Sick Newborn Care Units (SNCU) help reducing neo-natal deaths in India
Saraswati, eighteen years old, traveled for two hours from her remote village to reach the nearest big hospital in Birbhum district of West Bengal to deliver her baby. She delivered premature twin boys and both babies were severely underweight, weighing less then 1 kg. One of the twins died at birth and the surviving twin suffered from acute breathing difficulty and struggled to live.
Every year, about 1.5 million infants die in India. It was found that neonatal deaths contribute to almost 60% of infant deaths. Most of the deaths are preventable, and are mainly due to low birth weight, infections and asphyxia. West Bengal, one of the large states in India with 80 million people, records an estimated 58000 infant deaths (out of 1.5 million births) every year. The main reason for such a large number of deaths is the lack of access to quality health services in remote rural areas.
Stepping-up institutional care of newborns
To address the problem of neonatal deaths, the state Government of West Bengal with the
DFID support, decided to establish "Sick newborn care units" at district levels, to improve access to lifesaving medical services for thousands of newborns.
First a pilot was done in the district Purulia, where a 10 bedded sick newborn unit was established at the District Hospital in 2003. Based on the successful pilot, West Bengal has now scaled up the SNCU model to 6 districts with poor socio-economic and health indicators. These SNCUs caters to the very sick neonate with slim chances of survival. Among 1084 neonates managed at one of the SNCUs in West Bengal, 64% were of low birth weight and more then 20% were severely underweight, weighing less the 1.5 kg.
Manju’s ‘miracle’ baby
Manju and her husband belong to the disadvantaged scheduled caste community and living below the poverty line, in a remote village. 17-year old pregnant Manju was admitted in the hospital in an unconscious state with fits. She delivered a baby boy with severe respiratory problems.
The newborn was shifted immediately to the specialized care unit for the newborn - Sick new born Care unit (SNCU) where he received medical care at the hands of skilled personnel. After ten days of intensive care, Manju's baby is out of danger and improving. Manju had never expected that their sick baby would survive. They feel a miracle has happened. Manju can today walk into the SNCU and see her newborn and also feed him at regular intervals.
SNCUs in all the six locations in West Bengal have resulted in reduction of neonatal deaths, enhanced motivation among health service providers and brought greater credibility of government health institutions among people.
- Death rates amongst newborns are steadily reducing and data from the SNCU in the district of Purulia shows 30% reduction in neonatal death rates over last two years
- In another district, Birbhum, more than 1500 seriously sick neonates have used the SNCU, with 75% survival rates. Most of these babies were from the poorest families, and 70% were boys, highlighting the fact that there is strong male preference for care-seeking of sick babies. Efforts are being undertaken to promote early care seeking for girls also.
Lessons from the Purulia SNCU model have also been mainstreamed and scaled up nationally in India under the National Reproductive and Child Health Programme, which
DFID is supporting at the federal level. At present about 141 SNCUs are functioning in poor states like Orissa, Bihar, Rajasthan, MP, Chattisgarh, Assam, Uttar Pradesh, and Jammu and Kashmir