title: Reduction of Neonatal Mortality Requires Strengthening of the Health System: A Situational Analysis of Neonatal Care Services in Ballabgarh.
abstract: Planning a comprehensive program addressing neonatal mortality will require a detailed situational analysis of available neonatal-specific health infrastructure.
  
  
  
  We identified facilities providing essential and sick neonatal care (ENC, SNC) by a snowballing technique in Ballabgarh Block. These were assessed for infrastructure, human resource and equipment along with self-rated competency of the staff and compared with facility-based or population-based norms.
  
  
  
  A total of 35 facilities providing ENC and 10 facilities for SNC were identified. ENC services were largely in the public-sector domain (68.5% of births) and were well distributed in the block. SNC burden was largely being borne by the private sector (66% of admissions), which was urban-based. The private sector and nurses reported lower competency especially for SNC. Only 53.9% of government facilities and 17.5% of private facilities had a fully equipped newborn care corner.
  
  
  
  Serious efforts to reduce neonatal mortality would require major capacity strengthening of the health system, including that of the private sector.
authors.affiliation: Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Mudita
authors.initials: M
authors.lastname: Gosain
authors.affiliation: Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Akhil D
authors.initials: AD
authors.lastname: Goel
authors.affiliation: Department of Community Medicine, Government Medical College, Kannauj, Uttar Pradesh 209732, India.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Kharya
authors.affiliation: Division of Neonatology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Agarwal
authors.affiliation: Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Ritvik
authors.initials: R
authors.lastname: Amarchand
authors.affiliation: Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Sanjay K
authors.initials: SK
authors.lastname: Rai
authors.affiliation: Centre for Chronic Disease Control, Gurugram, Haryana 122002, India.
authors.forename: Suresh
authors.initials: S
authors.lastname: Kapoor
authors.affiliation: Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Vinod K
authors.initials: VK
authors.lastname: Paul
authors.affiliation: Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi 110029, India.
authors.forename: Anand
authors.initials: A
authors.lastname: Krishnan
mesh_terms: D002983:Clinical Competence; D003695:Delivery of Health Care / Q000379:methods / Q000458:organization & administration*; D005260:Female; D006275:Health Facility Planning / Q000458:organization & administration*; D006282:Health Personnel; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D000068101:Maternal-Child Health Services; D066087:Perinatal Death / Q000517:prevention & control*; D011247:Pregnancy; D011634:Public Health
keywords: audit; competency; health facility planning; human resources; neonatal health