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Times of India
17 February 2011
By Pushpa Narayan
Chennai, India

Primary Health Centres To Be Equipped With Webcams
City Doctors to Remote-Guide Child Births in Rural Areas
When a new born baby in distant village hospital is sick, specialists in Chennai may soon be able to assess the situation through video conferencing and offer advice to save life.

The state health department is considering equipping hospital rooms in primary health centres with cameras that will help duty doctors and nurses seek opinion from paediatricians at the Institute of Child Health in Chennai. As a pilot, the project will be started in Krishnagiri district with support from the UNICEF.

The initiative is a part of several measures the department is taking to reduce infant mortality rates in the state. "We can’t afford one paediatrician in every maternity ward. Though duty doctors and nurses have been given training to help a baby born with breathing difficulty, they may not know what they should do with other complications," said health secretary VK Subburaj.

The sample registration system (SRS) released by the registrar general of India shows that the number of infant deaths have dropped from 53/1,000 live births in 2008 to 50/1,000 live births in 2009. Tamil Nadu has also managed to bring down deaths from 31 to 28/1,000 live births but smaller states like Goa (10), Manipur (16) and Pondicherry (22) have done better. In Kerala, infant mortality rate remained static at 12/1,000.

In the last 10 years, Tamil Nadu has managed to bring down infant deaths by half. The state government has now set itself a target of bringing down IMR to 20/1,000 live births by 2012.

But most officials working in the field admit that it would be a challenge mostly because they don’t yet have data on the causes of death.

At least 98% of women in Tamil Nadu deliver in hospitals. Yet 15% of infant deaths happen on the first day. What has left the health department even more worried is that nearly 40% of the deaths happened in the government hospitals. Tamil Nadu government has proposed increasing facilities such as baby warmers, incubators and even neonatal care units in some maternity wards.

In the absence of a doctor at the time of delivery, nurses are being trained to resuscitate babies who do not breathe soon after birth.

With the installation of the proposed cameras, specialists who are available round–the–clock in the Chennai hospital will be able to diagnose conditions like low oxygen levels, fatal congenital defects, blue babies, infections like sepsis and respiratory distress.

The doctors will also be able to help the state government generate data on the cause of infant mortality. "It’s an extremely complex issue and has been difficult for the hospitals to generate data. In most cases there is no time to even audit deaths. But we are now evolving steps and hope to have some reliable data by next year," said Girija Vaidhyanathan, project director, reproductive and child health project.

In cases of emergency, ambulances belonging to 108 service will take the child to a referral care hospital. Since 29% of the deaths happen at home and nearly 38% of them in the first one week, parents will be counselled on child care. Treatment would be free, even at private hospitals, for infants of the one crore families who hold the state health insurance cards.

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