Abstract of Dissertation

Keyword : Morbidity Status; Mortality Status; Newborn; Inborn; Quality of Care; AMC; Cause of Morbidity

Objective : To assess the morbidity status and mortality status of newborns admitted at SNCU Departments of Ahmedabad Municipal Corporation Gujarat. Method: Secondary Data was collected from SNCU Departments using Semi structured Questionnare.

Background : India carries the highest single share of neonatal deaths in the world with around 30% of the global neonatal deaths. Of the 26 million babies born every year in India, about 940,000 babies die before the age of one month (1). According to the SRS 2015 report, neonatal mortality contributes to about two thirds of all infant deaths (NMR 25/1000 live births, IMR 37/1000 live births) and about half of under-5 deaths in the country (U-5MR 43/1000 live births, SRS 2015). Though IMR has shown a steady decline over the last few years (from 58/1000 live births 2004 to 37/1000 live births in 2015), the decline in NMR has been disproportionately slow (from 37/1000 live births in 2004 to 25/1000 live births in 2015).

Findings : 47 Percent of Inborn Newborn and 50 Percent of Outborn Newborns were low birth weight. Equal number of Inborn and Outborn Patients have weight above 2500 grams and only below 10 Percent of new borns have extremely low birth weight. Around 47 Percent of Inborn Newborn and 34 of outborn Newborn were suffering from Mild Birth Asphyxia and Lactation Problem and 19 Percent and 35 Percent of outborn were suffering from Jaundice requiring Phototherapy. Rest were suffering from Respiratory Distress Syndrome and Sepsis/Meningitis, Major Congenital Malformation. About two-thirds of Inborn Newborns who were admitted got discharged and 4/5th of Outborns were discharged from SNCU department and 15 percent of Inborn and nine percent of Outborn got died in SNCU department. Rest were left against medical advice and only very few in number were referred to higher facility for treatment. Majority of Inborn (37 percent) and Outborn (31 Percent) Newborns died because of Respiratory Distress Syndrome. Approximately 50 percent of outborn newborns were died because of Sepsis/Pneumonia/Meningitis. About one fifth of Newborns died within less than 1 Day of admission.50 Percent of Inborn and 40 Percent of outborn died between 1-3 Day of admission. Below 20 Percent of Inborn and 30 percent of outborn were died between 4-7 day of admission. About 71 Percent of Inborn and 50 percent of outborn newborns died within 1st week of Birth 19 percent of Inborn and six percent of outborn were died within less than 1 day of life, approximately 44 percent of outborn and ten percent of Inborn died greater than 7 Days of life.

Recommendations :48% of Newborn were low birth weight,11% were very low birth weight and 3% were extreme low birth weight at time of admission in SNCU Department. 39% of SNCU admitted Newborns were suffering from Birth Asphyxia and Lactation Problem and 15% of Newborns were suffering from RDS. 36% of the Newborns were died because of Respiratory Distress Syndrome. 49% of newborns died within 1-3 Day of admission and 20% were died within less than 1 day. 81% of Newborns die within Early Neonatal Period of their life.