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Newborn Health in India. Newborn health in India . 25 million (2.5 crore) births per year - Accounts for 20% of global births 0.9 million (9 lakh) die in neonatal period - Accounts for about 25% of global deaths. India accounts for highest births & neonatal deaths globally.
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Newborn health in India • 25 million (2.5 crore) births per year - Accounts for 20% of global births • 0.9 million (9 lakh) die in neonatal period - Accounts for about 25% of global deaths India accounts for highest births & neonatal deaths globally
Neonatal mortality rate (NMR) • Current (NFHS-3): 39/1000 live births (2005-06) Accounts for almost 2/3rd of IMR & ½ of U5-MR
NMR - State wise NMR is not uniform across the country
Differences in NMR Rural - Urban Poor - Rich NMR is high in rural areas and in those who are poor
Causes of neonatal deaths Infections, asphyxia and prematurity are the leading causes of neonatal deaths Source: ICMR, 2006
Timing of neonatal deaths Nearly 3/4th of neonatal deaths occur within 7 days, mostly during first 24 hours
Perinatal indices • Perinatal mortality rate (NFHS-3): 48.5 per 1000 pregnancies • Still-birth rate: 19.2 per 1000 pregnancies • Perinatal mortality rate also varies between the states (from 11 /1000 in Kerala to 63/1000 pregnancies in Assam )
Place of birth • About 50% of deliveries occur at home • Only 46.6% attended by skilled birth attendants* • Higher the institutional births, lower is the NMR * doctors, nurses, and midwives
Decline of NMR • Rapid decline in eighties • 69 in 1980 • 53 in 1990 • Stagnation since nineties • 48 in 1995 • 44 in 2000 • 39 in 2005-06
Why static NMR? • Govt. programmes focused mainly on post neonatal period -Diarrheal Disease Control - ARI - Immunization • Focus of essential newborn component was on a limited number of government facilities • Lack of skilled persons for managing newborns
Way forward Achieving National Goals NPP: National population policy 1 XI Plan 2 National Plan of Action for Children 2005
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
Way forward • National Rural Health Mission (NRHM) - ASHAs in each village to improve maternal and child health services - Strengthening of health facilities -Creation of SCNUs - Janani Suraksha Yojana (JSY): To promote institutional deliveries