Status of maternal and new born care at first referral units in the state of West Bengal.

A study was conducted in 12 First Referral Units (FRUs), selected through multistage sampling, from 6 districts of West Bengal. Infrastructure facilities, record keeping, referral system and MCH indicators related to newborn care were documented. Data was collected by review of records, interview and observation using a pre-designed proforma. Inadequate infrastructure facilities (e.g. no sanctioned posts of specialists, no blood bank at rural hospitals declared as First Referral Units etc.); poor utilization of equipment like neonatal resuscitation sets, radiant warmer etc, lack of training of the service providers were evident. Records/registers were available but incomplete. Referral system was found to be almost nonexistent. Most of the deliveries (86.1%) were normal delivery. Deliveries (87.71%) and immediate neonatal resuscitation (94.9%) were done mostly by nursing personnel. Institution based maternal, perinatal and early neonatal mortality rates were found to be 5.6, 62.4 and 25.2 per 1000 live births respectively. Eclampsia (48.9%), hemorrhage (17.7%), puerperal sepsis (7.1%) were reported to be major causes of maternal mortality. Common causes of early neonatal mortality were birth asphyxia (54.3%), sepsis (14.6%) and prematurity/LBW (12.4%).