Integrated Management of Neonatal and Childhood Illnesses (IMNCI)
Close to 50 per cent of newborn deaths in India occur during the first seven days of birth.
Many young lives are lost due to parents failing to recognise warning signs and sick children not being taken to health facilities on time, and because many mothers do not have sufficient knowledge on the protective value of breastfeeding. The IMNCI addresses such issues.
It focuses on strengthening homebased care and provides special care for under-nourished newborns. During home visits by health workers the mother is taught how to recognise diseases early and when to seek medical help. She is also educated on the benefits of exclusive breastfeeding. UNICEF has initiated the programme in one district in each of the following five states – Maharashtra, Rajasthan, Gujarat, Tamil Nadu and Madhya Pradesh – with plans to expand it into 20 other districts across the country.
In addition to collaborating with the Government’s Pulse Polio Immunisation programme, UNICEF promotes an integrated routine immunisation strategy for polio eradication, measles control, newborn tetanus elimination and Vitamin A supplementation at the state, district and subdistrict levels. Some weeks before the national and state immunisation days, UNICEF provides support at the district and sub-district levels in identifying areas where services need to be urgently provided and in ensuring their delivery.
UNICEF encourages social mobilisation as a means of reaching the maximum number of people by engaging community-based groups and self-help groups. The power supply needed to store the vaccine is unreliable in some states, so UNICEF supports monitoring and supervision of storage and transport equipment. The use of auto-disposable syringes remains crucial to injection safety; UNICEF works to help raise awareness about this.
Community action for safe motherhood Dhar, Madhya Pradesh
Dhar is a predominantly tribal district in southwestern Madhya Pradesh. Most deliveries take place at home. Long distances, the shortages of trained nurses, equipment and supplies and, of course, the lack of proper maternity wards in health centres, are the key deterrants to institutional deliveries in this area. Through local community structures, such as the Village Health Committees, Panchayati Raj Institutions and self-help groups, and in co-ordination with the District Administration, UNICEF has helped to raise awareness and concern among families in the villages.
More than 90 Auxiliary Nurse and Midwives (ANMs), from four blocks, were trained in standard midwifery practices and the equipment needed for standard deliveries has been provided. The referral health centre in Kukshi block of Dhar is now just one of several with an efficient maternity ward. As a result, in Kukshi alone, there has been a 10 per cent increase in institutional deliveries between 2001 and 2003.