Special Care Newborn Unit reduces neonatal mortality in Tangail
By Munima Sultana
Tangail, 25 March 2013: Hazera Begum was screaming with severe pain on an operation table in the Tangail District Hospitals operation theater of obstetric department, where doctors were carrying out an emergency operation on her with local anesthesia to deliver her baby.
As she had already passed two days with the ruptured membrane when reached the hospital, the doctors had no other options but to operate upon her to save both the baby and the mother.
Hazera finally gave birth to a premature low birth weight baby boy in an afternoon of March. The baby weighing 1.5 kilogram was not grown- up enough as he was born six weeks earlier than the expected date of delivery.
Prompt referral system pays off
Hazera of Inderjani village from Sakhipur upazila of Tangail district experienced a leakage of water from the perineum during midnight at her home. She was first taken to nearby Upazila (sub-district) Health Complex upon recommendation by a lady from her village in the following morning. But finding her condition critical, doctors at the health complex referred her to Tangail District Hospital the same night. She was operated the following day.
"How is my baby, my baby?" she cried out to her doctors although her condition was not stable enough to think of the just-bornbaby. She was very worried as the baby was her second issue after 10 years, and she had gone through two miscarriages in between.
"I want my baby. Please save my baby," she repeatedly implored, seeking the doctors' help.
Sick newborns get essential services
Prematurity and low birth-weight are responsible for the majority of 83,000 newborn deaths every year in Bangladesh. Hazera's baby was, however, declared safe by the doctors as he received a highly equipped medical service in special care newborn unit (SCANU) of the hospital immediately after the birth. Doctors in SCANU provided the newborn with oxygen supplementation and antibiotics soon after he was brought to the centre.
"The baby's condition might have gone beyond control if the delivery had been carried out at home and the baby brought to the hospital one or two days after the delivery, which usually happens in the villages," said Dr. Jahangir Alam, consultant pediatrician of the SCANU.
He said due to bad infrastructure and a lack of information about facilities with appropriate services, many mothers and their attendants do not come to the hospital in time, which leads to death of many newborns with complications.
Mothers and newborns see lights
With the support of UNICEF and Korea International Cooperation Agency (KOICA), the government of Bangladesh has set up the SCANU in 2012 at Tangail District Hospital under the project named "Home-based Maternal and Newborn Care Interventions to Accelerate Progress Towards Achieving MDG-4" which was launched in 2011. The project is know as Tangail Maternal, Neonatal and child Health programme (TMNCP).
Its target is to reduce the newborn deaths by 20 percent in the intervention areas over a three year period as it is still a major challenge for the country to meet the MDG-4.
Hazera's arrival with the support of the lady- who is a trained community health volunteer under the project- reflects one of the efforts of the government to achieve the target.
The duty doctors said after setting up the SCANU, they can now prevent many fatal newborn complications. They said babies are brought to the centre mostly with problems like perinatal asphyxia, septicemia and prematurity etc., which are the major causes of neonatal mortality.
The radiant warmer with table resuscitator, phototherapy unit, monitors for heart rate and blood pressure, spot lights, portable oxygen concentrator and etc., helped new born babies survive from fatal complications like neonatal jaundice, prematurity, sepsis and other neonatal conditions. And finally, their rights to survival could be ensured.
Child mortality on the wane
Dr. Jahangir said, nowadays as few as one or two babies among an average of 150 to 200 admitted babies in the District Hospital Tangail face death.
"We can now measure micro doses of medicine, using syringe pump supplied by UNICEF, for just-born babies as per requirements, which was impossible in the past," he said.
Mainul Islam, Project Coordinator of ICDDR,B in Tangail, through which the IMCI section of DGHS under the Ministry of Health and Family Welfare runs the UNICEF/KOICA supported project titled “Tangail Maternal, Neonatal and Child Health Project (TMNCP)” in three upazilas of Tangail district, said two interventions -- activities of the community health volunteers and referral HUBsin the entire process -- have helped people bring pregnant women and newborn babies to the Upazila Health Complexes as well as to District Hospital Tangail and thus prevented unnecessary deaths of mothers and children.
Three days after the baby was born, Hazera expressed her gratitude to the lady named Sumona of her village. "I feel now relieved as her guidance helped me get timely treatments", she said gently patting her baby on the lap.