Skip to main content

Advertisement

SpringerLink
Log in

Care of Healthy as well as Sick Newborns in India: A Narrative Review

  • Review Article
  • Published:
Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Majority of neonatal deaths occur in developing countries. There is an increase in the proportion of neonatal deaths as part of the under-5 mortality over the past decade. Hence we need to accelerate further to achieve the goal of single digit neonatal mortality rate (NMR) by 2030. The two major arms of NMR reduction include facility-based neonatal care (FBNC) and home-based neonatal care (HBNC). FBNC addresses care at birth, care of the normal newborn, and care of small and sick newborns. HBNC provides continuum of care for newborn and post-natal mothers facilitated by Accredited Social Health Activist (ASHA) workers. One of the main challenges is to maintain good quality of neonatal care. Zero separation, linkage of community & facility and roles of professional bodies are considered way forward to achieve India Newborn Action Plan (INAP) goals. This review summarizes existing programs for newborn health and diseases and provides an over-arching view of the way-forward.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Survive and Thrive. Transforming Care for Every Small and Sick Newborn. Available at: https://www.who.int/publications-detail-redirect/9789241515887. Accessed on 28 May 2023.

  2. UN-IGME-Child-Mortality-Report. 2022. Available at: https://childmortality.org/wp-content/uploads/2023/01/UN-IGME-Child-Mortality-Report-2022.pdf. Accessed on 28 May 2023.

  3. NSSK Resource Manual: National Health Mission. Available at: https://nhm.gov.in/index1.php?lang=1&level=1&sublinkid=1427&lid=781. Accessed on 9 May 2023.

  4. Facility Based Newborn Care (FBNC): National Health Mission. Available at: https://nhm.gov.in/index4.php?lang=1&level=0&linkid=484&lid=754. Accessed on 28 May 2023.

  5. Home Based Care of New Born and Young Child. Available at: https://hbnchbyc. mohfw.gov.in/AboutUs/aboutHBNC. Accessed on 28 May 2023.

  6. INAP-progress_card_2020. Available at: https://nhm.gov.in/images/pdf/programmes/INAP-progress_card_2020.pdf. Accessed on 28 May 2023.

  7. World Health Organization. Every newborn: an action plan to end preventable deaths. Geneva: World Health Organization; 2014. Available at: https://apps.who.int/iris/handle/10665/127938. Accessed on 9 May 2023.

  8. Bhutta ZA, Das JK, Bahl R, et al. Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost? Lancet. 2014;384:347–70.

    Article  PubMed  Google Scholar 

  9. Child Health Division MOHFW, INAP_final. Available at: https://nhm.gov.in/images/pdf/programmes/inap-final.pdf. Accessed on 9 May 2023.

  10. LaQshya-Guidelines.pdf. Available at: https://nhm.gov.in/New_Updates_2018/NHM_Components/RMNCH_MH_Guidelines/LaQshya-Guidelines.pdf. Accessed on 28 May 2023.

  11. NHM, MOHFW, RMNCH+A:National Health Mission . Available at: https://nhm.gov.in/index1.php?lang=1&level=1&sublinkid=794&lid=168. Accessed on 9 May 2023.

  12. Darmstadt GL, Bhutta ZA, Cousens S, et al. Evidence-based, cost-effective interventions: how many newborn babies can we save? Lancet. 2005;365:977–88.

    Article  PubMed  Google Scholar 

  13. WHO Recommendations On Maternal And Newborn Care For A Positive Postnatal Experience. Available at: https://www.who.int/publications-detail-redirect/9789240045989. Accessed on 28 May 2023.

  14. Operational-Guide-(FBNC). Available at: https://nhm.gov.in/images/pdf/programmes/CH-Programmes/FBNC/Operational-Guide-(FBNC). Accessed on 28 May 2023.

  15. Child Health Division, MOHFW, Operational Status of SNCU in India- Technical Report. Available at: https://nhm.gov.in/images/pdf/programmes/child-health/annual-report/sncu_technical_report_jan-march_2011.pdf. Accessed on 28 May 2023.

  16. National_Guidelines_Lactation_Management_Centres in Public Health Facilities. Available at:https://nhm.gov.in/images/pdf/programmes/IYCF/National_Guidelines_Lactation_Management_Centres.pdf. Accessed on 28 May 2023.

  17. Mishra N, Saini SS, Jayashree M, Kumar P. Quality of referral, admission status, and outcome of neonates referred to pediatric emergency of a tertiary care institution in north India. Indian J Community Med. 2022;47:253–7.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Admin YK, Nagu Magu Ambulance Service Yuva Kanaja. 2022. Available at: https://yuvakanaja.in/en/healthfamily-welfare-dept-en/nagu-magu-ambulance-service/. Accessed on 28 May 2023.

  19. Kumutha J, Rao GVR, Sridhar BN, Vidyasagar D. The GVK EMRI maternal and neonatal transport system in India: a mega plan for a mammoth problem. Semin Fetal Neonatal Med. 2015;20:326–34.

    Article  PubMed  CAS  Google Scholar 

  20. Neogi SB, Malhotra S, Zodpey S, Mohan P. Does facility based newborn care improve neonatal outcomes? A review of evidence. Indian Pediatr. 2012;49:651–8.

    Article  PubMed  Google Scholar 

  21. Kruk ME, Gage AD, Joseph NT, Danaei G, García-Saisó S, Salomon JA. Mortality due to low-quality health systems in the universal health coverage era: a systematic analysis of amenable deaths in 137 countries. Lancet. 2018;392:2203–12.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Kshirsagar VD, Rajderkar SS. An assessment of admission pattern and treatment outcomes of neonates admitted in centers under facility-based newborn care program in Maharashtra, India. J Family Med Prim Care. 2022;11:3455–8.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Child Health Division. MOHFW. Two Year Progress of SNCUs-A Brief Report_(2011-12_&_2012-13).pdf. Available at: https://nhm.gov.in/images/pdf/programmes/child-health/annual-report/Two_Year_Progress_of_SNCUs-A_Brief_Report_(2011-12_&_2012-13).pdf. Accessed on 28 May 2023.

  24. NHSRC, Monitoring Report: Karnataka. 2013;55. Available at: http://164.100.117.80/sites/default/files/Karnataka%20Monitoring%20Report%20-%20Q1%202013-14.pdf . Accessed on 28 May 2023.

  25. Lee H-Y, Leslie HH, Oh J, et al. The association between institutional delivery and neonatal mortality based on the quality of maternal and newborn health system in India. Sci Rep. 2022;12:6220.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  26. Garg S, Dewangan M, Krishnendu C, Patel K. Coverage of home-based newborn care and screening by ASHA community health workers: findings from a household survey in Chhattisgarh state of India. J Family Med Prim Care. 2022;11:6356–62.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Bang AT, Bang RA, Baitule SB, Reddy MH, Deshmukh MD. Effect of home-based neonatal care and management of sepsis on neonatal mortality: field trial in rural India. Lancet. 1999;354:1955–61.

    Article  PubMed  CAS  Google Scholar 

  28. Bang A, Baitule S, Deshmukh M, Bang A, Duby J. Home-based management of neonatal sepsis: 23 years of sustained implementation and effectiveness in rural Gadchiroli, India, 1996–2019. BMJ Glob Health. 2022;7:e008469.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Rasaily R, Saxena NC, Pandey S, et al. Effect of home-based newborn care on neonatal and infant mortality: a cluster randomised trial in India. BMJ Glob Health. 2020;5:e000680.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Mony PK, Tadele H, Gobezayehu AG, et al. Scaling up Kangaroo mother care in Ethiopia and India: a multi-site implementation research study. BMJ Glob Health. 2021;6:e005905.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Mukhopadhyay R, Arora NK, Sharma PK, et al. Lessons from implementation research on community management of possible serious bacterial infection (PSBI) in young infants (0–59 days), when the referral is not feasible in Palwal district of Haryana, India. PLoS One. 2021;16:e0252700.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  32. Jayanna K, Rao S, Kar A, et al. Accelerated scale-up of Kangaroo Mother Care: evidence and experience from an implementation-research initiative in south India. Acta Paediatr. 2022. https://doi.org/10.1111/apa.16236.

  33. Pathak PK, Singh JV, Agarwal M, Singh VK, Tripathi SK. Study to assess the home-based newborn care (HBNC) visit in rural area of Lucknow: a cross-sectional study. J Family Med Prim Care. 2021;10:1673–7.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Hannah E, Dumka N, Ahmed T, Bhagat DK, Kotwal A. Home-based newborn care (HBNC) under the national health mission in urban India – A cross country secondary analysis. J Fam Med Prim Care. 2022;11:4505.

    Article  Google Scholar 

  35. Annual Report 2018-19 | Ministry of Health and Family Welfare | GOI. Available at: https://main.mohfw.gov.in/basicpage/annual-report-2018-19. Accessed on 28 May 2023.

  36. Lawn JE, Ohuma EO, Bradley E, et al. Small babies, big risks: global estimates of prevalence and mortality for vulnerable newborns to accelerate change and improve counting. Lancet. 2023;401:1707–19.

    Article  PubMed  Google Scholar 

  37. Hofmeyr GJ, Black RE, Rogozińska E, et al. Evidence-based antenatal interventions to reduce the incidence of small vulnerable newborns and their associated poor outcomes. Lancet. 2023;401:1733–44.

    Article  PubMed  Google Scholar 

  38. Theobald S, Brandes N, Gyapong M, et al. Implementation research: new imperatives and opportunities in global health. Lancet. 2018;392:2214–28.

    Article  PubMed  Google Scholar 

  39. Standards for Improving the Quality of Care for Small and Sick Newborns in Health Facilities. Available at: https://www.who.int/publications-detail-redirect/9789240010765. Accessed on 28 May 2023.

  40. Semrau KEA, Mokhtar RR, Manji K, et al. Facility-based care for moderately low birthweight infants in India, Malawi, and Tanzania. PLOS Glob Public Health. 2023;3:e0001789.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Immediate “Kangaroo Mother Care” and Survival of Infants with Low Birth Weight. New Engl J Med. 2021;384:2028–38.

  42. Neogi SB, Khanna R, Chauhan M, et al. Inpatient care of small and sick newborns in healthcare facilities. J Perinatol. 2016;36:18–23.

    Article  Google Scholar 

  43. Hanson C, Singh S, Zamboni K, et al. Care practices and neonatal survival in 52 neonatal intensive care units in Telangana and Andhra Pradesh, India: a cross-sectional study. PLOS Med. 2019;16:e1002860.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Tripathi S, Srivastava A, Memon P, et al. Quality of maternity care provided by private sector healthcare facilities in three states of India: a situational analysis. BMC Health Serv Res. 2019;19:971.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Jain Y, Chaudhary T, Joshi CS, et al. Improving quality of intrapartum and immediate postpartum care in public facilities: experiences and lessons learned from Rajasthan state, India. BMC Pregnancy Childbirth. 2022;22:586.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Deorari AK, Kumar P, Chawla D, et al. Improving the quality of health care in special neonatal care units of India: a before and after intervention study. Glob Health Sci Pract. 2022;10:e2200085.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Prashantha YN, Shashidhar A, Balasunder BC, Kumar BP, Rao PNS. Onsite mentoring of special newborn care unit to improve the quality of newborn care. Indian J Public Health. 2019;63:357–61.

    Article  PubMed  CAS  Google Scholar 

  48. Srivastava S, Datta V, Garde R, et al. Development of a hub and spoke model for quality improvement in rural and urban healthcare settings in India: a pilot study. BMJ Open Qual. 2020;9:e000908.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Kumar H, Khanna R, Alwadhi V, et al. Catalytic support for improving clinical care in special newborn care units (SNCU) through composite SNCU quality of care index (SQCI). Indian Pediatr. 2021;58:338–44.

    Article  PubMed  Google Scholar 

  50. Saboth Md PK, Sarin PhD E, Alwadhi Md V, et al. Addressing quality of care in pediatric units using a digital tool: implementation experience from 18 SNCU of India. J Trop Pediatr. 2021;67:fmab005.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Lahariya C. Health & wellness centers to strengthen primary health care in India: concept, progress and ways forward. Indian J Pediatr. 2020;87:916–29.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Lahariya C. Ayushman Bharat” program and universal health coverage in India. Indian Pediatr. 2018;55:495–506.

    Article  PubMed  Google Scholar 

  53. Lahariya C, Roy B, Shukla A, et al. Community action for health in India: evolution, lessons learnt and ways forward to achieve universal health coverage. WHO South East Asia J Public Health. 2020;9:82–91.

    Article  PubMed  Google Scholar 

  54. Anand P, Thukral A, Deorari AK, National Neonatology Forum Network. Dissemination of best practices in preterm care through a novel mobile phone-based interactive e-learning platform. Indian J Pediatr. 2021;88:1068–74.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors would like to thank Dr. Chandrakant Lahariya and Data and Evidence Team at the Foundation for People-centric Health Systems, New Delhi for providing technical comments and inputs on earlier version of this manuscript.

Author information

Authors and Affiliations

  1. Department of Neonatology, St. John’s Medical College Hospital, Bangalore, Karnataka, 560038, India

    Suman Rao PN & Bharathi Balachander

Authors
  1. Suman Rao PN
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bharathi Balachander
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

SRPN conceived the flow of manuscript, wrote part of the first draft and reviewed it. BB performed literature search and wrote part of the first draft. Both the authors approve the final manuscript submitted. SRPN will act as guarantor for this manuscript.

Corresponding author

Correspondence to Suman Rao PN.

Ethics declarations

Conflict of Interest

None.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

PN, S.R., Balachander, B. Care of Healthy as well as Sick Newborns in India: A Narrative Review. Indian J Pediatr 90 (Suppl 1), 29–36 (2023). https://doi.org/10.1007/s12098-023-04752-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12098-023-04752-0

Keywords

Search

Navigation