We are proposing Up gradation of Transition Unit to reduce Infant mortality in NICU by treating infants at the earlier stage before admitting them in to Neonatal ICU.
As Sassoon General Hospital, Pune is a State Government run tertiary care hospital, patients are from lower Socio Economic strata, hence treated free of cost.
Sassoon General Hospital is over 1200 bed hospital. This large hospital in Pune is run by State Government. Also, B.J. Medical College and a Nursing college are attached to it. Being a Government hospital, it is mainly serving the below poverty or low income group of the society at the subsidized rates. Most of the rural population and lowest socioeconomic strata of Western Maharashtra are the main beneficiaries.
The Pediatrics Department of Sassoon General hospital has a dedicated & hard working faculty which includes a “Transition Unit” (TU) for the Newborn Babies, NICU*, Surgical NICU* & PICU.*
Being a facility mainly catering for underprivileged society section, it is always over burdened & at the same time inadequately equipped. Initially we were considering the option of up gradation of NICU* & Surgical NICU, but due to heavy budgeting we started looking for viable solution to cut down child mortality at initial stage after the birth.
For your ready reference, we would like to brief you about current situation of the Transition Unit mentioned above, which is as follows,
• Criteria for admission in transition unit:
1] Babies having birth weight between 1.2-1.5 Kg
2] Babies under respiratory distress
3] Babies delivered after forceps surgery
4] Near term babies: 32-34 weeks
5] Babies having antenatal problems
New born Babies showing clinical deterioration, hyper bilirubinaemia are transferred to NICU*. The Facilities in NICU* is inadequately equipped as mentioned above. Only single ventilator is in the partial working condition in this unit, which makes the situation more serious. The neonatal death rate in NICU* is approx.15-20%.This includes the babies transferred from the Transition Unit and directly admitted to NICU from outside including abandoned babies of unmarried mothers or other various reasons.
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As it was previously mentioned, the mothers come from lower socioeconomic strata of the society and are illiterate tending to pre natal carelessness, most of the babies need more medical attention. So the importance & responsibility on transition unit thus increases.
• Present scenario of the transition unit:
Total admissions in the transition unit per day are approx.30. To cater these babies only one warmer is in working condition out of 6 Nos. old Units. This unit is wall mounted under which, 6 to 8 babies are kept on a common bed, which doesn’t suffice the actual requirement of the babies.
Also, only one over head photo therapy unit is in actual working condition but medically they require under & over surface phototherapy Units which are not available.
Due to lack of transport carriers, the critical babies are carried to NICU in a corrugated box which is away from the Transition unit.
With just two portable suction machines are in working condition, there are no basic but vital equipments Such as,
1. Neonatal Resuscitation Units with C-PAP
2. Ventilators ( Optionally)
3. Transport Carriers
4. Oxygen Hoods
5. Double layer ( under surface& over head ) Photo Therapy Units
6. Warmers
7. UV sterilizers
8. Billirubinometer with micro centrifuge
9. Syringe Pumps
10. Infusion Pumps
11. Pulse Oxymeters
12. Resuscitation Kits
13. X-ray Unit
14. Central Oxygen Supply
15. Baby Beds etc.
To cater approx 30 babies daily (if this unit upgraded, nos. may rise), this unit is just under equipped but our Doctors & ward medical staff is trying their best to serve the community & looking towards organizations like Rotary to help them out!!!
• Why transition unit is selected for upgradadtion---
The up gradation of transition unit will help enormously to decrease the load of ill equipped NICU* which is overall in a bad condition. We are proposing to upgrade Transition unit with bare minimum required equipments suiting to our budget.
Following points are equally considered—
1. Mothers have easy access to babies, as “Mother Ward” is adjoining the transition unit which is very much convenient for most required mother care such as feeding etc.
2. Being close to mother’s ward, atmosphere at transition unit is not distressing for both mother & babies as like NICU.
3. Minimal intervention infections chances are automatically get reduced.
4. Considering conductive atmosphere in upgraded TU, Recovery at initial stage can be fast with fewer casualties.
The project will be completed within 2 to 3 Months after receiving grant amount from the RI. | 
