Development and effects of a neonatal care unit in rural India [letter]

The Purulia district of the state of West Bengal India has an area of 6259 km/2 a population of 2.54 million a birth rate of 24.8 and a neonatal mortality rate (NMR) of 55 per 1000 livebirths. The government health infrastructure in this district consists of a district hospital a subdistrict hospital five rural hospitals 15 community health centres and 53 primary health centres. Caesarean section and blood transfusion services are only available in the district hospital. Although an essential newborn care programme has been operational in the district for several years no specialised sick newborn care unit (SNCU) government or private is available in the district. We aimed to set one up in the district hospital and to estimate its effects on NMR. With the limited space manpower and funding available we developed a 12-bed state-of-the-art SNCU (based on level-II criteria from the National Neonatology Forum India). We did extensive hands-on training of in-service doctors and nurses and mobilised resources from the local self-government (panchayat). (excerpt)