‘Causes of high neonatal death rate preventable’
PESHAWAR: The Pakistan Paediatrics Association (PPA) has expressed concerns over the rising infant mortality of preventable causes and has called for deployment of lady health workers and training of birth attendants to tackle the problem at primary healthcare facilities.
“The health indicators of the country with regard to neonatal deaths are the worst in the region as 66 neonates die in the 1,000 live births compared to 38 in India and 31 in Bangladesh. All such deaths are preventable,” PPA central president Prof Rai Mohammad Asghar told a symposium on Sunday. He said that immunisation status was not good either as it varied from 40 to 60 per cent.
“We haven’t been able to eradicate poliomyelitis and epidemics of measles and other vaccine-preventable diseases due to lack of immunisation,” he said.
Prof Asghar said that PPA developed a uniform vaccination card, which would be launched very soon. He said that it would include same schedule for the 10 vaccine-preventable ailments and other vaccination.
He said that there was no authentic data about child health scenario in the country and all statistics were based on estimates. He said that efforts were afoot to establish a national pediatrics registry to pave way for collecting data on the basis of which policies could be framed.
Paediatricians say no authentic data about child health scenario available
The PPA chief said that neonates required proper evaluation with history of immunisation, nutritional status and complications. “We have to think about effective vaccination at the expanded programme on immunisation (EPI) centres.
Prof Meher Taj Roghani, the deputy speaker of provincial assembly, talked about the measures taken for mother and child health. “Women get Rs2,700 for six visits to hospital from pregnancy to post delivery period while Rs1,000 is given for transportation to the expected mothers,” she said.
Prof Roghani, a former head of child health department at Khyber Teaching Hospital, said that the province was awarded for 65 per cent immunisation coverage in mid-70s. She blamed influx of Afghans for the rapid deterioration of the infrastructure and overcrowded health facilities.
She said that powerful pharmaceutical industry sold formula milk, which cannot be a substitute for breastfeeding. Sixty per cent deliveries in the province were home-based, which caused complications, she added.
“The government has passed breasting feeding law and it is now up to paediatricians and doctors to work for its implementation. All the causes of neonate mortality were preventable. Sehat Insaf Card by government is benefiting mother and child at the health facilities,” said Prof Roghani.
Prof Ejaz A Khan of Shifa International spoke about the use of antibiotics and consequences for neonates. He said that knowledge about antibiotics and hand hygiene was important. He added that strict laws were needed to restrict sale of antibiotics in the country.
Prof Mohammad Suhail Salat of Aga Khan University Hospital Karachi said that mothers should know breastfeeding techniques to enable the neonates to suckle required quantity of milk continuously.
He said that wards should devise discharge plan for patients they admitted and recall patients for follow-ups.
Dr Kh. A Irfan Waheed of Children Hospital, Lahore talked about history of development of children care globally and nationally. He said that specialised hospitals were set up in Germany and France in 1802 and a 20-bed paediatric unit was established in Mao Hospital, Lahore in 1948.
Prof Amin Jan Gandapur, president Neonatology Group of PPA, Dr Khalil Ahmed, Dr Sikandar Hayat, Dr Rafia Gul, Dr Sadia Yasmeen, Dr Zeeshan Ahmed, Dr Shahid Mahmud, Dr Talal Waqar, Dr Ahmed Rana, Dr Mazhar Qadir, Dr Sulman Javaid, Dr Amirullah, Dr Noreen, Dr Aqeela, Dr Shireen Gul, Dr Rehan and Dr Shabina Arif facilitated workshops on ventilation and breathing for neonates.
Published in Dawn, May 1st, 2017