The document summarizes India's National Newborn Action Plan and Rewa District Newborn Action Plan. It provides statistics on neonatal, infant and under-5 mortality in India from 1990-2012, showing a 44-59% reduction. The Rewa District plan aims to reduce the neonatal mortality rate from 47 to under 10 per 1000 live births by focusing on interventions around labor/childbirth, newborn care, sick newborn care, and coordination across sectors like health, education and women/child development. Key commitments include training health workers, establishing developmental clinics, and implementing a community awareness campaign.

1. Global Every Newborn
Action Plan
The Every Newborn: an action plan to end preventable deaths is a roadmap
for change . It sets out a vision and proposes a goal and targets to end
newborn deaths from preventable causes.
Five guiding principles and five strategic objectives are at the core of the plan.

2. India Newborn Action Plan
Sept. 2014

3. Situational Analysis of newborn in India
Deaths
(in thousands)
1990 2000 2012*
Relative reduction
from 1990 to 2000
Relative reduction
from 2000 to
2012
Relative reduction
from 1990 to
2012
Neonatal deaths 1354 1118 758 17% 32% 44%
Infant deaths 2333 1751 1097 25% 37% 53%
Under-5 child
deaths 3325 2414 1359 27% 44% 59%
Source: UN inter-agency group *Source: MoHFW estimates
Estimates of child deaths in India for years 1990, 2000, and 2012

4. Trends of Child Mortality Rates
Source: SRS Statistical Reports (2000-2012)

5. NMR: SRS Statistical Reports (2012)

6. Less than
10
11-15 16-20 21-25 26-30 More than 30 Data not
available
• Kerala • Tamil
Nadu
• Maharashtra
• Punjab
• Karnataka
• West
Bengal
• Andhra Pradesh
• Assam
• Bihar
• Gujarat
• Haryana
• Himachal
• Jammu and
Kashmir
• Jharkhand
• Chhattisgarh
• Madhya
Pradesh
• Odisha
• Rajasthan
• Uttar Pradesh
• Arunachal
Pradesh
• Goa
• Manipur
• Meghalaya
• Mizoram
• Nagaland
• Sikkim
• Tripura
• Uttaranchal
NMR: SRS Statistical Reports (2012)

7. Causes of neonatal deaths in India
Source: Liu et al, Lancet 2012
Statistical Report

8. Rewa Neonatal Action Plan
2014
Single Digit In Single Year
SDSY

9. 48 47 45
73
70 68
102 100 100
0
20
40
60
80
100
120
2011 2012 2013
Mortality pattern in Rewa District: AHS bulletin
NMR IMR U5MR

10. Neonatal mortality trend in GMH Rewa
Year Total Death Deliveries Death per 1000 deliveries
2011 113 8488 13.3
2012 115 7838 14.6
2013 119 8019 14.9
2014 till sept. 69 5550 12.2
13.3
14.6 14.9
12.2
0
5
10
15
20
2011 2012 2013 2014 till sept.
Death per 1000 deliveries
Inborn neonatal deaths in GMH, Rewa

11. Health care delivery system in Rewa:
Situational Analysis
Health care delivery system: infrastructure
Medical College District hospital CHC PHC Sub centers
1 1 12 30 283
Health care delivery system: Manpower
1 Category Trained Untrained Total
2 LHV/MPW 174 14 188
3 ANM 379 49 428
4 ASHA 1793 383 2176
5 AWW 1902 1100 3014
6 FLW: ALL categories (1+2+3+4+5) 4248 1546 5806

12. Demographic profile of Rewa District
Population 2365106 Census 2011
Birth rate 2.6 % Census 2011
Expected birth per year 61492
IMR 68 per 1000 AHS 2012-13
Infant’s death per year with current IMR 4181
Neonatal Mortality rate (NMR) 47 per 1000 AHS 2012-13
Neonatal death per year with current NMR 2767
Single digit NMR (projected) 9 per 1000
Neonatal mortality per year with projected NMR 554
Targeted neonatal death to be reduced per year 2213

13. Sub centres in Rewa district 283
Sub centres required in Rewa district 473
Population covered by per health institution (PHC+CHC) 56143
Doctor Population Ratio in Rewa district (in Govt. facilities) 1:29564
Deliveries per year 61493
Bed requirement for the mother for postpartum period
(3 days)
505 beds per day

14. The Guiding Principles for Rewa newborn
action plan
1. Integration
2. Quality of Care
3. Convergence
4. Partnerships
5. Accountability

15. Suggested intervention packages

16. 1. Care during Labour and Childbirth
(20% cause of preventable mortality)
• Delivery at health Institution
• Assurance of resuscitation corner at every place of delivery
• Referral timely by the all heath worker
• Our commitment
We will be conducting NSSK on every Friday and Saturday in the
Department of Paediatrics S.S.M.C., Rewa, for 20 health workers and hope
train 1000 health workers in a year

17. 2. Immediate Newborn Care
• Health education
• Our commitment
• Propagating danger signs
• Train all ANM and help in ASHA training

18. 3. Care of Healthy Newborn
Count every newborn through measurement, programme-tracking
and accountability
• Health education
• Our commitment
Propagation of danger sign

19. 4. Care of Small and Sick Newborn
(68% cause of preventable mortality)
• Institutional care of the sick newborns
• Our commitment
Acts as a mentor in various blocks
Rewa Block Doctor concerned
Rewa Dr. Jyoti Singh
Raipur Karchuliyan Dr. Karan Joshi
Gangev Dr. Naresh Bajaj
Mauganj & Hanumana Dr. Sunil Rao
Sirmaur and Java Dr. Shabd Singh Yadav
Teonthar Dr. Deepak Dwivedi
Naigarhi Dr. Meena Singh

20. 5. Care beyond Newborn Survival
• Establishment fully functional District Early Intervention Centres
(DEICs)
• Our commitment
• Developmental clinic on every Tuesday
• Neonatal follow clinic with Ophthalmology support on every Friday

21. 6. Pre-Conception and Antenatal Care :
By Social Mobilisation
To harness the power of parents, families and communities
To reach every woman and newborn to reduce inequities.
• Health education by “Swasthya Gyan Ganga campaign”
• Parenting workshop to target population
(target population: 1. newly married couple up-to birth of their second child
2. late adolescents)
• Incorporation of Mahila Bal Vikas and college girl students as trainer for the
target populations
• Training of paramedical health workers

22. Coordination from other sector
• Health department
• Trainer identification
• Monitoring at work
• Provision of neonatal transport
• MCTS strengthening
• Couple survey
• LSCS in CHC

23. • Department of Education
• Master trainer group for school – class IX to XII
• Master trainer group for college
• Girl mobilisation

24. • Mahila Bal Vikas
• Parenting workshop for newly married and those having less than 2 babies
• Nutritional supplements to married preconceptional women
Coordination from other sector

25. thanks