Neonatal mortality remains a major health challenge across the world, which involves neonatal sepsis and other related factors of prematurity. Though many strides have been done in reducing NMR, there is a need for more appropriate interventions and strategies directed towards addressing the rise in the escalation of AMR. Combating AMR will be critical in improving neonatal survival rates while giving each newborn a healthier start into life globally.

The newborn period is the key period for infant health, and the first 28 days of life are critically important-both for survival and as a base to set lifetime health and development. Neonatal deaths globally have witnessed a significant decline over the past couple of decades. The neonatal mortality count has significantly reduced dropping from a high of 5 million in 1990 to as low as 2.3 million as of 2022. However, this decline notwithstanding, neonatal mortality is still staggeringly high across low-and middle-income nations.

Neonatal mortality rates are 22 per 1000 live births in India. Neonatal sepsis and prematurity are the main causes of neonatal deaths in these tragic events. Recognizing the gravity of the issue the Indian government started the Indian Newborn Action Plan (INAP) in 2014. The goal is to take NMR down to the single digits by 2030. This initiative has brought in several key interventions, including antenatal care (vaccines, micronutrient supplementation), skilled birth attendance, clean birth practices, and neonatal resuscitation techniques. More promisingly, postnatal interventions, including early initiation of breastfeeding and skin-to-skin contact, have been proven to work well in improving newborn survival rates.

Despite these improvements, one of the biggest concerns in neonatal care today is the growing problem of antimicrobial resistance (AMR) which seriously threatens efforts to reduce neonatal mortality.

What is Antimicrobial Resistance?

Antimicrobial resistance occurs when microorganisms such as bacteria, viruses and fungi evolve over time and become resistant to commonly used antibiotics and other medications. This resistance makes infections more difficult to treat, increasing the risk of mortality and complicating treatment options. The World Health Organization has classified AMR as one of the most urgent global health threats since it not only causes death and disability but also places immense pressure on healthcare systems, significantly raising the economic burden.

The sources of AMR are many, including poor hygiene and infection control in healthcare settings, overuse and misuse of antibiotics. Contributing factors to this rapidly growing problem are antibiotic prescriptions for patient needs that do not require them and failure to complete antibiotic courses, as prescribed.

AMR and Newborn Health

For neonates, the risk is much more vital for AMR. Neonates are particularly prone to developing infections due to their rather weak immune systems. Neonatal sepsis, severe bacterial infection, is one of the leading causes of neonate deaths and it often manifests complications when it is because of drug-resistant pathogens.

According to Dr. Apoorva Taduri, Consultant Neonatologist, "Neonatal sepsis accounts for a significant proportion of neonatal deaths, and AMR is making it worse. MDR pathogens cause around 30% of neonatal sepsis mortality globally.

Maternal health and care are also factors influencing AMR in neonates. Over-prescription of antibiotics during pregnancy increases the risk of neonatal sepsis and the development of multi-drug-resistant pathogens in newborns. This calls for prudent use of antibiotics during pregnancy and at the time of delivery. In fact, studies indicate that indiscriminate use of antibiotics in mothers has a direct impact on neonatal health, which may eventually lead to resistant infections in newborns.

One of the major issues is that the drug-resistant bacteria are causing an increasing number of healthcare-associated infections in the neonatal care settings, which include NICUs. Infections by such bacteria prove to be challenging to treat; they require more advanced, expensive interventions, and the period of risk of mortality and morbidity is extended.

Counteracting AMR in Neonatal Care

To combat AMR and reduce neonatal mortality a multifaceted approach is necessary. Dr. Taduri emphasizes the continuation of the strategies outlined by the Indian Newborn Action Plan (INAP), specifically in reducing neonatal sepsis and improving infection control. However, to combat AMR more must be done to ensure proper use of antibiotics in both maternal and neonatal care settings.

Key strategies for reducing AMR in neonatal care are:

1. Improving Infection Prevention Practice: This implies, therefore, that more efforts would be made regarding stricter hospital hygiene standards, strict equipment sterilization after its usage and even maintaining adequate hand hygiene. Enhanced infection control practices greatly impact minimizing AMR pathogens distribution.

2. Antibiotic Stewardship- Teaching the healthcare providers how not to use antibiotics is a crucial thing in preventing overuse prescription. Antibiotic stewardship programs are designed to promote use of antibiotics only when truly required; appropriate drug, dose and length of treatment should be taken.

3. Improved access to WASH: Access to clean water and sanitation is a fundamental aspect of preventing infections in mothers and newborns. WASH interventions such as clean birthing practices, can reduce the risk of neonatal sepsis due to unsanitary conditions.

4. Maternal Health Strengthening: Proper maternal care, such as proper vaccination, antenatal steroids, and supplementation of micronutrients, can reduce the risk of prematurity and neonatal infection. Prevention of infection in mothers is the first step towards prevention of infection in newborns.

5. Early Diagnosis and Treatment: Early identification and treatment of neonatal infections are very important. This includes proper screening for sepsis and the use of appropriate antibiotics based on the local resistance patterns. It also involves ensuring that infants receive adequate neonatal care, such as those provided in Special Newborn Care Units (SNCUs).

The rise of antimicrobial resistance is a global health challenge that requires urgent action. Combating AMR requires a coordinated effort from governments, healthcare systems and communities worldwide. In neonatal care, addressing AMR is essential to further reducing neonatal mortality rates and ensuring that every newborn has the opportunity to thrive.

As Dr. Taduri concludes, "While we have made substantial progress in reducing neonatal mortality, the emerging risk of antimicrobial resistance creates a major challenge for our efforts. Combating AMR requires a global collective effort, with priorities on infection prevention, responsible use of antibiotics, and enhancement of healthcare practices to ensure a healthier future for all newborns."

Dr Apoorva Taduri is a Consultant Neonatologist at Fernandez Hospital

With infertility affecting an estimated one in six couples, experts at the Times Network India Health Summit 2026 spoke about the importance of seeking timely reproductive health advice and acquiring awareness about treatment options.

They discussed how advancements in fertility treatment have improved the chances of conception, but in vitro fertilisation (IVF) cannot guarantee a pregnancy.

During a panel discussion titled “The Fertility Revolution: Reimagining Parenthood in Modern India,” experts also examined how technology is shaping fertility care, while focusing on the limits of treatment, the cost of repeated IVF cycles and the dire need to address stigma around infertility.

IVF Is A Ray Of Hope For Many Couples But Not A Guarantee

Dr. Hrishikesh Pai, Founder and Managing Director of Bloom IVF India, spoke about the improvement in IVF outcomes over the past three decades. “When I started my own area in 1990, the success rate was 5%. Now it has gone to 30%,” he said.

Pai also spoke about the expansion of India's fertility treatment sector, saying the country had moved from an emerging field to one with centres capable of matching international units in performance.

Technology is also fueling more possibilities in reproductive treatment. Pai discussed the use of artificial intelligence (AI) to assist with embryo selection, egg assessment and sperm identification, alongside emerging techniques like robotic-assisted microinjection.

However, Dr. Abha Majumdar, Emeritus Consultant in IVF and Human Reproduction at Sir Ganga Ram Hospital, cautioned against allowing these advances and spoke about the importance of maintaining unrealistic expectations.

“IVF is not a miracle,” she said, emphasising that patients should receive accurate information about likely outcomes and the limitations of treatment.

Majumdar also raised concerns about AI-generated advertisements promising successful IVF cycles. She stressed that technological progress does not remove the responsibility to communicate treatment outcomes honestly and compassionately.

Age And Fertility Preservation

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For couples considering parenthood later in life, understanding age-related fertility decline is important. Dr. Ranjana Sharma, Senior Consultant in Obstetrics and Gynaecology at Indraprastha Apollo Hospital, explained that women are born with a finite supply of eggs, which declines over time.

She highlighted the need for greater awareness of reproductive timing and the options available to people who plan to delay pregnancy.

Majumdar also discussed reproductive autonomy, noting that women increasingly have the freedom to decide when, or whether, to have children. However, she cautioned against viewing egg freezing as a guarantee of future pregnancy, describing it instead as a form of insurance.

Fertility preservation may also be relevant for people facing medical treatments that could affect their reproductive potential. Pai highlighted egg freezing before chemotherapy or radiation therapy as an option for some women who wish to preserve the possibility of having children later.

Sperm freezing can similarly help some men preserve fertility before cancer treatment or in circumstances where future fertility may be a concern.

Financial Burden Of IVF

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Even when treatment is available, its cost can be anobstacle. Some patients require more than one IVF cycle, making the overall expense staggering.

Majumdar warned that repeated treatment can become expensive for some families. Although access to fertility services and insurance coverage have improved, affordability remains an important concern.

She also emphasised that patients need realistic information before beginning treatment, including an understanding that one cycle may not result in pregnancy.

Dr. Vimal Grover, who spoke about rising infertility and changing reproductive patterns, identified delayed marriage and childbearing, along with work-related stress, among the factors she had observed. She also pointed to AI's potential role in transforming fertility care.

“One in six couples is infertile,” Grover said. The figure highlights the scale of the infertility crisis in the country.

Male Infertility Remains Overlooked

The panel also addressed the tendency to blame women when couples experience difficulty conceiving. Sharma said women are often held responsible for infertility, even though reproductive difficulties can involve either partner. She also said that fertility specialists increasingly make a point of consulting both partners to encourage shared responsibility for getting tested and treated.

Pai similarly emphasised the importance of evaluating male fertility. Alongside sperm freezing before chemotherapy or radiation therapy, he highlighted its relevance for men with low sperm counts and some patients who may need fertility treatment in the future.

The experts urged couples experiencing difficulties conceiving to seek medical advice rather than feel ashamed or assume that infertility is solely a woman's concern.

The panel was part of the Times Network India Health Summit 2026, held in New Delhi under the theme “The Blueprint for a Future-Ready Healthcare Ecosystem – Innovation. Access. Self-Reliance.” The summit brought together healthcare leaders, clinicians, researchers, policymakers and industry stakeholders to discuss the future of India's healthcare system.

At the Times Network India Health Summit 2026, Dr. Deepak Kumar, Professor and Head of the Department of Psychiatry at the Institute of Human Behaviour and Allied Sciences (IHBAS) said that suicidal thoughts should be treated as a medical emergency requiring immediate professional help, just as in cardiac emergencies.

He said, “A death wish is usually a cry for help. Just as we provide immediate medical care during cardiac emergencies, suicide risk also requires urgent medical attention.”

Speaking during a session titled “The Next Frontier in Indian Psychiatry: Specialization, Geriatric Mental Health, and De-addiction Strategies”, Dr. Kumar discussed the importance of recognising early warning signs and monitoring screen time in children to prevent serious mental health disorders.

Dr. Kumar stressed that suicidal thoughts or a wish to die should never be treated casually as they could be silent cries for help.

"It is a very good thing to give space to mind and mental health in a health conclave. If we look at the numbers in our country, the total proportion is alarming. For example, the national mental health survey shows a lifetime prevalence of 13.7%. One in every 5 people has some psychological issue. Suicide statistics show 12 per lakh. Top 3 causes of death in young adults - one of them is suicide."

Excessive Screen Time Can Affect Children's Mental Health

While discussing smartphones and social media, Dr. Kumar said excessive screen use can interfere with daily functioning as one could be hooked on instant dopamine hit.

He spoke about gaming addiction disorders and said that such problematic smartphone use and excessive screen exposure are forms of behavioural addiction.

He said, “I will not advocate a blanket ban on smartphones like in Australia as they can also support education and learning.”

He advocated for judicious use among children and more awareness among parents to prevent excessive screen exposure.

Also read: Children’s Mental Health In The Digital Age: Can Governments Protect Them Without Restricting Internet Access? | Interview

Why Parents Should Set Screen-Time Limits

Dr. Kumar expressed concern about parents giving smartphones to very young children. He also recommended avoiding screen time for children under two and limiting use among older children.

He also said that Parents should pay attention to changes in children's sleep, mood, social interactions and everyday activities. He said looking out for signs like social withdrawal, distress or other behavioural changes should be priority.

Behavioural Changes Can Be Mental Health Concerns

According to Dr. Kumar, psychiatric conditions are often identified through symptoms and changes in a person's thoughts, emotions and behaviour, rather than through blood tests or imaging alone.

Diagnosis depends on the nature, duration and severity of symptoms, as well as their effect on everyday functioning, relationships and family or social life.

A sudden change in behaviour can be a warning sign. Someone who is usually cheerful, for instance, may become withdrawn, gloomy or reluctant to leave their room. Constant mood changes, behavioural outbursts and changes associated with substance use may also warrant attention.

Physical conditions can affect mental well-being, too. Dr. Kumar cited thyroid disorders and diabetes as examples of conditions that may be associated with depression or anxiety.

When Emily Hughes saw that her 18-month-old daughter, Scarlett, had a swollen knee in late 2023, she initially thought it might be an injury from the toddler’s routine playtime. Scarlett was energetic and adventurous, and the swelling did not appear to cause her pain.

But the swelling did not improve, and further examinations eventually led to a diagnosis of juvenile idiopathic arthritis (JIA), a chronic inflammatory condition that affects children.

Hughes, who lives in Australia, told Mamamia that several doctors initially found no cause behind her daughter’s symptoms. The situation changed in February 2024, when Scarlett’s knee became hot, painful and more severely swollen. She could no longer bear weight on the affected leg. “She wouldn’t bear weight, and it was even more swollen,” Hughes said.

Scarlett was taken to the Royal Children’s Hospital in Melbourne, where doctors initially thought it was septic arthritis, a serious joint infection. Investigations failed but the family continued consulting specialists.

By May, after other possible explanations got investigated, Scarlett was referred to a rheumatologist and diagnosed with juvenile arthritis affecting three joints.

Now four years old, Scarlett is in remission and has returned to physical activities like climbing and doing cartwheels. Her experience highlights why stubborn joint swelling and changes in a young child’s movement deserve emergency medical attention, even when the child is not in pain.

What Is Juvenile Idiopathic Arthritis?

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Juvenile idiopathic arthritis is the most common form of chronic arthritis in children. It refers to a group of several conditions in which the immune system triggers inflammation in the joints by mistake. Although genetic and environmental factors may contribute, the exact cause is unknown.

The condition can affect children younger than 16 and may involve one or several joints. The knees, ankles, wrists and elbows are commonly affected.

Unlike arthritis, JIA can begin during toddlerhood. Its symptoms may also be difficult to recognise as young children cannot always describe pain, stiffness or discomfort accurately.

There is no single test that confirms JIA. Doctors start by assessing the child’s symptoms, medical history and physical examination, and may use blood tests and imaging to investigate inflammation and rule out other conditions.

Signs Of Juvenile Arthritis Parents Should Not Ignore

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According to the US National Institute of Arthritis and Musculoskeletal and Skin Diseases and the American Academy of Pediatrics, parents should watch for the following symptoms:

1. Continued joint swelling

A knee, ankle, wrist or other joint that remains swollen should be assessed on priority. In JIA, painless swelling may occur even when the child seems comfortable.

2. Morning stiffness

Children may struggle to move a joint after waking up or after sitting still for a long time. Stiffness may improve as they become more active during the day.

3. Limping or reluctance to walk

A toddler who starts limping, avoids putting weight on one leg or has difficulty walking may be experiencing joint inflammation.

4. Difficulty bending or straightening a joint

Limited movement is also one of the signs. A child may struggle to straighten an elbow, bend a knee or move a limb as freely as before.

5. Changes in play and everyday activities

A child who suddenly avoids climbing, running or playing, or struggles with activities they previously dud easily, may have pain or stiffness.

Some children with JIA may also experience fatigue, fever, rash or reduced appetite, depending on the type of disease. Untreated inflammation can damage joints and interfere with a child’s movement and development. Early diagnosis and treatment aim to control inflammation, maintain joint function and help children maintain their usual activities.

JIA can also affect the eyes. Some children develop uveitis, inflammation inside the eye that may cause no obvious symptoms initially but can threaten vision if left untreated. Regular eye examinations are therefore an important part of JIA.