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Endeavour

Better Care for Neonates

Ershad Kamol

The government's target to achieve the Millennium Development Goal 4 (related to child health) in the health sector will never materialise unless the death rate of neonates is reduced. Considering the fact, the government has set a target to reduce the mortality of neonates in the country by 2015 and already has had significant achievement of reducing the neonatal mortality rate, which is 37 per thousand at present; however, the target is 21 per thousand live births. This substantial reduction will not be possible without giving extra effort. Moreover, intervention in the neonatal period has a profound effect on the early childhood development.

Of the total deaths of the children under five years of age, 38 percent is contributed by neonatal deaths, states a report titled “Saving newborn lives”. Physicians consider neonates as the babies aged below one month. According to the child specialists the major causes for the death of neonates are perinatal asphyxia, preterm low birth weight, neonatal infections including pneumonia and others. On the other hand, under-five children in the country face diseases such as malnutrition, pneumonia, diarrhea, infectious diseases and vitamin A deficiency.

In the government medical college hospitals, there is no specialised Department of Neonatology for care of the sick newborns. General pediatricians are providing neonatal services along with other Pediatrics patients with existing limited facilities. Considering the fact, the Ministry of Health and Family Welfare is planning to introduce the Department of Neonatology in the oldest eight medical colleges in the country.

The government's decision to introducing the department has been welcomed by the leading child specialists of the country. Over the years the child specialists of the country have been demanding such a department since the treatment is different and more complex than children aged over one-month.

The common problems diagnosed with the neonates in the country are low birth weight with complications, perinatal asphyxia, neonatal infection, neonatal jaundice, neonatal tetanus and congenital malformation. On the other hand children aged below 14 years in the country face diseases like malnutrition, pneumonia, diarrhoea, infectious diseases and Vitamin A deficiency and others.

Appreciating the government decision child specialist Professor M Abid Hossain Mollah says, “Some private hospitals provide routine neonatal check-ups by specialised doctors. The treatment cost of these hospitals is far beyond the capability of common people. On the other hand the public medical colleges cannot provide quality neonatal check-up due to the shortage of logistic support. It is assumed that the introduction of Neonatology Department in public medical colleges will bring the neonatal services in the door to the masses. I believe it is a very timely decision taken by the government.”

“Though there are many skilled neonatologists in the government sector, at present they are not being able to provide services in their specialised field and help to run the neonatal health programmes in the right track,” Professor Mollah continues, “Many of them are providing services in the private sectors those are creating opportunity for them.”

“After the establishment of a well-equipped and expert-rich Neonatology Department in the public medical colleges, tremendous opportunities will open up for the services of neonates of the most vulnerable groups in the society, skilled manpower development in the field of neonatology, training of the newly passed intern doctors who will provide the essential neonatal services in the grass-root level of the communities in the nearest future and more importantly in the field of research pertaining to our native country. In the long run, this will not only reduce the neonatal mortality to achieve the millennium development goals but also help in the build up of a nation with healthy newborns and healthy children,” he adds.

It is expected that the government introduce the Neonatology Department at the public medical colleges immediately having proper facilities and skilled manpower for the accurate treatment of the neonates. The department will create opportunity for the graduates to acquire practical knowledge on the neonatal treatment during their internship. And these medical graduates after their posting at Upazila Health Centres can serve the nation.

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