The document provides performance indicators for newborn and child health programs in the region. Key metrics include admission and outcome data for Special Newborn Care Units (SNCU) such as inborn vs outborn admissions, case types, birth weight categories and outcomes of discharged, referred, left against medical advice and deaths. Performance is also reported for Newborn Stabilization Units (NBSU), Newborn Care Corners (NBCC) and Nutritional Rehabilitation Centres (NRC). Charts show trends in child mortality and progress towards national and international targets. Programs reviewed include facility and community-based newborn and child care as well as quality mechanisms.

1. Newborn
Child Health
Regional Review

2. What Indicators project?
15
20
28
32
16
21
27
30
0
5
10
15
20
25
30
35
ENMR NMR IMR UNDER-5
SRS-2020
INDIA BIHAR
2
19.5
3
25.5
1
10
100
TFR CBR
103
130
-10
10
30
50
70
90
110
130
MMR
SRS 2020 SRS 2019

3. Child Mortality Trend in Bihar
27 25 23 23 22 23 21 21 20 18 16
31 29 28 28 27 28 27 28 25 23 21
48
44 43 42 42 42
38 35
32
29
27
64
59
57 54 53 48
43 41
37
34
30
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
ENMR NMR IMR U5MR Source : SRS

4. 69
58
37
59
47
30
32 28 20
U5MR* IMR NMR
India (2005-2019)
2005 2010 2020
54%
reduction
75
61
32
64
48
31
30 27 21
U5MR* IMR NMR
Bihar (2005-2019)
2005 2010 2020
52%
reduction 46%
reduction
60%
reduction 56%
reduction 34%
reduction
NCH Indicators and Target
Child Health Indicator India Bihar NHP 2017 SDG 2030
Neonatal Mortality Rate 20 (SRS, 2020) 21 (SRS, 2020) 16 by 2025 <12
Infant Mortality Rate 28 (SRS, 2020) 27 (SRS, 2020) 28 by 2019 -
Under 5Mortality Rate 32 (SRS, 2020) 30 (SRS, 2020) 23 by 2025 ≤25

5. NCH:
Key Programs
 Newborn Care
• Special Newborn Care Unit (SNCU) at DHs
• Newborn Stabilization Unit (District) at FRUs
• Newborn Care Corner (NBCC) at all delivery points
 Paediatric Care
• Paediatric OPD
• Paediatric IPD
• Nutrition Rehabilitation Centre (NRC)
Facility-Based Care
• Home Based Newborn Care (HBNC)
• Home Based Young Child Care (HBYC)
• Anemia Mukt Bharat (AMB)
Community-Based Care
• Child Death Review
• Regular Monthly Review at all levels
Review Mechanism
• MusQan
Quality Standard

6. Special
Newborn Care
Unit (SNCU)

7. SNCU: Admission and Outcome profile
• Total Admission in the previous quarter in the Region (Sum of all districts)
(Jul-Sep 2022) : 200
[CELLRANGE], 80 [CELLRANGE], 70 [CELLRANGE], 30
[CELLRANGE], 20
Inborn Outborn Private Home
[CELLRANGE]
48
[CELLRANGE]
16
[CELLRANGE]
8
[CELLRANGE]
8
Inborn
[CELLRANGE], 42
[CELLRANGE], 14
[CELLRANGE], 7
[CELLRANGE], 7
Outborn
Discharged Referred LAMA Death
[CELLRANGE], 18
[CELLRANGE], 6
[CELLRANGE], 3
[CELLRANGE], 3
Private
[CELLRANGE], 12
[CELLRANGE], 4
[CELLRANGE], 2
[CELLRANGE], 2
Home

8. Case type and Outcome
[CELLRANGE]
20
[CELLRANGE]
5
[CELLRANGE]
3
[CELLRANGE]
2
Jaundice
30
[CELLRANGE
]
70
[CELLRANGE
]
50
[CELLRANGE
]
30
[CELLRANGE
]
20
[CELLRANGE
]
10
[CELLRANGE
]
10
[CELLRANGE
]
10
Asphyxia
RDS
Jaundice
Seizure
VLBW
Preterm
Others
[CELLRANGE]
10
[CELLRANGE]
5
[CELLRANGE]
3
[CELLRANGE]
2
Seizure
20
Discharged Referred LAMA Death
[CELLRANGE]
7
[CELLRANGE]
2
[CELLRANGE]
1
[CELLRANGE]
2
VLBW
10
[CELLRANGE]
6
[CELLRANGE]
1
[CELLRANGE]
1
[CELLRANGE]
2
Preterm
10
[CELLRANGE]
38
[CELLRANGE]
16
[CELLRANGE]
8
[CELLRANGE]
8
Asphyxia
70
[CELLRANGE]
28
[CELLRANGE]
6
[CELLRANGE]
8
[CELLRANGE]
8
RDS
50

9. Birth weight and Outcome
• Total Admission during the period: 200
[CELLRANGE]
68
[CELLRANGE]
16
[CELLRANGE]
8
[CELLRANGE]
8
Good Weight
[CELLRANGE], 100 [CELLRANGE], 50 [CELLRANGE], 50
Good Weight (≥2500 gm)
LBW (<2500gm)
LBW (≤1800gm)
[CELLRANGE]
28
[CELLRANGE]
6
[CELLRANGE]
8
[CELLRANGE]
8
LBW<1800gm
[CELLRANGE]
28
[CELLRANGE]
6
[CELLRANGE]
8
[CELLRANGE]
8
LBW <2500 gm
Discharged Referred LAMA Death

10. 70
100
Rational Use of Antibiotics
Newborn with Sepsis Newborn given Antibiotics
[CELLRANG
E], 50
[CELLRANG
E], 100
[CELLRANG
E], 25
[CELLRANG
E], 25
Duration of Stay at SNCU
>6 days 4-6 days 1-3 days <1 day
Duration of Stay and Rational use of Antibiotics

11. Delivery Point and SNCU Linkage
[CELLRANGE]
4
[CELLRANGE]
2
[CELLRANGE]
1
[CELLRANGE]
0
[CELLRANGE]
0
[CELLRANGE]
3
[CELLRANGE]
4
[CELLRANGE]
1
[CELLRANGE]
1
[CELLRANGE]
1
[CELLRANGE]
1
[CELLRANGE]
10
[CELLRANGE]
2
[CELLRANGE]
1
[CELLRANGE]
3
[CELLRANGE]
1
[CELLRANGE]
1
[CELLRANGE]
3
[CELLRANGE]
1
[CELLRANGE]
5
[CELLRANGE]
1
[CELLRANGE]
2
[CELLRANGE]
2
[CELLRANGE]
1
[CELLRANGE]
3
[CELLRANGE]
4
[CELLRANGE]
5
[CELLRANGE]
1
[CELLRANGE]
1
[CELLRANGE]
0
0
2
4
6
8
10
12
PHC
1
PHC
2
PHC
3
PHC
4
PHC
5
PHC
6
PHC
7
PHC
8
PHC
9
PHC
10
PHC
11
PHC
12
PHC
13
PHC
14
PHC
15
PHC
16
PHC
17
PHC
18
PHC
19
PHC
20
PHC
21
PHC
22
PHC
23
PHC
24
PHC
25
PHC
26
PHC
27
PHC
28
PHC
29
PHC
30
No. of Cases referred to SNCU
No. of Cases referred to SNCU

12. Performance: SNCU wise
Period: Jul-Sep 2022

13. SNCU : HR Availability
3
[CELLRANGE]
3
[CELLRANGE]
13
SNCU-1
Paediatrician GMO Nurse
3
[CELLRANGE]
3
[CELLRANGE]
13
SNCU-2
Paediatrician GMO Nurse
3
[CELLRANGE]
3
[CELLRANGE]
13
SNCU-3
Paediatrician GMO Nurse
As per DoH, Bihar (Letter No. 466 Dated 12.08.2014) Posts of 1 Paediatrician, 3 GMO and 13 Grade-A Nurse have
been created for each SNCU.

14. SNCU Performance: Outcome
[CELLRANGE]
68
[CELLRANGE]
16
[CELLRANGE]
8
[CELLRANGE]
8
SNCU-1
Discharged Referred LAMA Death
[CELLRANGE]
68
[CELLRANGE]
16
[CELLRANGE]
8
[CELLRANGE]
8
SNCU-3
Discharged Referred LAMA Death
[CELLRANGE]
68
[CELLRANGE]
16
[CELLRANGE]
8
[CELLRANGE]
8
SNCU-2
Discharged Referred LAMA Death
No. of Treated Cases: 100 No. of Treated Cases: 100 No. of Treated Cases: 100

15. SNCU: Bed Utilization
[CELLRANGE]
60
[CELLRANGE]
50
[CELLRANGE]
60
[CELLRANGE]
50
[CELLRANGE]
50
[CELLRANGE]
50
[CELLRANGE]
60
[CELLRANGE]
60
[CELLRANGE]
60
44
46
48
50
52
54
56
58
60
62
SNCU-1 SNCU-2 SNCU-3
Jul-22 Aug-22 Sep-22
Desirable No. of Admission=6 admissions per bed per month

16. Outcome of Low Birth weight (<1800gm) babies
[CELLRANGE]
70
[CELLRANGE]
14
[CELLRANGE]
10
[CELLRANGE]
6
SNCU-1
[CELLRANGE]
70
[CELLRANGE]
14
[CELLRANGE]
10
[CELLRANGE]
6
SNCU-2
[CELLRANGE]
70
[CELLRANGE]
14
[CELLRANGE]
10
[CELLRANGE]
6
SNCU-3

17. Outcome of Good weight (>2500gm) babies
[CELLRANGE]
70
[CELLRANGE]
14
[CELLRANGE]
10
[CELLRANGE]
6
SNCU-1
[CELLRANGE]
70
[CELLRANGE]
14
[CELLRANGE]
10
[CELLRANGE]
6
SNCU-2
[CELLRANGE]
70
[CELLRANGE]
14
[CELLRANGE]
10
[CELLRANGE]
6
SNCU-3

18. SNCU: Rational use of antibiotics
60
50
60
[CELLRANGE]
50
[CELLRANGE]
50
[CELLRANGE]
50
44
46
48
50
52
54
56
58
60
62
SNCU-1 SNCU-2 SNCU-3
No. of Sepsis Cases No. of babies treated with antibiotics

19. Functionality and utilization of CPAP machine
Sl.
No.
Name of SNCU No. of
CPAP
Machine
Available
No. of
CPAP
Machine
Functional
No. of
babies with
birth
weight
<1800gm
No. of
babies with
<34 Weeks
of gestation
No. of
babies with
RDS
admitted
during the
period
No. of
babies with
RDS
managed
using CPAP
during the
period
1
2
3
4

20. SNCU Performance: Other key areas
Review Point SNCU-1 SNCU-2 SNCU-3 SNCU-4
1. Daily Round of Paediatrician in all 3 shifts (Yes/No)
Morning Shift Yes Yes Yes No
Evening Shift Yes Yes Yes No
Night Shift Yes Yes Yes No
Round Register maintained properly No Yes Yes No
2. Equipment
Mapping of equipment completed Yes Yes Yes No
3. Availability of drugs and logistics
No Stockouts during the period
(Yes/No)
Yes Yes Yes No
4. Availability of Lab investigations (Serum bilirubin, Plasma glucose, Serum creatinine, Blood count, Platelet, C reactive protein,
Prothrombin time, Blood gas analysis with PH measurement analysis.)
All Lab investigations available Yes Yes Yes Yes

21. Newborn
Stabilization
Unit (NBSU)
Performance
Period: Jul-Sep 22

22. 8
5
5
5
All NBSU
LBW (<2500 gm)
Birth Weight <1800 gm
Jaundice Cases
Others
NBSU: Admission Profile
Sl. No. Name of NBSU Admission
LBW (<2500gm) Birth Weight
(<1800gm)
Jaundice Cases Others
1 NBSU-1
2 NBSU-2
3 NBSU-3
4 NBSU-4
5 NBSU-5
6 NBSU-6
7 NBSU-7

23. 8
5
5
5
All NBSU
Discharged
Referred
LAMA
Death
NBSU: Outcome Profile
Sl.
No.
Name of NBSU Admission Vs Outcome
Functional
(Yes/No)
Total
Admission
Discharge Referred LAMA Death
1 NBSU-1 10 4 (80%) 3 (30%) 2 (20%) 1 (10%)
2 NBSU-2
3 NBSU-3
4 NBSU-4
5 NBSU-5
6 NBSU-6
7 NBSU-7

24. Newborn Care
Corner (NBCC)

25. NBCC: Admission Profile
Sl.
No.
Name of District Weight and Maturity
Total Live
Birth
LBW
(<2500gm)
Birth
Weight
(≤2000gm)
Birth
Weight
<1800gm)
<34 Weeks <37 Weeks Cases
managed at
NBCC
Cases
Referred to
higher
centre
Desired Action Initial
management
at NBCC
followed by
quality HBNC
Initial
management
at NBCC
followed by
quality HBNC
Referral after
stabilization
1 District-1
2 District-2
3 District-3
4 District-4
5 District-5
6 District-6
7 District-7

26. Management of neonatal complications at NBCC
14
15
14
15
[CELLRANGE]
5
[CELLRANGE]
6 [CELLRANGE]
5
[CELLRANGE]
8
[CELLRANGE]
3
[CELLRANGE]
4
[CELLRANGE]
2
[CELLRANGE]
3
[CELLRANGE]
2
[CELLRANGE]
2
[CELLRANGE]
3
[CELLRANGE]
5
0
2
4
6
8
10
12
14
16
District-1 District-2 District-3 District-4
NBCC Performance
Sum of Live Births at all Delivery Points No. of Cases identified with neonatal complications Cases manged at NBCC Cases Referred

27. NBCC: Do’s and Don’ts
Do’s
• Always wash your hands before handling the baby
• Rooming in of baby with the mother
• Keep the baby with the mother
• Keep the baby warm
• Take extra care to maintain baby’s temperature is
preterm and LBW baby
• Keep the cord dry and clean
• Breast fed the baby exclusively
• Early initiation of breast feeding is essential for a good
reflex action
• Any signs/symptoms of complications must be referred
and attended to by a doctor
• The care provider should observe every 2 hours in the
first 6 hours and every 6 hours from 6-24 hours after
delivery
• If the newborn is LBW then at least three additional visits
should be ensured
Don’ts
• Do not keep all babies as a routine under the radiant
warmer
• Do not delay breast feeding beyond half an hour as that
may lead to rapid decrease in suckling reflex of the rapid
decrease in suckling reflex of the baby
• Do not use prelacteals even water
• Do not apply anything on the cord
• Do not bathe the newborn for 24hrs after birth
• Do not forget to undertake routine checkup

28. Nutritional
Rehabilitation
Centre (NRC)

29. NRC: ELA Vs Admission
60
50
60 60 60
[CELLRANGE]
50
[CELLRANGE]
50
[CELLRANGE]
50
[CELLRANGE]
50
[CELLRANGE]
50
44
46
48
50
52
54
56
58
60
62
NRC-1 NRC-2 NRC-3 NRC-4 NRC-5
ELA Admission

30. NRC: Average Duration of Stay
21
14
10
5
14
0
5
10
15
20
25
NRC-1 NRC-2 NRC-3 NRC-4 NRC-5
Average Duration of Stay

31. NRC: Availability of Diet and Drugs
Sl.
No.
Name of NRC Diet being provided as
per the guideline
Drugs and other
logistics available as
per the guideline
1 NRC-1 Yes Yes
2 NRC-2 No Yes
3 NRC-3 Yes Yes
4 NRC-4 Yes Yes
5 NRC-5 Yes No

32. Home Based
Newborn Care
(HBNC)

33. HBNC: Performance
3,000 3,000 3,000 3,000 3,000
5,000 5,000 5,000 5,000 5,000
3,000
2,500
2,700
3,000 3,000
4,000
5,000
4,000
3,000 3,000
[CELLRANGE]
200
[CELLRANGE]
150
[CELLRANGE]
125
[CELLRANGE]
100
[CELLRANGE]
100
0
1000
2000
3000
4000
5000
6000
District-1 District-2 District-3 District-4 District-5
#REF! No. of ASHA Live Birth No. of ASHAs having new HBNC Kit Cases visited by ASHA Sick Children identified by ASHA

34. HBNC: Supportive Supervision
5,000 5,000 5,000 5,000 5,000
[CELLRANGE]
4,000
[CELLRANGE]
5,000
[CELLRANGE]
4,000 [CELLRANGE]
3,000
[CELLRANGE]
3,000
[CELLRANGE]
400 [CELLRANGE]
250
[CELLRANGE]
300
[CELLRANGE]
500
[CELLRANGE]
450
[CELLRANGE]
10
[CELLRANGE]
15
[CELLRANGE]
30
[CELLRANGE]
25
[CELLRANGE]
50
[CELLRANGE]
5 [CELLRANGE]
3
[CELLRANGE]
10
[CELLRANGE]
12
[CELLRANGE]
25
1
10
100
1,000
10,000
District-1 District-2 District-3 District-4 District-5
Live Birth Cases visited by ASHA Cases visited by ASHA Faciliatators Cases vistited by Block level Officers Cases vistited by district level Officers

35. HBNC
• Availability of HBNC Kit
• Quality of home visit by the ASHA using HBNC Kit
• Supportive Supervision by ASHA Facilitators
• Timely payment
• Review of the program at all levels

36. Home Based Young Child
Care (HBYC)

37. Training of ASHAs on HBYC
2,000
2,500
3,000
2,000
2,300
[CELLRANGE]
1,500
[CELLRANGE]
1,200
[CELLRANGE]
2,000
[CELLRANGE]
2,000
[CELLRANGE]
230
-
500
1,000
1,500
2,000
2,500
3,000
3,500
District-1 District-2 District-3 District-4 District-5
No. of ASHA-Target No. of ASHA-Trained

38. HBYC: Visit by ASHA and Payment
2,000
2,500
3,000
2,000
2,300
[CELLRANGE]
1,500
[CELLRANGE]
1,200
[CELLRANGE]
2,000
[CELLRANGE]
2,000
[CELLRANGE]
230
[CELLRANGE]
1,000
[CELLRANGE]
1,000
[CELLRANGE]
1,500
[CELLRANGE]
1,500
[CELLRANGE]
100
-
500
1,000
1,500
2,000
2,500
3,000
3,500
District-1 District-2 District-3 District-4 District-5
ASHA-Trained on HBYC ASHA-Started visit ASHA-Received Payement for atleast 1 case

39. Child Death Review (CDR)

40. CDR
• Reporting: Timely, Completeness, Correctness
• Review of reported cases as per the CDSR guideline
• Online Reporting on the MPCDSR Portal

41. CDR: Reporting and Review
500
300
400
500 500
[CELLRANGE]
25
[CELLRANGE]
55
[CELLRANGE]
22
[CELLRANGE]
35
[CELLRANGE]
32
[CELLRANGE]
12
[CELLRANGE]
12
[CELLRANGE]
13
[CELLRANGE]
15
[CELLRANGE]
15
[CELLRANGE]
5
[CELLRANGE]
6
[CELLRANGE]
7
[CELLRANGE]
8
[CELLRANGE]
9
1
10
100
1000
District-1 District-2 District-3 District-4 District-5
ELA-Child Death Reported on HMIS Reported on CDR Format Detailed Investigation

42. MusQan: Gap Assessment
Sl. No. Name of District Credential (Login ID and
Password) Received from
the state
(Yes/No)
Online Reporting started
(Yes/No)
1 District-1 Yes Yes
2 District-2 Yes No
3 District-3 Yes Yes
4 District-4 No No
5 District-5 Yes Yes

43. MusQan
Progress Update

44. Progress on MusQan initiative
Sl.
No.
Name of District Facility identified for
QI as per MusQan
Baseline
Assessment
Completed using
MusQan Checklist
Nodal Officer
Nominated
(Yes/No)
1 District-1 Yes Yes Yes
2 District-2 Yes No Yes
3 District-3 Yes Yes Yes
4 District-4 No No Yes
5 District-5 Yes Yes Yes