Special Newborn Care Units: Saving precious young lives

As we enter the courtyard of Meera Devi’s house in Shravasti district in Uttar Pradesh through a low, blue door, a colourful wall painting of a deity welcomes us. “The other deity for us is the SNCU (Special Newborn Care Unit),” Meera Devi said from the sidelines, holding her three-month-old baby in arms.

As she made herself comfortable on a cot in the open courtyard, the young, first-time mother said that it was because of the SNCU that her baby “is alive today”. Born healthy in the Community Health Centre (CHC), and weighing 2.5 kg, Amar, which means ‘immortal’, was brought back home to a big, joint family of grandparents, uncles and aunts, amid happiness.

Trouble began when, on the third day, the Accredited Social Health Activist (ASHA), Kiran Devi, visited them and weighed the baby. “The baby’s weight had lowered, and the mother complained that he was not breastfeeding properly,” the ASHA said. As part of Home-based Newborn Care (HBNC), the ASHA had reinforced time and again about the importance of exclusive breastfeeding for the first six months and on the correct way of doing it.

When she returned on the seventh day, the young mother looked distraught. “By the sixth day, my baby had started vomiting and had diarrhoea. On the seventh morning, he was not moving much,” Meera narrated. His weight had also dropped to 1.4 kg. The ASHA immediately asked the family to take the newborn to the SNCU in the district hospital where he was then admitted. The baby spent the next 10 days on a tiny bed in the SNCU in the company of other unwell newborns, all under the watchful eyes of the doctor and other paramedic staff who monitored their vitals regularly.

Meera stayed in a separate ward, worried, but at peace that her baby was in safe hands. Since he was not breastfeeding, Meera was taught how to express her milk which the staff fed the baby through a syringe.

SNCU is one of the interventions that is helping to ensure a safe passage through the first thousand days of his or her life for more children in India. This concept, which is supported by UNICEF and the IKEA Foundation, calls for a holistic approach that seeks to converge health, nutrition, and WASH (water, sanitation, and hygiene) interventions. The aim is to ensure better survival and health of newborns, their growth, and development.

In Uttar Pradesh, 500,000 babies have been given crucial health interventions through SNCUs since it first started operating in 2008. There are 78 SNCUs, each in a district hospital, in the state. In 2008 there were fewer than 20 SNCUs countrywide. Today, close to 1 million babies are treated in more than 700 SNCUs in India every year.

 “We had 96 cases in May. When we started out, we had probably four to six babies at a time — people were not aware of the facility and what it does. Then there was such a heavy response that we had to turn the eight-bed facility to a 12-bed one, and all are usually occupied,” said Dr Pradeep Kumar, the Chief Medical Superintendent of the Shravasti district hospital where the SNCU is. Some of the cases come from within the hospital, some through referrals from other health centres, and some are brought by ASHAs after the newborns go home.

The work of the SNCU staff — the nurses, had undergone a two-day specialised training — is, however, not just limited to the medical care of the newborns. They also counsel mothers. “If the baby is underweight, we tell mothers about Kangaroo Mother Care and about the importance of skin-to-skin contact. That making eye contact with their baby while breastfeeding stimulates the flow of milk and is good for both mother and child,” Dr Kumar said.

There is a Kangaroo Mother Care ward adjoining every SNCU, and a separate space provided to breastfeed babies in regular intervals.  “Awareness is a tough concept. But things are improving, and more people are seeking the help of facilities like SNCU and Nutrition Rehabilitation Centres. I am confident that with UNICEF working with us to improve the health indicators, Shravasti will break free of its tag in the next two-three years,” said District Magistrate, Deepak Meena.

Back in Meera’s house, Amar is now healthy and happy. He weighs 3.4 kg and now breastfeeds properly, the ASHA informed. “Till date, I have referred three other babies to the SNCU. Interventions like these are helping save lives,” she said.