighted in the daily. Such presentations only create wrong impressions in the mind of users of the roads. The concern is definitely the percent change in the number of accidents for NH-1 and GT Road and the corrections needed should be noted and implemented by the road administrators.