Community health workers to treat tribal kids for sepsis

MUMBAI, September 2017:

In an effort to save thousands of infants dying from infections every year, the state has decided to train 7,000 community health workers to administer oral antibiotics. The medical fraternity, which had in the past vehemently contested the idea of non-medicos giving antibiotics, seems to be on board this time, but with caveats.

In a meeting held recently following the deaths of 55 infants in Nashik’s Civil Hospital, the public health department took a decision to train Accredited Social Health Activists (Ashas) to give amoxicillin to critical babies who may not have immediate access to a hospital. The project will initially be tested in six districts with tribal population—Thane, Nashik, Nandurbar, Amravati, Gadchiroli and Chandrapur.

Studies have shown that deaths due to septicemia, pneumonia and meningitis, collectively termed as sepsis, account for over 50% of infant deaths in certain tribal areas. Experts say the idea of allowing community health workers to treat very ill babies with antibiotics was first recommended to the state about 12 years ago.

Dr Satish Pawar, who heads the Directorate of Health Services (DHS) said that ASHAs will be trained to recognize and treat sepsis. “The plan is primarily for tribal areas, where hospitals are not in vicinity. Critical babies often deteriorate rapidly... Children suffering from sepsis stop accepting feeds, feel lethargic and dull. The Ashas will be trained to pick up such signs. They will be taught to calculate dosages and ways to administer it. They will also be taught to recognize the adverse effects,” he said.

Dr Abhay Bang, noted pediatrician and founder of non-profit SEARCH, welcomed the move saying that it was an evidence-based and scientific approach that was backed by three extensive studies. “Between 1995 to1998, the SEARCH had done its first field trial in Gadchiroli with the help of women health workers. The mortality among infants dropped by 70%. The findings provided the base for the intervention to be incorporated in the national guidelines for home-based care, besides being lauded by the Lancet as one of their best publications in 80 years,” he said.

The state is developing a module along with the Indian Academy of Pediatrics (IAP). Dr Pramod Jog, former president of IAP, said the urgent need to tackle baby deaths has outweighed all other concerns. “The distance between house and neonatal centre in many tribal areas is 70-80km. If the involvement of ASHA protects the baby from becoming very critical, we should give it a chance,” he said.