A fresh batch of nurses, who completed their training in neonatal care on Monday at the Institute of Child Health (ICH) in Egmore, will be posted in intensive and special neonatal care units across the State.

This is part of the State government's initiative to improve neonatal health and reduce the infant mortality rate (IMR).

“For three decades, no attention was paid to neonatal care. By setting up an emergency care unit for neonates, we have been able to provide much better care,” said S. Srinivasan, State nodal officer for the neonatal facility at the ICH, which has set up a neonatal emergency room, the first of its kind in the country.

The major causes for infant deaths are preterm birth, asphyxia, low birth weight and sepsis.

“We insist on transporting the sick baby in a special vehicle to avoid infection,” Dr. Srinivasan said. ICH receives at least 10 to 15 such babies every day. Specialised intensive neonatal care units in government hospitals in Madurai and Tiruchi also receive an equal number of such babies.

Since June 29, 2011, when the State government introduced its first neonatal ambulance, which is part of the Emergency Management and Research Institute (EMRI) 108 fleet, around 930 babies less than 28 days old, and weighing less than 2 kg, have been transported for emergency care to tertiary hospitals for treatment.

While ICH accounts for 671 cases, the Chengalpet Medical College Hospital's neonatal unit accounts for 259 babies.

“Ninety per cent of the babies we transported were critical and would not have survived if they did not have facilities like oxygen supply, warmers and a sterile atmosphere,” said Adeline Dhivya Israel, an emergency physician at the EMRI 108 control room.

With better awareness about the need for cleanliness, death or complications due to sepsis are on the decline. But birth asphyxia is a challenge, as it requires a team effort.

“The first 24 hours are crucial. We are losing low birth weight babies. If a baby does not cry at birth even though efforts are made to make it cry, then we generally ask that it be referred to a neonatal care unit for observation and assessment,” Dr. Srinivasan said.

However, the situation is not as bleak as it was some time ago. With every district headquarters and taluk hospital being equipped with a neonatal care unit, the IMR has fallen.

From 28 per 1,000 live births in 2010, it has reduced to 24/1,000.

According to Dr. Srinivasan, this is a significant improvement, considering that for four years the IMR had hit a plateau.

At present at the ICH, two doctors recruited by the EMRI are undergoing training in treating neonates. Three more doctors will soon join the team. When they are trained, they will be sent to various districts to assist paediatricians there.

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R. SujathaJune 28, 2012

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