NIPI newborn care project is playing a crucial role in reducing IMR through evidence-based interventions to bring forth standard infant care practices, and that too at home through home visitation. Additionally, by making paediatric emergency care services functional, an increased number of children are being attended in the emergency department.
The Norway-India Partnership Initiative (NIPI) newborn care project team has developed and implemented innovations in the 13 districts of 4 states, including 3 districts of Alwar, Dausa and Bharatpur in Rajasthan. The newborn project activities have been implemented for providing catalytic, innovative and strategic support to assist states in reducing neonatal and infant mortality. The following innovations were successfully implemented and scaled up in the last 5 years:
Home-Based Newborn Care Plus (HBNC+): This is an innovative packaging and delivery of preventive and promotive evidence-based interventions for optimal infant care practices at home. This is implemented through community link workers (accredited social health activist (ASHA)), by home visitation at regular intervals. A total of 7,083 ASHA/ANMs were trained under HBNC+ in three districts of Rajasthan. Successful implementation in 13 districts through achieving a coverage of 70 per cent in 3 years has led to the countrywide scale up of HBNC+ in all low birthweight babies. The innovation has shown improved nutrition indices in infants and when results were extrapolated has shown the potential to reduce under 5 mortality by 10 per cent using Lives Saved Tool (LiST). More than 1,90,000 infants have been initiated HBNC+ home visits in three districts since 2014 whereas 1,17,409 infants have received complete four visits.
Emergency Triage & Treatment (ETAT) by Nurses: This innovation reduces treatment delays for sick children in health facilities by making the paediatric emergency care services functional. NIPI newborn team has demonstrated various models of emergency paediatric care in district hospitals; thus, paving the way for countrywide scale up. MoHFW, GoI with technical support from NIPI, developed operational guidelines to facilitate the establishment of paediatric care services have been developed. In Alwar district of Rajasthan, a total of 4,293 children were attended in the emergency department since October 2015 requiring immediate care.
Family-Centred Care (FCC) in SNCUs: FCC as a low-cost innovation is well aligned with India Newborn Action Plan 2014 and is serving as a platform to deliver (1) care of small and sick babies and (2) care beyond newborn survival. It also facilitates Kangaroo Mother Care (KMC) and optimal feeding for low birthweight babies. No additional human resources are required; currently, employed nurses & doctors provide FCC. This innovation leads to empowerment of mothers/parents for caring of sick and small babies while in the health facility and to continue at home after discharge. FCC has been started in SNCUs across the state. In SNCU, Alwar a total of 749 (43 per cent) mothers have received FCC sessions since October 2015.