Neonatal Intensive Care Units (NICUs), which attend to premature or ill babies and Paediatric Intensive Care Units that attend to older children with serious ailments, across the state of Karnataka are underequipped. These units, especially in the peripheral regions, lack basic facilities and usually keep referring cases to the larger hospitals in the cities. This, in turn, makes it difficult for the public hospitals in the cities, which anyway are in bad shape and lack basic facilities to attend to infants.
According to a report in The New Indian Express, many infants are brought dead to the public hospitals in the cities even when these deaths could have been avoidable. The report said that these care units in the peripheral hospitals in the state need to be strengthened along with the public hospitals in general.
With the crisis in the public healthcare in India and a decline in the government expenditure on health, the roads for the privatisation of healthcare are getting opened. The case of NICUs, as discussed here, shows that the only way to deal with health is by focusing on the government hospitals, especially in the peripheral regions. As one passes by the All India Institute of Medical Sciences (AIIMS), New Delhi, the sight of people camping on the footpaths and in the hospital premises is very common. On speaking to them, one can find out that they are mostly from villages and towns around the national capital, from the neighbouring states of Haryana and Uttar Pradesh. Most of them are referred to AIIMS by the local doctors in those villages and towns due to the lack of facilities there. These people wait outside the hospital for days together to either get an appointment or until the discharge of a relative.
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Neonatal care is something that needs to be provided immediately after birth. However, across the country, there is a lack of infrastructure in neonatal healthcare. As Dr. Pratap Chandra writes in The Indian Express, premature birth is a global crisis. According to the WHO, in India, out of 27 million babies born every year (2010 data), 3.5 million babies born are premature. India has the highest number of first day deaths and stillbirths at 5,98,038 per year — a quarter of the 2.2 million lost lives. Most of these deaths are said to be avoidable by having functional and highly efficient NICUs in the hospitals.
Chandra explains, “It is important for the government healthcare sector to improve their NICU care with proper equipment and trained staff. The higher number of patients who visit these hospitals will benefit from the upgraded facilities. The networking of all the NICUs should form the basis of care delivered to these vulnerable babies in order to achieve a single digit neonatal mortality rate (NMR), which currently stands at 22 / 1000 live births (Karnataka- 2013).” According to reports from 2015, Karnataka has 36 special care newborn units (SNCUs) and only half of the deliveries happen in these hospitals.
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Chandra observes, “Unfortunately, prematurity, birth asphyxia and congenital malformations are more common in low socioeconomic strata. According to 2015 statistics, prematurity and birth-related complications like birth asphyxia contributed to two-thirds of all the neonatal mortality. There is good evidence that the majority of these deaths are preventable with the availability of well-established NICU set-ups.”
On the one hand, there is a lack of efficient NICUs across the hospitals and on the other hand, as the case of Karnataka shows, there exists a disparity between the infrastructure of the central hospitals and those situated along the periphery. Speaking to the The New Indian Express, a superintendent of the paediatric wing of Vani Vilas Hospital noted that these crucial hospital units in the state “are grossly inadequate to meet the basic needs.” This report explains this inadequacy based on the traffic in the NICUs and pediatric ICUs in Bangalore. Dr Naveen Benkappa, the in-charge of the NICU and medical superintendent of the Indira Gandhi Institute of Child Health, Bangalore observes in the report, “We receive cases from Andhra Pradesh, North Karnataka, Tumakuru, Balgalkot and many such places, the government needs to provide better access and facilities at those places.” The issue, according to the report, is not only rooted in lack of doctors, but also lack of space.
As a report in the Economic Times observes, the NICUs in India lack infrastructure. According to this report, in India, there are only about 18,000 NICU beds available. Additionally, overcrowding, lack of hygiene, poor resources, insufficient staff, restricted entry for the mothers are some of the other problems that add to the burden. This infrastructure issue can be solved by strengthening the district hospitals, thus making the neonatal care available to people living in the towns and villages in and around the district. However, the current state of the public healthcare system in the country and the continuation of its depletion shows the lack of will on the part of the governments to strengthen the government hospitals.
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