Preventive neonatal mortality: Where do we stand?

Everyday 5100 babies die globally of preventable causes; 1200 of these deaths happen in India. So by the time you are done contemplating the enormity of the situation, we would have had 8 more deaths, majority of which will happen in rural and inaccessible locations, where referrals are neither fast enough nor common enough.

A third of these deaths (close to 400 newborns everyday) happen due to infections. Annually a total of 6.9 million newborns are diagnosed with severe bloodstream infections all over the world. India accounts for over 2.7 million of cases of newborn infections. This is despite years of maternal and child health programs, antenatal workshops, the Every Newborn Action Plan. While we have come a long way from a NMR of 52 in 1990 to 21 in 2020, we still need to put in a lot of work to achieve the SDG target of newborn deaths which is less than 12.7 per 1000 live births. As we move further down the road, this task gets harder as we now need to implement interventions in geographies that aren’t catered to either by a good public health system, nor have the resources to come in the purview of private healthcare systems in India.

The public health model of maternal and child health depends heavily on our army of volunteer health workers and trained midwives. While the model has been able to target most risk factors (such as maternal malnutrition, lack of antenatal care, unhygienic labor conditions and immediate newborn feeding), we still wouldn’t be able to tackle issues arising from high-risk pregnancies, deaths due to preterm physiologies, metabolic disorders and lack of critical care till the general health infrastructure is made stronger.

A critical missing piece in our health infrastructure is a strong evidence-based referral mechanism which brings up the quality of care in primary health centers as well as NICUs. A system where we enable the PHCs to obtain data around diagnostics with tools that are bedside, easily accessible and high-accuracy. A system that enables faster referrals as well as faster discharges, ensuring that no newborn, who needs it, goes without critical care and at the same time ensuring smaller admission durations to avoid unnecessary mother and child separation and risk of acquiring nosocomial infections.

Providing high-accuracy diagnostics in the hands of nurses, midwives, technicians and first responders often reduces the burden of care downstream and simplifies treatment decisions. At SpotSense we are committed to developing diagnostics which are designed specifically for the Indian demography and simplify the care continuum by making the decision making processes simple and a lot more evidence based.