Though India has achieved a significant reduction in below five neonatal infant and maternal mortality ratio, the rates are still very high in many parts of the country. To improve the maternal and child health care, the Indian Council of Medical Research (ICMR) has called for research by calling for letters of intent from different stakeholders of society.
Dr Mona P Gajre, Paediatric at Lokmanya Tilak Municipal General (Sion) Hospital, said, “Strengthening neonatal health care is crucial as maximum mortality and morbidity occurs in below age five. Even today, efficient Indian health care systems are still lacking. In addition to early sepsis, communicable infections malnutrition forms the main bulk for high mortality.”
On the other hand, Gajre added, survival of low birth weight (LBW) is on the rise due to superior expertise in neonatal intensive care unit (NICU).
“So, we are looking at a combined burden of old diseases and new related morbidities such as learning disabilities, autism, attention disorders affecting the young NICU graduates. So, ICMR proposal to study strategies to improve both child and maternal health care in light of critical 1,000-day concept is highly appreciable,” said Gajre.
For the research, the ICMR- INCLEN (International Clinical Epidemiology Network) had undertaken a nationwide exercise for priority setting for the country involving all stakeholders including academia, public health, policymakers and programme managers. Top priority research questions under the domain of implementation science in the field of maternal, new born and child health and nutrition based on scrutiny of INCLEN list and feedback has been received from other stakeholders.
Under the National Health Mission (NHM) of Government of India, evidence-based interventions that improve maternal and child survival are being promoted. Many challenges are being faced by programme managers while implementing these interventions / programmes.
Dr Paras Kothari, Head of Paediatric Surgery Department at Lokmanya Tilak Municipal General (Sion) Hospital, said, “There are not advanced research has been done so far in the field of neonatal, infant and maternal mortality rate. There are but few in numbers. In government hospitals, the volume of maternal and child health is high as compared to private hospitals and the workforce is less for research.”
In last one year, there is a drop in the surgeries done on children less than a month in private hospitals, but the flow continues in government hospitals.
“So, research should be done in public hospitals because footstep is more at there. But the problem is to do a good research or study fund is required, manpower is needed. This point is needed to be taken care of,” the doctor said.
Under this call, letter of intent is invited to conduct implementation research in maternal and new born healthcare.
The following three types of research studies will be considered:
- New implementation research studies.
- Within ongoing studies, additional implementation research.
- Analyses of relevant existing datasets and policy analyses as part of routine reporting systems under M&E.
“Implementation research is the scientific inquiry into questions concerning implementation—the act of carrying an intention into effect, which in health research can be policies, programmes, or individual practices (collectively called interventions).”
According to recent data of National Family Health Survey-4, the child mortality rate is nearly 24 (per 1,000 births) in Maharashtra where as in India it is 41 in 2015-16.
Dr Mukesh Agarwal, Professor, Head of Paediatrics Department at King Edward Memorial Hospital and Seth GS Medical College and Hospital, said, “There has been drop in infant mortality rate. Also infection rate has reduced and intake of nutrition has increase. But, now the other causes like heart disease, congenital malformations (congenital disease, deformity, birth defect, or anomaly, is a condition existing at or before birth regardless of cause). Neurological issues have become the important cause of mortality. This has to be looked after through research and study. It is good that research will be held because there is always scope in this field to give best medical service and save more new lives.”