Opening of Nursing Schools rather than Medical Colleges essential, says Dr. Shubhashish Sircar

Eminent physician and pediatric specialist Dr. Shubhashish Sircar has stressed upon creation of more nursing schools than medical colleges to reduce neonatal deaths in India, so alarming and calling in the world scenario. His concern published in social media on April 2 deserves attention of our thinking and responsible visitors.

Here is his version:

Neonatal and Infant deaths in India top the list in the world. With exceptions like Kerala, most of Indian provinces witness alarming numbers of death of the new born within 24 hours of birth, as per ‘State of the World’s Mothers’ released on Tuesday, which shows, over three lakh newborns in India die within 24 hours of their birth every year.

In exact numerical terms, a total of 3,09,000 babies hardly survive a day.

India accounts for 29 per cent of all such deaths — ahead even of Nigeria, Pakistan and China, a study by Save the Children says.

According to the report, of the one million babies who die each year on the day they are born, almost 40 per cent are in India, Pakistan and Bangladesh. It is disturbing that 3,09,000 out of 4,20,000 babies across South Asia die on their first day in India.

Quoting Sample Registration Survey (SRS 2011) figures, the report says Madhya Pradesh has the highest burden of early newborn deaths (0-7 days) at 32, followed closely by Uttar Pradesh and Orissa (30). Other States with high burden of neonatal deaths are Rajasthan, Chhattisgarh, Bihar, Jharkhand and Jammu & Kashmir.

Bangladesh has reduced newborn mortality by 49 per cent since 1990. Our neighboring Nepal has also reduced this mortality by 47 per cent since 1990. Community health workers reaching mothers and babies at home, and training birth attendants and medical staff in resuscitation devices to help babies breathe are factors in this progress.

What do we need to do?

We need to strengthen this basket of services with opening of Nursing Schools rather than Medical colleges. We need trained health personnel, not doctors, to address this urgent issue along with political commitment.

The starkest marker of tribal deprivation is child mortality, with under-five mortality rates among rural tribal children remaining startlingly high, at about 100 deaths per 1,000 live births in 2005 compared with 82 among all children. Three World Bank-supported State Health Systems Projects – in Rajasthan, Karnataka, and Tamil Nadu adopted a number of innovative strategies to improve the health of tribal groups. This multi pronged strategy has not found a platform in Jharkhand. It needs to be adopted here.

Young tribal girls enter the reproductive age as victims of undernourishment and anemia,and face greater health risks as a result of early marriage, frequent pregnancies, unsafe deliveries,and sexually transmitted diseases. Women’s low social status makes them more likely to seek treatment only when the ailment is well advanced. Adolescent health, particularly tribal adolescent health needs prioritization. Without addressing adolescent health, we cannot address neonatal (NNMR) and infant mortality rates (IMR), not to talk of MMR.

There was no mention of immunization in the report. Though India boasts of the largest immunization program in the world, every year about 1.4 million children below the age of five die largely from vaccine preventable diseases like pneumonia, diarrhea, measles and newborn complications like sepsis.With over 27 million newborn targeted for immunization every year, the National full immunization coverage hovers around 61 per cent, implying that over nine million children are left out.

Immunization saves lives.

Period!