The neonatal unit at AIIMS was established in 1962 in the Department of Pediatrics. Over the years, it has grown into a full-fledged clinical and academic division of national, regional, and international reputation. We cater to approximately 2500 neonates per year delivered to high-risk mothers referred from all over the country. Apart from imparting undergraduate and postgraduate training, we have run a vibrant post-doctoral course (DM) in neonatology since 1999. The division became the 'WHO Collaborating Centre for Training and Research' in 1997 and is recognized as a 'Centre of Excellence' by the Government of India.

 

We have contributed immensely to promoting newborn care at the national, regional, and global levels. The faculty has been actively involved in most policy decisions of the Government of India in newborn health, including RMNCH+A strategy, IMNCI, Navjat Shishu Suraksha Karyakaram, Home-based Newborn Care, Maternal and Child Health strategy for RCH II (2005), Facility-based newborn care, Newborn and Child Health Policy 2009, Kangaroo Mother Care (KMC), India Newborn Action Plan, and the Universal Health Coverage program.

 

The division has steered country- and region-wide training programs in neonatal resuscitation, ventilation, CPAP, KMC, and Quality improvement (https://www.pocqi.org). Online education platforms (www.ontop-in.org) and various e-resources, including mobile phone apps (https://www.youtube.com/c/AD10), have trained thousands of healthcare providers in India and beyond.

 

The division has been at the forefront of various research activities, including the Young Infant Clinical Signs Study (WHO, Geneva), the Neonatal-Perinatal Database (NNPD; ICMR), NNPD–South East Asia Region (WHO-SEARO), Home-based management of young infants (ICMR), multi-centric trial on an indigenous goat lung surfactant extract (Wellcome Trust, UK), Profile of neonatal sepsis in district hospitals of India (Bill & Melinda Gates Foundation, USA), and the Neonatal Sepsis Program to identify context-specific solutions (Department of Biotechnology).

 

The faculty members have conducted or updated more than 60 systematic reviews and synthesized the evidence for critical clinical and public health questions, including the use of universal vitamin K prophylaxis; topical application of chlorhexidine to umbilical cord; low-birth-weight feeding; and effects of kangaroo mother care in preterm neonates. The efforts have culminated in formulating global WHO guidelines on newborn health. Also, we have been actively involved in the development of cost-effective healthcare innovations.

 

 

 Faculty

 

 

 

 

Past Faculty

 

 

Clinical Work

 

The neonatal unit caters to 2800 neonates delivered every year, most of whom are born to high risk pregnancies. A well equipped 35-bedded Neonatal Intensive Care Unit provides the inpatient services. Five faculty members, 2 Research Consultants, 1 Senior Resident, 12 DM residents, and 6 Junior Residents constitute the team. All deliveries are conducted and attended by resident doctors. The NICU ensures a nurse-patient ratio of 1.0 for critically sick babies and 0.3 to 0.5 for others. The Obstetric Perinatal Care services have facilities for antenatal diagnosis, fetal monitoring, and fetal intervention. There are two follow up clinics for the newborn infants, one each for the high-risk neonates and normal neonates. We have a multidisciplinary team to provide comprehensive multimodal care, especially to our high-risk neonates. The team is constituted by a physiotherapist, clinical psychologist, neonatologist, and an audiologist, in collaboration with Pediatric Neurology, ENT, Orthopedics, and PMR departments. The improvement in neonatal care is reflected in the improving survival of neonates in recent years. The overall neonatal mortality rate has dropped from 38 per 1000 live births in 1983 to 15 per 1000 live births in 2000 and is currently 13 per 1000 live births (2022), despite more babies being born as extreme preterm or less than 1000 grams at birth .

 

 

 

Training Program

 

Under Graduate Training

 

Around 15 lectures are taken in neonatology for MBBS graduate students during 8th semester, 10 lectures for B.Sc. (Hons) Nursing students and 2 lectures for B.Sc. (Hons) Speech and Hearing course. Workshops on Neonatal Resuscitation are held every year for the 6th and 8th semester students to provide them hands-on training. Competency based curriculum in neonatology for undergraduate medical students has been developed.

 

Postgraduate Training

 

Junior residents (MD students) are posted in the NICU for a period of 6-9 months during their 3-year residency programme. They attend daily teaching rounds and weekly ‘High risk Neonates Follow up Clinic’ under the supervision of faculty. They regularly participate in journal clubs, clinical combined rounds, grand rounds, bed-side clinical demonstrations, radiology conferences, and weekly mortality audits. Around 45 junior residents are registered for the 3 year MD training programme. We conduct Objective Structured Clinical Examination (OSCE) for their internal assessment and for the final MD practical exit examination in Neonatology which is the first of its kind in the country.

 

DM (Neonatology) Training

 

We have a vibrant DM course in Neonatology which was started in July 2000 and enrols 12 DM students at one given time. They regularly participate in the teaching activities of the Department besides having a separate DM teaching schedule in the division. The DM students receive specialized training in Pediatric Surgery, Obstetrics, Fetal Medicine, Cardiology, Community Neonatal care, and Genetics, besides being trained in core Neonatology. Our first DM student appeared for his exams in May 2002. Till now 54 candidates have completed DM and another 12 are enrolled .

 

Fellows Training

 

Various fellows from other colleges in the country and abroad have received training in Neonatology in our unit over the last 20-25 years. We have imparted training in Neonatology to Pediatricians from the Armed Forces, Medical colleges, as well as Private practitioners.

 

Training in Rural Services

 

AIIMS has a rural outreach project located 35 km away for training and research. This Comprehensive Rural Health Services Project (CRHSP) caters to a rural population of 72,182 through 2 Primary Health Centres, 11 Extended Health Centres and a 60 bedded level II Hospital at Ballabhgarh. The CRHSP has a fully computerized disease surveillance system. Every year around 1800 deliveries occur in the community and 1200 deliveries take place in the hospital. This project provides a unique opportunity for community-based training and research in Obstetrics, Pediatrics and Neonatology.