Neonatal research in India: current status, challenges, and the way forward.

The present article systematically reviews the current status of neonatal research in India by examining the research articles published by Indian authors in the last 10 years. It also enlists the major challenges and proposes a few potential solutions to improve the status of neonatal research in the country. The systematic review of 574 eligible articles indicates that majority of the studies were observational in nature, facility-based, and primarily investigator-driven with no external funding, had small sample size, and were published in journals with low impact factor. Only a few select government and non-government academic institutions contributed to most studies. The major challenges include shortage of faculty, no provision for dedicated research time, inadequate knowledge/skills in research methods, lack of funding opportunities, limited access to literature, non-existence of research administrative cell, inappropriately low perks to research staff, and poor support for data management and statistical analysis. The recently revised guidelines on clinical trials involving drugs have further increased the researcher's dilemma. The potential solutions are to increase the faculty strength in medical colleges, allow dedicated research time to them, appoint dedicated research cadre with emoluments at par with clinical faculty, initiate formal training in research methods, create nationwide free portal for access to literature, facilitate development of good protocols through technical guidance at all stages, make the process of funding quick and transparent, and to promote collaborative trans-disciplinary research. Experts from different domains should come together and formulate evidence based research priorities. Regulatory mechanisms should be kept proportionate to plausible risks of research, and detailed ethical guidelines for research in children should be formulated. And last but not least, harnessing postgraduate thesis potential to answer simple and relevant clinical questions in a methodologically rigorous way is the need of the hour.