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Challenges in scaling up of special care newborn units-lessons from India

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Abstract

Neonatal mortality rate in India is high and stagnant. Special Care Newborn Units (SCNUs) are being set up to provide quality level II newborn care services in district hospitals of several districts to meet this challenge. The units are located in some of the remotest districts where the burden of neonatal deaths and accessibility to special care is a concern. A recently concluded evaluation of these units indicates that it is possible to provide quality level II newborn care in district hospitals. However, there are critical constraints such as availability and skills of human resources, maintenance of equipment and bed occupancy. It is not the SCNU alone but an active network of SCNU (level II care), neonatal stabilization units (level I care) and newborn care corners can impact neonatal mortality rate reduction higher. Number of beds is also not sufficient to cater to the increasing demand of such services. Available number of nurses is a problem in many such units. An effective and sustainable system to maintain and repair the equipment is essential. Scaling up these units would require squarely addressing these issues.

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References

  1. Darmstadt G, Bhutta ZA, Cousens S, Admas T, Walker N, Bernis LD. Evidence based, cost-effective interventions: how many newborn babies can we save? Lancet. 2005;365:977–988.

    Article  PubMed  Google Scholar 

  2. Mullem CV, Conway AE, Mounts K, Weber D, Browning CA. Regionalization of care in Winconsin: a changing health care environment. WMJ. 2004;103:35–38.

    PubMed  Google Scholar 

  3. Kirby RS. Perinatal mortality: the role of hospital at birth. J Perinatol. 1996;16:43–49.

    PubMed  CAS  Google Scholar 

  4. Jivani SKM. Evolution of neonatal intensive care in a district general hospital. Arch Dis Child. 1986;61:148–152.

    Article  PubMed  CAS  Google Scholar 

  5. Berge LN, Rasmussen S, Dahl LB. Evaluation of fetal and neonatal mortality at the University Hospital of Tromso, Norway, from 1976 to 1989. Acta Obstet Gynecol Scand. 1991;70:275–282.

    Article  PubMed  CAS  Google Scholar 

  6. Subramaniam C, Dadina ZK. Intensive care for high risk infants in Calcutta. AJDC. 1986;140:885–888.

    Google Scholar 

  7. Were FN, Mukhwana BO, Musoke RN. Neonatal survival of infants less than 2000 grams born at Kenyata National hospital. East Afr Med J. 2002;79:77–79.

    PubMed  CAS  Google Scholar 

  8. Mootabar H, Fox HE. Level 2 hospital delivery of low birth weight infants 1970–1979. Int J Gynaecol Obstet. 1983;21:27–32.

    Article  PubMed  CAS  Google Scholar 

  9. Hotrakitya S, Tejavej A, Siripoonya P. Early neonatal mortality and causes of death in Ramathibodi Hospital: 1981–90. J Med Assoc Thai. 1993;76:119–129.

    PubMed  Google Scholar 

  10. Sen A, Mahalanabis D, Singh AK, Som TK, Bandyopadhyay S. Impact of a district level newborn care unit on neonatal neonatal mortality rate: 2 year follow up. J Perinatol. 2009;29:150–155.

    Article  PubMed  CAS  Google Scholar 

  11. Swyer PR. The regional organization of special care for the neonate. Ped Clin North Am. 1970;17:761–776.

    CAS  Google Scholar 

  12. Northern neonatal network. Requirements for neonatal cots. Arch Dis Child. 1993;68:544–549.

    Article  Google Scholar 

  13. Laryea CCE, Nkyekyer K, Rodrigues OP. The impact of improved neonatal intensive care facilities on referral pattern and outcome at a teaching hospital in Ghana. J Perinatol. 2008;28:561–565.

    Article  Google Scholar 

  14. Mugford M, Szczepura A, Lodwick A, Stilwell J. Factors affecting the outcome of maternity care II: neonatal outcomes and resources beyond the hospital of birth. J Epidemiol Community Health. 1988;42:170–176.

    Article  PubMed  CAS  Google Scholar 

  15. Cooper PA, Rothberg AD, Davies VA, Herman AA. Needs for special care beds for the newborn in the Witwatersrand area. S Afr Med J. 1987;71:645–646.

    PubMed  CAS  Google Scholar 

  16. Mukasa GK. Morbidity and mortality in the Special Care Baby Unit of New Mulago Hospital, Kampala. Ann Trop Paediatr. 1992;12:289–295.

    PubMed  CAS  Google Scholar 

  17. Williams JL, McCarthy B. Observations from a maternal and infant hospital in Kabul, Afghanistan-2003. J Midwifery Womens Health. 2005;50:e31–e35.

    Article  PubMed  Google Scholar 

  18. English M, Ntoburi S, Wagai J, Mbindyo P, Opiyo N, Ayieko P, et al. An intervention to improve pediatric and newborn care in Kenyan district hospitals: understanding the context. Implement Sci. 2009;4:42.

    Article  PubMed  Google Scholar 

  19. Sen A, Mahalanabis D, Singh AK, Som TK, Bandyopadhyay S, Roy S. Newborn aides: an innovative approach in sick newborn care at district level special care unit. J Health Popul Nutr. 2007;25:495–501.

    PubMed  Google Scholar 

  20. Toolkit for setting up of special care newborn units, stabilization units and newborn corners. Available at: http://www.unicef.org/india/SCNU_book1_April_6.pdf (Accessed on August 20, 2009).

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Correspondence to Sutapa Bandyopadhyay Neogi.

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Neogi, S.B., Malhotra, S., Zodpey, S. et al. Challenges in scaling up of special care newborn units-lessons from India. Indian Pediatr 48, 931–935 (2011). https://doi.org/10.1007/s13312-011-0149-z

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  • DOI: https://doi.org/10.1007/s13312-011-0149-z

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