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Assessment of Special Care Newborn Units in India
The neonatal mortality rate in India is high and stagnant. Special Care Newborn Units (SCNUs) have been set up to provide quality level II newborn-care services in several district hospitals to meet this challenge. The units are located in some remotest districts where the burden of neonatal deaths...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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International Centre for Diarrhoeal Disease Research, Bangladesh
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3225112/ https://www.ncbi.nlm.nih.gov/pubmed/22106756 |
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author | Neogi, Sutapa Bandyopadhyay Malhotra, Sumit Zodpey, Sanjay Mohan, Pavitra |
author_facet | Neogi, Sutapa Bandyopadhyay Malhotra, Sumit Zodpey, Sanjay Mohan, Pavitra |
author_sort | Neogi, Sutapa Bandyopadhyay |
collection | PubMed |
description | The neonatal mortality rate in India is high and stagnant. Special Care Newborn Units (SCNUs) have been set up to provide quality level II newborn-care services in several district hospitals to meet this challenge. The units are located in some remotest districts where the burden of neonatal deaths is high, and access to special newborn care is poor. The study was conducted to assess the functioning of SCNUs in eight rural districts of India. The evaluation was based on an analysis of secondary data from the eight units that had been functioning for at least one year. A cross-sectional survey was also conducted to assess the availability of human resources, equipment, and quality care. Descriptive statistics were used for analyzing the inputs (resources) and outcomes (morbidity and mortality). The rate of mortality among admitted neonates was taken as the key outcome variable to assess the performance of the units. Chi-square test was used for analyzing the trend of case-fatality rate over a period of 3-5 years considering the first year of operationalization as the base. Correlation coefficients were estimated to understand the possible association of case-fatality rate with factors, such as bed:doctor ratio, bed:nurse ratio, average duration of stay, and bed occupancy rate, and the asepsis score was determined. The rates of admission increased from a median of 16.7 per 100 deliveries in 2008 to 19.5 per 100 deliveries in 2009. The case-fatality rate reduced from 4% to 40% within one year of their functioning. Proportional mortality due to sepsis and low birthweight (LBW) declined significantly over two years (LBW <2.5 kg). The major reasons for admission and the major causes of deaths were birth asphyxia, sepsis, and LBW/prematurity. The units had a varying nurse:bed ratio (1:0.5-1:1.3). The bed occupancy rate ranged from 28% to 155% (median 103%), and the average duration of stay ranged from two days to 15 days (median 4.75 days). Repair and maintenance of equipment were a major concern. It is possible to set up and manage quality SCNUs and improve the survival of newborns with LBW and sepsis in developing countries, although several challenges relating to human resources, maintenance of equipment, and maintenance of asepsis remain. |
format | Online Article Text |
id | pubmed-3225112 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | International Centre for Diarrhoeal Disease Research, Bangladesh |
record_format | MEDLINE/PubMed |
spelling | pubmed-32251122011-11-29 Assessment of Special Care Newborn Units in India Neogi, Sutapa Bandyopadhyay Malhotra, Sumit Zodpey, Sanjay Mohan, Pavitra J Health Popul Nutr Original Papers The neonatal mortality rate in India is high and stagnant. Special Care Newborn Units (SCNUs) have been set up to provide quality level II newborn-care services in several district hospitals to meet this challenge. The units are located in some remotest districts where the burden of neonatal deaths is high, and access to special newborn care is poor. The study was conducted to assess the functioning of SCNUs in eight rural districts of India. The evaluation was based on an analysis of secondary data from the eight units that had been functioning for at least one year. A cross-sectional survey was also conducted to assess the availability of human resources, equipment, and quality care. Descriptive statistics were used for analyzing the inputs (resources) and outcomes (morbidity and mortality). The rate of mortality among admitted neonates was taken as the key outcome variable to assess the performance of the units. Chi-square test was used for analyzing the trend of case-fatality rate over a period of 3-5 years considering the first year of operationalization as the base. Correlation coefficients were estimated to understand the possible association of case-fatality rate with factors, such as bed:doctor ratio, bed:nurse ratio, average duration of stay, and bed occupancy rate, and the asepsis score was determined. The rates of admission increased from a median of 16.7 per 100 deliveries in 2008 to 19.5 per 100 deliveries in 2009. The case-fatality rate reduced from 4% to 40% within one year of their functioning. Proportional mortality due to sepsis and low birthweight (LBW) declined significantly over two years (LBW <2.5 kg). The major reasons for admission and the major causes of deaths were birth asphyxia, sepsis, and LBW/prematurity. The units had a varying nurse:bed ratio (1:0.5-1:1.3). The bed occupancy rate ranged from 28% to 155% (median 103%), and the average duration of stay ranged from two days to 15 days (median 4.75 days). Repair and maintenance of equipment were a major concern. It is possible to set up and manage quality SCNUs and improve the survival of newborns with LBW and sepsis in developing countries, although several challenges relating to human resources, maintenance of equipment, and maintenance of asepsis remain. International Centre for Diarrhoeal Disease Research, Bangladesh 2011-10 /pmc/articles/PMC3225112/ /pubmed/22106756 Text en © INTERNATIONAL CENTRE FOR DIARRHOEAL DISEASE RESEARCH, BANGLADESH http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Papers Neogi, Sutapa Bandyopadhyay Malhotra, Sumit Zodpey, Sanjay Mohan, Pavitra Assessment of Special Care Newborn Units in India |
title | Assessment of Special Care Newborn Units in India |
title_full | Assessment of Special Care Newborn Units in India |
title_fullStr | Assessment of Special Care Newborn Units in India |
title_full_unstemmed | Assessment of Special Care Newborn Units in India |
title_short | Assessment of Special Care Newborn Units in India |
title_sort | assessment of special care newborn units in india |
topic | Original Papers |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3225112/ https://www.ncbi.nlm.nih.gov/pubmed/22106756 |
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