PESHAWAR: Unnecessary referral of newborns from district hospitals coupled with shortage of equipment and trained staff in Peshawar-based teaching hospitals have been causing deaths of preventable ailments, according to sources.

Paediatricians say that 16 per cent of the neonates die at nursery ward of Khyber Teaching Hospital (KTH), 30 per cent at Lady Reading Hospital (LRH) and 25 per cent at Hayatabad Medical Complex (HMC) Peshawar mostly due to late referral by doctors from the district headquarters hospitals and shortage of facilities at the Peshawar’s hospitals to deal with load of patients.

“The factors accounted for deaths are 40 per cent infections, 29 per cent premature delivery, 22.5 per cent birth asphyxia and 15 to 20 per cent jaundice,” they say. Bed occupancy in these hospitals remains more than 200 per cent.

Experts say teaching hospitals short of space, equipment for neonates

Each of the three hospitals -- KTH, LRH and HMC -- admits more than triple patients of their capacities, which lead to infections. “KTH is extremely short of space and has to admit three infants on one cot due to which they get infections and don’t get care to a desired level,” say paediatricians.

According to them, the teaching hospitals have well-qualified doctors and health workers but they are unable to give proper attention to additional patients and it affects the healthcare services.

One year ago, the government of Turkey gave seven incubators to KTH and five of those went out of order owing to electricity fluctuation.

The situation in LRH and HMC is more or less the same as newborn babies are referred from all districts of the provinces, making it difficult for the staff to provide treatment to the patients to a desired level.

Recently, HMC got specialised nursery unit but mortality was still 25 per cent because of extreme load of patients, a senior pediatrician told Dawn.

According to him, the neonates can get quality treatment if the district hospitals stop referral of patients to Peshawar-based health facilities.

The government has been establishing medical colleges in district now and then but the attached hospitals are short of facilities for newborns.

The hospitals, which are required to keep at least five cots empty for critically-ill neonates to give them emergency treatment, can spare a single cot owing to which the people requiring prompt treatment cannot get it. These hospitals have brought the issues into the notice of the government but all such requests haven’t been responded and children up to 30 days of age continue to suffer.

The well-off people visit a few private maternity homes where facilities exists but majority don’t afford the cost, which runs from Rs10,000 to Rs20,000 per 24 hours.

Pakistan Pediatrics Association says that 54 neonates die in every 1,000 live-births annually while 16 per cent neonates die due to infections and premature births.

The association blames shortage of basic equipment including incubators, cardiac monitors, phototherapy, resuscitator, apnea alarm, jaundice meter, infusion pumps, pulse oximeter and oxygen checking machine, which adversely affects the patients.

Recently a study carried out at one of the teaching hospitals showed that 50 per cent patients visited Peshawar despite presence of hospitals in their native districts.

The government has been claiming to put in place a proper referral system of patients but the plan is yet to materialised.

Published in Dawn, January 15th, 2019

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