Sick New Born Care Unit

Neonatal mortality accounts for over 60% of Infant mortality and around 40% or fewer than five mortality. Further reduction

in Infant and Child mortality is critically dependant upon significant decline in Newborn deaths. Now with Advent of JSY an

average 70% of deliveries are conducted in the institutions, i.e., at P.H.C, C.H.C. & C.H and District hospitals, there are no

separate facilities to manage sick Neonates in the hospital and health centers, Even at district hospital, the sick Neonates

(Home delivered and Institutional delivered) are generally treated along with the older sick children.

OBJECTIVE:

The sole objective of these UNIT’s in NIPI Districts is to reduce the Neonatal mortality Rate or death of Newborn during the first

month of life.

Global Estimate of Cause of Neontal Mortality (WHO)

Infections , 32%

Asphyxia, 29%

Prematurity, 24%

Congenital Anomalies,

10%

Other, 5%

COMPONENTS:

(a) Coordination of Health Department, NIPI and IPGME & R(Kolkatta) to

provide strategic partnership to bring down the NMR.

(b) Strengthening of Health facilities already existing, by developing level-

II Care at the District Hospital and Stabilizing Units at the P.H.C, CHC

(c) Capacity development including training of Sisters and Doctors in

Critical Newborn Care. ( Training is planned to be done by NNF M.P.

Chapter and IPGME&R Kolkatta.

FACILITIES:

The fully air conditioned 12, bedded (Step Down 8 bed Extra) unit has a set up with servo 'controlled radiant warmer" photo

therapy units, digital weighing scale, pulse oxi-meter, syringe pump, ABG machine, electrolyte analyzer, portable X-ray, Central

Oxygen supply, autoclave and washing machine (supported by AHSD, Purulia Branch) which can be compared with any

modern super specialized institution.

The unit is manned with four trained Pediatricians, Twelve trained nursing staff and other supportive staffs which are arranged

from the existing manpower of District Hospitals.

FUTURE EXPANSION:-

All the CHC’s / DH would have stabilization units linked up to the central unit.

Community Mobilization, such as Women's group, TBA School Children, Adolescent girls for community participation in

Neonatal Care would be developed to reach the deprived. Yashoda Working in Maternity Wards will be helping the care of

newborn and educating mothers of children needing special care.

All such programmes will be linked and integrated with the Apex Unit.

PROTOCOLS FOR NEWBORN UNIT

1. Neo-natal Unit is a separate unit within the District Hospital

2. Civil Surgeon, District Hospital is the overall charge of the unit like other units of the District Hospital

3. All babies born in this hospital will be looked after by this unit

4. New born babies, will be admitted directly in the pediatric ward under the bed-in charge of pediatrics

and if they require intensive care, they may be transferred to the Neonatal Unit subject to availability of

beds. Once stabilized the newborn will be transferred back to the pediatric ward under the same

pediatrician. During the newborn's stay at the Neonatal Unit his/her mother will occupy his/her bed.

5. There is provision of running 21 beds, but to start with it will run with 12 beds.

6. The District Health Society will provide for any critical gap in terms of economics.

7. DHS may change the terms and conditions after reviewing the progress of this unit.

GENERIC PLAN FOR DISTRICT LEVEL SICK NEWBORN CARE

UNITS (LEVEL II)

Sick Newborn Care Units (SNCU) are a special newborn unit meant primarily to reduce the case fatality among sick children

born within the hospital or outside, including home deliveries within first 28 days of life.

These units will have:

1) Main Sick Newborn Care Unit: This should have at least 12 beds, which would cater to the sickest child in the Hospital. It

will have space for nursing work station, Hand Washing and Gowning at the point of entry.

2) Step down unit for children: This is an additional 6 bed Step down Unit where recovering neonates can stay i.e. neonates

who don’t need intensive monitoring.

3) Special newborn care ward: This is an additional 10 beds , where both the mother and the newborn can stay together for

neonates who require minimal support such as for phototherapy , uncomplicated low birth weight for observation esp. weighing

more than 1800gm and superficial infections etc.

4) Follow up area: This should be an additional area outside but not far away from the SNCU. This should be designated for

follow up of the neonates discharged from the SNCU.

5) Newborn corner with facilities for neonatal warmer and resuscitation at the labor room and Obstetrics Operation Theatre

6) Side laboratory room with facilities for at least doing neonatal septic screen and measuring bilirubin level

7) Teaching and training room.

8) Day and Night shelter for mothers of out born neonates with I.E.C. facilities e.g. T.V. with Audio- Video facilities

9) Place for In-house facility for washing, drying and autoclaving

10)Duty room for doctors and Nurses

11) Place for Promotion of Breast feeding and learning mother craft

12) Place for Soiled Utility/Holding Room and Clean Utility/Holding Area(s)

Pictures of a Model SNCU:- (Pictures Courtesy IPGME & R Kolkatta:- Dr Arun Singh)

WARDHAND WASHING CORNER

NEWBORN CARE SIDE LAB

Pictures Courtesy IPGME&R and District Health Society Purulia and GOVT of West Bengal

STERILISATION UNITSTERILISATION UNIT

PHOTOTHERAPYSister Giving care to Baby

Pictures Courtesy IPGME&R and District Health Society Purulia and GOVT of West Bengal

NIPI- A Child Health Initiative to Achieve MDG-4

BREAST FEEDING & SISTERS STATION

Infant Mortality Rates Decline in India

Dr Amitav Sen Presentation