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Objective To describe women who attended two delivery huts in rural Haryana, India. Methods The present observational study assessed routinely collected service provision data from two delivery huts located at primary health centers in the district of Faridabad. Data on sociodemographic characteristics, prenatal care, use of free transport services, and maternal and neonatal indicators at delivery were assessed for all pregnant women who used the delivery hut services from January 2012 to June 2014. Results During the study period, 1796 deliveries occurred at the delivery huts. The mean age of the mothers was 23.3 ± 3.3 years (95% confidence interval 23.1–23.5). Of 1648 mothers for whom data were available, 1039 (63.0%) had travelled less than 5 km to the delivery hut. The proportion of mothers who belonged to a lower caste increased from 31.0% (193/622) in 2012 to 41.1% (162/394) in 2014. The proportion of mothers who were illiterate also increased, from 8.1% (53/651) in 2012 to 26.4% (104/394) in 2014. Conclusion Belonging to a disadvantaged social group (in terms of caste or education) was not an obstacle to use of delivery hut services. The delivery huts might have satisfied some unmet needs of community members in rural India.

Background Reducing the global total of 3.3 million neonatal deaths is crucial to meeting the fourth Millennium Development Goal. Until recently, attention has been on the medical causes of the neonatal deaths, while the social factors contextualising these deaths have largely remained unaddressed. The current review aimed to quantify the role of these factors in neonatal deaths. Methods A systematic search was performed through PubMed, Google scholar, Cochrane library, Medline, IndMed, Embase, World Health Organization and Biomed central databases. Studies published from 1995 to 2011 were included. Random effects meta-analysis was performed to derive at an estimate of the burden of delays, as defined by the ‘three delays model’ by Thadeus and Maine. Results A total of 17 studies were reviewed. The majority of them (n = 10) were from the African continent. Level 3 delay, i.e. delay in receiving appropriate treatment upon reaching a health facility (38.7%, 95% CI, 21.7%–57.3%) and delay in deciding to seek care for the illness (Level 1 delay) (28%, 95% CI, 16%–43%) were the major contributors to neonatal deaths. Level 2 delay, i.e. delay in reaching a health facility (18.3%, 95% CI, 2.6–43.8%) contributed least to the neonatal deaths. Conclusion Creating awareness among caregivers regarding early recognition and treatment seeking for neonatal illness along with improving the quality of neonatal care provided at the health facilities is essential to reduce neonatal mortality.

Aim: The study aimed to document home-based neonatal care practices and their association with type of birth attendance. Methods: This study was conducted in rural Haryana on mothers who had delivered a live baby one to 2 months prior to interview. The study instrument, administered through home visits, had questions related to cord care, breastfeeding, thermal care, baby handling and healthcare seeking. Logistic regression was performed to test for association [OR; 95% CI] of key newborn care practices with skilled birth attendance. Results: Of the 415 mothers interviewed, 26.7% applied nothing on umbilicus; 15% were kept in skin-to-skin contact with mother; 20.2% were exclusively breastfed in first month. Seeking care in private sector and cost incurred in the treatment for a neonatal illness was significantly higher for male babies. Delivery by skilled birth attendant (68.5%) was associated with applying nothing on the cord [1.8; 1.01–3.25], in skin-to-skin contact with mother for ≥6 h a day [2.21; 1.18–4.13], bathing the baby after third day [14.63; 6.85–31.21] and exclusive breastfeeding [8.84; 3.42–22.8]. Conclusion: The results of this study call for not only upscaling skilled birth attendance but also improving the quality of care currently provided.

Objective: Clinical case definitions used for influenza surveillance among hospitalized patients vary and need systematic evaluation. Design, setting and sample: During July 2009–August 2011, we collected clinical data and specimens (nasal and throat swabs) from rural patients hospitalized for acute medical illnesses. Specimens were tested by rRT-PCR for influenza viruses. Main outcome measures: Case definitions evaluated the following: influenza-like illness (ILI: measured fever plus cough or sore throat); severe acute respiratory illness (SARI: ILI with difficulty breathing in ≥5 years, Integrated Management of Childhood Illness–defined pneumonia or severe pneumonia, or physician diagnosed lower respiratory infection in