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The art, science and philosophy of newborn care
1Child Care Centre, 625, Sector 37, Arun Vihar, Noida, 201301, India, drmbsk@gmail.com.
Insights
Reducing neonatal deaths requires focusing on newborn health and survival strategies. Prioritizing preventive care and equitable resource distribution in neonatology is crucial for improving infant survival rates.
Area of Science:
- Neonatology
- Pediatrics
- Public Health
Background:
- Neonatal mortality significantly contributes to infant and under-5 child deaths.
- Technological advancements have shifted neonatology towards more aggressive interventions.
- Current strategies necessitate a focus on improving newborn health and survival.
Purpose of the Study:
- To emphasize the critical importance of neonatal care for national development.
- To advocate for a balanced approach in neonatology, integrating art and science.
- To highlight the need for improved healthcare infrastructure and professional delivery of care.
Main Methods:
- Review of current trends and historical approaches in neonatology.
- Analysis of neonatal mortality data and contributing factors.
- Discussion of policy implications for resource allocation and healthcare practices.
Main Results:
- Neonatal deaths constitute over 60% of infant deaths and 40% of under-5 deaths.
- Preventable disorders like birth asphyxia, hypothermia, hypoglycemia, and infections are major causes of neonatal mortality.
- There is a need for equitable resource distribution and high-tech newborn care facilities.
Conclusions:
- Reducing infant mortality necessitates a strategic focus on newborn health and survival.
- Transitioning from traditional birth attendants to facility-based deliveries by trained professionals is essential.
- A balanced "middle path" integrating the art and science of neonatology is recommended for optimal newborn care.
Abstract:
Neonates truly constitute the foundation of a nation and no sensible government can afford to neglect their needs and rights. In the last 50 y, technology has revolutionized neonatology and we have moved from an exceedingly passive or "hands-off" philosophy to an extremely aggressive or mechanistic approach. Deaths during first 28 d of life account for over 60 % of all infant deaths and 40 % of all deaths of under-5 children. If we have to further reduce infant mortality rate in our country we must focus our strategies to improve health and survival of newborn babies. There should be equitable distribution of resources for the care of mothers and babies in the community and establishment of high-tech newborn care facilities. In 21st century, we must delink and sever our dependence on traditional birth attendants or dais and develop necessary infrastructure and facilities to ensure that every pregnant woman is provided with essential antenatal care and all deliveries take place at health care facilities and they are conducted by trained health care professionals. In the best pediatric tradition, there is a need for greater focus on preventive rather than curative health care strategies because a large number of neonatal deaths occur due to potentially preventable disorders like birth asphyxia, hypothermia, hypoglycemia and infections. The art and science of neonatology should be integrated and we should follow a "middle path" and strike a balance between art and technology in the care of newborns.
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