We assessed the feasibility of involving routine district health system personnel in tracking survival of institutional births for neonatal period in two district hospitals (Nagaur in Rajasthan and Chhatarpur in Madhya Pradesh) for the month of March 2010. A centralized district level tracking system was used in Nagaur, whereas in Chattarpur, block-wise tracking of births was performed. A total of 607 live births were tracked with 17 identified neonatal deaths. Prematurity and infections were commonest causes of deaths with majority occurring within first week of life. The block-wise approach resulted in identifying extra neonatal deaths.