The state of India's neonatal units in the mid-nineties

Abstract

Background: A previous study in 1987 showed that neonatal care facilities in major hospitals in the country were of a very poor standard. The present study was done to reassess their status. Design: A survey. Methods: A pretested structured questionnaire was sent to 48 centers in 1994-95. The responses were analyzed. Results: A total of 37 centers returned the questionnaire duly filled. Of them, 22 belonged to the government sector, the rest 15 to the private sector. A nursery bed: nurse ratio of less than 1.0 was reported by only 4 centers. Majority of the centers cited inadequate nursing strength and frequent transferring out of nurses as a major problem. Twenty nine (78%) centers had ventilation facilities. Most of them had 1 or 2 ventilators. Blood gas facility was available with 29 centers and parenteral nutrition was undertaken at 20 (54%) centers. Resuscitation bag(s) were available at all the centers and incubators at all except one. In quantitative terms, the following equipment was available in satisfactory numbers: resuscitation bags, resuscitation bassinet, incubators/open care systems, vital sign monitors, infusion pumps and pulse oximeters in 78.3%, 43.2%, 72.9%, 56.7%, 64.8% and 43.5% centers, respectively. Indigenous products of the following categories were reasonably well accepted: resuscitation bags, resuscitation bassinets, incubators, open care systems and dextrometers. Conclusion: The newborn care facilities, particularly the ventilation facilities, have improved in recent years. Almost 10 units were operating at or near level III standard of newborn care. Indigenous equipment of selected categories is replacing the imported equipment. However, most units continue to face problems of shortage of nursing personnel.