Investigation report on death of infants at Attappady

A UNICEF investigation report on the recent infant deaths at Attappady says that “anaemia in pregnant mothers and inadequate nutrition” are the main causes for the tragedy.

“Lack of medical facilities and trained medical personnel and inadequate transport facility also caused a large number of infant deaths in Attappady,” the report says.

There was lack of “standard protocols and MCH registers for antenatal care. All medical officers and staff nurses, including newly appointed obstetricians and paediatricians, (in the Government Tribal Specialty Hospital, Kottathara) have not been trained on standard Emergency and Essential Maternal Obstetric and Newborn Care (EMONC) skills with focus on newborn resuscitation skills, for the last two years.”

The report, by a United Nations Children’s Fund (UNICEF) team from Tamil Nadu, headed by health specialist Vandana P. Bhatia, says that most of the infants deaths were due to lack of health facilities and quality of antenatal services.

Causes of death

The report says, “The cause of deaths was recorded for 33 out of 39 cases as asphyxia, ARDS, aspiration and apnoea, preterm and low-birth weight, development growth delay and Intrauterine Growth Retardation (IUGR), congenital heart disease, pneumonia, and meningitis.”

All had reported preterm low-birth weight, ranged from 800 gm to 2,200 gm. The age of mothers ranged from 19 to 27 years and weight from 39 to 45 kg.

Age of death

Out of the 39 cases, the age of seven cases is within three days, another seven cases -- four to seven days, four cases -- eight to 14 days, three cases -- 15 to 30 days, eight deaths -- more than 30 days, and in 10 cases, the age was not recorded.

Among the eight young infants who died after 30 days, seven were more than 130 days old.

The report says that ‘‘39 deaths had been reported from April 2012 to May 2013. All deaths are equally distributed across the three public health centres of Sholayur, Pudur, and Agali.”

Lack of medicine

The report says the Government Tribal Specialty Hospital (GTSH) at Kottathara in Attappady has “no iron and folic acid supplied for the last two years. No protocol available for Injection Iron Sucrose IV to control and treat severe anaemia among pregnant mothers.”

It says that the “labour room and new born corners and SNCU are not connected to generator. No post-natal care protocol facility level or home based level.”

Recommendations

The UNICEF report recommends “standard for antenatal care in the Community Health Centre in Agali and the GTSH at Kottathara. Early registration of antenatal care for weight management of mothers to prevent low birth weight and Intrauterine Growth Retardation.”

There is need for “prenatal treatment of anaemia on pregnancy and community assessment and screening for anaemia and haemoglobinopathies.”

The UNICEF report calls upon authorities to “improve community outreach services to identify high-risk mothers for facility and referral.”

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