Raju, three month old baby born to Joga Devi and Dinesh Kumar of Sherpur village in District Nalanda, was born a healthy. However in the month of June, Raju fell severely sick with high grade fever, continuous vomiting and loose motions. The parents took the child to local village practioner but was not of much help and his condition deteriorated considerably. Joga Devi sought help from the local ASHA and ANM workers who guided them to the Paediatric Emergency Unit at Sadar Hospital, in District, Nalanda.
By the time they reached the hospital, Raju was already gasping and had sunken eyes. The duty nurse immediately resuscitated Raju. In the meantime, the Medical Officer on duty also reached and started the treatment. Raju’s response to the treatment and progress was monitored by the duty nurse for the entire night. His condition became stable by early next morning. Raju was discharged after three days.
In 2014, an evaluation was conducted by (MoHFW), supported by NIPI Newborn Project, in 13 District Hospitals across the states of Bihar, Madhya Pradesh, Odisha and Rajasthan to assess quality of care for children. The study revealed that none of the 13 District Hospitals included in the study have a system for triage and emergency care for sick children. Precious time is being lost during transfer of children to paediatric wards for initiation of treatment. The study also revealed the lack of specific guidelines or standards for setting up and operationalization of paediatric care facilities.
To address this gap, the NIPI Newborn Project supported the Child Health Division of MoHFW in the development of Operational Guidelines for strengthening paediatric care at District Hospitals. The NIPI New Born project team in consultation with the state governments also identified select District Hospitals as Demonstration Centres for NHM in NIPI-support states to implement Emergency Triage and Treatment (ETAT) of children.
For more information on Strengthening of paediatric care services in district hospitals, click here.