The death of 16 infants in Ajmer’s JLN Hospital within 11 days is alarming but it may not sound scary considering that 193 kids die daily in Rajasthan where health infrastructure is in tatters.
Over 70,500 children died before attaining the age of one in 2015-16. Officials blame acute shortage of specialists as a prime reason for this high death toll. There is just one specialist doctor for every 556 newborns.
According to the health department, Rajasthan has around 9,000 doctors of which 30% are specialists, which turn out to be just 2,700. Around 2,000 posts of doctors are lying vacant in public health institutions in districts and below.
Health minister Rajendra Rathore says directions have been given to all government medical institutions to give top priority to the health of infants at newborn care units. “Instructions have been given to provide immediate treatment to newborns, and the serious cases referred to advanced health institutions. Inquiry will be done on each infant death to ascertain the causes and to ensure all necessary measures to prevent deaths.”
Jan Swasthya Abhiyan’s Rajasthan convener Dr Narendra Gupta said maximum deaths are reported in neonatal (1-28 days) and early neonatal (1-7 days) stages. “The government should give more emphasis on ante natal care. If pregnant women don’t get immunization and ante natal care, then neonatal deaths cannot be arrested.”
The line of treatment administered to newborns should be looked into, as there are chances of fatalities due to overtreatment and overmedication, he added.
A health department official said an agreement was signed in December between the health department and College of Physicians and Surgeons of Mumbai to run two-year diploma courses for in 13 disciplines. There are 266 seats, of which 133 seats are for the in-service doctors, while the remaining are for fresh MBBS students.
“These diploma-holding doctors will have to serve for two years in earmarked hospitals. After two years, they are free either to work with government hospitals or join private hospitals,” the official added.
Another health official said neonatal care is available at primary and community health centres and district hospitals. New Born Care Corner (NBCC) is available in 1,660 delivery points at hospitals associated with medical colleges, district hospitals, PHCs, CHCs and sub-district hospitals; New Born Stabilisation Unit (NBSU) at 303 CHCs and Sick Newborn Care Unit (SNCU) at 36 district hospitals.
The most complicated cases are referred to the Neonatal Intensive Care Unit or Paediatric Intensive Care Unit at the hospitals associated with medical colleges. At present there are 11 NICUs in six government medical colleges.
Rathore said free transportation is provided through 600 Janani Express vehicles along with 108-ambulance and, if required, vehicles under Janani Shishu Suraksha Yojana.
“There will be no dearth in treatment at tertiary care centres where newborns are referred in serious condition. If carelessness is found, action will be taken as per the rules,” he said.