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Query: UMLS:C0032285 (pneumonia)
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Improvement in neonatal care in India is needed in order to fulfill the National Health Policy to reduce infant and perinatal mortality and low birth weight babies. 50-60% of perinatal and infant mortality is due to neonatal mortality, specifically low birth weight. There have been no declines in any of the states even though there are literacy, fertility, poverty and health personnel differences between states. The health delivery system is described. Basic facilities are lacking in subcenters and primary health centers: weighing scales, blood pressure recorder, urine analysis, and blood transfusion capability; pregnancy registration is 40%. 40% of women believe that the female multipurpose worker (ANM) is a maternal and child health worker; Dais made postnatal visits to 25% of the women and infants, while physicians and ANM's visited 10%. The most frequent method of delivery is home delivery with a Dai or relative in attendance. Information on temperature control at birth, hand washing, feeding, and identification of high risk infants by health personnel is inadequate. There are no neonatal units in the entire country even though there are 8 million low birth weight babies/year and 1 million neonatal deaths/year. Neonatal causes are primarily birth injuries, aspiration syndrome, and neonatal infections (tetanus, pneumonia, and diarrhea). Studies have identified health service improvements to reduce neonatal mortality. In India, the priority should be to 1) establish delivery of neonatal and perinatal care at all 3 levels of care, 2) train and educate all health personnel in perinatal and neonatal care, and 3) improve community participation by involving the community in decision making on kind of care, perinatal care, and health education and by monitoring such services. Infant care must extend from prenatal through postnatal care, which is currently fragmented, through a 3-tiered system. 80-85% of all infants need care at Level I; 15-20% require Level II care; and 1-5% need Level III care. Health services and supplies may need to be provided at the village rather than the subcenter level and in postpartum services. Other possibilities are to include neonatal care within the Integrated Child Development Program or the Universal Immunization Program. Community leaders could monitor neonatal services. Regional institutes could provide training for all health personnel.
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PMID:Current status of neonatal care and alternate strategies for reduction of neonatal mortality in the decade of nineties. 181 63