Global Every Newborn Action Plan

The Every Newborn: an action plan to end preventable deaths is a roadmapfor change . It sets out a vision and proposes a goal and targets to endnewborn deaths from preventable causes.

Five guiding principles and five strategic objectives are at the core of the plan.

India Newborn Action PlanSept. 2014

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

Trends of Child Mortality RatesSource: SRS Statistical Reports (2000-2012)

NMR: SRS Statistical Reports (2012)

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)

Causes of neonatal deaths in India

Source: Liu et al, Lancet 2012 Statistical Report

Rewa Neonatal Action Plan2014

Single Digit In Single Year

SDSY

48 47 45

7370 68

102 100 100

0

20

40

60

80

100

120

2011 2012 2013

Mortality pattern in Rewa District: AHS bulletin

NMR IMR U5MR

Neonatal mortality trend in GMH RewaYear 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

13.314.6 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

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

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

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

The Guiding Principles for Rewa newbornaction plan

1. Integration

2. Quality of Care

3. Convergence

4. Partnerships

5. Accountability

Suggested intervention packages

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

2. Immediate Newborn Care

• Health education

• Our commitment

• Propagating danger signs

• Train all ANM and help in ASHA training

3. Care of Healthy Newborn

Count every newborn through measurement, programme-tracking and accountability

• Health education

• Our commitment

Propagation of danger sign

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

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

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

Coordination from other sector

• Health department

• Trainer identification

• Monitoring at work

• Provision of neonatal transport

• MCTS strengthening

• Couple survey

• LSCS in CHC

• Department of Education

• Master trainer group for school – class IX to XII

• Master trainer group for college

• Girl mobilisation

• 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

thanks