Newborn Care Week is celebrated every year in the country from15 to 21 November. The aim of celebrating the week is to raise awareness about the importance of newborn care for child survival and development.
The neonatal period (the first 28 days of life) is the crucial period for child survival; as this period carries the highest risk of deaths per day than any other period during the childhood. The first month of life is also a foundational period for lifelong health and development. Healthy babies grow into healthy adults who can thrive and contribute to their communities and societies.
Every year 2.6 million babies die in the first 28 days of life; most in the first week and an additional 2.6 million stillbirths occur each year.
Nearly, 0.75 million neonates died in India in 2013; though the neonatal mortality rate (NMR) has declined from 44 per 1000 live births in 2000 to 28 per 1000 live births in 2013. The goal of reducing under-five mortality to 20 or less per 1000 live births by 2035 can only be attained with specific efforts to reduce newborn mortality.
Labour, birth and the immediate postnatal period are the most critical for newborn and maternal survival. And 75% of newborn deaths can be prevented with known, effective health measures provided at birth and during the first week of life.
The main causes of newborn deaths are:
- Complications during birth
- Severe infections
Causes of newborn deaths in India*: The major causes of newborn deaths in India are pre-maturity/preterm (35%); neonatal infections (33%); intrapartum related complications/ birth asphyxia (20%); and congenital malformations (9%).
Newborn care: All newborns require essential newborn care to minimize the risk of illness and maximize their growth and development.
Warmth, normal breathing, mother’s milk, and prevention of infection are the basic needs of a normal baby at birth. These basic needs indicate that a baby’s survival is totally dependent upon her mother and other caregivers. Therefore it is important to provide proper care to all the neonates immediately after birth. This care will also prevent many newborn emergencies.
Care of newborns includes:
- Immediate and thorough drying,
- skin to skin contact of the newborn with the mother,
- cord clamping and cutting after the first minutes after birth,
- early initiation of breastfeeding, and exclusive breastfeeding.
- Newborns who do not start breathing on their own by one minute after birth should receive positive pressure ventilation with room air by a self-inflating bag and mask.
After the first hour of life, newborns should receive eye care, vitamin K, and recommended immunizations (birth dose of OPV and Hepatitis B vaccine, BCG).
They should be assessed for birth weight, gestational age, congenital defects and signs of newborn illness. Special care should be provided for sick newborns, those who are preterm and/or low birth weight, and those who are exposed or infected by HIV or have congenital syphilis.
Progress of newborn health interventions in India:
The Ministry of Health and Family Welfare (MoHFW), Government of India has made vital policy decisions to combat major causes of newborn deaths, with special attention to safe motherhood interventions, sick newborns, babies born too soon (premature/preterm), and babies born too small (small for gestational age) with the launch of the Child Survival and Safe Motherhood Programme (CSSM) in 1992; Reproductive and Child Health Programme Phase I (RCH I) in 1997, followed by RCH II in 2005; the National Rural Health Mission (NRHM) in 2005 which, along with the National Urban Health Mission, became part of the National Health Mission in 2013; the Call to Action for Child Survival and Development, and the subsequent Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH+A) strategic framework in 2013.
India newborn care action plan (INAP) and RMNCH+A:
MoHFW has developed the India Newborn Action Plan (INAP) in response to the global Every Newborn Action Plan (ENAP) in 2014. INAP aims to significantly reduce preventable newborn deaths and stillbirths and to bring down the neonatal mortality rate and stillborn rate to “single digits” by 2030.
The INAP is implemented within the existing RMNCH+A framework. Its strength is built on its six pillars of intervention packages, which include: pre-conception and antenatal care; care during labour and childbirth; immediate newborn care; care of a healthy newborn; care of small and sick newborn; and care beyond newborn survival.
MAA (Mothers Absolute Affection)** launched in 2016, is a nationwide programme for promotion of breastfeeding through health system
Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA)*** initiated in 2016, is aimed to reduce maternal and infant mortality rates through safe pregnancies and safe deliveries.