The Neo cradle Scheme: Leveraging Public-Private Partnerships to Maintain Single-Digit Mortality among Neonates in Kerala

Abstract

Kerala has consistently recorded the lowest Infant Mortality Rate (IMR) in the country, with the most recent Sample Registration System (SRS) data showing a figure of 5 per 1,000 live births. However, further reducing this rate faces a major challenge: overcrowding in public sector Level III Neonatal Intensive Care Units (NICUs). High-risk neonates who require advanced treatments such as mechanical ventilation often encounter referral difficulties when government medical college NICU beds are unavailable.  To bypass this logistical limitation, the Government of Kerala has introduced a program called the "Neo cradle" scheme in 2024.(1) This initiative operationalizes a strategic Public-Private Partnership (PPP) by means of a centralized digital network. The system helps in the immediate transfer of the neonates from the overcrowded government facilities to the empanelled private hospitals at the full cost of the treatment package to be borne by the exchequer of the state¹. This correspondence assumes an analytical approach to the frame of Neo cradle and its role in the separation of the advanced neonatal survival from the financial ability of the household.