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A new model for newborn child survival in rural India

© UNICEF India/2009/ Caravotta
Newborn baby Jitu in the Sick Newborn Care Unit at Guna District Hospital, where UNICEF implemented a pilot programme in 2007.

This year, UNICEF’s flagship report, ‘The State of the World’s Children’ – launched on 15 January – addresses the need to close one of the greatest health divides between industrialized and developing countries: maternal mortality. Here is one in a series of related stories.

By Jorge Caravotta

GUNA, India, 19 January 2009 – Bhooribai Sing was seven-months pregnant when her labour pains began. She had already lost her first two pregnancies and the nearest health centre was an hour away from her home. 

As her delivery neared, a local nurse discovered the baby was breech. She took charge of the situation, and Bhooribai’s 1.9 kilogram baby boy, Jitu, was born alive but wouldn’t cry. 

The nurse promptly referred Jitu and his mother to the Sick Newborn Care Unit (SNCU) at the Guna District Hospital, where UNICEF implemented a pilot programme in 2007. 

“We acted immediately,” said Dr. Preeti Dwivedi, an expert in neonatal care at the SNCU. Thanks to the care he received at the unit, Jitu is now responding well. 

‘The Guna model’

The District Health Society and UNICEF conceptualized what came to be known as the 'Guna model' to ensure a quality continuum of care. This approach embraces every stage of maternal, newborn and child health for the rural community. 

The model provides emergency transportation from villages to health care facilities through a round-the-clock call centre. Other services include newborn care units, safe delivery centres and trained birth attendants. 

Linking these interventions increases efficiency and cost-effectiveness and provides a greater opportunity to extend and enhance health services’ coverage.

“One and a half years ago, Guna was like any other district of central India. Health facilities were limited, specialized care was non-existent and access of rural communities to facilities was difficult,” said Health Specialist for UNICEF’s Madhya Pradesh office, Gagan Gupta. 

‘Progress is possible’

In the past, frontline health workers in Madhya Pradesh lacked the skills to identify, track and treat sick newborns and their mothers in the community. This resulted in the high mortality rate of sick newborns and their mothers both in the community and at health facilities. 

UNICEF is now working closely with district and state health officials, and the Guna model has been adapted by the Ministry of Health across the state. It is causing ripples of change elsewhere in the country, as well. 

“Rapid scaling-up of services and ensuring greater coverage is the need of the hour. The Government of Madhya Pradesh has replicated the Guna model in 20 districts,” said UNICEF State Representative Hamid El-Bashir. 

“Progress is possible when sound strategies, political commitment, adequate resources and collaborative efforts are applied in support of the health of both mothers and newborns,” he added.




12 January 2009:
UNICEF correspondent Sarah Crowe reports on the success of the ‘Guna model’ of newborn care in Madhya Pradesh, India. Made in association with  Dr. Jorge Caravotta and Dr. Hamid El-Bashir.
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