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Letters to the Editor

Indian Pediatrics 1999; 36:750-751

Reply


The main criticism of Dr. Jai Kishan pertains to the 'time lag' in the publication of the data gathered by the National Neonatal Perinatal Database (NNPD) network. It needs to be clarified that the report for the year 1995 was originally released as early as in the first week of November 1996 at the inauguration of the 16th Annual Convention of the National Neonatology Forum at Chandigarh. The report document has been widely circulated to. the policy makers and others since then. The decision to publish the salient findings of the report in the form of a paper was taken by the investigators at Chandigarh during the said Convention. Accordingly, the manuscript was prepared after some additional analyses and published subsequently in the Indian Pediatrics(1). The second installment of the excerpts of the report was published recently(2) in view of the good feedback on the first paper and in order to cover some additional findings which could not be accommodated in the first manuscript.

It is agreed that in the era of hitech information technology many things are possible, but, unfortunately, such technology also has a price tag. To establish and run a 16 center database for a year using computer and information highway, a conservative budget of Rs. 16-18 lacs is required. The Forum does not have resources of this magnitude. The whole study as published had a budget of approximately Rs. 45,0001- only, the cost of a single personal computer! The gap in the resources was, however, bridged by personal time and sincere effort of the faculty to produce a document which encompasses in- formation on neonatal morbidity and mortality on a never-before scale in the country. It is not only a 'laudable job', but also a unique achievement on two other counts:

(i) This initiative has set an example of a successful venture for collaborative research catalysed by a professional body in the country.

(ii) This activity has led to the creation of a network of institutions who have con- firmed their ability to work together on common protocols, thus creating a nucleus for further multi-center studies including clinical trials.

Of the two centers which did not provide data for full one year, only one center deviated from the original commitment because of some unforeseen administrative reasons and fed only six months' data. The other center provided four months' data as per the proto- col. It was decided beforehand that centers with more than 5000 deliveries per annum will feed data for only four months (Jan, Apr, July, Oct) to avoid overrepresentation from one center.

The participation in the NNPD is voluntary provided the concerned centers are accreditable as level II neonatal units by the NNF. The two centers referred to in the letter should write to the Forum if they are interested in joining the network.
The suggestions of Dr. Jai Kishan regarding information on additional variables are very useful and will be duly considered for inclusion in the next phase of the NNPD activities.

 

Vinod K.Paul,
Meharban Singh,
For the Faculty Investigators of the National
Neonatal Perinatal Database of NNF,

Department of Pediatrics,
All India Institute of Medical Sciences,
New Delhi I IO 029, India.

 

References

 

1. Neonatal Morbidity and Mortality. Report of the National Neonatal Perinatal Database. Indian Pediatr 1997; 34: 1039- 1042.

2. Neonatal Morbidity and Mortality. Report of the National Neonatal Perinatal Database. Indian Pediatr 1999; 36: 167-169.

 

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