2. Skills for saving life
• Maternal Health
• Newborn Health
• Child Health
• Nutrition
• Infections
• Social mobilization
Home-Based Newborn and Child Care
*
3. JSY reduced NMR by 2 ( Lancet 2010)
IMNCI can reduce NMR by 13 % ( 4)
The MDG : to reduce IMR to 28 by 2015
The current IMR : 53
Reduction to be done by 25 points
More effective interventions urgently needed.
4.
5. Newborns in India
27 million newborns are born each year
51 % born at home
Even the hospital delivered mother and
newborn are sent home < 24 hr.
Newborn health care must visit
where the neonates are.
*
SEARCH, Gadchiroli
6. Home-Based Newborn Care
Goal : To reduce neonatal mortality by
developing a low-cost, home-based model
of primary newborn care by using the
human potential in villages.
SEARCH, Gadchiroli
7. How to provide HBNC
Mother
TBA
CHW
Supervisor
Training + Supervision + supplies + incentives
SEARCH, Gadchiroli
9. • Health education for behavior change & care
seeking
• Attending home delivery : with TBA
• Care of baby at birth
• Home visits and support in newborn care
• Monitor the newborns
• Management of NB sicknesses
- Birth asphyxia
- LBW / Preterm
- Sepsis / Pneumonia
Interventions
SEARCH, Gadchiroli
10. Supervision: Every 15 days
1. Is the work of CHW complete ?
2. Is the quality of work good ?
3. Are her skills up to the mark ?
4. Does she have the supplies ?
5. Are there any complications ?
6. Is the community satisfied &
supportive ?
7. How much should she be paid ?
SEARCH, Gadchiroli
11. Neonatal mortality rate (1993 to 2003)
(intervention and control area)
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
1993-95 1995-96 1996-97 1997-98 1998-01 2001-03
Baseline Training
& visiting
Interventions Full
Interventions
Continuation of care
Neonatal mortality rate
70 % reeducation in the NMR SEARCH, Gadchiroli
12. The Infant Mortality Rate in Gadchiroli (1988 – 2007)
39 intervention villages
0
20
40
60
80
100
120
140
Infant Mortality Rate
Pneumonia case management
Home-based newborn care
Year
Linear regression trend in IMR
SEARCH, Gadchiroli
17. What is necessary to implement HBNCC
successfully ?
• Community support
• Training : Contents, duration, strategy
and quality of trainers.
• Management support to ASHA program
in the field
• Computerized records and MIS
• Support by the Health System
• Finances
18. Training for HBNCC
• Program Manager : 10 days
• Trainer : 30 days
• Facilitator : 25 days
• ASHA : 20 days + Work in her Community
19. Educational Aids from SEARCH
Dialogue with Mother
Home Based Newborn Care
CHW Training Manual
Flip-Chart for Health
Education of Mothers
A Film for Health
Education of Mothers
SEARCH, Gadchiroli
23. SEARCH, Gadchiroli
ANKUR Project in Mahatashtra
HBNCC Replication sites
ICMR Study: Government of India, five states.
Other NGOs
Africa
Other Countries
Total 49 Sites
SEARCH, Gadchiroli
Other States
4 countries
24. 11th Five Year Plan
• HBNCC Gadchiroli model to be
the main strategy to reduce IMR in
India.
• Introduce HBNCC in all districts
with IMR > 45
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30. Global Policy Acceptance
Joint statement by WHO, UNICEF,
US-AID and Save the Children ( 2009).
Endorsement of home visiting the
neonates and management of sick
neonates at home by trained worker if
the referral is not possible.
33. Payment to CHW
• Time spent : 1 hr / day
per 1000 popl.
• Performance linked payment
• Rs 200 Per mother-newborn
• Average Rs 500 Per month
SEARCH, Gadchiroli
