First Technical Report of Special Newborn Care Units (SNCUs) in India (original) (raw)
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Second Technical Report of Special Newborn Care Units (SNCUs) in India
Facility Based Newborn Care (FBNC) programme is one of the key initiatives launched by the Ministry of Health & Family Welfare, Government of India (MoHFW, GoI) under NRHM and RCH II to improve the status of newborn health in the country. Under this programme, Special Newborn Care Units (SNCUs) are being established at district hospitals and some sub-district hospitals to provide special care for sick newborns, that is, to provide all type of neonatal care except for assisted ventilation and major surgeries. This Technical report presents the results of the quarterly data collected from the States/UTs for the period April to June 2011. For the report, submission of written records was considered an essential pre-requisite for SNCU to be considered as an operational unit. After checking data for completeness and accuracy, a set of pre-defined indicators were calculated. The key findings are presented in this report.
Assessment of Special Care Newborn Units in India
Journal of Health, Population and Nutrition, 2011
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 Journal of Research in Medical Sciences
Background: India accounts for 24% of global neonatal mortality. It is important to study the mortality and morbidity pattern as it helps to implement new treatment protocols, interventions, planning and policy making which helps in better survival and improvement in the quality of life among survivors. The aim of the project study was to determine the causes of morbidity and mortality in neonates admitted in our hospital.Methods: This study was conducted at Special Newborn Care Unit (SNCU) of Veer Chandra Singh Garhwali Government Institute of Medical Science and Research providing level II neonatal care. This is a retrospective hospital based observational study. Data from admission and discharge registers were extracted, compiled and analyzed from March 2016 to February 2018. Neonates taken against medical advice and those referred to tertiary care centers were excluded in calculation of survival outcome. Statistical analysis was done in form of percentage, proportions and chi sq...
Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine
Facility Based Newborn Care (FBNC) is a key strategy to improve child survival, especially in newborn care where neonatal mortality rate (NMR) is stagnant in declining. Gujarat has achieved considerable amount of reduction in child deaths, but neonatal health requires attention. The study was aimed to assess the admission pattern of Special Newborn Care Units (SNCUs) which supports decision-making. A cross-sectional descriptive analysis was done from secondary data of the SNCU reports on the aspects of admission patterns, morbidity, and mortality pattern. The reports had been analyzed on various critical variables. In 2015-2016, Gujarat has operationalized forty SNCUs by saturating each district with at least one SNCU. The study found near proportions of (53%) inborn - (47%) outborn admission and 44% admission of female. Out of 69,662 admissions, 67% were discharged, 16% died, 10% leaving against medical advice, and 7% referred to higher centers. Major reasons for admission were res...
International Journal of Research in Medical Sciences
Background: Globally, neonatal deaths constitute 44% of all deaths in less than 5 years age group .The concept of SNCU is based on the learning from the “Purulia model”. This research study was undertaken, to assess the profile of sick newborns admitted in the SNCU.Methods The investigators analyzed this data and establish the morbidity profile of newborns admitted in SNCU Hamirpur in 2019.Results: Total of 422 newborns were admitted 197 (46.7%) were females and 225 (53.3%) were males. Out of these 381 (90.3%) were inborn and 41(9.7%) were out born. In inborn 293 (76.9%) weighed more than 2.5 kg, 83 (21.8%) were low birth weight <2.5 kg to 1.5 kg and 2 (0.52%) were very low birth weight i.e < 1.5 kg to 1 kg and one newborn was extreme low birth weight i.e <1 kg. In the out born group, 23 (56.1%) weighed more than 2.5 kg and 13 (31.8%) were low birth weight <2.5 kg to 1.5 kg, 4 (9.8%) were very low birth weight < 1.5 kg to 1 kg. Jaundice was the most common neonatal co...
IAR Consortium, 2021
Background: SNCUs have reduced the mortality& morbidity along with increased the survival of sick newborns. But the limited knowledge on the magnitude of neonatal morbidity patterns and its associated factors is hampering the early intervention in these SNCUs. This study was undertaken to study the disease pattern and its associated factors among neonates admitted to the inborn sick neonatal intensive care unit of Kamla Nehru Hospital Shimla district of Himachal Pradesh, India. Methods: Retrospective review of five years medical records of all neonates admitted to the Inborn Specialized Neonatal Care Unit of Kamla Nehru Hospital, Shimla covering the period January 2016 to December 2020 was conducted. The most important causes of admissions and its related factors were analyzed. Results: A total of 6607 neonates were admitted in the Inborn SNCU of Kamla Nehru Hospital Shimla in 5 years from Jan 2016 to Dec 2020. Among the total admissions, 3655(55.32%) were males while 2952 (44.68%) were females. Among the total admission in the SNCU in the study period, 3208 (48.55%) neonates were >2500 gm, 2483(37.58%) were1500-2499 gm, 752(11.38%) were 1000-1499gm and 164(2.48%) were <1000gm. Among the total admission 2877(43.54%) were >37 weeks of age, 2392 (36.20%) were 34-37 weeks, 1338(20.25%) were <34 weeks age. Among the total admission at SNCU,maximum 2840 (42.98%) were neonates having Jaundice which required phototherapy followed by Respiratory Distress syndrome 1420(21.49%), moderate &severe Birth Asphyxia 530 (8.02%), Others 463(7.01%), Sepsis 390(5.90%), Other causes of respiratory distress335(5.07%), Major congenital malformation 242(3.66%), Hypoglycemia 242(3.66%), Meconium aspiration syndrome 49(0.74%), Pneumonia 34(0.51%), Meningitis 26(0.39%), Hypothermia 20(0.30%) and HIE 16(0.24%). Conclusion :More centers with neonatal intensive care facilities in the hilly statesshould beestablished up by the government keeping in mind the difficult geographic terrain in Himachal Pradesh.
Global Health: Science and Practice
Combining a training package to improve the knowledge and skills of health care workers in managing sick and preterm neonates with pointof-care quality improvement skills successfully reduced the unindicated use of oxygen, antibiotics, and phototherapy while increasing the use of enteral feeds. n Despite a significant reduction in the use of 2 lifesaving medical interventions-oxygen and antibiotics-no increase in mortality or short-term adverse outcome was observed, indicating an overuse of these interventions in the preintervention period.
Special Newborn Care Unit is second level of facility-based care established to provide care for sick newborn. SNCUs are an important component of neonatal healthcare, particularly in settings where access to advanced medical care may be limited. The aim of this study is to analyze the survival status and cause of deaths of admitted newborn of neonates admitted at Special Care Newborn Units at district hospitals, Siddharthnagar, Uttar Pradesh.The secondary data from hospital authority about admitted newborn of Special Newborn Care unit is obtained for year 2019 and 2020. Information on age, sex, weight, duration of stay, cause of death, outcome of newborn is obtained for 4,752 newborns admitted during this period. Percentage distribution, Kaplan Meier, log rank and cox proportional methods are used to get results. The STATA 14 is used to analyse the data.The early neonatal period is high risk of mortality. Also, Low Birth weight newborns are at higher risk than Normal birth weight newborns. The primary cause of death is HIE/birth asphyxia followed by Sepsis.The results of the present study can be used by hospital administrative authorities for new policy implications to improve the health status of neonatal admitted to the hospital.