Impact of a district level sick newborn care unit on neonatal mortality rate: 2-year follow-up.

OBJECTIVE: To evaluate the impact of creating a sick newborn care unit (SNCU) in a district hospital on neonatal mortality rate (NMR). STUDY DESIGN: This study was conducted in a district hospital with 6500 deliveries a year. A 14 bed SNCU that included controlled environment, individual warming and monitoring devices, infusion pump, central oxygen and oxygen concentrators, resuscitation and exchange transfusion, portable X-ray and in-house laboratory was created. Doctors and nursing personnel were trained. Baseline data for 10 months were compared with 2 years data of SNCU operation. RESULTS: Compared with the baseline neonatal mortality in the district hospital, neonatal mortality was reduced by 14% in the first year and by 21% in the second year after SNCU became functional. Estimated neonatal deaths averted were 329, which would reduce NMR of the district from 55 to 47 in 2 years. CONCLUSION: A modern sick newborn care facility created in a district hospital can substantially reduce hospital neonatal deaths and NMR of the district. This model may be an effective tool to reduce NMR of the country.

Study of the Impact of Deltamethrin Impregnated Mosquito Nets on Malaria Incidence at a Military Station.

Deltamethrin impregnated mosquito nets have been successfully used all over the world to combat malaria. To study the efficacy of these mosquito nets in the service conditions of Armed Forces, a field trial of Deltamethrin impregnated mosquito nets was carried out at Military Stations 'A' (trial station) and B (control station) between July 96 to June 99. July 96-June 97 was the pretrial year during which base line data was collected for malaria incidence. Three rounds of Deltamethrin impregnation of the mosquito nets were done in the trial station for the actual trial duration (July 97-June 99) in lieu of residual spraying. Antimalaria measures including residual spray were continued as usual in the control station. The intervention led to a significant decline in slide positivity rate and malaria incidence in the trial station. Malaria cases declined by 87% in the trial station whereas the control station noticed an increase by 75% at the end of the trial.