Abstract

PIP: Due to the nonavailability of separate nursing staff for a special care neonatal unit in a rural medical college, the strategy for neonatal care of high risk babies was changed from January 1, 1985 onwards. These babies were managed mainly in postnatal wards with emphasis on maternal involvement reinforced by day-to-day orientation of mothers, nurses, and doctors to neonatal care. The incidence of fullterm (FT), preterm (PT), and low birthweight (LBW) babies were comparable in 1984 and 1985. The overall neonatal mortality (NM) was 8.3% in 1984 and 4.3% in 1985, NM in PT was 50.8% in 1984 and 30.0% in 1985, and NM in LBW was 17.0% in 1984 and 9.3% in 1985. These rates were reduced by approximately 40-50% of that recorded in 1984. The difference in all groups was statistically significant. However, the NM in the VLBW (1500 g) did not change substantially. Deaths due to severe asphyxia and intraventricular hemorrhage were reduced from 4.03% of all livebirths in 1984 to 2.2%, the difference being statistically significant. The most significant reeducation was seen in deaths due to infection which dropped from 2.45% of total livebirths in 1984 to 0.88% of the total in 1985. With this experience, the authors recommend the measures adopted by them to reduce the NM, especially in small centers and rural areas where nursing and other facilities are not optimal.