Around 8.6 lakhs babies born every year in Odisha. As newborns (Birth -28 days) are very delicate and have to go through a transitional phase i.e. intra uterine to extra uterine environment they require appropriate care at this stage. Due to lack of knowledge about newborn care in the family, community, grass root level health care providers, these tiny babies face a lot of problem. Presently as per SRS 2013 data, 37 neonates are dying every year out of 1000 live births in our state. Common causes of neonatal deaths are Birth asphyxia, Prematurity and infection or sepsis.
Steps taken for reduction of Neonatal Mortality
NBCC at Delivery Points :-
Provides routine care for all the newborn babies in the form of warmth, normal respiration, breast feeding and prevention of infection.
For prevention of birth asphyxia, it is very important to take care at the time of delivery. Out of total deliveries 90% babies cry after birth. They don’t require any resuscitation. Those babies can simply dried and kept with mother after cutting the cord and mother can start breast feeding inside labour room. For those 10% babies who may not cry after birth requires resuscitation inside the labour room or OT within one minute of birth. For that simple equipment's are required in the form of Newborn Care Corner (NBCC). At present 736 NBCCs are functional in the state with NSSK training to all health care providers on resuscitation. All three medical colleges have functional NBCCs in labour rooms and OTs.
NBSU at CHCs :-
49 Newborn Stabilisation Units are functional in different CHCs and SDHs for stabilisation of a very sick newborn before transport to SNCUs and management of less sick newborns. Paediatricians and staff nurses working in NBSUs are trained in Facility Based Newborn Care.
SNCU at DHH and Medical Colleges :-
30 special Care Neonatal Units are functional in the states till March 2016.Some are in District Head Quarter Hospitals and 3 medical colleges and one is at SVPPGIP, Cuttack. (List attached). In the year 2015-16 around 40746 babies were admitted in these SNCUs out of which 28738(70%) survived and discharged from the SNCUs. Details of analysis attached.
Mentoring visits :-
State Newborn Resource Centre established at SVPPGIP, Cuttack for regular mentoring of NBCC, NBSU and SNCUs by NNF members and faculties of medical colleges. After submission of report review meetings for SNCU staffs are being conducted and feedbacks were given time to time.
Community intervention for Newborn Care :-
Home Based Newborn Care by ASHA- All the newborns are followed up at 1st, 3rd, 7th, 14th, 21st, 28th and 42nd days of life by ASHA to know the condition of the baby and early referral to the facility if required.
All the LBW babies will have monthly follow up for 1 yr and all SNCU discharge babies up to 2 yrs of age.
Other initiatives for survival of the newborn :-
India Newborn Action Plan
1. Administration of Antenatal Corticosteroid in premature labour
2. KMC Practice for LBW babies- Kangaroo Mother Care is practised for stable babies having weight <2.5 kg. So all the health workers working in DPs, SNCUs, NBSUs are trained to promote KMC in their institutions. SNCUs are having one separate KMC ward for training of mothers.
3. Injection Vitamin K for all Newborns
4. Administration of Inj. Gentamicin and Amoxycillin to manage sepsis in Newborn by ANM
Besides these state govt has implemented “Special strategy for reduction of IMR and MMR “in 15 districts with intensive drive and line listing of high risk mothers and children for early intervention.
With all these interventions we are expecting a gross change in the neonatal mortality in the state.
2 DAYS NSSK Training was conducted for Doctors, Staff nurses and ANMs working in Delivery points throughout the state. More than 90%staffs throughout the state got trained on resuscitation.
FBNC Training-4 Days FACILITY BASED NEONATAL CARE training were conducted for Doctors and staff nurses working in 30SNCUs and 49 NBSUs. Till now 200 doctors and 611 staff nurses were trained.
2 weeks observership training for SNCU doctors and staff nurses- They were trained at National Collaborative centres like Kalawati Saran Children’s Hospital, New Delhi and KEM Hospital ,Mumbai for development of confidence on neonatal care. Till now 61 doctors and 166 SNs including medical college faculties were trained.