I read with great interest the recent editorial "Improving Status of Neonatal Health in India"(1). We know from SEARCH trial (Gadchiroli), and from the example of Sri Lanka that investments in Level I and II care can bring significant reductions in neonatal mortality(1). We, however, rarely discuss overcoming negative parental attitudes in a large section of vulnerable communities like rural areas, urban slums in India, which can attribute significantly to neonatal mortality. Negative parental attitudes like gender bias, not seeking timely care for their sick newborns, not following medical advice in the presence of freely available services could arise from a feeling of helplessness due to poverty, social taboos and pre-fixed mindset(2,3).

Training of birth attendants, ASHA, AWW, FMPW and primary care physicians must involve cultural sensitization and mastery in behavioral skills. In order to be effective these primary level workers will have to act like social scientists and clinical psychologists to transform the negativities into a more positive focused action towards the desired goal.

Pankaj Garg,
Department of Pediatrics,
Sitaram Bhartia Institute of Science and Research,
B-16, Qutab Institutional Area,
New Delhi 110 016, India.
E-mail: [email protected]