SummaryObjective: To study the effectiveness of locally assembled low-cost version for continuous positive airway pressure (CPAP) delivery. Patients: Babies with respiratory distress from two contiguous periods, one with CPAP therapy and the other without, were compared for following parameters: birth weight, gestational age, severity of respiratory distress, as assessed by Silverman-Anderson retraction score (SARS), maximum SARS, days taken for score to become 0, duration of oxygen therapy, hospital stay and the outcome. Results: The profile of subjects was comparable in two groups. Severity of respiratory distress (SARS) was significantly higher in post-CPAP group. Time taken for SARS to become 0 and number of deaths were significantly lower, and the duration of oxygen administration and hospital stay were significantly higher in post-CPAP group. The cost of an individual disposable CPAP unit was Rs 160 (USD 3). Conclusion: A low-cost and locally assembled CPAP delivery system may reduce neonatal mortality among babies with respiratory distress.

A simple and inexpensive air pump can work as a safe and effective oxygen blender.

Families in rural India have substantial costs incurred in OPD attendance, most of which is for preventive health care such as immunization.

Background: In spite of the ongoing Universal immunization program (UIP), National family health survey data shows declining trend in the number of children fully immunized in Maharashtra. Hence this study was undertaken to determine immunization status in 12-23 months age children admitted to pediatric wards of a tertiary care hospital and factors affecting it.Methods: A prospective, cross sectional study was carried out in which children between 12-23 months age admitted to paediatric wards of a tertiary care hospital were included. Immunization history for Universal immunization program vaccines and socio-demographic information was collected and analysed to find the immunization status and its correlation with various demographic factors.Results: Of total 418 children, 70.3% were completely immunized, 27.8% incompletely immunized and 1.9% unimmunized. Majority were immunized in government centers. 83.3% subjects were of 1st/2nd birth order, 90.4% were delivered institutionally and 76.1% were delivered vaginally. Around half of the children’s fathers and mothers were illiterate. Only father was employed in 75.4% while both parents were employed in 23.4%. Birth order, place of delivery, mode of delivery, father and mother’s education and employment status were statistically associated with immunization while gender, presence of immunization card, migrant status and place of immunization were not associated. Reasons for incomplete immunization included lack of knowledge about immunization and ‘child not well’ at time of immunization.Conclusions: Even in a population with health seeking behaviour almost one third of the children were incompletely immunized. Special efforts are required for finding groups of children with high chances of being incompletely immunized.

On the basis of our results, we suggest that in resource-limited settings, the first level health facility may be able to look after short-stay babies that weigh more than 1500 g and that have no respiratory distress. The FRU may look after MLBW babies, with or without respiratory distress, and VLBW babies without respiratory distress by giving special care.