Deepak Sawant has announced a slew of measures—ranging from creating an antibiotic protocol, increasing special newborn care unit(SNCU) beds to giving steroids to pregnant women— after a review of the 55 infant deathsin Nashik Civil Hospital pointed towards significant lacunae in the existing facilities. The Directorate of Health Services (DHS), in a first such initiative, has also decided to start neonatal ICUs (NICU) in districts and two super-specialty hospitals.
In a meeting convened by Sawant with neonatologists, paediatricians, gynaecologists and experts from the private sector on Tuesday, the admission and death figures of the Nashik hospital were discussed. The minister said, "Our analysis showed that of the 55 babies who died in August, 18 weighed below 1kg, while 12 of them weighed in the range of 1-1.5kg." He added that only five babies weighed over 2.5kg. "Despite these odds, the death rate in the Nashik Hospital for 2017-18 is around 12 percent, which is better than most Mumbai hospitals," he said.
Sawant added that SNCUs, which are a level below a NICU that comes equipped with ventilatory support and trained manpower, are often flooded with critical babies who need the care of highest level. "According to the government of India guidelines, NICUs can only be in tertiary care hospitals like medical colleges. But now we will seek permission to start NICUs at super-specialty hospitals in Nashik, Amravati and a district hospital in Chandrapur. We will also add another 230 SNCU beds to the existing strength of 660 beds across the state," he said. The Nashik hospital, where the deaths were reported, will get 28 new SNCU beds and non-invasive ventilators.
After years of indifference over preterm births and the factors leading to it, the state has finally decided to give steroids to mothers, who are at risk of premature delivery, even in smaller centres. Former head of JJ Hospital Dr Rekha Daver said one of the suggestions in the meeting was to give two doses of steroids between the 31st and 34th week. "It increases the lung maturity in babies, which is crucial given that respiratory distress syndrome is one of the biggest killers in preterm babies." She added that the state has to invest in pregnant mothers to decrease perinatal mortality.
Paediatrician Dr Bhupendra Avasthi said a team of experts will design protocols on feeding, treatment of sepsis, use of antibiotics and resuscitating critical babies. Sawant added that the nurses would be trained by KEM Hospital doctors. "Doctors from the private sector will be roped in to make up for the manpower crunch," said Sawant, adding that they have already sought help of the Indian Academy of Paediatrics. – TOI