NEONATAL HEALTH
TN TAKES A GIANT LEAP IN OFFERING BETTER NEONATAL HEALTHCARE
More Babies Are Being Saved In TN Than Earlier Due To Institutional Interventions
Pushpa.Narayan@timesgroup.com
08.01.2020
Nano babies weighing less than half a kg and sumo babies weighing a little more than 5kg are not uncommon in neonatal units of Tamil Nadu. What is uncommon is how the state’s healthcare infrastructure is helping fragile newborns recover and get back home safe and sound.
While risks such as low birth weight, preterm births, high risk delivery and infections have risen due to a combination of factors including poor lifestyle, more babies born in the state are now able to survive, said several neonatologists.
The infant mortality rate – number of child deaths per 1,000 live births – in Tamil Nadu has been on a steady decline. Tamil Nadu recorded the second lowest IMR in the country in 2017 with 16 deaths per 1,000 live births. Kerala registered the lowest, 10. The number of underweight babies being brought in for intensive care in the state has gone up both in private and government tertiary care units.
“More babies are being saved in TN now than earlier,” said director of public health Dr K Kolandaswamy. But it wasn’t long before some districts in Tamil Nadu reported higher number of infant deaths owing to inadequate human resources and healthcare infrastructure. There weren’t enough doctors or trained nurses, transport facility for babies or adequate number of intensive care units, said Dr Kolandaswamy, who is also the registrar of births and deaths in the state.
While most private hospitals have managed to set up facilities with advanced equipment in bigger cities like Chennai and Coimbatore, the state administration has taken intensive care to the rural areas by establishing 73 neonatal care units. These units provide intensive care for newborns in medical colleges, district headquarters and subtaluk hospitals. Each of these intensive care units have at least four paediatricians. “Unlike many other states, 65% of deliveries in TN take place in government hospitals and almost 98% of deliveries are institutionalised. Enhancing care in government hospitals would mean keeping out-of-pocket expenditure low,” said K Senthil Raj, director of National Health Mission (Tamil Nadu).
In 2018, the state had 1.11 lakh admissions to its neonatal units, of which 6,000 infants had died, a 1% decline in deaths from what the state-run units saw in 2017, said Dr S Srinivasan, coordinator, State Nodal Centre-National Rural Health Mission. “This year, the mortality has dipped further,” he said.
To match what Kerala has achieved, the state has to push itself further to monitor every pregnancy, identify high risk groups and ensure early care. The state has taken some pro-active steps including protocols to tag high risk pregnant women. Every pregnant woman is registered with the state government. Those visiting government hospitals are categorised as red (high risk), yellow (moderate risk) and green (safe). Those in high risk category are advised to deliver only at a government-run tertiary care centre.
Apart from state-led institutional interventions, doctors said the health of the mother needs to be improved too in order to achieve low infant mortality levels. Increase in hyperte4nsion, gestational diabetes and anaemia among women are some of the leading factors for pre-term births and conditions such as birth asphyxia. As part of maternity benefits, women living below the poverty line are being given protein supplements, multi-vitamin syrups and dry fruits in two trimesters. These supplements help boost haemoglobin levels in the blood. Doctors said at least a quarter of pregnant women have anaemia, and an equal number of them have pregnancy-related diabetes.
“These can impact the health of a child. Earlier, we used to see the average underweight baby was around 2kg, now it’s between 900gm and 1,200gm,” said Dr Rahul Yadav, a neonatologist at Rainbow Childrens’ Hospital. It may not be easy to save them, but with resources that Tamil Nadu has built in neonatal childcare, saving them is no more a tall order.
Unlike many other states, 65% of deliveries in Tamil Nadu take place in government hospitals and almost 98% of deliveries are institutionalised
K Senthil Raj | DIRECTOR, NATIONAL HEALTH MISSION, TAMIL NADU
TN TAKES A GIANT LEAP IN OFFERING BETTER NEONATAL HEALTHCARE
More Babies Are Being Saved In TN Than Earlier Due To Institutional Interventions
Pushpa.Narayan@timesgroup.com
08.01.2020
Nano babies weighing less than half a kg and sumo babies weighing a little more than 5kg are not uncommon in neonatal units of Tamil Nadu. What is uncommon is how the state’s healthcare infrastructure is helping fragile newborns recover and get back home safe and sound.
While risks such as low birth weight, preterm births, high risk delivery and infections have risen due to a combination of factors including poor lifestyle, more babies born in the state are now able to survive, said several neonatologists.
The infant mortality rate – number of child deaths per 1,000 live births – in Tamil Nadu has been on a steady decline. Tamil Nadu recorded the second lowest IMR in the country in 2017 with 16 deaths per 1,000 live births. Kerala registered the lowest, 10. The number of underweight babies being brought in for intensive care in the state has gone up both in private and government tertiary care units.
“More babies are being saved in TN now than earlier,” said director of public health Dr K Kolandaswamy. But it wasn’t long before some districts in Tamil Nadu reported higher number of infant deaths owing to inadequate human resources and healthcare infrastructure. There weren’t enough doctors or trained nurses, transport facility for babies or adequate number of intensive care units, said Dr Kolandaswamy, who is also the registrar of births and deaths in the state.
While most private hospitals have managed to set up facilities with advanced equipment in bigger cities like Chennai and Coimbatore, the state administration has taken intensive care to the rural areas by establishing 73 neonatal care units. These units provide intensive care for newborns in medical colleges, district headquarters and subtaluk hospitals. Each of these intensive care units have at least four paediatricians. “Unlike many other states, 65% of deliveries in TN take place in government hospitals and almost 98% of deliveries are institutionalised. Enhancing care in government hospitals would mean keeping out-of-pocket expenditure low,” said K Senthil Raj, director of National Health Mission (Tamil Nadu).
In 2018, the state had 1.11 lakh admissions to its neonatal units, of which 6,000 infants had died, a 1% decline in deaths from what the state-run units saw in 2017, said Dr S Srinivasan, coordinator, State Nodal Centre-National Rural Health Mission. “This year, the mortality has dipped further,” he said.
To match what Kerala has achieved, the state has to push itself further to monitor every pregnancy, identify high risk groups and ensure early care. The state has taken some pro-active steps including protocols to tag high risk pregnant women. Every pregnant woman is registered with the state government. Those visiting government hospitals are categorised as red (high risk), yellow (moderate risk) and green (safe). Those in high risk category are advised to deliver only at a government-run tertiary care centre.
Apart from state-led institutional interventions, doctors said the health of the mother needs to be improved too in order to achieve low infant mortality levels. Increase in hyperte4nsion, gestational diabetes and anaemia among women are some of the leading factors for pre-term births and conditions such as birth asphyxia. As part of maternity benefits, women living below the poverty line are being given protein supplements, multi-vitamin syrups and dry fruits in two trimesters. These supplements help boost haemoglobin levels in the blood. Doctors said at least a quarter of pregnant women have anaemia, and an equal number of them have pregnancy-related diabetes.
“These can impact the health of a child. Earlier, we used to see the average underweight baby was around 2kg, now it’s between 900gm and 1,200gm,” said Dr Rahul Yadav, a neonatologist at Rainbow Childrens’ Hospital. It may not be easy to save them, but with resources that Tamil Nadu has built in neonatal childcare, saving them is no more a tall order.
Unlike many other states, 65% of deliveries in Tamil Nadu take place in government hospitals and almost 98% of deliveries are institutionalised
K Senthil Raj | DIRECTOR, NATIONAL HEALTH MISSION, TAMIL NADU
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