hshrc STATE HEALTH SYSTEMS RESOURCE CENTRE, HARYANA hshrc

Assessment of Functional SNCUs in Haryana


Government of India (GOI) is committed to improve the availability of quality newborn care services for reduction in IMR and U5MR since neonatal mortality is one of the major contributors to IMR. Establishment of Special Newborn Care Unit (SNCU) in the states was a step towards achieving this goal. In order to check the utility of SNCUs, NHSRC took an initiative to evaluate the overall functioning of SNCUs in two states of India i.e. Haryana and Maharashtra and asked HSHRC to conduct an evaluation at 15 functional SNCUs in Haryana.



Key findings:


Human Resource:


ResourceShortage
(as per standards)
Medical Officers 25%
Paramedical Staff 15%
Lab Technicians 20%
Class - IV 32%


Equipment and Supply:


ResourceShortage
(as per standards)
Monitoring Equipment 53%
Pulse Oximeters 68%
Resuscitation Equipment 14%
Suction Machines 47%
Oxygen Concentrators 60%

  • Equipment for oxygenation facility and head boxes for oxygen were available in excess.


Laboratory Facilities:

  • Separate investigation facility was not available in any SNCU. However, few basic tests like Blood Cell Count, Platelets, Plasma Glucose and Serum Bilirubin were done in all the SNCUs using infrastructure of hospital laboratory.


Protocols and Processes at SNCU:

  • Written instructions/guidelines for equipment cleaning, disinfection and fumigation were available in only 60% SNCUs.
  • About 33% SNCUs did not have provisions for proper hand washing and staff was unable to demonstrate hand washing technique as per the norms.


Infection Control Practices at the SNCU

  • In 80% of SNCUs, the periodic bacteriological surveillance was not done by infection control committee.
  • 26% SNCUs did not have adequate availability of coloured biomedical waste bins.


Related to utilization of SNCUs

  • Only 11.8% (274) facilities referred the neonates to SNCUs for their intensive treatment and care.
ResourceShortage
(as per standards)
Monitoring Equipment 53%
Pulse Oximeters 68%
Resuscitation Equipment 14%
Suction Machines 47%
Oxygen Concentrators 60%


  • 62% neonates were admitted for the treatment of single illness, 20% with two illnesses and 38% neonates suffered multiple illnesses.
  • Mean duration of stay in the facility of sick neonates came out to 4.5 days.
  • On average 60.5% of the newborn were given antibiotics for their treatment
  • 5 out of 15 SNCUs had more than 80% discharge rate. SNCU Faridabad and Fatehabad had reported highest death rates i.e. 17% and 15.7% respectively.

Key Recommendations:

  • For effective functioning of SNCUs, a dedicated lab facility catering to the SNCUs only, should be provided.
  • Standard Operating Procedures (SOPs) should be provided for all kinds of services in SNCUs and strict adherence to protocols should be monitored.
  • Blood culture should be done before prescribing antibiotics to the newborn to avoid un-necessary antibiotic medication.