Elizabeth Wolff

44889
Brittany Biesiada
10/24/14
Cover Letter
This unit was my favorite to write about, because I was very passionate about my
topic. At first I was unsure if I would be able to join the conversation in an appropriate
way and use the right formal language. My first draft was a little rough, my citation was
incorrect and the anwers to the different questions were not answered very well or
completely. The week of the first draft was very busy for me which is why my first draft
was not the best. Through peer review and your comments I was able to fix my paper so I
could better answer the questions and fix my citation.
I chose this article because I am a nursing major and I want to be a neonatal nurse.
My article was on neonatal health care in India. I hoped to learn more about neonatal
health care outside of the US and see how other countries handled neonatal births. I was
very surprised to learn that compared to the US and other developed countries Indias
neonatal health care is very poor and needs a great deal of improvement. Outside of my
major I personally just love babies, which is a huge reason of why I chose to go into
nursing.
I could have used a little bit more of a formal language throughout my paper; I
found this a lot harder than to do than I expected it to be. After this unit I feel better about
joining the academic conversation and more equipped to do so. Overall, I enjoyed
learning more about neonatal health care and liked this unit.

Neonatal Care
1)

This article assesses newborn care services in lower health care facilities
in India. It also talks about different ways to help improve essential newborn care,
through the analyzation of different health care facilities. I chose this article
because I am a nursing major and want to become a neonatal nurse, so this article
was very relevant to what I want to do

Malhotra S, Neogi SB, et. al. Assessment of essential newborn care services in
secondary-level facilities from two districts of India. ICDDR,B: Centre for
Health and Population Research. 32.1 (2014): 130-141. Web. 10 October 2014.
2)

The article I chose analyzes newborn care services in lower-level facilities in

India because most neonatal deaths occur in developing Asian countries, mainly India
(130). This is proven in the article when the author states, The risk of deaths in the
neonatal period in developing countries is over 7 times greater than in developed
countries (130). In John Swales CARS model move 1: Establishing a Territory, the
article follows the second step, which is making topic generalization, because the author
starts off by making this generalization, Worldwide out of the 133 million live births,
3.7 million die in neonatal period. (130) The author does not reference any other works
in the introduction, which would be the 3rd step of the CARS model: reviewing previous
items of research.
In move 2: Establishing a Niche, the author does not counter-claim anything in
the introduction; he mostly uses statics and graphs instead of comparing one study to
another. This would make sense why the author also did not indicate a gap between
different studies done before, which is the second part of move 2. However, the author

does raise questions throughout the introduction such as, What kind of essential
newborn care were provided at secondary-level study facilities? Whether all equipment
were available and functional? and Whether facilities has necessary infrastructure,
human resources, and other supplies for rendering essential newborn care services (133).
The author also talks about how a lot of focus has been put on the government to improve
newborn care in India, because of how high their neonatal mortality rate is.
Move three is occupying a niche, which is done by outlining the purpose; the
main purpose of this article is to assess the current condition of newborn care in India by
evaluating the strengths and weaknesses to hopefully improve them, he states this by
saying, The overall purpose of the assessment was to ascertain the current situation of
essential newborn care so as to find out the strengths and weaknesses in the quality of
newborn care service provision (132). In India, their weaknesses for infant death are risk
of infection, birth asphyxia, prematurity, and low birth rate (130). The article also
presents its research when it says that the data was collected from April 2009 to March
2010 in Madhya and Pradesh. The article does not announce the principal findings until
later in the research.
3)

The author references a great deal of the research that was conducted throughout

the article. Most of the research and statics comes from different hospitals in India, such
as Nagaur District Hospital and Chattarpur District Hospital (133). The author uses
twenty-five different sources from many different places like: World Health
Organization, India. Ministry of Health of and Family Welfare, and an article written on
Improving newborn infant heath in developing countries. The author also references
different statistics done on mortality in infants and reasons why they died; the author uses

a specific method for this by selecting, three facilitiesone district hospital (DH) and
two community health centers (CHCs) (131). If the districts had a high delivery load
then they were selected. Data about neonatal births and mortality were taken from these
different hospitals and then analyzed to see why different problems, like low birth rate
and breathing problems, occurred. The author also took data like: number of births and
the details of the births for different statics (131). The author uses the government data
from India to also help with this study. One can tell that this academic conversation has
been going on for a long time because of all the different references and the way the
author continually analyzes the articles throughout the paper.
4)

The tone of this paper is very formal; it assesses causes of newborn death and

how they can be improved, which is not something that can be taken lightly. The paper is
informative because it is talking about what needs to be done to help with infant
mortality. According to the article, things like better equipment, more essential drugs, and
human resources need to be added to help make it better (134). The tone of this paper is
also intelligent because it is written in a formal way for an academic community
composed of intelligent people (133). Another chart talks about the knowledge and skill
grade of healthcare providers and how well they can prevent hypothermia, resuscitate,
and prevent infection (135).
This article uses different headings throughout the article like materials and
methods and results to help format the paper. The article also uses various charts and
graphs to show causes and details of neonatal admissions and a study live and stillbirths
at different facilities. Different charts about the causes of neonatal admissions at district
hospitals and the details about those admissions such as the timing of admissions, cause

of admission, and if plausible the cause of death are also used throughout the article to
show why infants were brought into the hospital and see if things like timing and cause
were contributing factors.
The author is very clear and effective throughout the article. The author analyzes
data well and relates in a clear way that most people can understand. The author doesnt
use a great deal of big words, which also helps keep the paper more clear. There are some
parts of the paper that are harder to understand because of the wording. The author wrote
this for not only the academic community but also for different health care professionals,
so they can see what they need to improve on.
5)

The thesis of this paper is the analyzation of Indias newborn care services

in lower-level facilities and to explain why improvement is needed, which is stated in the
article, The overall purpose of the assessment was to ascertain the current situation of
essential newborn care so as to find out the strengths and weaknesses in the quality of
newborn care service provision. (132) The article does succeed in its purpose of
explaining why India needs to improve their newborn care through the discussion of
health care facilities strengths and weaknesses. For example, health care facilities that
have better tactics for breathing recovery, infection prevention and care at birth,
hypothermia prevention, and breastfeeding have better infant survival rates (141). The
article also convinces everyone that it needs improvement. The article does this through
various graph, facts, and statistics. For example, the article uses charts on live and
stillbirths to emphasize the high number of stillbirths and Indias need for improvement.
The article also talks about the current neonatal mortality rate in India, which is 31 per
1,000 live births with infection, birth asphyxia, and prematurity/low birth weight being

the main cause of death (130). Healthcare systems need to be properly equipped with the
necessary supplies to prevent this from happening. It is vital that health systems are
equipped with the necessary supplies, such as: a heating source, resuscitation bags and
mask, and mucus devices. None of the six out of the six hospitals analyzed in the article
had cups or spoons to feed the newborns (134). Different facilities in India had no bag or
mask to perform resuscitation and had to use mouth-to-mouth breathing techniques,
which is not as effective. The workers also need to be trained enough to provide the
essential care that newborns need (131-132). Neonatal health care is somewhat dependent
on the knowledge and skill grade of healthcare providers and how well they can prevent
hypothermia, resuscitate, and prevent infection (135). The health care providers may also
lack knowledge in knowing the six correct steps of hand washing (137). India needs all of
their health care professionals to be properly educated and trained so they can prevent
different problems. The government of India is constantly being pressured to improve
these facilities and hopefully studies like these can help them see how much the
improvement is needed.