PESHAWAR: The shortage of equipment and trained staff in major hospitals of the province has been causing neonatal deaths from preventable causes in the province, paediatricians say.

There are 20 cots and two incubators in nursery ward of Hayatabad Medical Complex; 35 cots and eight incubators in Khyber Teaching Hospital; 30 cots and 23 incubators in Lady Reading Hospital; and 20 cots and four incubators in nursery ward of Ayub Medical Complex Abbottabad. These are without ventilation.

About 50 infants were seen in OPDs of these hospitals. Thirty-five babies delivered in the labour rooms but the wards in Peshawar received infants from all over the province.

District headquarters hospitals in province lack nurseries

The doctors in Peshawar say that they admit 20 neonates per day and witness rise in hospitalisation owing to non-existence of nursery wards at district headquarters hospitals in the province.

The hospital in Malakand is the only one, which has a nursery unit. The nursery wards in Mardan Medical Complex, Dera Ismail Khan and Swat don’t have the required facilities and specialised services.

The hospitals in Bannu, Kohat, Swabi and Nowshera Medical College have no nursery unit.

The combined military hospitals and private healthcare outlets charge for such services and common people take their newborn children to public sector hospitals.

Maulvi Ameer Shah Memorial Hospital Peshawar, which was supposed to be women and children facility, doesn’t have a ward for newborns. There is no such ward in Naseerullah Babar Teaching Hospital. The Children Hospital in Haji camp admits only tetanus-affected babies.

“Neonatal period, the first 28 days of life of a live-born, is a delicate one, with many diseases presenting during this time,” said the doctors.

According to them, deaths of neonates account for 41 per cent worldwide under-five child mortality. The survival of newborns depended on the care they received but the situation in the province’s biggest hospitals was not up to a desired level, they added.

The doctors said that neonatology was a growing specialty of paediatrics but it was neglected by the government owing to which infant wards couldn’t be developed. They added that international donor agencies spent a lot of money on capacity building of the staff but they didn’t establish a newborn care unit.

In Pakistan, 54 neonates die in every 1000 live-births annually. Sixteen per cent neonates die due to infections and premature births.

“The existing facilities are understaffed, ill-equipped to cope with patients’ load and face shortage of medical officers, nurses, house officers. There are no laboratory services round the clock in these facilities,” said the doctors.

They said that shortage of basic equipment including incubators, cardiac monitors, phototherapy, resuscitator, apnea alarm, jaundice meter, infusion pumps, pulse oximeter and oxygen checking machine had adversely affected patients.

The Pakistan Paediatrics Association has been asking for the establishment of neonatal units in districts, human resources and allotting space for mothers at the nursery wards.

In 2015, KTH received 4,456 neonates of whom 693 died due to premature births, jaundice, infections and low birth weight. Most of the deaths occurred because the newborns were brought to the hospital in critical condition from other parts of the province.

The Special Care Baby Unit, established in 1976, provides tertiary care facilities to all sick babies. It has a capacity to accommodate 40 babies.

“Most of the diseases may not have serious consequences and need only minimal care, which can be provided by the mother if properly counseled by health workers,” said the doctors.

Published in Dawn, August 25th, 2016