District hospitals can bring specialised prenatal diagnosis closer to rural families, study finds
A large multi-state study has shown that specialised prenatal diagnostic services for thalassemia and sickle cell disease can be delivered safely and effectively through district
A large multi-state study has shown that specialised prenatal diagnostic services for thalassemia and sickle cell disease can be delivered safely and effectively through district hospitals and referral networks, potentially bringing advanced preventive care closer to families in rural and semi-urban India. The findings, published in the journal Blood Global Hematology, come as India pursues its goal of eliminating sickle cell disease and substantially reducing the burden of thalassemia by 2047. The study analysed outcomes from a prevention programme led by Bengaluru-based Sankalp India Foundation in partnership with State governments, the Health Mission and fetal medicine specialists across Karnataka, Gujarat, Maharashtra, Andhra Pradesh and Madhya Pradesh. 2.18 lakh pregnant women Since 2021, more than 2.18 lakh pregnant women across 82 districts and 87 maternity centres have undergone screening for haemoglobin disorders. Through a coordinated referral network, 2,092 invasive prenatal diagnostic procedures were performed, helping prevent 286 births affected by severe haemoglobin disorders. Unlike conventional models that require families to travel to metropolitan centres for prenatal diagnosis, the programme connected pregnant women identified as being at risk to fetal medicine specialists located closer to their homes.
“Traditionally, invasive prenatal diagnosis was available only in cities such as Delhi, Mumbai, Hyderabad, or Bengaluru. For many families in tribal and remote districts, travelling to these centres during pregnancy was simply not possible,” Rajat Kumar Agarwal, President of Sankalp India Foundation and corresponding author of the study, told The Hindu. He said the programme addressed this gap by linking screening centres with 26 existing fetal medicine centres and centralised diagnostic laboratories. “We did not create new centres of excellence. We used existing doctors, existing hospitals and existing expertise. Samples were collected locally and sent to accredited central laboratories. The study demonstrates that this approach is both safe and effective,” he said. The screening programme covers both thalassemia and sickle cell disease. “The test used to identify thalassemia is the same one used to identify sickle cell disease. From the beginning, we treated them as part of a combined screening programme,” Mr. Agarwal said. District hospitals’ role The study highlighted the role of district hospitals as entry points into advanced preventive healthcare.
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