Rural Child Population and Congenital Heart Defects

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Mangesh Wange

One of our assets as a nation is our youth population. According to the ILO, India has the largest youth population in the world – a promising demographic for a developing country. We may greatly benefit from the energy of this dynamic group if we nurture them. Health, of course, plays a massive role here. There is a worrying statistic that reflects the vulnerability of our young population – specifically children – that we must address in this regard.   

According to a study by Indian Pediatrics, nine in a thousand children bear the impact of CHDs in India. Given our population, that translates to an estimated two lakh children born with congenital heart disease in India every year. 

But there is scope to bring down these numbers if we make a concerted effort in the following ways: 

Institutional delivery – According to paediatric medical experts, an institutional delivery can detect heart conditions at the earliest stage. The delivery is followed by a saturation check of the limbs – after birth and before discharge, with 95-96 per cent sensitivity to diagnose a defect. One can then further investigate it and seek the necessary help. Timely intervention, therefore, is paramount.

Rise in institutional deliveries – The good news is that the number of institutional deliveries has risen in the last decade – from 40.8 per cent in 2005-6 to 88.6 per cent in 2019-20 (National Family Health Survey). Our health volunteers – SwadesMitras as we call them – act as catalysts for families to opt for institutional deliveries by educating them about its importance. More such frontlines cadres around the country must educate communities in this way. 

Local health camps organised by non-profits along with hospitals treating congenital heart defects (CHD) will encourage many more to undertake free check-ups and treat CHDs at an early stage. Swades Foundations’ collaborative efforts with Jupiter Hospital (Pune) and Wockhardt Hospital have supported many operations over the years by making cardiac help accessible through local camps.

Robust government schemes – Central government schemes such as Janani Suraksha Yojana in 2005 incentivised institutional deliveries by offering a cash transfer to mothers who delivered their babies at a healthcare facility instead of at home. The rise in institutional deliveries is largely attributed to this scheme. The Rashtriya Bal Swasthya Karyakram (RBSK) screens children up to 18 years of age, followed by free treatment at the district level. Communities must be made aware of these programmes and work with the local administration to ensure maximum impact.

Free check-ups at local camps – Healthcare infrastructure is poor in our rural areas. Often, community members seeking primary check-ups have to travel a fair distance. Many of them are daily wage workers. The trip means losing a day’s worth of livelihood. Instead of communities travelling for healthcare, we must bring healthcare to them. Local health camps organised by non-profits along with hospitals treating congenital heart defects (CHD) will encourage many more to undertake free check-ups and treat CHDs at an early stage. Swades Foundations’ collaborative efforts with Jupiter Hospital (Pune) and Wockhardt Hospital have supported many operations over the years by making cardiac help accessible through local camps.

Bust misconceptions – Children with a CHD condition often have poor physical build. Paediatric cardiac experts observe many misconceptions among parents and families and also often among local healthcare workers that jeopardise timely treatments. For instance, parents often delay treatment because they are told that procedures are successful if the child puts on weight before the operation. As a result, many children come for help at a stage when they become less treatable.

This reminds me of a recent visit to Nashik’s Peth block, where we met a little boy called Arun (name changed). Arun looked like any toddler in his neighbourhood – except he wasn’t. He is 4.5 years old, but with his petite frame due to a CHD, he looked just over 2.5 years. His parents are smallholder farmers who could not meet the financial demands of surgery. Fortunately, our health team at Swades Foundation became aware of this situation. Under our Cardiac Pediatric Care programme, the team arranged for his surgery. Arun is now recovering well. 

But there are many more like Arun who live without medical attention, and we must make a concerted effort to reach out to each of them.  

 Mangesh Wange is the CEO of Swades Foundation.