The Indian Journal of Pediatrics

, Volume 74, Issue 3, pp 241–247 | Cite as

Newborn care in rural Uttar Pradesh

  • Abdullah H. BaquiEmail author
  • E. K. Williams
  • G. L. Darmstadt
  • V. Kumar
  • T. U. Kiran
  • D. Panwar
  • R. K. Sharma
  • S. Ahmed
  • V. Sreevasta
  • R. Ahuja
  • M. Santosham
  • R. E. Black
Original Article



To describe selected newborn care practices related to cord care, thermal care and breastfeeding in rural Uttar Pradesh and to identify socio-demographic, antenatal and delivery care factors that are associated with these practices.


A cross-sectional survey in rural Uttar Pradesh included 13, 167 women who had a livebirth at home during the two years preceding data collection. Logistic regression was used to identify socio-demographic, antenatal and delivery care factors that were associated with the three care practices.


Use of antenatal care and skilled attendance at delivery were significantly associated with clean cord care and early breastfeeding, but not with thermal care. Antenatal home visits by a community-based worker were associated only with clean cord care. Women who received counseling from health workers or other sources on each of the newborn care practices during pregnancy were more likely to report the respective care practices, although levels of counseling were low.


The association between newborn care practices and antenatal care, counseling and skilled delivery attendance suggest that evidence-based newborn care practices can be promoted through improved coverage with existing health services.

Key words

Neonatal Cord care Thermal care Breastfeeding Community-based study Home delivery 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    SNL. State of the World’s Newborns. Washington, DC: Save the Children Federation USA; 2001.Google Scholar
  2. 2.
    Tinker A, Hoope_bender P, Azfar S, Bustreo F, Bell R. A continuum of care to save newborn lives. Lancet 2005; 365(March 5).Google Scholar
  3. 3.
    Lawn JE, Cousens S, Zupan J. 4 million neonatal deaths: When? Where? Why? Lancet 2005; 365(9462): 891–900.PubMedCrossRefGoogle Scholar
  4. 4.
    World Health Organization. The World Health Report: Shaping the Future. Geneva; 2003.Google Scholar
  5. 5.
    Lawn J, Cousens S, Bhutta Z, Darmstadt G, Martines J, Paul V, et al. Why are 4 million babies dying each year? The Lancet 2004; 364: 399–401.CrossRefGoogle Scholar
  6. 6.
    Bryce J, Boschi-Pinto C, Shibuya K, Black RE. WHO estimates of the causes of death in children. Lancet 2005; 365(9465): 1147–1152.PubMedCrossRefGoogle Scholar
  7. 7.
    Hyder A, Morrow R, Wali S, McGuckin J. Burden of disease for neonatal mortality in South Asia and Sub-Saharan Africa. Washington, DC: Save the Children Federation USA; 2001.Google Scholar
  8. 8.
    World Health Organization. Essential newborn care: a report of a technical working group. Geneva; 1996.Google Scholar
  9. 9.
    Moss W, Darmstadt G, Marsh D, Black R, Santosham M. Research priorities for the reduction of perinatal and neonatal morbidity and mortality in developing country communities. J Perinatol 2002; 22: 484–495.PubMedCrossRefGoogle Scholar
  10. 10.
    Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, de Bernis L. Evidence-based, cost-effective interventions: how many newborn babies can we save? Lancet 2005; 365(9463): 977–988.PubMedCrossRefGoogle Scholar
  11. 11.
    Saving Newborn Lives. State of the World’s Newborns. Washington DC: Save the Children Federation-US; 2001.Google Scholar
  12. 12.
    Marsh D, Darmstadt G, Moore J, Daly P, Oot D, Tinker A. Advancing newborn health and survival in developing countries: a conceptual framework. J Perinatol 2002; 22: 572–576.PubMedCrossRefGoogle Scholar
  13. 13.
    Bhutta Z, Darmstadt G, Hasan B, Haws R. Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence, Pediatrics 2005; 115: 519–617.PubMedGoogle Scholar
  14. 14.
    Knippenberg R, Lawn J, Darmstadt G, Begkoyian G, Fogstad H, Walelign N et al. Systematic scaling up of neonatal care in countries. Lancet 2005; 365: 1087–1098.PubMedGoogle Scholar
  15. 15.
    NFHS India. National Family Health Survey; 1998–1999.Google Scholar
  16. 16.
    NFHS-II. National Family Health Survey-II 1989–1999. Mumbai: International Institute for Populations Sciences and ORC-Macro; 2001.Google Scholar
  17. 17.
    Baqui AH, Darmstadt GL, Williams EK, Kumar V, Kiran TU, Panwar D et al. Timing, Levels and Causes of Neonatal Deaths in Rural India: Implications for Neonatal Interventions. Bull WHO 2006; In press.Google Scholar
  18. 18.
    StataCorp. Stata Statistical Software: Release 8.0. In College Station, Texas: Stata Corporation; 2003.Google Scholar
  19. 19.
    WHO. Care of the umbilical cord: a review of the evidence. Geneva: World Health Organization; 1998.Google Scholar
  20. 20.
    Bhutta Z, Darmstadt G, Ransom E. Using evidence to save newborn lives. Policy brief. Washington, DC: Population Reference Bureau; 2003.Google Scholar
  21. 21.
    Bhutta Z. Effective interventions to reduce neonatal mortality and morbidity from perinatal infection. In Costello A, Manandhar D, eds. Improving newborn infant health in developing countries. London: Imperial College Press; 2000; 289–308.Google Scholar
  22. 22.
    Manandhar D, Osrin D, Shrestha B, Mesko N, Morrison J, Tumbahangphe K et al. Effect of participatory intervention with women’s groups on birth outcomes in Nepal: cluster-randomised controlled trial. Lancet 2004; 364(9438): 970–979.PubMedCrossRefGoogle Scholar
  23. 23.
    Nandan D, Mishra S. Delivery Practices in West Uttar Pradesh. Indian J Public Health 1996; 40(1): 20–21.PubMedGoogle Scholar
  24. 24.
    Osrin D, Tumbahangphe K, Shrestha D, Mesko N, Shrestha B, Manandhar M et al. Cross sectional, community based study of care of newborn infants in Nepal. BMJ 2002; 325(1063).Google Scholar
  25. 25.
    Sibley L, Ann Sipe T. What can a meta-analysis tell us about traditional birth attendant training and pregnancy outcomes? Midwifery 2004; 20(1): 51–60.PubMedCrossRefGoogle Scholar
  26. 26.
    Iyengar S. Prevention of Neonatal Hypothermia in Himalayan Villages: Role of the domiciliary caretaker. Trop Geogr Med 1990; 43(1191): 293–296.Google Scholar
  27. 27.
    WHO. Thermal protection of the newborn: a practical guide. Geneva: World Health Organization; 1997.Google Scholar
  28. 28.
    Choudhary S, Bajaj R, Gupta R. Knowledge, attitude and practices about neonatal hypothermia among medical and paramedical staff. Indian J Pediatr 2000; 67(7): 491–496.PubMedGoogle Scholar
  29. 29.
    Dragovich D, Tamburlini G, Alisjahbana A, Kambarami R, Karagulova J, Lincetto O et al. Thermal control of the newborn: knowledge and practice of health professional in seven countries. Acta Paediatr 1997; 86: 645–650.PubMedGoogle Scholar
  30. 30.
    Talukder M. The importance of breastfeeding and strategies to sustain high breastfeeding rates. In: Costello A, Manandhar D, editors. Improving newborn infant health in developing countries. Singapore: World Scientific Publications; 2000. p. 309–342.Google Scholar
  31. 31.
    Huffman S, Zehner E, Victora C. Can improvements in breast-feeding practices reduce neonatal mortality in developing countries? Midwifery 2001; 17: 80–92.PubMedCrossRefGoogle Scholar
  32. 32.
    Engle P. Infant Feeding Styles: Barriers and Opportunities for Good Nutrition in India. Nutrition Reviews 2002; 60(5): S109–S114.PubMedCrossRefGoogle Scholar
  33. 33.
    Singh M, Haldiya K, Lakshminarayana J. Infant weaning and feeding practices in some semi-arid rural areas of Rajasthan. J Indian Med Assoc 1997; 95(11): 576–8, 590.PubMedGoogle Scholar
  34. 34.
    Singh R, Kumar O, Rana R. Breast feeding and weaning practices among urban Muslims of district Lucknow. Indian Pediatr 1992; 29(2): 217–219.PubMedGoogle Scholar
  35. 35.
    Srivastava SP, Sharma VK, Kumar V. Breast feeding pattern in neonates. Indian Pediatr 1994; 31(9): 1079–1082.PubMedGoogle Scholar
  36. 36.
    Fikree F, Ali T, Durocher J, Rahbar M. Newborn care practices in low socioeconomic status settlements of Karachi, Pakistan. Social Sci Med 2005; 60: 911–921.CrossRefGoogle Scholar
  37. 37.
    Holman D, Grimes M. Colostrum Feeding Behavior and Initiation of Breastfeeding in Rural Bangladesh. J Biosoc Sci 2001; 33: 139–154.PubMedCrossRefGoogle Scholar
  38. 38.
    Haider R, Ashworth A, Kabir I, Huttly S. Effect of community-based peer counselors on exclusive breastfeeding practices in Dhaka, Bangladesh: a randomized controlled trial. Lancet 2000; 356: 1643–1647.PubMedCrossRefGoogle Scholar
  39. 39.
    Haider R, Kabir I, Ashworth A. Are breastfeeding promotion messages influencing mothers in Bangladesh? Results from an urban survey in Dhaka, Bangladesh. J Trop Pediatr 1999; 45(5): 315–318.PubMedCrossRefGoogle Scholar
  40. 40.
    Caldwell J, McDonald P. Influence of maternal education on infant and child mortality: levels and causes. Health Policy Educ 1982; 2: 251–267.PubMedCrossRefGoogle Scholar
  41. 41.
    Mosley W, Chen L. An analytical framework for the study of child survival in developing countries. Population and Development Review 1984; Suppl. (10): 25–45.Google Scholar
  42. 42.
    Khanna R, Kumar A, Vaghela JF, Sreenivas V, Puliyel JM. Community based retrospective study of sex in infant mortality in India. BMJ 2003; 327(7407): 126.PubMedCrossRefGoogle Scholar
  43. 43.
    Borooah VK. Gender bias among children in India in their diet and immunisation against disease. Soc Sci Med 2004; 58(9): 1719–1731.PubMedCrossRefGoogle Scholar
  44. 44.
    Coale A. Excess Female Mortality and the Balance of the Sexes in the Population: An Estimate of the Number of “Missing Females”. Popul and Dev Rev 1991; 17(3): 517–523.CrossRefGoogle Scholar
  45. 45.
    Leone T, Matthews Z, Zuanna G. Impact and Determinants of Sex Preference in Nepal. International Family Planning Perspectives 2003; 29(2): 69–75.PubMedCrossRefGoogle Scholar
  46. 46.
    DasGupta M, Bhat P. Fertility Decline and Increased Manifestation of Sex Bias in India. Population Studies 1997; 51(3): 307–315.CrossRefGoogle Scholar
  47. 47.
    Bang AT, Reddy HM, Deshmukh MD, Baitule SB, Bang RA. Neonatal and infant mortality in the ten years (1993 to 2003) of the Gadchiroli field trial: effect of home-based neonatal care. J Perinatol 2005; 25Suppl 1: S92–S107.PubMedCrossRefGoogle Scholar
  48. 48.
    Bang AT, Bang RA, Reddy HM. Home-based neonatal care: summary and applications of the field trial in rural Gadchiroli, India (1993 to 2003). J Perinatol 2005; 25Suppl 1: S108–S122.PubMedCrossRefGoogle Scholar
  49. 49.
    Jones G, Steketee R, Black R, Bhutta Z, Morris S, Group BCSS. How many child deaths can we prevent this year? Lancet 2003; 362: 65–71.PubMedCrossRefGoogle Scholar
  50. 50.
    Pallikadavath S, Foss M, Stones R. Antenatal care: provision and inequality in rural India. Soc Sci and Med 2004; 59: 1147–1158.CrossRefGoogle Scholar
  51. 51.
    Ramarao S, Caleb L, Khan M, Townsend J. Safer maternal health in rural Uttar Pradesh: do primary health services contribute? Health Policy Plan 2001; 16(3): 256–263.PubMedCrossRefGoogle Scholar
  52. 52.
    Bloom S, Lippeveld T, Wypij D. Does antenatal care make a difference to safe delivery? A study in urban Uttar Pradesh, India. Health Policy Plan. 1999; 14(1): 38–48.PubMedCrossRefGoogle Scholar
  53. 53.
    Bang A, Bang R, Baitule S, Reddy M, Deshmukh M. Effect of home-based neonatal care and management of sepsis on neonatal mortality: field trial in rural India. Lancet 1999; 354: 1955–1961.PubMedCrossRefGoogle Scholar
  54. 54.
    Bang AT, Bang RA, Reddy HM, Deshmukh MD, Baitule SB. Reduced incidence of neonatal morbidities: effect of home-based neonatal care in rural Gadchiroli, India. J Perinatol 2005; 25Suppl 1: S51–S61.PubMedCrossRefGoogle Scholar

Copyright information

© Dr. K C Chaudhuri Foundation 2007

Authors and Affiliations

  • Abdullah H. Baqui
    • 1
    Email author
  • E. K. Williams
    • 1
  • G. L. Darmstadt
    • 1
    • 2
  • V. Kumar
    • 1
  • T. U. Kiran
    • 4
  • D. Panwar
    • 4
  • R. K. Sharma
    • 1
  • S. Ahmed
    • 1
  • V. Sreevasta
    • 3
  • R. Ahuja
    • 3
  • M. Santosham
    • 1
  • R. E. Black
    • 1
  1. 1.Department of International HealthJohns Hopkins University Bloomberg School of Public HealthBaltimoreUSA
  2. 2.Saving Newborn LivesSave the Children/USAWashingtonUSA
  3. 3.King George Medical UniversityLucknowIndia
  4. 4.CARE-IndiaNew DelhiIndia

Personalised recommendations