India Struggles to lower Neonatal Deaths

The United Nations released data regarding neonatal deaths on the 16th of September 2014. The released numbers show that between 1990 and 2013 mortality rate among children under the age of five had dropped by 49 percent. This however was falling short as the UN had set global target to reduce under five mortality rate by two-thirds at the end of 2015.

In 2014 as per the UN data 6.3 million children had died before their fifth birthday. Tragedy is that most of these deaths were from preventable causes. As per the UN neonatal period which is 0 to 27 days is the most vulnerable period for a newborn.

India has highest neonatal deaths

During the year 2012 the neonatal deaths were three million of which 779,000 took place in India. Thereby India became the country where the highest number of neonatal deaths in the world happen.

India has worst figures for deaths of children during the first day itself. Over 300,000 newborn die in India on the very first day of the birth. India accounts for around one-third of all deaths of all babies who dies on the first day of birth.

With an aim to improve these figures based on the Global Every Newborn Action Plan (ENAP); India Newborn Action Plan (INAP) was launched in September 2014. The aim was to make concerted efforts towards attainment of the goals of "Single Digit Neonatal Mortality Rate" and "Single Digit Stillbirth Rate", by 2030.

INAP has considered life cycle approach to address the neonatal mortality. That means health of adolescents as well as care of mother during pregnancy; at the time of delivery and after delivery has direct bearing on the health of newborn. Accordingly six life stages have been identified with specific intervention to reduce neonatal mortality.

The concept of continuum of care

The concept of continuum of care i.e. linking institutions with community care is another strategic approach in the India Newborn Action Plan. The home based newborn care provided by ASHA addresses this issue appropriately.

The newer evidence based approaches like empowering ANM to give injection Gentamycin, Injection Vitamin K at birth, Kangaroo Mother Care for preterm newborn and strengthening of care of sick newborn services have been incorporated in INAP.

The state Governments have started implementing INAP and this is expected to reduce neonatal mortality and thereby overall child mortality in the country.

Public health institutions in states and UTs which implement Janani Suraksha Yojana (JSY) are equipped to deal with institutional deliveries. Funds are being provided to the States and UTs under the National Health Mission to strengthen their public health facilities in terms of infrastructure up gradation in labour room, wards, hiring of medical officers and staff nurses, procurement of essential drugs and supplies so that these facilities get equipped for conducting institutional deliveries.

There has not been a delay of 2-3 years in disbursement of JSY funds under DBT as the DBT payments under JSY has been expanded to all the districts of the country from 2015-16 only.