State of Neonatal and Pediatric ICU in Nepal and ANMF's role

Dr. Sangita Basnet, current president of ANMF has been instrumental in advancing pediatric and neonatal critical care services and training in Nepal. She led the fundraising efforts as well as implementation of the project to establish the PICU and NICU at Patan Hospital along with generous support from the Simons Foundation. She has written extensively about the challenges of establishing such center in low-resource setting. Her recent paper analyzes the need to invest in advancing the care to the most vulnerable population in Nepal. 

Important findings - 

  • 75% could manage central venous catheters and only 75% had a blood gas analyzer.
  • 32% had only one functioning mechanical ventilator
  • 38% had only two ventilators
  • Only one institution had a pediatric intensive care specialist.
  • The majority of patients (88%) came from families with an income of just over a dollar per day. All patients were self funded with a median cost of PICU bed being $25 U.S. dollars (interquartile range, 15-31) per day. The median stay was 6 (interquartile range, 4.8-7) days.
  • Mortality was 25% (interquartile range, 20-35%) with mechanical ventilation and 1% (interquartile range, 0-5%) without mechanical ventilation.

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References
1. Challenges in Setting Up Pediatric and Neonatal Intensive Care Units in a Resource-Limited Country Sangita Basnet, Neelam Adhikari, Janak Koirala Pediatrics Oct 2011, 128 (4) e986-e992; DOI: 10.1542/peds.2010-3657
2. Aayush Khanal, MD, Arun Sharma, MD, Sangita Basnet, MD, FAAP, FCCM. n.d. “Current State of Pediatric Intensive Care and High Dependency Care in Nepal.” Pediatric Critical Care Medicine: A Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies. 
3. ANMF  Patan Hospital ICU Project