DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20173709

Status of neonatal death in sick newborn care unit of a tertiary care hospital

Ashish Kumar Mishra, Sadhu Charan Panda

Abstract


Background: In view of clusters of death in Sick New Born Care Units of tertiary care hospitals in recent past and few studies done so far in this field necessitates a research. The aim of the present study was to assess the factors associated with neonatal mortality and the infrastructure of the SNCU.

Methods: All sick neonates admitted in the SNCU during June and July 2017 were followed up till they were discharged or declared dead. Data were collected by facility observation, interview of parents/attendants and from patient case sheet with a predesigned a pretested questionnaire and were analyzed applying appropriate statistical methods.

Results: Prevalence neonatal death was 12 per cent among 250 sick neonates studied. Majority of neonatal deaths occurred   among mothers having lower SE Status 25 (27.4), antenatal visits less than 4 times (22, 22%), undernourished neonates (24, 37.5%) all of which were significant. Majority of morbidity were of Prematurity, (110, 44%) followed by Birth Asphyxia (96, 38.4%) and Infections (35.2%) and leading cause of death was infection. There was a deficit of resources from 25% to 75% and no monitoring and supervision were done till date.

Conclusions: Health care delivery system at block level and below needs to be strengthened in terms of   antenatal visits, improvement of nutritional status of mother. The resource constraint of SNCU at tertiary care hospital and surveillance and monitoring mechanism requires prompt action to make SNCU more effective. 


Keywords


Antenatal visit, Awareness, Neonatal death, SNCU, Undernourished

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References


Lawn JE, Wilczynska-Ketende K, Cousens SN. Estimating the causes of 4 million neonatal deaths in the year 2000. Int J Epidemiol. 2006;35(3):706-18.

TNN, 11 deaths in SNCU of Malada hospital TNN Apr 7, 2012. Available at http://articles.timesofindia.indiatimes.com/keyword/neonatal-deaths

Press trust of india, ‘probe begins into death of nine infants in hospital of odisha” 21 July, 2013. Available at http://www.ndtv.com/india-news/probe-begins-into-the-death-of-nine-infants-in-odisha-hospital-529076. Accessed 5th June,2014.

Staff Reporter. THE HINDU 12 infants die in two days in West Bengal hospital August 3, 2014, Available at http://www.thehindu.com/todays-paper/12-infants-die-in-two-days-in-west-bengal-hospital/article6276436.ece. Accessed 8th August, 2014.

Agrawal KC, Gupta R, Roy MP. Mortality in newborns referred to tertiary hospital: An introspection. J Fam Med Prim Care. 2015;4(3):435-8.

Jeet G1, Sharma A, Mohanta TG, Trakroo A. Health seeking behavior of the mothers for the special care new-born unit discharged children: a comparative study. Indian J Public Health. 2013;57(2):113-6.

Park K. Park’s textbook of preventive and social medicine. 22nd edition

Ministry of Health and Family welfare. A strategic approach to RMNCH+A in India for healthy mother and child. MoHFW. Govt. of India. 2013. Available at http://cghealth.nic.in/ehealth/2016/RMNCH/1_RMNCHA_Strategy.pdf

Tuladhar H, Dhakal N. Impact of antenatal care on maternal and perinatal outcome: A Study at Nepal medical college teaching hospital. NJOG. 2011;6(2):37-43.

Singh A, Pallikadavath S, Ram F, Alagarajan M. Do antenatal care interventions improve neonatal survival in India? Health Policy Plan. 2014;29(7):842-8.

MacDorman MF, Declercq E, Menacker F, Malloy MH. Infant and neonatal mortality for primary cesarean and vaginal births to women with "no indicated risk," United States, 1998-2001 birth cohorts. Birth. 2006;33(3):175-82.

Kumar MK, Thakur SN, Singh BB. Study of the morbidity and the mortality patterns in the neonatal intensive care unit. J Clin Diagnostic Res. 2012;6(2):282-5.

Singh A, Kumar A, Kumar A. Determinants of neonatal mortality in rural India, 2007–2008. PeerJ. 2013 May 28;1:e75.

World Health Organization. Neonatal and perinatal mortality: country, regional and global estimates. Geneva: World Health Organization;2006. Available at http://apps.who.int/iris/bitstream/10665/43444/1/9241563206_eng.pdf

WHO (World Health Organization). Basic newborn resuscitation: practical guide. 1998a. Available at http://apps.who.int/iris/bitstream/10665/63953/1/WHO_RHT_MSM_98.1.pdf

Kramer MS. Determinants of low birth weight: methodological assessment and meta-analysis. Bull World Health Organization. 1987;65(5):663.

Kousar T, Memon Y, Sheikh S, Memon S, Sehto R. Risk factors and causes of death in neonates. RMJ. 2010 Jul;35(2):205-8.

Singh AK. SNCU Toolkit. Presented by NCRC & Department of Neonatology. IPGMER, Kolkata; 2007:13-14.

Augustine T, Bhatia BD. Early neonatal morbidity and mortality patterns in hospitalized children. Indian J Maternal Child Health. 1994;5(1):17-19.

Lawn JE, Zupan J, Begkoyian G, Knippenberg R. Newborn Survival Chapter 27, Disease control priorities in developing countries. 2nd edition. Jamison DT, Breman JG, Measham AR, et al, editors. Washington (DC): World Bank; 2006

Pathak U, Aspatal MV. Consolidated reply to Query: Facility Based Newborn Care – Experiences; Solution exchange for MCH Community, Compiled by Joy Elamon, Resource Person and Meenakshi Aggarwal, Research associate, MCH Community, Solution Exchange, Issue Date: 11 November 2009, Available at file:///E:/ResearchPUBLISELF/cr-se-mch-03090901-public.pdf Accessed date 20th August, 2014.