Telangana Today recently published an in depth report on our maternal and newborn child work in Telangana, India. Read the original post here or the excerpt from the post below.
The population of Telangana State is roughly close to 3.5 crore or 35 million out of which at present the birth cohort for the newly formed State is nearly 6,50,000 births in a year.
At present, according to various statistics, the Telangana State loses nearly 15,000 infants in the first 28 days of their birth every year. The Neonatal Mortality Rate (NMR), which according to World Health Organisation (WHO) is the number of infants who die in first 28 days for 1,000 live births, is quite high in Telangana when compared to other South Indian States.
Overall, according to the Sample Registration System (SRS) survey of Registrar General of India, 6,85,000 neonatal deaths occur in India. Both the Telugu speaking States contribute to 5.5 per cent of neonatal deaths in India.
So what is the reason behind higher NMR in TS?
According to public health experts, while upgrading infrastructure does play an important role in reducing mortality, the more vital aspect is the quality of healthcare that is available at State-run birthing centres and the ability of the healthcare workers to provide safe delivery options for pregnant women.
It is the safe birthing practices and standard protocols that are followed while delivering a baby, which matter a lot in saving infants. Another vital aspect in saving neonates is identifying high risk pregnant women at the right time and guiding them to the right place.
On its part, health authorities here have realised the importance of concentrating on quality, in addition to upgrading and standardising infrastructure. In this direction, the delivery rooms in State-run hospitals at all the levels are being standardised and healthcare workers are undergoing training to follow best practices.
There has been a lot of efforts to work and change the behavioural aspects of healthcare workers, especially those posted in primary health centres (PHCs) and Area Hospitals.
Major steps towards changing and adopting the best practices that are followed worldwide in delivering infants in Telangana State has already been made. However, it will take a few more years for everybody to reap the results, when the neonatal and infant mortality rates match the world standards.
Telangana government taking measures for infant care
Hyderabad: One of the most promising measures that the State government has taken to save the lives of neonates in Telangana is to work closely with UNICEF and public health experts who specialise in infant care.
As part of this initiative, Arogyasri Trust and ACCESS Health International have launched ‘Safe Care, Saving Lives’ initiative, which is basically aimed at quality improvement of all the birthing centres in Telangana State.
The Safe Care, Saving Lives initiative is under implementation since bifurcation in almost all the Special Newborn Care Units (SNCU) in Telangana.
The aim is to reduce neonatal deaths by at least 15 per cent over a period of four years by just improving the quality of medical services. As part of this initiative, the ACCESS Health International has developed a quality improvement kit aimed at addressing three major reasons for the death of infants in State-run birthing centres-sepsis, birth asphyxia and complications due to premature birth.
The kit under implementation clearly specifies steps to be taken by healthcare providers to ensure quality while delivering and infants in State-run hospitals. The project provides in person and ongoing support to medical staff in Government hospitals, teaching them how to identify areas for improvement and then collect and analyse data to measure the results.
The government staff has been trained to develop simple systems and collect data and analyse them over short intervals to ensure that the actions are producing desired results. Such measures build a culture of improvement and increases and sense of ownership of the quality improvement process by the healthcare staff of the State-run health institute.
According to top officials from ACCESS International, in its first year of implementing Safe Care, Saving Lives, it has managed to help more than 45,000 babies in various newborn intensive care units in the State.
SNCUs to the rescue in Telangana to save newborns
Hyderabad: Developing hi-tech Special Care Newborn Care Units (SNCU) to take care of very sick infants has been a major initiative by the authorities in Telangana State to save the lives of neonates.
Anywhere between Rs 70 lakh and Rs 90 lakh was spent to develop each of the 21 SNCU units in the Telangana State under the funds made available by National Health Mission (NHM) and to some extent even State government.
Recently, recognising the important role that the SNCUs have played, the Ministry of Health and Family Welfare (MOHFW) had ranked Telangana State second in the country and Haryana on top in providing quality services to the newborn.
The top billing in the Special Care Newborn Units (SNCU) Quality of Care Index indicated that Telangana State has the best facilities at public health institutions to take care of infants and mothers.
In the last two years, the health authorities had set up 21 hi-tech SNCU units in the districts which were known for high infant mortality rate. Another 14 speciality SNCU units are being planned out of which seven SNCUs will be shortly inaugurated.
The development of SNCUs has played a big role in gradual reduction of Infant Mortality Rate (IMR) in Telangana State.
In the last one-year, 29,000 high-risk just borne infants were admitted to the 21 SNCU facilities in the State out of which over 75 per cent of the infants had survived. The birth cohort of TS is close to 6, 50, 000 of which estimates suggest that 1 lakh infants need to be treated in the SNCUs.
When a bell rang a life-saving alarm
Hyderabad: This is an instance where a bell came to the rescue of neonates that were born in the Special New Born Care Unit (SNCU) at Nalgonda, which was facing a rather strange problem.
Despite implementing quality improvement measures, there was no reduction in birth asphyxia, a medical condition in which infants die due to lack of oxygen.
The Quality Improvement Team of ACCESS International and local healthcare workers had initially assumed that lack of knowledge, compliance with proper protocols was the root cause for higher number of birth asphyxia cases in Nalgonda SNCU. The treatment protocols were tweaked and standardised but the results did not change.
Later, the Quality Improvement Team came across the issue and found out that there was a lack of communication between staff in the delivery room and those in the SNCU unit. The nurses in the special units were often unaware that a high risk newborn needs care and weren’t able to treat the child in time, thereby increasing the risk of asphyxia.
The reason for this was simple: The mobile phone network was not strong in the hospital building and without access to landlines, the delivery room was unable to contact the SNCU in times of need.
The hospital authorities then strung a bell between the delivery room and SNCU and whenever there was a risky delivery, the delivery room staff simply rang the bell and additional nurses from SNCU would rush in. Since the bell, there has been 25 per cent reduction in birth asphyxia cases in Nalgonda.