Impact of a district level sick newborn care unit on neonatal mortality rate: 2-year follow-up

Abstract

To evaluate the impact of creating a sick newborn care unit (SNCU) in a district hospital on neonatal mortality rate (NMR). This study was conducted in a district hospital with 6500 deliveries a year. A 14 bed SNCU that included controlled environment, individual warming and monitoring devices, infusion pump, central oxygen and oxygen concentrators, resuscitation and exchange transfusion, portable X-ray and in-house laboratory was created. Doctors and nursing personnel were trained. Baseline data for 10 months were compared with 2 years data of SNCU operation. Compared with the baseline neonatal mortality in the district hospital, neonatal mortality was reduced by 14% in the first year and by 21% in the second year after SNCU became functional. Estimated neonatal deaths averted were 329, which would reduce NMR of the district from 55 to 47 in 2 years. A modern sick newborn care facility created in a district hospital can substantially reduce hospital neonatal deaths and NMR of the district. This model may be an effective tool to reduce NMR of the country.