With birth defects and paediatric surgical issues accounting for a significant proportion (as high as 10%) of infant deaths, paediatric surgeons have proposed that a Paediatric Surgery unit be made available in all medical colleges.
December 29 is observed as National Paediatric Surgery Day. This year’s theme for Paediatric Surgery Day emphasises the critical need for paediatric surgeons in all districts.
In the government sector in Karnataka, paediatric surgery units are available only in the State-run medical colleges in Bengaluru, Mysuru, Vijaynagar in Ballari and Hubballi. Although a lot of private medical colleges have such units, affordability is an issue for many.
Lack of recognition
Anand Alladi, Professor and Head of the Department of Paediatric Surgery at Bangalore Medical College and Research Institute (BMCRI), told The Hindu that paediatric surgery as a super speciality is yet to be recognised.
“The number of undergraduates choosing to specialise in Paediatric Surgery is very low. This is mainly because many hospitals do not have Paediatric Surgery units. As a result, parents consult adult surgeons for paediatric anomalies, but children are not mini-adults,” Dr. Alladi said.
Pointing out that BMCRI and Indira Gandhi Institute of Child Health together conduct around 5,000 paediatric surgeries a year, the doctor said neonatal congenital anomalies, often referred to as birth defects, have a variety of causes ranging from pregnancy or birth complications to genetic malformations to viral infections in utero. In many cases, however, a congenital anomaly may have no known cause. “If picked up early and treated appropriately, the potential for recovery in such children is very good,” he said.
“The National Medical Commission (NMC) has allotted 10% of beds in each medical college for Paediatric Surgery, but not all colleges have paediatric surgeons. Children constitute 40% of the population, and we request the NMC to increase the Paediatric Surgery bed allotment and also ensure that surgery unit is made available for the children at peripheral areas,” he said.
Insurance issues
According to the Indian Association of Paediatric Surgeons (IAPS), another pressing concern is the financial support and insurance coverage for birth defects, particularly external defects which are currently excluded by insurance companies.
“This is in contrast to developed countries where there is no such rider. Even within India, State and central insurance schemes (Ayushman Bharat) do cover birth defects. However, the packages are low and do not cover the entire surgery cost in private empanelled hospitals,” Dr Alladi said. In a statement, IAPS president Ramesh Babu said that an inclusive insurance policy addressing all birth defects is imperative.
For prevention
Prevention of birth defects is another goal of IAPS. “A significant causative factor of many birth defects, including a few crippling ones like spine defect, is the deficiency of Folic Acid Vitamin in the expecting mother. By the time pregnancy is diagnosed and folic acid supplementation started by health centres, most of the organs of the baby are already formed, and it becomes too late to prevent defects,” the doctor said.
“If folic acid supplements are given before conception, the levels needed to prevent birth defects become significant. This needs a prompt reform of fortification of certain food items. Tea with folic acid fortification is emerging as a cost-effective and game-changing strategy to prevent birth defects. We strongly recommend the government to study the feasibility of this preventive measure,” he added.
Published - December 29, 2023 11:06 pm IST
