title: Availability of emergency neonatal care in eight districts of Karnataka state, southern India: a cross-sectional study.
abstract: BACKGROUND
  Emergency Neonatal Care (EmNC) is an important service for the health and survival of newborns. The objective of our study was to assess the availability of emergency neonatal care services in the north-eastern region of Karnataka state in India.
  
  
  METHODS
  We undertook a cross-sectional epidemiologic study in the year 2010. We assessed the provision of eight life-saving 'signal functions' (Comprehensive EmNC) or at least five 'signal functions' (Basic EmNC) by self-reporting through a structured questionnaire, coupled with verification by direct observation for presence of drugs and equipment in the prior three months. The assessment was undertaken in 443 government and 422 private healthcare facilities of eight districts of Karnataka.
  
  
  RESULTS
  There was an average of 3.6 EmNC facilities available per 500,000 population for the entire region. Only three out of eight districts and 10 of 42 sub-districts in the region had the recommended [greater than or equal to 5] EmNC facilities per 500,000. Further, over 95 % of CEmNC facilities and 88 % of BEmNC facilities were within the private sector. About 80 % of government hospitals at district and sub-district levels did not have EmNC capability.
  
  
  CONCLUSIONS
  This study demonstrates the feasibility of using a simple assessment tool to measure health facility availability of life-saving services for newborn care. EmNC availability was seen to be suboptimal at the regional, district and sub-district levels within the northern part of Karnataka state. There is a need to improve availability of emergency newborn care in health facilities, with special emphasis on equity at population level.
authors.affiliation: St John's National Academy of Health Sciences, Bangalore, India. premkmony@gmail.com.|Division of Epidemiology & Population Health, St John's Medical College &Research Institute, St John's National Academy of Health Sciences, 100 feet road, Koramangala, Bangalore, 560034, India. premkmony@gmail.com.
authors.forename: Prem K
authors.initials: PK
authors.lastname: Mony
authors.affiliation: Karnataka Health Promotion Trust, Bangalore, India. krishnamurthy@khpt.org.|Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada. krishnamurthy@khpt.org.
authors.forename: Krishnamurthy
authors.initials: K
authors.lastname: Jayanna
authors.affiliation: St John's National Academy of Health Sciences, Bangalore, India. srekha74@rediffmail.com.
authors.forename: Swarnarekha
authors.initials: S
authors.lastname: Bhat
authors.affiliation: St John's National Academy of Health Sciences, Bangalore, India. raosumanv@gmail.com.
authors.forename: Suman V
authors.initials: SV
authors.lastname: Rao
authors.affiliation: Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada. crockett@cc.umanitoba.ca.
authors.forename: Maryann
authors.initials: M
authors.lastname: Crockett
authors.affiliation: Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada. avery@cc.umanitoba.ca.
authors.forename: Lisa
authors.initials: L
authors.lastname: Avery
authors.affiliation: Karnataka Health Promotion Trust, Bangalore, India. bmramesh@khpt.org.
authors.forename: B M
authors.initials: BM
authors.lastname: Ramesh
authors.affiliation: Karnataka Health Promotion Trust, Bangalore, India. smoses@cc.umanitoba.ca.|Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada. smoses@cc.umanitoba.ca.
authors.forename: Stephen
authors.initials: S
authors.lastname: Moses
authors.affiliation: Karnataka Health Promotion Trust, Bangalore, India. james_blanchard@umanitoba.ca.|Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada. james_blanchard@umanitoba.ca.
authors.forename: James
authors.initials: J
authors.lastname: Blanchard
mesh_terms: D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D005260:Female; D006296:Health Services; D006297:Health Services Accessibility; D006801:Humans; D007194:India; D007224:Infant Care; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D017149:Private Sector; D011795:Surveys and Questionnaires