Upadhyay Ravi Prakash, Chinnakali Palanivel, Odukoya Oluwakemi, Yadav Kapil, Sinha Smita, Rizwan S A, Daral Shailaja, Chellaiyan Vinoth G, Silan Vijay
Department of Community Medicine, Vardhman Mahavir Medical College and Safdarjang Hospital, New Delhi 110049, India.
ISRN Pediatr. 2012;2012:968921. doi: 10.5402/2012/968921. Epub 2012 Nov 18.
The neonatal mortality rate in India is amongst the highest in the world and skewed towards rural areas. Nonavailability of trained manpower along with poor healthcare infrastructure is one of the major hurdles in ensuring quality neonatal care. We reviewed case studies and relevant literature from low and middle income countries and documented alternative strategies that have proved to be favourable in improving neonatal health. The authors reiterate the fact that recruiting and retaining trained manpower in rural areas by all means is essential to improve the quality of neonatal care services. Besides this, other strategies such as training of local rural healthcare providers and traditional midwives, promoting home-based newborn care, and creating community awareness and mobilization also hold enough potential to influence the neonatal health positively and efforts should be made to implement them on a larger scale. More research is demanded for innovations such as "m-health" and public-private partnerships as they have been shown to offer potential in terms of improving the standards of care. The above proposed strategy is likely to reduce morbidity among neonatal survivors as well.
印度的新生儿死亡率位居世界前列,且农村地区情况更为严峻。缺乏训练有素的人力以及医疗保健基础设施薄弱是确保高质量新生儿护理的主要障碍之一。我们回顾了低收入和中等收入国家的案例研究及相关文献,并记录了已被证明有利于改善新生儿健康的替代策略。作者重申,千方百计在农村地区招募和留住训练有素的人力对于提高新生儿护理服务质量至关重要。除此之外,其他策略,如培训当地农村医疗保健提供者和传统助产士、推广家庭新生儿护理以及提高社区意识和动员,也具有足够潜力对新生儿健康产生积极影响,应努力在更大范围内实施这些策略。对于“移动健康”和公私伙伴关系等创新举措,需要开展更多研究,因为它们已显示出在提高护理标准方面的潜力。上述提议的策略也可能降低新生儿幸存者的发病率。