Birth defects services in low resource settings: implications from a community-based study in India

Area of Science:

• Public Health
• Pediatrics
• Genetics

Background:

• Birth defects (congenital anomalies) are significant contributors to child mortality, morbidity, and disability globally.
• A critical gap exists in public health guidelines for managing birth defects in low- and low-middle-income countries.
• Existing interventions are insufficient to address the burden of congenital anomalies in resource-limited settings.

Purpose of the Study:

• To determine essential public health interventions for addressing congenital anomalies in low-resource settings.
• To analyze the prevalence and impact of birth defects using data from a primary health center in India.
• To propose a framework for public health interventions for birth defect services.

Main Methods:

• A study was conducted in eight villages under a Primary Health Centre in Pune district, India.
• Prevalence of congenital anomalies was determined in children under five years.
• Associated factors including disability, out-of-pocket expenditure, and maternal risks were assessed.

Main Results:

• The study identified 90 children with congenital anomalies per 10,000 children under five years (95% CI 62.2-126.8).
• Congenital anomalies accounted for 13% of childhood disability in the study population.
• Identified missed opportunities included out-of-pocket expenditure, lack of diagnosis and standard care, and maternal risk factors.

Conclusions:

• A significant burden of congenital anomalies necessitates targeted public health interventions in low- and low-middle-income countries.
• The findings provide a basis for developing a framework for essential public health services for birth defects.
• Addressing service gaps requires integrated interventions focusing on diagnosis, care, and risk factor management.