Plan (1985-90) highlighted the priorities that ought to be addressed and
also the planning considerations for child health, in particular the
need for specialized manpower to deliver child health interventions from
tertiary to the primary [5,6]. These publications, one is led to
believe, impacted the thinking of planners, since what we see in the
country today is clearly an offshoot of those vision documents. The
publications included not just the pediatrician’s perspectives. The
journal also provided a platform for the Ministry of Health of the
Government of India to share its views. A Special article "Integrated
Approach to Maternal and Child Health and Family Planning" by Dr. Indra
Bhargava outlined the proposed path to integration of MCH services in
the country [7].
Neonatal care was clearly a neglected area in the
country till the nineteen eighties. The Editorial "Neonatal Care: A
Newborn’s Right and a not a luxury" in 1981 by Dr SK Bhargava, was the
clarion call for bringing back neonatal health onto the national agenda
[8]. The Editor made a fervent appeal to focus on levels of neonatal
care, its integration with existing maternal and child health services,
redesigning medical and paramedical education to include newborn health
within its curricula and focus on productive newborn research. The
publication of the Recommendations of the Task Force on Minimum
Perinatal care in 1983 [9] with its accompanying editorial [10]
reflected the vision for perinatal care in the country and was clearly
the catalyst that newborn care in India needed. Interestingly, the birth
of the National Neonatology Forum just preceded the 1981 editorial. The
announcement of the founding of this professional organization, which
has singularly changed neonatal care in India over the last three
decades, was published in the 1980 September issue of Indian
Pediatrics (Fig. 1).
|
Fig.1 Announcement of formation of
NNF.
|
The journal also published articles on the existing
national programs related to child health. The areas covered included
utilization of health services, immunization (particularly poliomyelitis
and control of tetanus) primary health care, All India post partum
program, and supplementary nutrition programs. The editorial by Jacob
John [11] in 1981 addressed the question on eradication of polio in
India, initiated the debate on IPV and the challenges in polio
eradication. The publications of articles on immunization strategy [12],
and control of neonatal tetanus [13] have been amongst the seminal
publications in Indian Pediatrics which have contributed to the
current changed scenario in vaccine preventable diseases in the country.
|
Fig. 2 Report of special committee on
breastfeeding.
|
The editorials and articles published during the
period 1980-84 reflected the priorities in child health in that era.
Infectious diseases, malnutrition, nutrition, neonatal health and Indian
childhood cirrhosis dominated the publications in the journal during
this period. The infectious diseases that found a priority for their
publication included vaccine preventable diseases such as poliomyelitis,
tuberculosis, diphtheria, measles and tetanus; diarrheal diseases, and
respiratory infections. Nutrition and in particular breast feeding, was
an area of concern. The journal published the policy statement of a
Special Committee of the Indian Academy of Pediatrics on Breast feeding
in the 1984, January issue of the journal (Fig. 2 is a
reproduction of the first page of this published report) and in the same
year the March issue published the Indian National Code For protection
and Promotion of Breast Feeding [14] along with an Editorial by Dr PM
Udani [15]. Clearly, the editorial team was not only focusing on
clinical research but also promoting social pediatrics. There was always
a concern for the persistence of childhood malnutrition. An article by
Vijayraghavan published in the December 1980 [16] issue of the journal
carried a table on how to compute an etiology/predisposition based
malnutrition index. The table from the article is reproduced as
Fig. 3. One wonders why such a risk index did not gain
popularity even though malnutrition is still widely prevalent 30 years
since that article was published.
|
Fig. 3 Table of malnutrition index.
|
Pediatric sub-specialties were yet to come of age.
However, clearly the Editor and his team had identified the need to
bring pediatric sub-specialties to the forefront. The numerous articles
and editorials on this theme are a reflection of this prioritization -
Cancer in childhood: need for a planned approach [17], Non-invasive
cardiac evaluation [18], Developmental pharmacology [19], Pediatric
endocrinology: Future perspectives [20], Renal failure in children [21],
Pediatric neurology: Need for development [22], and Pediatric hematology:
a neglected specialty [23], just to name a few. This was a period when
Indian Childhood Cirrhosis, an entity not seen any more, was very common
and the journal published several articles including an editorial on
this subject during Dr Bhargava’s editorship. A major contribution of
Indian Pediatrics to the academic world was the publication of a
complete comprehensive classified review on the subject from 1887 to
1980 in its July 1980 issue [24].
The Editor had certainly not forgotten medical
education and research. Editorials and articles on medical education
were important themes [25,26]. Research priorities, which was a stated
goal of the new team in its first editorial, also found a place in the
publications during the tenure of this editorial ream [27]. The
publication of an article on ethics in research at a time when these
considerations were nascent, is a tribute to the editor’s vision of
things to come [28].
The Editor ensured that the journal continued to
cater to the varied interests of the readership. Practitioner’s column
was a regular feature which provided ready updates on common pediatric
problems for the clinicians. The issues of the journal published in 1982
carried an interesting column "Diagnostic and Therapeutic Aids" which
dealt with common investigations–their indications, interpretation and
utility. One wonders why the Editor discontinued this interesting column
in the subsequent volumes published during his tenure. The editor also
recognized innovations and found a place for them in the journal. One
such innovation was a "Wet nappy detector" for the NICU published in its
September 1983 issue [29]. The image of the innovation is reproduced in
Fig. 4.
|
Fig. 4 Wet Nappy detector.
|
Indian Pediatrics was not only a platform for
sharing academic work, but it also became a voice for the marginalized.
Children with disabilities were a marginalized group in the early
nineteen eighties. Two publications are worthy of mention. The first is
an Editorial by Dr. Sinclair on legislation for the mentally handicapped
in the January 1981 issue of the journal [30] which made a strong plea
to change existing lunacy laws that discriminated against the mentally
challenged and accord them their due right in society. This was a
forerunner which has contributed to the existing Persons with
Disabilities [Equal Opportunities, Protection of Rights and Full
Participation] Act, 1995, of the Department of Social Justice,
Government of India. The other publication is the one by Pandit and
Bhave (1981) [31] which for the first time in India provided information
on the patterns of various handicaps in children. The table from that
article is reproduced as Fig. 5.
|
Fig. 5 Patterns of childhood
handicaps, Pandit and Bhave [13].
|
The era 1980-84 saw Indian Pediatrics shift
gears in its style and format and publish important research work which
contributed to the journal’s international visibility. It also became a
platform for sharing child health planning strategies, which influenced
thinkers in the national government. Finally as an academic journal it
also fulfilled its obligations of improving medical education and
research.
References
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5. Santhanakrishnan BR. Child health in 7th Plan.
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