Neonatal deaths in Odisha remain a significant public health problem, accounting for over half of infant and under-5 mortality. The neonatal mortality rate in Odisha is 42 per 1000 live births, with 33 occurring in the early neonatal period. Prematurity, low birth weight, birth asphyxia, and infections are the leading causes. Coverage of antenatal care, institutional deliveries, and postnatal practices like early and exclusive breastfeeding remain areas for improvement. Expanding programs like the Janani Surakshya Yojana and improving access to skilled birth attendance and emergency obstetric and newborn care can help reduce neonatal mortality in Odisha.

1. NEONATAL DEATHS IN
ODISHA
DR. SUDHIRA KUMAR PARIDA.

2. DEFINITION
• Deaths occuring during the neonatal period
i.e., within 28 completed days of birth.
• Calculated as no. of neonatal deaths in a given
yr / 1,000 live births in that yr.

3. IMPORTANCE
• Over 2/3rd of IMR &
• ½ of U5MR
• 90% of neonatal deaths-within 1st 14 days of
life
• ½ of neonatal deaths-within 1st 7 days

4. PROBLEM STATEMENT
SRS 2010:
• NNMR- 42 (R-43,U-32)
• Early NNMR-33 (R-35,U-21)
AHS 2011:
• 31(Angul) - 75(Balangir)
NNMR 10-19 20-29 30-39 40-49 50-59 60-69 70-79
No.of - - 17 10 2 - 1
districts:
• In rural areas of districts - significantly higher
than that in urban areas

5. IMR & NNMR
70
60
50
40
9 (14.8% 0f IMR)
30 61
20
33 (54% of IMR: R-55%,
10 U-50%)
0
IMR NNMR
[SRS 2010]

6. U5MR & NNMR
90
80
70
60
50
78
40
30
42 ( 54% of U5MR )
20
10
0
U5MR NNMR
[SRS 2010]

7. CAUSES
D
CONG. 2 NT
%
MALFORMATIONS 2%
8%
Others
11% PREMATURITY & LBW
29%
BIRTH ASPHYXIA & TRAUMA
23%
SEVERE INFECTION
25%

8. NNMR
EARLY NNMR LATE NNMR
• Prematurity & congenital • Infection
anomalies • Diarrhoea
• Asphyxia

9. DETERMINANTS

10. ANC
120%
98
100%
80% 77
58.4
60%
40% 37.5
20%
0%
at least 1 2+ 3+ full
[COVERAGE EVALUATION SURVEY 2009]

11. CONSUMPTION OF IFA DURING
PREGNANCY
%
None
10%
30 days 100 days
16%
47%
31-90 days
27%
[COVERAGE EVALUATION SURVEY 2009]

12. PLACE OF DELIVERY
%
At home
24.5%
Institutional
75.5%
[COVERAGE EVALUATION SURVEY 2009]

13. Duration of stay at health facility
4+ days
8%
3 days
8%
2 days
1 day
12%
44%
1 day
28%
[COVERAGE EVALUATION SURVEY 2009]

14. DELIVERY ATTENDED BY SBA
90
79%
80
70
60
50
40
30 21%
20
10
0
SBA none
[COVERAGE EVALUATION SURVEY 2009]

15. INSTITUTIONAL DELIVERIES & JSY
JSY 60.7 %
Institutional deliveries
75.5 %
0.00% 20.00% 40.00% 60.00% 80.00%
[COVERAGE EVALUATION SURVEY 2009]

16. BF AFTER CHILD BIRTH
70.00%
63.7
60.00%
50.00%
40.00%
30.00% 27.2
20.00%
8.8
10.00%
0.3
0.00%
< 1 hr 1-23 hr ³ 24 hr No BF
[COVERAGE EVALUATION SURVEY 2009]

17. INTERVENTIONS

18. BEFORE PREGNANCY
• Delayed child-bearing
• Well-timed, well-spaced & wanted
pregnancies
• Well- nourished & healthy mother
• Female literacy

19. DURING PREGNANCY(ANC)
• Early registration
• TT
• IFA
• Good diet
• Counseling on birth preparedness & BF
• Identification of major risk factors of
obstructed labor.

20. INTRAPARTUM & IMMEDIATE
NEWBORN CARE
• PROM-Antibiotics
• Complications- EmOBC
• SBA
• 5 ”C’’s
• Prevention of hypothermia
• Early EBF
• Cord & eye care
• Neonatal resuscitation
• Spl. care for LBW

21. EARLY NBC
• EBF
• Temp maintenance
• Optimal cord care & hygiene
• Immunisation
• Care for LBW baby
• Management of sickness

22. LATE NBC
• EBF
• Cord care & hygiene
• Care for LBW baby

23. HEALTH PROGRAMMES
• JSY
• UIP
• IMNCI
• Mamta dibas
• Pustikar dibas
• JSSK
• Mamta scheme
• E-janani

24. PROGRESS
• ASHAs - in 40,000 villages
• 380 JSY Express
• JSY + Mamta dibas : 26 lakh women
• JSSK - 382 health centre
• ASHA Gruha
• Maa gruha - tribal & outreach area
• 1482 MCH centres
• 394 Health centres -24 7
• 56 Blood banks
• 20 Blood preservation centres

25. REFERENCES
• SRS 2010
• AHS 2011
• UNICEF’s Coverage evaluation survey 2009
• PARK’S textbook of preventive & social
medicine. 21st edition
• Textbook of preventive & social medicine :
sunderlal
• RCH module for MO(PHC).