Neonatal resuscitation is an important intervention to reduce neonatal mortality [1,2]. It is vital that health systems are equipped with necessary supplies, and the staff members are competent enough to provide evidence-based resuscitation [3]. Indian Academy of Pediatrics (IAP) in collaboration with National Rural Health Mission (NRHM) of Government of India developed Basic Newborn Care and Resuscitation Program (BNCRP) of Navjaat Shishu Suraksha Karyakram (NSSK) adopted from Neonatal Resuscitation Program (NRP) guidelines for grassroot workers as well as pediatricians [4]. The objective of present study was to find out the availability of requisite equipment at Newborn Care Corner (NBCC) as well as health personal trained in NSSK, in public health facilities of Ludhiana district, Punjab, India.

The study was conducted in the month of July and August 2015. Fifteen out of the total 30 public health facilities of Ludhiana District, were selected as guided by the delivery load in each of the four categories viz., District Hospital (one out of one), Sub-divisional hospitals (two out of four), Community Health Centers (four out of nine) and Primary Health Centers (eight out of sixteen). The ethical approval was obtained from the Institutional Ethics Committee (IEC) of Dayanand Medical College and Hospital, Ludhiana; permission from NRHM, Punjab was also obtained.

The findings of requisite equipment available for neonatal resuscitation are summarized in Table I. All the health facilities had medical officer, staff nurse or auxiliary nurse midwife (ANM) to conduct the delivery and provide newborn care. NSSK trained staff nurse/ANM were available round the clock at only four (2 SDH, 1 CHC, 1 PHC) out of 15 public health facilities. None of these facilities had round the clock availability of NSSK-trained medical officer. Out of the total ANM’s/staff nurses and medical officers available at the time of delivery, 57% and 28% were trained in NSSK, respectively.

TABLE I	Overall Status of Facility-based Newborn Care Corner in Ludhiana 

Of the 22 delivery points studied at 15 public health facilities, NBCC were established at all delivery points except one, with radiant warmers in place. Radiant warmers at four of these facilities were not in functioning state. Self-inflating resuscitation bag was available at 20 delivery points with mask available at 18 of these delivery points. Masks of both sizes were available at only four (18%) delivery points.

For neonatal resuscitation, the most important step is positive pressure ventilation with bag and mask [5]. A similar study from 13 CHCs from Bharatpur District of Rajasthan [6] reported deficiencies in the presence of equipment related to essential newborn care services. Only 3 out of 13 (23.1%) had radiant warmers, 4 out of 13 (30.8%) had resuscitators, and 9 out of 13 (69.2%) had suction pumps available in the facilities. None of the included CHCs in this assessment had fully-equipped newborn care corner [6]. In another facility-based survey in rural area of Lucknow District, Uttar Pradesh in 9 community health and 9 primary health centers, availability of essential newborn care equipment and trained personnel was grossly inadequate in almost all the PHCs [7].

This study revealed that, despite availability of NBCCs, these were not fully equipped. This calls for a change of mindset and provision of adequate sensitization of care providers using the NBCCs. Availability and functionality of necessary equipment and NSSK-trained staff to use the equipment will be important to realize the potential gains that can be achieved through provision of neonatal resuscitation – an important intervention for reducing neonatal mortality.

Acknowledgements: Director, National Health Mission, Department of Health and Family Welfare, Government of Punjab for support to conduct the study.

Contributors: SG, SS, RG: designed the study, and interpreted the data; SS, RG: drafted the work; SG, RG: collected the data. All authors approved the final manuscript.

Funding: Indian Council of Medical Research (ICMR), India under Short Term Studentship (STS)-2015 program.

Competing Interest: None stated.

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