By Padmini Copparapu
Siddipet, India, 30 December 2015 – In 2013, Siddipet, the most populous city in the Medak district of united Andhra Pradesh, recorded the highest levels of infant mortality (46 per 1,000) and maternal mortality (110 per 1000) in the State.
To improve the situation, the State Government introduced Integrated Mother and Child Health Action Plan in 2013. The plan envisaged improvement in infrastructure, innovations in healthcare services, effective delivery of public welfare schemes, incentives for medical staff to improve healthcare services in Government hospitals.
“I would have never visited a Government hospital. My sister-in-law, working in a private clinic, convinced me that my child had a better chance of surviving here,” says a beaming first-time mother Farhana. Farhana had rushed her critically ill preterm baby to the MCH Hospital at Siddipet. The hospital also has as Special Newborn Care Unit (SNCU) and Kangaroo Mother Care Unit.
In 2013, Farhana’s critical ill baby would have been shifted to a tertiary care facility in Hyderabad. But today, the Special Newborn Care Unit (SNCU) and CEMONC Center at Siddipet handle most complications related to pregnancy and newborn care.
“The hospital and staff service here is nothing like I had imagined. They are taking good care of me and my baby and at a no cost,” adds Farhana.
A New Age Facility
Low birth weight and pre-term deliveries, a frighteningly common occurrence among newborn delivered by women from the lowest socio-economic brackets in India like Farhana’s, account for over 42 per cent of total newborn deaths in the state.
“Earlier, we didn’t have too much confidence in our own abilities to handle high risk cases, so we used to refer them out. With infrastructural and manpower improvements, we are now able to assure the quality of care and provide planned interventions, says Dr Raghuram Reddy, Superintendent of the Siddipet MCH Hospital.
In fact, the hospital has seen a tremendous change in the past few years even in the delivery of services.
“We were trained on evidence based best practices in care of mother and newborn. NHM with the technical support from UNICEF has provided state of art equipment and world class infrastructure and supported our capacity building. We intend to make this a model facility with all the best quality services,” says Dr Kashinath —medical officer in-charge, high-risk units in Patancheru, Gajwel, Siddipet.
Even as he speaks, Dr Kashinath remotely monitors the CCTV footage feed from SNCUs in neighboring mandals directly on his mobile phone. He makes a call when he sees a unit unattended and the nursing staff are immediately back on their feet —a checks and balances system previously unimaginable in a Government hospital.
Kangaroo Mother Care Unit
The real game changer for the Siddipet CEMONC is its state-of-the-art Kangaroo Mother Care (KMC) facility, being touted as one of its kind in the country.
Kangaroo Mother Care is a cost-effective type of care that allows low-birth weight and preterm babies to continue their natural development by promoting skin to skin contact —stabilizing body temperature, encouraging breast feeding and preventing infection. It has proven to be an evidence based, high impact practice leading to better neurodevelopment and bonding between mother and baby.
With a dedicated floor for KMC patient rooms, a special fluid preparation area, a fully-stocked cafeteria and an exclusive mothers’ lounge, the Siddipet KMC is a far cry from the structures that one has come to associate with Government facilities.
The Siddipet KMC Ward is now being considered the largest in the state and is ten times bigger than the average KMC Ward across private and public health facilities in the state. For a state which has the maximum deaths due to prematurity, this one of a kind KMC Ward is the need of the hour.
But the uniqueness of the ward is more than the just the comfort it provides, it also has immense potential in becoming a center of excellence, say officials from UNICEF. UNICEF is the technical partner in the project implementation.
The KMC unit, using common-place mobile and internet solutions, video conferencing and similar technological innovations reduce the load on Outpatient facilities and improve efficiency at the Community Health Center levels.
“It can become a place for integrating facility based care with active community participation. It has the potential to become a knowledge and training hub, for women from the farthest corners of the State to participate, learn and benefit from the expertise we will build here,” explains Dr Srikrishna, State Child Health Consultant, UNICEF Andhra Pradesh and Telangana.
Improve, innovate and deliver
The KMC unit is among the many innovations and improvements taking places across Government hospitals in the State.
Dr Sanjeev Upadhyaya, Health Specialist, UNICEF says “Telangana State was one of the first states to operationalize SNCU Online Software. UNICEF is supporting the state government in equipment maintenance and training. The State is ensuring that every SNCU staff is trained and the saturation of FBNC Training is almost 100 per cent Quality of care has been a priority for newborn care and Telangana has two SNCUs which are NNF Accredited.
“From nutrition supplements to battle malnutrition/anemia among adolescent girls to providing pick and drop facilities for pregnant women, there is a concerted interest and effort being made in improving the quality and efficiency of service among government hospitals,” says Jagannath Reddy, District Project Officer, National Health Mission. “And, it is gradually yielding results.”
In the last two years, institutional deliveries in Siddipet and Gajwel government hospitals went up from 22 percent to over 58 per cent.