Scaling-up access to medical technologies can increase survival of premature babies in India
Date:21 November, 2016
Spokesperson: Dr. Kishore Kumar, chairman and neonatologist, Cloudnine Group of Hospitals
India has the highest number of preterm births and deaths due to premature births in the world. By improving access to NICUs equipped with the latest medical technologies, especially to those belonging in the lower socio-economic strata who are most vulnerable, survival of premature babies in India can improve significantly and Neonatal Mortality Rate due to preventable premature deaths can be brought down notes Dr. Kishore Kumar, Paediatrician and Chairman, Cloudnine Group of Hospitals
As per data from the World Health Organization, India has the highest number of preterm births and deaths due to premature births in the world. Every year, an estimated 3.5 million babies are born prematurely in India, of which approximately 3,00,000 do not survive. While the risk of deaths due to premature birth complications remains alarmingly high, at the same time the chances of survival of preemies have improved to a considerable extent. This can be partly attributed to an increase in Neonatal Intensive Care Units (NICUs) and advanced medical technologies in India’s hospitals, which have enabled healthcare providers to better manage complications related to premature births.
A 40-week pregnancy is full term and babies born before 37 weeks are considered premature. Preemies are fragile and at a high risk of infections because their organs are not fully developed at birth. They can suffer from difficulty in breathing, heart problems, low blood pressure, gastrointestinal problems, anaemia, infant jaundice, and experience extreme and rapid loss of body heat. Which is why premature babies require several interventions immediately after birth to survive. Their vital signs must be continuously monitored, they need to undergo screening tests, they require replenishing fluids, medications, some need to be placed in an incubator or require a blood transfusion, and in certain cases preemies need to undergo surgery. So they need to stay in the hospital till they are able to breathe on their own and start growing adequately.
Data from SRS indicates that only half of premature and low birth weight babies in India survive beyond 29 days (neo-natal mortality). Majority of the preventable premature deaths in India occur because of lack of timely access to medical support. Premature babies born to those belonging to the lower socio-economic strata are the most vulnerable because of lack of access to Neonatal Intensive Care Units (NICUs) and healthcare providers who are skilled at implementing interventions for the survival of preemies. To bring down the Neonatal Mortality Rate due to preventable premature deaths, we must scale-up access to medical support across all socio-economic strata and geographies.
Many of the danger signs of preterm complications can be foreseen and diagnosed during ante-natal care. So, adequate ante-natal care is also very essential in the continuum-of-care. Regular antenatal checkups and ultrasounds allow the doctor monitor the growth and development of the foetus and take preventive measures in case of any potential complications.
We continue to lose a lot of infants before 29 days and especially those foetuses that are born prematurely between 24 weeks and 28 weeks. These babies are currently not even counted, as our viability for statistical purposes is defined as 28 weeks and babies between 24 and 28 weeks in India are not even counted –in the birth or death statistics. Latest technologies and talent is available in NICUs to handle complicated cases of prematurity in the private sector. However, the public sector needs to strengthen its capacities in these areas to further reduce preventable neonatal deaths. Innovation has also led to the development of low-cost devices like affordable incubators, which are needed in low-resource settings. Now, we must focus our efforts on wide-spread implementation of the resources and technologies we have on hand to ensure survival of all premature newborns.