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Need to improve preterm care

In September last year, 11 babies died at the Jigme Dorji Wangchuck National Referral Hospital’s Neonatal Intensive Care Unit. Some insiders even took the number of deaths to 19. How that Early Essential Newborn Care (EENC) and Kangaroo Mother Care (KMC) for preterm babies are found to require improvement is an indictment of our health system.

There is a lot to be done and we can ill afford complacency.

After the death of the babies, the hospital issued a press release stating: “As caregivers, we are extremely sorry for the loss of the infants’ life and we are concerned as much as the parents of those infants and the public about the unfortunate loss of those nine infants.”

To the parents, the explanation from the hospital was most insensitive and hurtful.

What the people found especially difficult to reconcile with was the fact that even as delinquencies lay more with the hospital and the staff, not a single individual or professional was held responsible.

Several life-saving measures were put in immediately. But too many lives had already been lost.

Newborn deaths contribute to about 56 percent of under-five mortality in the country.

A study carried out in three hospitals showed although EENC and KMC were implemented in these hospitals, more needed to be done. EENC is the care given to a baby during delivery and the first days after birth. It includes three principal components. When a baby is born, the baby is dried and embraced, then put in skin-to-skin contact, and clamping of the umbilical cord is delayed. KMC is care of preterm infants carried through skin-to-skin contact with either father or mother.

With us though, it always brings us back to the issue of resource or rather the lack of it. When 11 babies died, we were told that the standard requirement for nurses in the NICU and ICU is 1:1, which is one nurse for one patient; ours was 1:4. Besides doctor shortages, the hospital currently has shortages of 173 nurses, 80 ward boys or girls and 35 cleaners.

If we were to institute EENC and KMC at all levels, do we have infrastructure requirements like KMC beds, space and mannequins for KMC practices? Monitoring and supervision in hospitals will be critically important.

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