English

Abstract

INTRODUCTION: The neonatal mortality rate in India is high and stagnant. Special Care Newborn Units (SCNUs) have been set up at different levels Health Care Delivery System to provide quality newborn-care services in several hospitals to meet this challenge. Many units are located in the districts where the burden of neonatal deaths is high, and access to special newborn care is poor. MATERIALS AND METHODS: The study was conducted to assess the functioning of SCNUs in six centers of India. The evaluation was based on an analysis of secondary data from the six units that had been functioning for at least three year. A cross-sectional survey was conducted to assess the availability of infrastructure, equipment’s and human resources and assessment of the beneficiaries. Descriptive statistics were used for analyzing the inputs (Resources) and outcomes (Assessment of the beneficiaries). Correlation coefficients were estimated to understand the possible association of satisfaction rate of beneficiaries with factors, such as bed: doctor ratio, bed: nurse ratio, average duration of stay, and bed occupancy rate. RESULTS: The major reasons for admission and the major causes of deaths were birth asphyxia, sepsis, and LBW/prematurity. Likart’s Analysis is used to analyze Beneficiaries Assessment. Beneficiaries were not found at Level I NBSUs at the time of evaluation. The units had a varying nurse: bed ratio (1:1-1:2.14). The bed occupancy rate ranged from 83% to 121% (median 115%), and the average duration of stay ranged from three days to 8 days (median 5 days). Repair and maintenance of equipment were a major concern. CONCLUSION: 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 infrastructure, human resources and maintenance of equipment remain.