Utilization and Effectiveness of Free Newborn Care Service Package in Inpatient Care of Sick Newborns –A Time For its Revision to Ensure Sustainability: Evidences From a Tertiary Level Public Hospital in Nepal

Authors

  • Prajwal Paudel Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal
  • Kalpana Upadhyaya Subedi Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal
  • Shailendra Bir Karmacharya Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal
  • Sarita Shrestha Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal
  • Anil Kumar Shrestha Kanti Children’s Hospital, Kathmandu, Nepal
  • Pratikshya Subedi Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal
  • Sunil Kumar Sah Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal
  • Megha Mishra Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal
  • Asia Tamrakar Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal
  • Nisha Khati Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal
  • Astha Singh Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal
  • Kirtipal Subedi Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal
  • Avinash K Sunny Nepalese Society of community medicine, Nepal
  • Sangeeta Kaushal Mishra Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal

DOI:

https://doi.org/10.3126/jnps.v41i3.37654

Keywords:

Free newborn care, length of hospital stay, SNCU/NICU, sick newborns, neonatal mortality

Abstract

Introduction: Free Newborn Care (FNC) service has been implemented to address the financial barriers to access sick newborn care in Nepal. This study was designed to evaluate the effectiveness of FNC package in terms of its adequacy to support a facility financially and the factors to be considered for reimbursement schemes in the FNC guideline.

Methods: This is a cross sectional retrospective study where 2907 newborns who received FNC service from 2019 Mar 15 to 2021 Jan 14 over 20 months were included. Descriptive statistics using frequency and percentages were used to describe the package received. Pearson’s Chi squared test was used to determine if the various factors receiving different newborn packages were statistically significant or not.

Results: Amount reimbursed by FNC package for 20 months fell short by NRs 1355541. Majority of preterm (58%), LBW (52.3%) and MAS (55.3%) received package C. Babies who received package C with single morbidity was 576 (37.3%) with two to three morbidities was 380 (48.7%) and with more than three morbidities was 301 (70.2%). Those newborns who stayed for four to seven days, majority 654 (53.4%) received package B, whereas those who stayed for eight to 14 days, 15 - 21 days and > 21 days, the majority 490 (38.4%), 66 (5.2%), 32 (2.5%) received package C respectively. There was an association between receiving package C mortality among cases (P  < 0.001).

Conclusions: Inpatient quality newborn care can save lives of many vulnerable newborns. FNC service has provided opportune context in care of sick newborns with promising results. However, revising the reimbursing schemes by focusing on length of stay, mortality and disease severity can better strengthen sick newborn care.

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Published

2021-12-31

How to Cite

Paudel, P., Subedi, K. U., Karmacharya, S. B., Shrestha, S., Shrestha, A. K., Subedi, P., Sah, S. K., Mishra, M., Tamrakar, A., Khati, N., Singh, A., Subedi, K., Sunny, A. K., & Mishra, S. K. (2021). Utilization and Effectiveness of Free Newborn Care Service Package in Inpatient Care of Sick Newborns –A Time For its Revision to Ensure Sustainability: Evidences From a Tertiary Level Public Hospital in Nepal. Journal of Nepal Paediatric Society, 41(3), 439–446. https://doi.org/10.3126/jnps.v41i3.37654

Issue

Vol. 41 No. 3 (2021)

Section

Original Articles

License

Copyright (c) 2021 Prajwal Paudel; Kalpana Upadhyaya Subedi, Shailendra Bir Karmacharya, Sarita Shrestha, Anil Kumar Shrestha, Pratikshya Subedi, Sunil Kumar Sah, Megha Mishra, Asia Tamrakar, Nisha Khati, Astha Singh, Kirtipal Subedi, Avinash K Sunny, Sangeeta Kaushal Mishra

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