Paediatric cardiology – Life Saviour for children in remote areas

Pediatric Cardiology in India is a critical medical speciality that plays a lifesaving role, especially for children in remote and underserved areas. With congenital heart diseases (CHDs) contributing to 8 - 10 per cent of infant deaths, the need for specialised care has never been more urgent. Dr Nihar Pathak, Consultant Paediatric, Fetal and Structural Interventional Cardiologist, Sterling Hospitals

Despite significant strides in technology and healthcare, over 180,000 to 200,000 children are born with CHD in India every year, with a large number requiring early intervention. Yet, only about 2,500 cases receive the necessary surgical treatment, leaving thousands at risk due to insufficient infrastructure and lack of access to care.

Current challenges

The current state of cardiology in India faces several challenges, primarily due to the acute shortage of specialists. With fewer than 500 pediatric cardiac specialists for a population of 1.4 billion, the gap in care is overwhelming. Critical areas such as cardiac intensive care and electrophysiology are particularly neglected, leaving thousands of children without timely medical interventions. Geographical disparities compound the problem, as most cardiac centres are concentrated in urban, private-sector hospitals. Families in rural areas, where healthcare access is already limited, find it nearly impossible to obtain the specialised care their children need. The lack of uniform schemes covering all states and limitations of certain procedures that are not being covered makes it more difficult to sustain the programme. There are limited centres that have dedicated teams of paediatric cardiologists, paediatric cardiac surgeons intensivists and trained nursing staff to manage such tiny hearts.

Financial constraints further burden these issues, as many families cannot afford treatment. Additionally, low awareness about CHD in rural areas leads to late diagnoses or untreated cases, contributing to a high infant mortality rate associated with these conditions. The lack of resources and awareness is a significant barrier to improving survival outcomes.

Government initiatives

Recognising the challenges, the Government of India has introduced several initiatives to improve healthcare access for children with CHD. Schemes like ‘Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana’ (AB-PMJAY), ‘Janani-Shishu Suraksha Karyakram’ (JSSK), and ‘Rashtriya Bal Swasthya Karyakram’ (RBSK) provide financial aid for cardiac surgeries, reducing out-of-pocket healthcare costs from 62.6 per cent in 2014-2015 to 47.1 per cent in 2019-2020. These efforts have improved the financial burden for many economically disadvantaged families.

However, administrative bottlenecks and limited infrastructure hinder the full potential of these programmes. Families in remote areas often struggle to access care due to the scarcity of paediatric cardiac centres. To bridge this gap, the government is working to improve institutional deliveries, expand paediatric cardiology divisions, and enhance training programs for paediatricians, aiming to boost early diagnosis and treatment in underserved regions.

The role of the private sector

The private sector in India has played a crucial role in enhancing cardiac care, complementing government efforts. By investing in advanced medical technologies—such as robotic surgery platforms, advanced imaging systems, and minimally invasive procedures—private hospitals have significantly improved patient outcomes and expedited recovery. They have also focused on specialised training for healthcare professionals in cardiology and related subspecialties, addressing the talent gap within the public healthcare system.

As the complexity of treating conditions like congenital heart defects increases, the need for sub-specialisation becomes urgent. Additionally, private providers emphasise a patient-centric approach, prioritising the needs and preferences of families, and introducing specialised treatments that allow access to world-class medical care without the need to travel abroad.

Role of healthcare companies in product development

Healthcare companies are significantly enhancing cardiology by developing innovative products and technologies tailored for young patients. These advancements include advanced diagnostic tools for early detection of congenital heart defects and minimally disturbing surgical devices that shorten recovery times. Telemedicine platforms have become vital for children in remote areas, enabling specialists to provide consultations and diagnoses from afar, ensuring timely care. Additionally, recognising financial barriers, companies are focusing on cost-effective solutions, including affordable technologies and mobile health applications, which have the potential to revolutionise cardiac care in rural India, making specialized services more accessible.

The path forward

Despite the challenges, optimism surrounds the future of cardiology in India. Increasing awareness, rising per-capita income, and a focus on congenital diseases are driving more diagnoses and treatments. Government initiatives to relax recruitment rules and boost healthcare spending are beginning to yield positive results, supported by innovations in the private sector and technological advancements. To transform pediatric cardiac care, we must enhance training for specialists, particularly in rural areas, and develop robust referral systems. Mass awareness campaigns are essential to educate communities about early detection and timely treatment.

As we work towards these goals, it’s crucial to remember that a huge number of children are born with congenital heart defects annually in India, highlighting the urgent need for accessible care. One must remember that –“Saving a child’s life is like saving a whole universe,” a sentiment that reflects the mission of all those dedicated to paediatric cardiology.