PESHAWAR: The shortage of beds, staff and equipment at the nursery wards is hampering proper treatment of neonates in public sector hospitals of the province, pediatricians say.

They say that the 1200-bed Khyber Teaching Hospital (KTH) has capacity for only 35 babies whereas bed occupancy rate is 150. The ward has eight incubators, which are not enough to cater to the needs of patients. At least six more incubators are required to treat the patients. Similarly, it also needs the services of more trained staff nurses.

Lady Reading Hospital (LRH), the province’s biggest health facility, has 30 cots capacity but the number of hospitalised babies remains more than 55. The 1700-bed hospital has only three incubators. Recently, the government established three children units in the hospital but no attention was paid to expansion of the nursery ward to facilitate the newborns.

Likewise, the 700-bed Hayatabad Medical Complex (HMC) has only 20 cots at its nursery unit where one of the three incubators is also out of order. The number of baby patients at the hospital remains more than 30.

54 of every 1,000 neonates die annually of acute infection, low birth weight, birth asphyxia and premature birth in the province

The pediatricians say that neonates are the most vulnerable to diseases as 54 of them die annually per 1,000 in Khyber Pakhtunkhwa which is the highest mortality in Pakistan. The reasons are acute infections, low birth weight, birth asphyxia and premature birth, they add.

The experts say that most of these causes are preventable. According to them, one in three neonates dies of hypothermia and not due to lack of high technological equipment but they require availability of simple facilities at the right time. The lack of attention by the government is resulting in the deaths of neonates from preventable causes, they say.

In absence of the desired infrastructure at the government-run hospitals, the treatment given to neonates is not up to the mark, the pediatricians say.

There are only four neonatal units in the province that include three in Peshawar and one in Ayub Teaching Hospital with 20 cots which has six incubators. There is no proper unit for neonates at Saidu Group of Hospitals, Gomal Medical College Dera Ismail Khan, Kohat Institute of Medical Sciences and Bannu Medical College.

On contrary, there are more than 12,000 beds for adult patients in the hospitals of the province and more units to cater to the needs of adult patients are being built.

Not only extreme shortage of beds but the existing nursery units at the public sector hospitals are totally dependent on the children units from where health staff, including house officers, medical officers, trainee medical officer and consultant is assigned the task to cover patients there which adversely affects the patient care, the experts say.

There is only one sanctioned post of consultant at KTH while units in other hospitals don’t have permanent posts of consultants owing to which treatment of patients is affected. KTH has also a sanctioned post of registrar.

The existing nursery units don’t have ventilation facilities which force people to rush their ailing babies to Islamabad. The province has two nursery units but common people can’t afford their daily charges, which are about Rs5,000.

The current facilities receive more than triple number of patients of their capacity where they can’t get treatment according to the standard protocols, pediatricians lament.

They say that doctors have to accommodate two and three neonates on a single bed, which is medically harmful for their health. Several requests were made to the government to build nursery units at district headquarters hospitals in Khyber Pakhtunkhwa and agency headquarters hospitals in Federally Administered Tribal Areas to facilitate patients but all such requests hadn’t been heard, they say.

The pediatricians told Dawn that there was great need to establish one more nursery unit each at KTH, LRH and HMC in view of the workload to put brakes on avoidable deaths of newborns. To further ensure specialised treatment to the babies, the government should recruit consultants for those units, they said.

According to them, the government should appoint diploma-holders in child health by giving them special allowance. The staff working in those wards also needs to be given special allowances in view of the hard duty, they said.

The pediatricians say that UNICEF, Save the Children and other non-governmental organisations don’t provide funds for such interventions.

Published in Dawn, January 17th, 2015

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