NBH-2
Newborn health in India
25 million (2.5 crore) birthsper year
- Accounts for 20% of global births
0.9 million (9 lakh) die inneonatal period
- Accounts for about 25% of globaldeaths
Teaching Aids: ENC
India accounts for highest births & neonatal deaths globally
NBH-3
Neonatal mortality rate (NMR)
Current (NFHS-3): 39/1000 live births (2005-06)
Teaching Aids: ENC
Accounts for almost 2/3rd of IMR & ½ of U5-MR
NBH-4
NMR - State wise
NMR is not uniform across the country
Teaching Aids: ENC
NBH-5
Differences in NMR
NMR is high in rural areas and in those who are poor
Teaching Aids: ENC
Rural - Urban
Poor - Rich
NBH-6
Causes of neonatal deaths
Infections, asphyxia and prematurity are theleading causes of neonatal deaths
Source: ICMR, 2006
Teaching Aids: ENC
NBH-7
Timing of neonatal deaths
Nearly 3/4th of neonatal deaths occur within 7 days,mostly during first 24 hours
Teaching Aids: ENC
NBH-8
Perinatal indices
Perinatal mortality rate (NFHS-3): 48.5 per1000 pregnancies
Still-birth rate: 19.2 per 1000 pregnancies
Perinatal mortality rate also varies between thestates (from 11 /1000 in Kerala to 63/1000pregnancies in Assam )
Teaching Aids: ENC
NBH-9
About 50% of deliveries occur at home
Only 46.6% attended by skilled birth attendants*
Higher the institutional births, lower is the NMR
Place of birth
* doctors, nurses, and midwives* doctors, nurses, and midwives
Teaching Aids: ENC
State
Institutional births
NMR
Kerala
99.3
11.5
Uttar Pradesh
20.6
47.6
NBH-10
Decline of NMR
Rapid decline ineighties
69 in 1980
53 in 1990
Stagnation sincenineties
48 in 1995
44 in 2000
39 in 2005-06
Teaching Aids: ENC
NBH-11
Why static NMR?
Govt. programmes focused mainly on postneonatal period
- Diarrheal Disease Control
- ARI
- Immunization
Focus of essential newborn component was on alimited number of government facilities
Lack of skilled persons for managing newborns
Teaching Aids: ENC
NBH-12
Way forward
NPP: National population policy
1 XI Plan
2 National Plan of Action for Children 2005
Teaching Aids: ENC
Current
NPP 2010
Targets
IMR
53 (2008)
<30
28 (2012)1
NMR
36 (2007)
<20
18 (2010)2
MMR
254 (2004-06)
<100
<100
Hospitalbirths
34%
80%
Achieving National Goals
NBH-13
Way forward
Importance to newborn health
Reproductive and Child Health – II (2005-10)
- IMNCI: Community & facility
- Skilled care at birth
-Essential newborn care for health professionals
- Home based newborn care
- Up gradation of health facilities
Teaching Aids: ENC
NBH-14
Way forward
National Rural Health Mission (NRHM)
- ASHAs in each village to improve maternal and childhealth services
- Strengthening of health facilities
-Creation of SCNUs
- Janani Suraksha Yojana (JSY): To promote institutionaldeliveries
Teaching Aids: ENC