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Admissions to a sick new born care unit in a secondary care hospital: Profile and outcomes
Ravi Shekhar Sinha1, D Sharon Cynthia2, P Vinod Kumar3, Lois J Armstrong4, Anuradha Bose5, Kuryan George5
1 Field Research Officer – VL, CARE India, Patna, India
2 Assistant Professor, Department of Community Medicine, Government Vellore Medical College, Vellore, Tamil Nadu, India
3 Paediatric Infectious Diseases Fellow, Department of Child Health – Unit 3, Christian Medical College, Vellore, Tamil Nadu, India
4 Research Coordinator, Epidemiology and Research Department, Duncan Hospital, Raxaul, Bihar, India
5 Professor, Department of Community Medicine, Christian Medical College, Vellore, Tamil Nadu, India
Correspondence Address:
D Sharon Cynthia
Department of Community Medicine, Government Vellore Medical College, Adukkamparai, Vellore - 632 011, Tamil Nadu
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ijph.IJPH_106_18
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Background: To reduce neonatal mortality in North Bihar, evidence is required about the impact of sick newborn care units (SNCUs) in secondary level hospitals on mortality at the end of the neonatal period. Objectives: The objective of the study is to assess the profile of neonates admitted to an SNCU and the outcome at the completion of neonatal period. Methods: A cohort of neonates admitted from March to June 2014 to an SNCU was assessed through family interviews and hospital records. Demographic details (age, sex, and socioeconomic status) and clinical details (antenatal care, birthplace, weight, diagnosis, and family history) were documented. Follow-up was done at discharge or death or referral and the completion of neonatal period. The primary outcome was survival at the completion of neonatal period. Secondary outcomes were case fatality rate at discharge and weight gain. Results: Of 210 neonates assessed, 87.6% (95% confidence interval [CI] 82.4–91.4) survived till the end of the neonatal period. The case fatality rate at the time of discharge was 0.9% (95% CI 0.3–3.4). Majority of the diagnoses were infections, hyperbilirubinemia, and infant of diabetic mother. Mean weight gain at the end of neonatal period (n = 157) was 706 g (P = 0.00). Sex ratio at admission was 567 girls to 1000 boys (95% CI 428/1000–751/1000). No neonate from lower socioeconomic families was admitted. Conclusions: SNCUs in remote areas can bring down neonatal mortality in North Bihar. Unequal access of SNCUs services to girls and lower socioeconomic groups highlighted the existing barriers which require attention.
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