Most reports of survival of very-low-birth-weight (VLBW) babies focus on infants in tertiary care centres in large metropolitan areas.1-5 Extrapolating data from major centres to peripheral hospitals is problematic because of various factors, including poor socio-economic conditions, absence of intensive/special-care facilities and equipment, and limited number of staff with knowledge and skills in neonatal care in smaller hospitals.3 We were able to raise the survival rate (SR) from 21% to 40% following the use of low-cost measures between 2002 and 2005.