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Addressing Neonatal Mortality: Taiwan's New Healthcare Initiative



Neonatal mortality has become a growing concern in Taiwan, surpassing rates observed in countries like Japan and South Korea. In an effort to enhance the care and emergency treatment for newborns, the National Health and Welfare Administration of the Ministry of Health and Welfare has announced a new system of benefit payment. The implementation of the "emergency treatment fee for high-risk pregnancy and childbirth" is scheduled to commence as early as September 1, 2023. However, experts have expressed skepticism regarding its effectiveness in reducing neonatal mortality.


Current Neonatal Mortality Situation


Recent statistics have revealed a rise in neonatal mortality rates despite a decline in the number of newborns in Taiwan since 2015. The mortality rate currently stands at 2.4 per thousand live births, which is 2.7 times higher than that of Japan and 1.6 times higher than South Korea. Neonatology experts, such as Director Zhou Hongjie from the Neonatology Department of National Taiwan University Children's Hospital, have highlighted common causes of death including peripartum respiratory diseases and complications related to gestational age and fetal growth. There is a pressing need for greater attention and focus from the government on addressing these issues.


Challenges and Factors Contributing to Neonatal Mortality


The National Health Administration of the Ministry of Health and Welfare conducted an analysis in 2010, identifying various factors contributing to neonatal and under-five mortality. These factors include the uneven distribution of pediatricians, inadequate allocation of care resources for high-risk pregnancies and newborns, and challenges related to high-risk pregnancy screening and referral. Additionally, there is a lack of integrated child and family-centered care, exacerbating the situation.


The New Healthcare Initiative


To address these challenges and improve neonatal care, the National Health Insurance Department has announced the introduction of the "emergency treatment fee for high-risk pregnancy and newborn babies." The fee structure will be categorized into three levels: elementary, middle, and high, with corresponding payment points of 2,354, 5,000, and 100,000 respectively. This initiative is expected to increase healthcare finance by approximately 105 million, providing additional support and resources to neonatology departments.


Looking Ahead


While the new benefit payment system is a step towards improving neonatal care, experts have expressed reservations about its potential impact on reducing neonatal mortality. They emphasize the need for a comprehensive approach that includes addressing the underlying causes of neonatal deaths, ensuring equitable distribution of care resources, and promoting integrated child and family-centered care. It is crucial for the government and healthcare stakeholders to collaborate and implement holistic strategies that will effectively tackle neonatal mortality, ensuring a healthier future for Taiwan's newborns.


Learnings relevant to India


As Taiwan introduces its new healthcare initiative to tackle neonatal mortality, there are valuable lessons that India can learn from these efforts. India, being a country with a significant population and diverse healthcare challenges, can benefit from studying Taiwan's approach and adapting it to its own context.


Equitable Distribution of Care Resources


India can focus on strengthening the allocation of care resources for high-risk pregnancies and newborns. Ensuring equitable distribution of healthcare facilities, skilled healthcare professionals, and necessary equipment across different regions can help address the disparities in neonatal care.


Integrated Child and Family-Centered Care


India can prioritize the implementation of integrated child and family-centered care through an already existing and evolved ICDS. ICDS was launched in 1975 in accordance to the National Policy for Children in India. Over the years it has grown into one of the largest integrated family and community welfare schemes in the world. Given its effectiveness over the last few decades, Government of India has committed towards ensuring universal availability of the programme. Transparency in NHM's policies, like the Home Based New Born Care (HBNC) program, can help reduce India's infant mortality. The HBNC program, launched in 2011, aims to accelerate the reduction of neonatal mortality and morbidity rates, particularly in rural and remote areas with limited access to healthcare. The program's guidelines were revised in 2014, emphasizing the role of ASHA workers who make scheduled visits to newborns for the first 42 days of life. These visits include additional care for pre-term, low birth weight, and ill babies, as well as those discharged from SNCUs. Additionally, comprehensive care that considers the physical, emotional, and social well-being of both the newborn and their family can be introduced. By fostering collaboration among healthcare providers, social workers, and families, India can create a supportive and nurturing environment for newborns.


Leveraging Technology for Neonatal Care:


Additionally, India can explore the possibility of integrating innovative technologies and digital solutions to enhance neonatal care. Taiwan's use of artificial intelligence and deep tech research in healthcare could serve as an inspiration for India to leverage technology in improving diagnostics, treatment, and monitoring of neonates.


Mentorship and Support for Healthcare Startups:


India can establish strong mentorship and support programs for aspiring entrepreneurs and startups in the healthcare sector, particularly those focused on neonatal care. Taiwan's efforts to provide mentoring and guidance to new founders through multiple stage based systems which include Private Public Partnerships can be an inspiration to India's healthcare ecosystem.


Collaborative Efforts for Sustainable Change:


By observing and adopting successful strategies from Taiwan's initiatives, India can make significant strides in reducing neonatal mortality and improving the overall health outcomes for its newborns. It requires a collaborative effort involving government bodies, healthcare institutions, entrepreneurs, and the community to create a comprehensive and sustainable approach to neonatal care.

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