To be opened in 59 government hospitals
Intensive newborn care facilities for resuscitation and management of sick newborns will be opened at 59 select government hospitals.
A Centrally sponsored programme intended to bring down the infant mortality rate (IMR), Special Newborn Care Units (SNCUs) will be opened at three medical colleges and nine district hospitals, while Special Newborn Stabilisation Units (SNSUs) will be opened at 47 taluk hospitals.
Health Minister V.S. Sivakumar, who inaugurated the first SNCU at the Women and Children Hospital, Thycaud, here on Friday, said the new facilities were being introduced as part of the Health Department’s aim to bring down the IMR from 12 (12 per 1,000 live births ) to a single digit number — possibly nine — within three years. The State’s IMR has been more or less static for the past ten years and it has been pointed out often that any more reduction in the IMR will be possible only if more attention is given on bringing down the neonatal mortality (NMR) rate.
(The Health Department maintains that the IMR of the State, as per its field-level data, is only 8 and that it is a more accurate assessment than the IMR of 12 as per the Sample Resource Survey, which alone figures in official statistics)
About 42 per cent of the NMR in Kerala has been occurring within the first seven days of birth, especially within the first 24 hours.
The department’s analysis has shown that infant deaths are slightly higher in the rural areas and that in the urban areas.
“The survival of sick newborns depends on the level of care given to them in the first 24 hours. If these sick infants can be stabilised after birth and then transported to a higher centre, they have better chances of survival,” say a senior health official.
The NBSUs are being set up in taluk hospitals so that they can stabilise the sick newborns and maintain the condition before referring the babies to tertiary care centres. The SNCUs will be set up at the tertiary level, which will have all the facilities for neonatal intensive care except the ventilator. But then 98 per cent of the infants do not require ventilator support, it is pointed out.
As part of these initiatives, the Health Department has also been doing trial runs of a “baby wrapper”, which will help keep the sick babies warm and maintain the body temperature. The wrapper is expected to help the survival of newborns, especially in districts such as Idukki or Wayanad where referral hospitals are far away.
The NBSUs and SNCUs will be set up as per the Indian Public Health Standards and will feature radiant warmers, phototherapy unit, ambu bag, pulse oxymeter, oxygen concentrator and all facilities which can manage problems of babies with low birth weight, respiratory distress or infection.