Safdarjung Hospital’s MNCU Model Reduces Neonatal Mortality by 34%

Mahesh Chandra - Delhi

Safdarjung Hospital has taken a major leap forward in neonatal care by establishing a 40-bed Level-III Mother Newborn Care Unit (MNCU) in February 2024. This innovation has dramatically improved the survival and health outcomes of small and sick newborns, especially those born preterm or with low birth weight.

Before the MNCU was operational, extramural neonates—newborns referred from other facilities—were managed in pediatric wards alongside older children, with no dedicated space or infrastructure for intensive neonatal care. This often compromised the quality of care and mother–infant bonding.

Now, with the MNCU in place, mothers and newborns stay together 24×7, enabling practices like Immediate Kangaroo Mother Care (iKMC) and exclusive breastfeeding. The facility is fully equipped with mechanical ventilation (invasive and non-invasive), CPAP, KMC garments, binders, and specially designed KMC chairs, creating a nurturing and medically advanced environment.

A retrospective cohort study comparing data from before and after the MNCU’s operationalization reveals striking improvements:

• Neonatal mortality dropped from 28.3% to 18.7% (Group I: 515 deaths out of 1822 neonates vs Group II: 370 deaths out of 1980).

• Exclusive breastfeeding rates at discharge jumped from 35% to 87%.

• Effective Kangaroo Mother Care (average 8 hours/day) was adopted for 78% of low birth weight infants, compared to 0% before MNCU.

The World Health Organization (WHO) has long advocated for Kangaroo Mother Care (KMC) for infants under 2.5 kg or less than 37 weeks gestation, citing up to 40% reduction in mortality when practiced post-stabilization, and 25% further reduction when initiated immediately after birth.

The authors of the study emphasized that the continuous presence of mothers enhances bonding, enables early danger sign detection, reduces cross-infection risk, and contributes to better overall outcomes. Previously, one nurse cared for 6–8 babies. Now, mothers are empowered to be primary caregivers within the hospital environment.

The study, published in the Indian Journal of Pediatrics, concludes that both low birth weight and normal weight sick neonates have significantly better chances of survival when cared for alongside their mothers in dedicated MNCUs. The success of this model makes a strong case for its replication across tertiary and district-level hospitals nationwide.

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