Referral Review of a SNCU in a District Hospital in Resource Limited Setting: A Retrospective Observational Study

Abstract

Introduction: Special newborn care units (SNCUs) have been established in several district and subdivisional hospitals to meet the challenges of high neonatal mortality. With single digit target of infant mortality in 2030, we need to review the functioning of these SNCUs in order to strengthen them to reach the target. So this study was undertaken with primary objective to study mortality and referral pattern. Methods: This retrospective observational study was conducted in district hospital Udhampur by analysing case records from SNCU admissions over three years from 2017-2019 Results: There were total of 341, 352 and 414 admissions in 2017, 2018 and 2019 respectively with a cumulative sex ratio of 702/405(male/female) over these 3 years. Referral rate was 31.31%, 31.31% and 30.19% for 2017, 2018 and 2019 respectively, whereas mortality rate was 2.05%, 1.93% and 2.41% for these 3 years respectively. Respiratory distress syndrome (RDS), sepsis and birth asphyxia were the major causes for referrals. Conclusion: With stagnant, non decreasing referral rates over 3 years, and ventilatory support as a major cause of referrals, a lot needs to be improved as far as respiratory support at SNCU level is concerned.