MP govt sets up special units to battle infant mortality

GUNA: Sharda Bai, 22, of Aaron prematurely delivered a baby girl on December 21 at Guna district hospital. The baby was born with neo-natal jaundice. On the same day, Anjum Bi gave birth to a male child in the same ward. This newborn showed symptoms of respiratory distress syndrome. Both newborns were immediately shifted to the Sick Newborn Care Unit (SNCU) adjoining the hospital's delivery ward and are undergoing treatment now.
A year ago, these newborns may not have survived.Now, state-of-the-art medical facilities are available at Guna district hospital. Four paediatricians, 12 nurses, two laboratory technicians and six ward boys man the Guna SNCU, saving the lives of an average 80 to 100 newborns every month.
The SNCU was set up on December 14, 2007 by the Shivraj Singh Chouhan government to combat infant mortality. Mad hya Pradesh has the country's highest infant mortality rate at 72 per 1000 live births. Two- thirds of these casualties occur in the neo-natal period the first 20 days of life.
Encouraged by the success at Guna, the state health department with technical sup port from UNICEF has set up a second SNCU in Shivpuri, which started functioning from July 2, 2008. Together, these two units have the capacity to save lives of 1,200 to 1,500 newborns annually.
"We have saved the lives of 1,565 newborns since the inception of this particular unit,'' said Dr Prakash Verma, paediatrician at the Guna SNCU. "Sick newborns come to us from the adjoining delivery ward here in the district hospital, delivery centres si tuated in the remote rural areas and even private nur sing homes.
"About 15% newborns re quire specialized care which cannot be provided in community health centres, including district hospitals and delivery institutions. The most com monailments are birth as phyxia, respiratory distress syndrome, pre-maturity, neo- natal septicemia and jaundice. Lack of specialized care results in infant mortality. Most neo-natal casualties occur in the first seven days after birth. Hospitals generally tell the parents that the baby was still-born. But we are saving them here,'' the doctor added.
According to the state government, while the number of institutional deliveries improved considerably under the state's Janani Suraksha Yojana, the absence of quality care at the delivery centres and hospitals failed to effectively reduce infant mortality. During a detailed medical analysis of infant and maternal mortality, the health department realised that establishing Sick Newborn Care Units could re duce infant mortality. UNICEF became the technical partner for planning, designing and monitoring these units. Costs for construction and equipment of each SNCU worth Rs 40 lakh was provided by UNI CEF while the government decided to pay running costs of Rs 30 lakh annually and an ad ditional Rs 15 lakh for medicines, salaries, consumables and day-to-day expenditure.
According to Guna hospital records, 1,820 newborns were admitted in its SNCU. While 255 babies could not be saved, the rest survived and went home.
Specialised equipment like pulse oxymeters, infusion pumps, radiant warmers, photo therapy machines which dissolve the neo-natal jaundice pigment and oxygen concentrators have been provided at the SNCUs. A centralized oxy gensystem complete with a 15 KV generator and photo therapy units are used to treat neo-natal jaundice.
"The medical equipment for each SNCU costs more than Rs 50 lakh. This kind of a medical facility was never available in these areas,'' Dr Verma said. "Infant mortality graph would come down if this kind of medical facility is available in every district.''
The state government has started construction work to set up 17 more SNCUs by the end of 2009. These units will be in the districts of Gwalior, Bhind, Datia, Jabalpur, Katni, Satna, Shahdol, Bhopal, Vidisha, Sehore, Ratlam, Mandsaur, Khargone, Ujjain, Chhattarpur, Mandla, Chhindwara.