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Indian Pediatr 2017;54: 243-244 |
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Assessment of Newborn Care Corner in Public
Health Facilities of Ludhiana, India
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Samridhi Gulati, Sarit Sharma and *Rajinder
Gulati
Department of Community Medicine, Dayanand Medical
College and Hospital, and *Department of Pediatrics, Civil
Hospital; Ludhiana, Punjab, India.
Email:
[email protected]
Published online: February 02, 2017.
PII:S097475591600047
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In this cross-sectional study of 15
public health facilities in Ludhiana, India, we evaluated 22 delivery
points for equipment and trained health personal available at Newborn
Care Corner (NBCC) for neonatal resuscitation. NBCCs were established at
all the delivery points except one, with radiant warmers in place
including non-functional warmers at four (18%) delivery points.
Self-inflating resuscitation bag was available at 20 delivery points but
shoulder roll and masks of both sizes were available at only 4 (18%) and
5 (27%) delivery points, respectively. Only 4 (27%) facilities had
round-the-clock availability of a nurse or midwife trained in neonatal
resuscitation, whereas none of the facility had round the clock
availability of medical officer trained in neonatal resuscitation.
Keywords: Healthcare evaluation, Neonatal
mortality rate, Neonatal resuscitation.
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Neonatal resuscitation is an important
intervention to reduce neonatal mortality [1,2]. It is vital that health
systems are equipped with necessary supplies, and the staff members are
competent enough to provide evidence-based resuscitation [3]. Indian
Academy of Pediatrics (IAP) in collaboration with National Rural Health
Mission (NRHM) of Government of India developed Basic Newborn Care and
Resuscitation Program (BNCRP) of Navjaat Shishu Suraksha Karyakram
(NSSK) adopted from Neonatal Resuscitation Program (NRP) guidelines for
grassroot workers as well as pediatricians [4]. The objective of present
study was to find out the availability of requisite equipment at Newborn
Care Corner (NBCC) as well as health personal trained in NSSK, in public
health facilities of Ludhiana district, Punjab, India.
The study was conducted in the month of July and
August 2015. Fifteen out of the total 30 public health facilities of
Ludhiana District, were selected as guided by the delivery load in each
of the four categories viz., District Hospital (one out of one),
Sub-divisional hospitals (two out of four), Community Health Centers
(four out of nine) and Primary Health Centers (eight out of sixteen).
The ethical approval was obtained from the Institutional Ethics
Committee (IEC) of Dayanand Medical College and Hospital, Ludhiana;
permission from NRHM, Punjab was also obtained.
The findings of requisite equipment available for
neonatal resuscitation are summarized in Table I. All the
health facilities had medical officer, staff nurse or auxiliary nurse
midwife (ANM) to conduct the delivery and provide newborn care. NSSK
trained staff nurse/ANM were available round the clock at only four (2
SDH, 1 CHC, 1 PHC) out of 15 public health facilities. None of these
facilities had round the clock availability of NSSK-trained medical
officer. Out of the total ANM’s/staff nurses and medical officers
available at the time of delivery, 57% and 28% were trained in NSSK,
respectively.
TABLE I Overall Status of Facility-based Newborn Care Corner in Ludhiana
Equipment |
No (%) |
Heating Source |
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Availability of warmers |
21 (95) |
Non-functional warmers |
4 (18) |
Availability of Resuscitation apparatus |
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resuscitation bag |
20 (91) |
Mask size 0 |
9 (41) |
Mask size 1 |
13 (59) |
Mask size 0 & 1 |
4 (18) |
Availability of two clean dry sheets |
16 (73) |
Availability of suction/mucus extractor |
21 (95) |
Availability of shoulder roll |
5 (23) |
Availability of Oxygen/filled cylinders |
17 (77) |
Availability of baby weighing scale
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21 (95) |
Pediatric |
0 |
Adult |
18 (82) |
Availability of clock with seconds hand |
17 (77) |
Availability of sterile gloves |
21 (95) |
Of the 22 delivery points studied at 15 public health
facilities, NBCC were established at all delivery points except one,
with radiant warmers in place. Radiant warmers at four of these
facilities were not in functioning state. Self-inflating resuscitation
bag was available at 20 delivery points with mask available at 18 of
these delivery points. Masks of both sizes were available at only four
(18%) delivery points.
For neonatal resuscitation, the most important step
is positive pressure ventilation with bag and mask [5]. A similar study
from 13 CHCs from Bharatpur District of Rajasthan [6] reported
deficiencies in the presence of equipment related to essential newborn
care services. Only 3 out of 13 (23.1%) had radiant warmers, 4 out of 13
(30.8%) had resuscitators, and 9 out of 13 (69.2%) had suction pumps
available in the facilities. None of the included CHCs in this
assessment had fully-equipped newborn care corner [6]. In another
facility-based survey in rural area of Lucknow District, Uttar Pradesh
in 9 community health and 9 primary health centers, availability of
essential newborn care equipment and trained personnel was grossly
inadequate in almost all the PHCs [7].
This study revealed that, despite availability of
NBCCs, these were not fully equipped. This calls for a change of mindset
and provision of adequate sensitization of care providers using the
NBCCs. Availability and functionality of necessary equipment and
NSSK-trained staff to use the equipment will be important to realize the
potential gains that can be achieved through provision of neonatal
resuscitation – an important intervention for reducing neonatal
mortality.
Acknowledgements: Director, National Health
Mission, Department of Health and Family Welfare, Government of Punjab
for support to conduct the study.
Contributors: SG, SS, RG: designed the study, and
interpreted the data; SS, RG: drafted the work; SG, RG: collected the
data. All authors approved the final manuscript.
Funding: Indian Council of Medical Research
(ICMR), India under Short Term Studentship (STS)-2015 program.
Competing Interest: None stated.
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