Current challenges and future prospects of neonatal care in India

Maternal and neonatal health is the current focus of central and state governments as well as various funding organizations. There is a lot happening in terms of expansion of secondary healthcare facilities and training of the healthcare personnel. This offers an exciting opportunity like never before, for those interested in the welfare of the newborns. Although infant and neonatal mortality rates in our country have been falling progressively, the pace has been much slower than expected, especially for neonatal mortality and we are likely to miss the Millennium Development Goals. In this article, the authors critically review the current status of neonatal health, infrastructure for neonatal care, the current national programs, the peculiar challenges we face and offer suggestions for alternative approaches to the way forward. The authors propose that neonatal care should be delivered as a continuum through an integrated district based model run by empowered District Coordination Committees with a smooth flow of referral and back-referrals between different levels of care. The prioritization and planning should be based on local data, needs and geopolitical scenario rather than a single national plan, which can provide a broad guideline. The need of the hour is to revive and make the primary care system functional and accountable while expanding and ensuring quality of special care services.