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

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

Publication:
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

creativeworkseries.issn	ISSN 1990-7974 eISSN 1990-7982
dc.contributor.author	Paudel, Prajwal
dc.contributor.author	Subedi, Kalpana Upadhyaya
dc.contributor.author	Karmacharya, Shailendra Bir
dc.contributor.author	Shrestha, Sarita
dc.contributor.author	Shrestha, Anil Kumar
dc.contributor.author	Subedi, Pratikshya
dc.contributor.author	Sah, Sunil Kumar
dc.contributor.author	Mishra, Megha
dc.contributor.author	Tamrakar, Asia
dc.contributor.author	Khati, Nisha
dc.contributor.author	Singh, Astha
dc.contributor.author	Subedi, Kirtipal
dc.contributor.author	Sunny, Avinash K
dc.contributor.author	Mishra, Sangeeta Kaushal
dc.date.accessioned	2025-11-30T08:52:28Z
dc.date.available	2025-11-30T08:52:28Z
dc.date.issued	2021
dc.description	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
dc.description.abstract	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.
dc.identifier	https://doi.org/10.3126/jnps.v41i3.37654
dc.identifier.uri	https://hdl.handle.net/20.500.14572/3306
dc.language.iso	en_US
dc.publisher	Nepal Paediatric Society (JNPS)
dc.subject	Free newborn care
dc.subject	length of hospital stay
dc.subject	SNCU/NICU
dc.subject	sick newborns
dc.subject	neonatal mortality
dc.title	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
dc.type	Article
dspace.entity.type	Publication
local.article.type	Original Article
oaire.citation.endPage	446
oaire.citation.startPage	439
relation.isJournalIssueOfPublication	0b99c152-1968-4a9d-81aa-91bd247df181
relation.isJournalIssueOfPublication.latestForDiscovery	0b99c152-1968-4a9d-81aa-91bd247df181
relation.isJournalOfPublication	6f9be05c-05a9-4a3e-a5b5-a19a15ab042c