Indian Pediatrics

, Volume 49, Issue 8, pp 651–658

Does facility-based newborn care improve neonatal outcomes? A review of evidence

  • Sutapa Bandyopadhyay Neogi
  • Sumit Malhotra
  • Sanjay Zodpey
  • Pavitra Mohan
Review Article

DOI: 10.1007/s13312-012-0135-0

Cite this article as:
Neogi, S.B., Malhotra, S., Zodpey, S. et al. Indian Pediatr (2012) 49: 651. doi:10.1007/s13312-012-0135-0

Abstract

Context

Facility based newborn care is gaining importance as an intervention aiming at reduction of neonatal mortality.

Objective

To assess different factors that affect effectiveness of facility based newborn care on neonatal outcomes.

Evidence acquisition

Electronic search using key search engines along with search of grey literature manually. Observational and interventional studies published between 1966–Aug 2010 in English having a change in neonatal mortality as an outcome measure were considered.

Results

A total of 40 articles were fully reviewed for generating synthesized evidence. All were observational studies. The exposure variables that affected neonatal outcomes were grouped into three categories-regionalization of perinatal care (17 articles), strengthening of lower level neonatal facilities (12), and other miscellaneous factors (11). Regionalization played a key role in advancing newborn care practices. It increased in-utero transfer of high risk newborns and improved survival outcomes especially for very low birth weight neonates at level III facilities. It led to reduction in neonatal mortality owing primarily to enhanced survival of low birth weight infants. Strengthening of lower level units contributed significantly in reducing neonatal mortality. High patient volume (>2,000 deliveries/year), inborn status, availability of referral system and inter-facility transfers, and adequate nursing care staff in neonatal units also demonstrated protective effect in averting neonatal deaths.

Conclusions

Countries investing in facility based newborn care should give impetus to establishing regionalized systems of perinatal care. Strengthening of lower level units with high case loads, can yield optimal reduction in NMR.

Key words

EfficacyEvaluationMortality rateNewborn OutcomeRegionalization

Supplementary material

13312_2012_135_MOESM1_ESM.pdf (265 kb)
Supplementary material, approximately 264 KB.

Copyright information

© Indian Academy of Pediatrics 2012

Authors and Affiliations

  • Sutapa Bandyopadhyay Neogi
    • 1
    • 2
    • 4
  • Sumit Malhotra
    • 1
    • 2
  • Sanjay Zodpey
    • 1
    • 2
  • Pavitra Mohan
    • 3
  1. 1.Indian Institute of Public HealthDelhiIndia
  2. 2.Public Health Foundation of IndiaHaryanaIndia
  3. 3.UNICEFIndia Country OfficeNew DelhiIndia
  4. 4.Indian Institute of Public Health (IIPH-Delhi)Public Health Foundation of India (PHFI)GurgaonIndia