A study to evaluate the functioning of Special Care Newborn Unit (SNCU) established at a District Hospital

Abstract

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 districts where the burden of neonatal deaths is high, and access to special newborn care is poor. A cross-sectional survey was 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 first year of operationalization of SNCU as the base. The Average Neonatal Mortality Rate reduced from 1.29% before the start of SNCU in 2012 to 0.845% after 1 year of start of SNCU in Rajouri district during 2013-14 study periods. Proportional mortality due to sepsis and low birth weight (LBW) declined significantly over a period of one year (LBW <2.5 kg). The major reasons for admission and the major causes of deaths were birth asphyxia, sepsis, and LBW/prematurity. 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.