Neonatal Near Miss Cases of Different Health Facilities


  • Sunil Raja Manandhar Assistant Professor, Department of Paediatrics, Kathmandu Medical College Teaching Hospital (KMCTH)
  • Dharma S Manandhar Head, Department of Paediatrics, KMCTH & President and Executive Director, MIRA
  • Dhruba Adhikari Research Officer, Mother and Infant Research Activities (MIRA)
  • Jyoti Raj Shrestha Research Coordinator, Mother and Infant Research Activities (MIRA)
  • Chandra Rai Project Director and Country Representative, Health Right International
  • Hari Rana Training and Operation Coordinator, Health Right International
  • Mohan Paudel Monitoring and Evaluation Coordinator, Health Right International



Neonatal near miss, birth asphyxia, PSBI


Introduction: The near miss concept and the criterion-based clinical audit are proposed as useful approaches for obtaining such information in newborn health care. There is currently no Standard definition and criteria for neonatal near miss especially for the community level intervention. Thus, lifesaving interventions could be an entry point to initiate the development of the neonatal near-miss definition. Mother and Infants Research Activities and Health Right International (HRI) developed a new tool for assessing neonatal near miss cases based on the Community based newborn care package programme. This is a part of operational research programme on strengthening the health facilities of Electoral constituency No; 2 of Arghakhanchi district of Nepal. The objective of this study was to identify and analyze neonatal near miss cases at different health facilities of Electoral constituency No; 2 of Arghakhanchi district, Nepal.

Materials and Methods: One day of training on identifying neonatal near miss cases was given by an expert at Arghakhanchi district hospital to the health facilities staff in two groups. Health facility staffs were trained on identifying neonatal near miss cases and completing the modified neonatal near miss case forms. Neonatal near miss cases were documented for nine months period.

Results: There were a total of 28 cases of neonatal near miss reported from different health facilities. Among them, 90% babies were delivered at health facility and 72% babies were of normal birth weight. Low birth weight incidence is 21% among near miss cases. Neonatal near miss contributed possible severe bacterial infection/ severe infection 47%, birth asphyxia in 43% cases and very low birth weight 7%.

Conclusions: Birth asphyxia and PSBI were the two most common causes of neonatal near miss in the health facilities of Arghakhanchi district. There is a need to improve the quality of neonatal care in health facilities to properly manage these neonatal near miss cases which were referred to higher centre.


J Nepal Paediatr Soc 2014;34(2):115-118 



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How to Cite

Manandhar, S. R., Manandhar, D. S., Adhikari, D., Shrestha, J. R., Rai, C., Rana, H., & Paudel, M. (2014). Neonatal Near Miss Cases of Different Health Facilities. Journal of Nepal Paediatric Society, 34(2), 115–118.



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