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Comprehensive newborn care initiative launched in Bihar

© UNICEF 2008
UNICEF-Patna Health Specialist Dr. Sherin Varkey (extremeright) escorting Deputy Chief Minister of Bihar Sushil Kumar Modi and other dignitaries around the newly inaugurated Sick Newborn Care Unit in Vaishali district of Bihar.

Priyanka Khanna

Hazipur (Vaishali), 4 April 2008 :With the inauguration of the state-of-the-art Sick Newborn Care Unit (SNCU) in Vaishali district hospital, the Government of Bihar marked the launch of a comprehensive newborn care initiative in the state that promises to reduce newborn deaths significantly

Inaugurated by Deputy Chief Minister Sushil Kumar Modi, the SNCU is fully equipped to save lives of acutely unwell and very low-weight babies born in Vaishali district. “The 12-bed unit provides specialized near Level-II care which is usually available only in big cities at very astronomical costs and hence inaccessible for an overwhelming majority of families,” said Modi.

Health Minister Chandra Mohan Rai was also present at the inauguration and lauded the initiative. Reaffirming the commitment of the government towards children, he declared that similar units will be opened in 23 districts of Bihar in the next one year.

The SNCU established by the state government with technical support from UNICEF and Patna-based National Neonatology Forum is an advanced facility in a multi-layer health service structure that is geared to save lives of each and every child born even in remotest parts of the district.

 

With today’s launch, Vaishali has become one of the few districts in India that provide comprehensive care to newborns from village to block to district-level. The near Level-II care offered at Hazipur SNCU is suitable for caring for sick and low-weight neonates (less than 28-days-old infants) born at the hospital or in other facilities. Feeding into this SNCU are 11 UNICEF-supported Neonatal Stabilization Units (NSUs) located in Primary Health Centres (PHCs) in each block of the district, that also became operational today.

The 11 NSUs across Vaishali are equipped to provide essential newborn care for the deliveries taking place at the PHCs. Most importantly, the units treat sick newborns who have been detected and referred by the 3,000-strong force of trained village government health workers that include Auxiliary Nurse and Midwives (ANMs) and Anganwadi Workers (AWWs).

Over the last two years, these health workers have been trained by the state government with UNICEF’s support under Integrated Management of Neonatal and Child Illnesses (IMNCI) protocol across the district. The trained village health workers conduct home visits and provide appropriate care to newborns and prescribe referral to health facilities in cases where complications are detected.

Global evidence has established that this combined strategy of community, outreach and facility-based child health care can avert more than 60 per cent of all neonatal deaths. “If successfully implemented statewide, this initiative has the potential to save the lives of one lakh infants each year who die needlessly in Bihar,” said Bijaya Rajbhandari, State Representative, UNICEF Office for Bihar.

Speaking at the inauguration, the health minister committed that similar NSUs will open in all the 533 Primary Health Centres in the state shortly. The need for these NSUs has become heightened with the steep increase in the number of babies born in institutional facilities owing to the successful implementation of a national scheme wherein mothers belonging to low economic strata get monetary incentive for giving birth at clinics as against home delivery by untrained traditional midwives. The state government is also committed to train all its field health workers under the IMNCI protocol using its own funds in 24 districts over the next two years.

With 25 per cent of all infant deaths across the world occurring in India each year, the country accounts for the single highest share. Likewise, 21 per cent of the 26,000 children below the age of five dying everyday in the world are from India. Given the alarming predicament, the world will not be able to achieve the MDG No. 4 unless the scenario changes rapidly in India.

Today’s launch of the comprehensive newborn care initiative comes at a time when Bihar is taking major strides to reduce infant mortality rate (IMR).With 1,58,000 infant deaths occurring annually, Bihar contributes about 9.9 per cent to the national burden of infant deaths in India. The state has the second highest number of child deaths in the country and the goal is to bring down the current IMR of Bihar from 60 per 1,000 live births (SRS - 2006) to 35  per 1,000 live births by the year 2009-2010.

It is hoped that the Vaishali model of community, outreach and facility-based newborn care initiative will help accelerate Bihar’s progress towards the Millennium Development Goal (MDG) No. 4 of reducing under-five mortality by two-third between 1990 and 2015. 

The lessons learnt in the Vaishali model will not only benefit other districts in Bihar but also help address child survival challenges across the country.

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