Home-based Newborn Care Research Articles

People's Health in People's Hands: Dr. Abhay Bang and Dr. Rani Bang's Pioneering Approach to Rural Healthcare in India.

Dr. Abhay Bang and Dr. Rani Bang, a husband-and-wife team, have dedicated their lives to reforming healthcare in rural India. Their pioneering work in Gadchiroli, Maharashtra, through the Society for Education, Action, and Research in Community Health (SEARCH), has led to revolutionary interventions such as the Home-Based Newborn Care (HBNC) model, significantly reducing infant mortality rates. Their emphasis on women's health and community empowerment has revolutionized conventional healthcare practices and influenced global health policies. This review article sheds light on the historical context and lasting impact of their contributions to community-based healthcare and public health research.

Effect of the Mamás del Río programme on essential newborn care: a three-year before-and-after outcome evaluation of a community-based, maternal and neonatal health intervention in the Peruvian Amazon

Despite remarkable progress in maternal and neonatal health, regional inequalities persist in Peru. In rural areas of Amazonian Loreto, access to quality care is difficult, home births are frequent, and neonatal mortality is high. We conducted a prospective before-and-after study to assess the effect after implementation and over time of a community-based intervention on essential newborn care (ENC). Mamás del Río consists of tablet-enhanced educational home visits by Community health workers (CHW) to pregnant women and mothers of newborns, with supportive training on ENC of traditional birth attendants and facility staff. The study area comprised 79 rural communities of three districts in Loreto. Primary outcomes were ENC practices in home births, secondary outcomes were ENC in facility births as well as healthcare seeking, measured at baseline before and at year 2 and year 3 after intervention implementation. Community censuses included questionnaires to women aged 15-49 years with a live birth. We calculated prevalence of outcomes at each time point and estimated adjusted prevalence differences (PD) between time points using post-estimation based on logistic regression. Following implementation early 2019, 97% of communities had a trained CHW. At year 2 follow-up, 63% (322/530) of women received a CHW visit during pregnancy. Seven out of nine ENC indicators among home births improved, with largest adjusted prevalence differences in immediate skin-to-skin contact (50% [95% CI: 42-58], p<0.0001), colostrum feeding (45% [35-54], p<0.0001), and cord care (19% [10-28], p=0.0001). Improvements were maintained at year 3, except for cord care. At year 2, among facility births only three ENC indicators improved, while more women gave birth in a facility. Sensitivity analyses showed ENC prevalence was similar before compared to after onset of Covid-19 lockdown. ENC practices in home births improved consistently and changes were sustained over time, despite the onset of the Covid-19 pandemic. A community-based approach for behaviour-change in home-based newborn care appears effective. Process evaluation of mechanisms will help to explain observed effects and understand transferability of findings. Grand Challenges Canada and Peruvian National Council of Science and Technology.

A STUDY TO ASSESS THE PRE-TEST AND POST-TEST KNOWLEDGE ON HOME BASED NEWBORN CARE AMONG ASHAS IN CONTROL AND EXPERIMENTAL GROUP IN SELECTED CHCS OF DISTRICT KHORDA, ODISHA

Newborn health is the key to child survival. Newborn is the foundation of human life. The journey for its protection has already started and still there is a long way to go. The birth of a newborn baby is a special moment of joy with lot of expectations. Quasi-experimental pre and post-test with control group design with experimental approach was used to evaluate the effectiveness of the video-assisted teaching module on home-based newborn care. Study was conducted in PHCs of Khorda district. - The population for the present study was all the ASHAs working in PHCs, Khorda. The sample size constitutes 100 ASHAs working in selected PHCs, Khorda. In Khorda district, there are quite a number blocks in first stage, 2nd stage-selection of blocks and third stage decision of CHCs and PHCs. So Multi stage random sampling was appropriate Cluster/ multi stage sampling technique was used to select the sample for the study.

Case Studies on State and District Level Stakeholders Perspective on Home Based Newborn Care Program in Uttar Pradesh, India

Case Studies on State and District Level Stakeholders Perspective on Home Based Newborn Care Program in Uttar Pradesh, India

Evaluation of existing Home Based Newborn Care (HBNC) services and training for improving performance of Accredited Social Health Activists (ASHA) in rural India: A multiple observation study

BackgroundOne-fourth of global neonatal deaths occur in India alone. Accredited Social Health Activists (ASHA) was launched with the purpose of improving healthcare services, including neonatal survival primarily in rural areas. The aim of this study is to determine the status of ASHA's knowledge, practices, and attitude regarding Home Based Newborn Care (HBNC) services, as well as to provide necessary trainings for improvement of their performance. MethodsFor this study, 102 ASHA working in Doiwala were recruited at random, and Quasi Experimental Design - Multiple Observation Method (single group time series design) was adopted. The data were collected using pretested tools consisting of knowledge questionnaires, attitude scale, and practices and skill-based questionnaires on various domains of HBNC. The data from the ASHA were collected 4 times at a regular interval of 30 days. Each time, the assessment of ASHA was accompanied by re-education and training on HBNC. ResultsEven though, about 90% of ASHA had been working for more than 5 years, they possessed average knowledge regarding HBNC before the training. Less than 50% of them were aware of mandatory vaccines and infection care services for newborns. About 70% of them were uninformed about the potential risk of hypothermia in neonates and also lacked knowledge regarding its preventive measures. Their knowledge, practices and attitude regarding HBNC was significantly improved after the training (p ˂ 0.05). About 54% of ASHA became aware of the avoidance of pre-lacteal feeding in newborns. Their practices score regarding prevention of hypothermia was increased from 80% to 95%. The number of ASHA who understood the importance of Kangaroo Mother Care (KMC) was also increased from 56% to 87%. About 95% of the ASHA understood the significance of feeding breast milk to newborns. Moreover, the attitude of ASHA towards the traditional way of newborn care such as early bathing, giving pre-lacteal feed, application of turmeric and ghee to the umbilicus of baby etc. was significant improved. ConclusionASHA must be assessed regularly in order to identify their basic needs, knowledge gaps, challenges and difficulties to quality HBNC services. Proper training on HBNC at regular interval significantly improved their knowledge, practices, and attitude toward their responsibilities, which is crucial for improving newborn health status.

Assessment of Health Status of Newborns Discharged From Sick Newborn Care Units of the Five Cyclone Fani Affected Districts of Odisha, India.

This study was undertaken to assess the health status of newborns discharged from Sick Newborn Care Units (SNCU) of the Cyclone Fani affected districts of Odisha, which is amongst the highest neonatal mortality rate states in the country. Cyclone Fani hit the coast of Odisha on May 3, 2019. This cross-sectional study was conducted in 5 districts and targeted the babies discharged from SNCU's from January to May 2019. A telephonic interview of the caregivers was conducted to assess the health status of the newborns. Data was collected in a web-based portal and analyzed by statistical package for social sciences SPSS (IBM Corp., Armonk, New York, USA). We inquired about 1840 babies during the study period but only 875 babies could be followed up, with the highest proportion of the babies from the most affected district. Out of 875 babies, 111 (12.7%) had 1 or more illnesses during follow up. Distance from the health facility and time constraints were the major reasons for not seeking health care. Of the babies, 35.7% were reported as being underweight. Poor breastfeeding (14.1%) and kangaroo mother care (31.7%) practices were reported. Only 32% of the babies were completely immunized. The health status of the babies discharged from the SNCUs was found to be poor. Newborn care can be strengthened by improving home-based and facility-based newborn care.

Barriers in reaching new-borns and infants through home visits: A qualitative study using nexus planning framework.

BackgroundHome visitation has emerged as an effective model to provide high-quality care during pregnancy, childbirth, and post-natal period and improve the health outcomes of mother- new born dyad. This 3600 assessment documented the constraints faced by the community health workers (known as the Accredited Social Health Activists, ASHAs) to accomplish home visitation and deliver quality services in a poor-performing district and co-created the strategies to overcome these using a nexus planning approach.MethodsThe study was conducted in the Raisen district of Madhya Pradesh, India. The grounded theory approach was applied for data collection and analysis using in-depth interviews, and focus group discussions with stakeholders representing from health system (including the ASHAs) and the community (rural population). A key group of diverse stakeholders were convened to utilize the nexus planning five domain framework (social-cultural, educational, organizational, economic, and physical) to prioritize the challenges and co-create solutions for improving the home visitation program performance and quality. The nexus framework provides a systemic lens for evaluating the success of the ASHAs home visitation program.ResultsThe societal (caste and economic discrimination), and personal (domestic responsibilities and cultural constraints of working in the village milieu) issues emerged as the key constraints for completing home visits. The programmatic gaps in imparting technical knowledge and skills, mentoring system, communication abilities, and unsatisfactory remuneration system were the other barriers to the credibility of the services. The nexus planning framework emphasized that each of the above factors/domains is intertwined and affects or depends on each other for home-based maternal and newborn care services delivered with quality through the ASHAs.ConclusionThe home visitation program services, quality and impact can be enhanced by addressing the social-cultural, organizational, educational, economic, and physical nexus domains with concurrent efforts for skill and confidence enhancement of the ASHAs and their credibility.

Home-based management of neonatal sepsis: 23 years of sustained implementation and effectiveness in rural Gadchiroli, India, 1996–2019

IntroductionAlthough hospitalisation remains the preferred management for neonatal sepsis, it is often not possible in resource-limited settings. The Home-Based Newborn Care (HBNC) study in Gadchiroli, India (1995–1998) was the first...

Role of Homoeopathy in Home Based Newborn Care (HBNC) practices in UP and India

A newborn struggle in the first month of his or her life as is evident from mythology that Lord Krishna too had a turbulent neonatal stage. The struggle of newborns continues in India even today and that too in the state of UP even today. The current Neonatal Mortality Rate in India is 22 per 1000 live births (UNIGME, 2019), 24.9 as per NFHS 5 (2019-2021) &amp; for the state of UP, it is 35.7 (NFHS 5, 2019-2021). The high neonatal mortality both in India and UP stand as a testimony to this fact as reducing this indicator is a priority. The current article focuses on the initiatives of the role of homoeopathy in public health system to address neonatal mortality. Basically, there are two approaches to reduce neonatal mortality. These are Home Based Neonatal Care (HBNC) practices and the Facility Based Neonatal Care (FBNC) practices. The article focuses exclusively on the first approach which is HBNC .There are three objectives of the article. The first is to find out the current status of Homoeopathy in the HBNC practices, the second is to find out the details of the current &amp; past implementation strategies and the third is to find out the link between Homoeopathy &amp; HBNC practices. The study uses secondary data. The gap that the article worked on is to explore a link between Homoeopathy &amp; HBNC &amp; its modalities. It deciphers whether there is a functional link or not &amp; suggests future strategies based on the functionality of the link. The article also proposes a 2 year plan to introduce homoeopathy in the field of newborn care where all the related stake holders of the state &amp; national level will be involved. It will be a step in the right direction to fulfill the plans to achieve the SDG by 2030 especially for neonatal &amp; infant mortality related goals. For the benefit of the readers, the article includes its expected outcome, relevance to society &amp; policy making through the context of the identified issues &amp; the research gap. Through all these sections, the current ......

EVALUATION OF KNOWLEDGE, AWARENESS AND IMPLEMENTATION GAP OF HOMEBASED NEWBORN CARE AMONG ASHA WORKERS AND MOTHERS IN RURAL AREAS OF AMRITSAR, PUNJAB

Background: India contributes to 17.5% of the world's population, nearly 20% of the total live births, in spite of signicant steps that have been taken to reduce child and neonatal mortality, yet accounts for 26% of global neonate deaths. India has witnessed a signicant reduction in the number of neonatal deaths - from 1.35 million in 1990, to around 0.76 million in 2012. In an attempt to address the issue of high neonatal mortality, Government of India issued Home Based Newborn Care (HBNC) guidelines in 2011; and Accredited Social Health Activist (ASHA) workers were mobilized for providing maternal and immediate newborn care. Methods: This cross-sectional study was conducted in the rural areas of Amritsar District. The duration of study was 1 year (January 2020 to December 2020) and data was collected using a predesigned pretested semi-structured questionnaire. Total 400 subjects were recruited in the study in which 200 ASHA workers and 200 mothers were included.20-30 ASHA workers who had completed their NRHM training were selected from each block randomly. 20-30 mothers from each block of Amritsar were selected randomly. Results: In this cross-sectional study, 90% ASHA workers had knowledge on weighing, temperature measurement (78%), feeding frequency (63%), handwashing (2%) and Kangaroo Mother Care (KMC) positioning (12%) . Majority of ASHAs had knowledge about danger signs like bleeding stump (95%) ,distended abdomen (75%), fever (69.5%), chest indrawing (61.5%) and lethargy (35%).The study concluded that 54% of ASHA workers provided average quality and 46% ASHAs provided good quality care of newborn care. Out of 200 mothers, 74.5% mothers were aware of frequency of feeding, initiation of breastfeeding (32%), proper positioning of breastfeeding and attachment (21%), urine and stool frequency (44%), danger signs for which they should seek help (41%), temperature assessment (59%) and Kangaroo Mother Care positioning (2%). Conclusion: Present study concluded that majority of newborns get all the age-appropriate home visits but very less mothers had knowledge and awareness about HBNC provision.

Reduced incidence of maternal health conditions associated with the home-based newborn care intervention package in Rural Gadchiroli, India: a 13 years before – after comparison

Background To evaluate the association between home-based neonatal care interventions and the incidence of maternal health conditions as well as to estimate the longitudinal trend of the incidence of maternal health conditions over 13 years in 39 villages of the field program area of the of home-based neonatal care from rural Gadchiroli, India. Methods This was a before-after comparative analysis of a program implemented in thirty-nine villages in Gadchiroli, India. The home-based newborn care interventions were incrementally introduced during the field trial (1995 – 1998) and continued as a service program until 2008. Over thirteen years (1995–2008), pregnant women were recruited and followed up from the seventh month of pregnancy to 28 days postpartum by trained female community health workers who made antenatal, natal and post-natal home visits, provided health education to mothers for behavior change, managed normal and sick neonates as well as encouraged seeking medical care when necessary. They recorded maternal symptoms and signs, which a physician supervisor verified. Based on these symptoms and signs, a computer algorithm diagnosed 20 different maternal health conditions. The incidence of these conditions in the first year (1995-96) was compared with the intervention’s last two years (2006 - 2008). Result The mean coverage of home-based newborn care, assessed on eight indicators, increased from 48.5% in 1995 – 96 to 87.1% in 2006 – 08. The proportion of women with any maternal health conditions during pregnancy reduced by 44.76% (P&lt;0.001), during labor by 44.59% (P &lt;0.001) and during the postpartum period by 77.82% (P&lt;0.001). The mean number of maternal conditions per 100 women reduced by 69% (P&lt;0.001). The need for emergency obstetric care was reduced by 78.83% (P&lt;0.001). The proportion of women free of any maternal health condition increased from 32.9 % to 64.6 %. Conclusions Home-based neonatal care interventions were associated with a significant reduction in the incidence of maternal health conditions. Developing a dedicated package of home-based maternal care in combination with neonatal care may further improve maternal health.

Home-based newborn care (HBNC) under the national health mission in urban India - A cross country secondary analysis.

There is a paucity of evidence in the coverage of the home-based newborn care (HBNC) program delivered through the National Urban Health Mission (NUHM). Hence, an analysis was undertaken to identify gaps and progress in its implementation and inform policy and strategies to achieve universal access to newborn services. The study aimed to evaluate and understand the status of the HBNC program in urban areas of India through a health systems approach. Cross-sectional intra-country study was undertaken based on facility records and supporting literature available in the public domain. After categorizing the states into four groups, the programme's status in urban areas was analysed and presented in median and interquartile ranges. Statistical significance in the difference between the medians across the groups was checked using the Kruskal Wallis test. Overall, the median full HBNC coverage was less than one-fifth (< 20%) of the total reported live births (P = 0.17). Excepting the union territories (UTs), the median coverage was found to be less than one-fifth (< 20%) of the reported institutional deliveries (P = 0.16) and more than half (> 50%) of the reported home deliveries (P = 0.83) in urban areas. The differences in the medians across the groups were not statistically significant. The differential coverage calls for strengthening referral linkages to specialized newborn care facilities, ensuring skilled personnel at varying levels of facilities, and improving the engagement of frontline workers in urban communities under the NUHM.

Assess Knowledge and Attitude on Home Based Newborn Care (HBNC) Among Post Natal Mothers in Selected Hospital, Bhubaneswar, Odisha

Introduction: Each year nearly 3.1 million of the newborns die during the neonatal period and almost (99%) death occur in the developing countries. They need optimal care for improved survival. The care depends on the knowledge and attitude of mother. Objectives: To identify the knowledge &amp; attitude on home based newborn care among post natal mothers.Methodology: A total of 169 post natal mothers were participated in the study. A non-experimental descriptive survey design and consecutive sampling was used in this study. Data were collected by the researcher by face to face interview. A structured interview schedule covering socio-demographic factors, knowledge, &amp; attitude of post-natal women on home-based baby care was employed, using 25 MCQs and a 5-point Likert scale. Data were analyzed by SPSS-20.Results: The study’s findings revealed that there was a weakly positive association between knowledge &amp; attitude on home-based newborn care among postnatal mothers, with a correlation coefficient of 0.079 and a p value of 0.937, which was not statistically significant. The knowledge level are statistically significant with selected socio demographic variables of Educational qualification, Occupation, Parity, Monthly family income and the attitude level are statistically significant with selected Socio demographic Variables Age, Educational qualification, Parity and Monthly family income.Conclusion: The mother is the typical person who provides immediate care for the infant. As a result, a variety of factors influence her knowledge and attitude towards baby care. As a result, time and satisfactory performance at home-based new-born care necessitate instructional programmes aimed specifically at postnatal mothers.

Coverage of home-based newborn care and screening by ASHA community health workers: Findings from a household survey in Chhattisgarh state of India.

Community health workers known as Accredited Social Health Activists (ASHAs) provide home visits for home-based newborn care (HBNC) in India. The objectives of the study were to assess coverage of HBNC, to assess current practices of newborn care by the care providers and to assess status of screening of sick newborns by ASHAs in rural Chhattisgarh. The study was a quantitative cross-sectional study. Multi-stage random sampling was applied to draw a representative sample from rural Chhattisgarh. The survey collected primary data of 1928 newborns by interviewing the caregivers. Descriptive statistical analysis using cross tabulations was performed. Confidence intervals at 95% were computed for key indicators. ASHAs were present during 84.3% of the deliveries. 74.1% newborns received the designated six home visits from ASHAs whereas 3.6% newborns did not receive any visits. Coverage of different important messages ranged from 74% to 90%. Around 95% of newborns were screened by ASHAs for signs of sickness. ASHAs identified 12.9% of newborns as sick. Of the identified sick newborns, 48.1% were referred by ASHAs to health facilities, whereas 34.7% were treated directly by ASHAs by using amoxicillin. Early initiation of breastfeeding was reported for 85.4% of newborns and skin-to-skin contact was practiced for 63.6%. ASHAs were able to achieve an adequate coverage of HBNC in rural Chhattisgarh. Uptake of desired newborn care practices by caregivers was found. Identification of sick newborn was also adequate. Further research is recommended to identify factors facilitating the coverage under HBNC.

Maternal aspects of home based newborn care (HBNC) practices in rural areas of Uttarakhand, India: A cross-sectional study

Background and objectivesAround 2.6 million infants die within the first one month of life every year and India alone accounts for about one-fifth of global live births and one-fourth of neonatal deaths. Uttarakhand being a rural predominant state of India has neonatal mortality rate of 31 per 1000 live births in 2018 that is much higher than the targeted 12 deaths per 1000 live births by 2030 as per Sustainable Developmental Goal-3. The present study is being undertaken to examine Home Based Newborn Care practices of mothers in rural areas of Uttarakhand, India. MethodsA community based cross-sectional study was conducted on 205 postnatal mothers who were within 42 days of delivery in Doiwala, Uttarakhand using total enumeration technique. Data were collected using reliable, structured and pretested tools comprising various aspects of home based newborn care practices. The data were analyzed using SPSS version 21. ResultsDelivery of most of the mothers (94.15%) took place in health centers though they never consulted obstetricians during pregnancy. While the remaining 5.85% of mothers gave birth at home with the help of local Dais and family members. Most of the babies (95.12%) were born full-term and about half of them (47.40%) were immunized with BCG, OPV and HEP-B vaccines. About 78.05% of mothers initiated breast feeding within the first hour of delivery and 88.29% of the mothers reported exclusive breastfeeding. However, the remaining 11.71% of mothers provided water, gripe water or ghutti to their babies as pre-lacteal feeds. 72.68% of mothers delayed the first bath of their baby for at least 48 h post-delivery and Kangaroo Mother Care (KMC) was practiced by 74.63% of mothers. Most of the participants (93.66%) were aware of keeping umbilical cords clean and dry, however, the remaining 6.34% of the mothers still practiced traditional methods of applying turmeric powder and ghee to the cord. ConclusionMost of the mothers were aware of hygiene maintenance and thermal protection for babies during the post-natal period. Some of the major challenges experienced by the mothers include early bathing of newborns, delayed initiation of breast feeding, cord care, avoidance of KMC, providing pre-lacteal feeds to newborns, as well as others.

Incidence of Postpartum Depression and Its Association With Antenatal Psychiatric Symptoms: A Longitudinal Study in 25 Villages of Rural South Karnataka.

Background:Postpartum depression (PPD) is the commonest mental health disorder post-childbirth, yet there is a paucity of data in rural areas regarding the actual incidence of PPD, which excludes pre-existing or antenatal depression. To estimate the incidence of PPD among rural women of south Karnataka and identify predictors of PPD, including antenatal psychiatric disorders.Methods:A longitudinal study in 25 villages in south Karnataka among 150 pregnant women in the third trimester of pregnancy using simple random sampling. Baseline data collected and revised Clinical Interview Schedule used to screen antenatal psychiatric disorders. Participants followed-up 6–8 weeks postpartum, end-line data collected, and Edinburg Postnatal Depression Scale administered. Chi-square and Fischer’s exact tests for association between PPD and covariates. Logistic regression to calculate adjusted odds ratios.Results:Prevalence of antenatal psychiatric disorders was 15.3%. The incidence of PPD was 11%. A significantly higher proportion of PPD was found among women with adverse events in the last year, low socioeconomic status, and perceived lack of care/support at home. Predictors of PPD were antenatal psychiatric disorders (AOR = 4.3, 95% CI = 1.22–5.11; P = 0.028), mothers reporting worry about their infant’s health (AOR = 7.7, 95% CI = 1.22–48.32; P = 0.012) and mothers receiving postpartum care by caregivers other than their own mother (AOR = 4.0, 95% CI = 1.13–8.09; P = 0.030).Conclusions:Our study found that one in ten rural women is developing PPD and there is a strong link between PPD and antenatal psychiatric disorders and family factors. This calls for capacity building of general physicians and village-level workers and strengthening of the Home-Based Newborn Care Program, where weekly postpartum home visits by ASHA are an opportunity for screening and counselling mothers.

Evidence-based interventions to reduce mortality among preterm and low-birthweight neonates in low-income and middle-income countries: a systematic review and meta-analysis

BackgroundPreterm birth is the leading cause of under-five-mortality worldwide, with the highest burden in low-income and middle-income countries (LMICs). The aim of this study was to synthesise evidence-based interventions for...

Tracking Weight-for-Age of Infants Using Home Based Newborn Care Plus by ASHA Workers

Malnutrition in all its forms remains a serious global concern, particularly affecting children, a highly vulnerable population group. Home visits during the first year of life using the community worker platform is an unexplored opportunity for making improvements in nutritional status. To analyze the nutritional status (weight for age) of a cohort of infants between 3 and 12 months of age. Tracking weight for age of infants by ASHA workers. 13 districts in the states of Bihar, Madhya Pradesh, Odisha and Rajasthan. Home visits under a home-based newborn care program, home-based newborn care plus (HBNC+). Norway India Partnership Initiative (NIPI) project supported implementation of HBNC+, in 13 districts across four states in India. A descriptive analysis of infants based on retrospective record based program data was done. The nutritional status (weight-for-age) of the cohort was analyzed. Categories were defined based on the z-scores of weight for age (≤-3 SD; ≤-2 SD and > -3 SD; and > -2 SD). Trend of malnutrition and proportions of children in each category at 3, 6, 9 and 12 months were assessed. At 3 months of age, out of 3,50,986 infants provided home visits, 1,82,049 (51.97%) were underweight as per WHO definition with weight for age z-score ≤- 2 SD; this reduced to 11.1% at 12 months of age. Difference of means at 3 months and 12 months significantly different for weight for age z-score (P<0.001). There was a decline in the proportion of children in severe and moderate malnutrition categories by 15% and 26%, respectively. Catch-up growth in terms of weight-for-age among malnourished children is possible within one year of age. Frequent contacts with the health care functionaries may result in this improvement, though it is difficult to conclude in the absence of an appropriate control.

Study to assess the home-based newborn care (HBNC) visit in rural area of Lucknow: A cross-sectional study.

Introduction:Home-based newborn care (HBNC) is a strategy adopted by government of India to overcome the burden of newborn deaths in the first week of life, it provides continuum of care for newborn and post-natal mothers. HBNC introduced since 2011 is centred around Accredited Social Health Activist (ASHA) and it is the main community-based approach to newborn health.Aims and Objectives:The objective of the present study was to assess the HBNC during HBNC visit in rural area of Lucknow, Uttar Pradesh (U.P.).Materials and Methods:The present cross-sectional study was carried out in the field practice area of Primary Health Centre Sarojini Nagar, Lucknow UP. A total of 200 mothers of newborn (age 03 days to 60 days) born in the catchment area of PHC Sarojini Nagar during 8 months period were included in cross-sectional study.Results:The result of study showed that majority of newborns got all the age appropriate home visit. None of the mothers had knowledge and awareness about the HBNC provision for home visits and the number of home visit by ASHA decreases as age of baby increases. All the ASHAs were aware about the schedule of home visit, the number of home visit in case of home delivery and institutional delivery.Conclusion and Recommendation:ASHA was found to be the major facilitator for HBNC programme. Knowledge and awareness of ASHA on importance of postnatal care needs to be enhanced via hands on training.

Comparison of knowledge and skills of Home-Based Newborn Care (HBNC) among Accredited Social Health Activists (ASHA) and health workers (SAKHI) of Ambuja Cement Foundation.

Context:Ambuja Cement Foundation (ACF) started replicating the famous “Gadchiroli” model to reduce neonatal mortality in Chandrapur in 2005. ACF conducted the Home-Based Newborn Care (HBNC) model through trained female health workers, viz., “SAKHIs.” In 2008, Government of India introduced community health worker, viz., Accredited Social Health Activist (ASHA). ACF withdrew its services steadily and few SAKHIs were hired as ASHAs.Aims:We assessed and compared the knowledge level and skills of trained ASHA workers with SAKHIs in providing HBNC.Methods and Material:A cross-sectional study was conducted in three blocks of Chandrapur district of Maharashtra, India. A structured questionnaire consisting of 34 questions was used for knowledge assessment and checklists assessed hand washing, weight recording, temperature recording, kangaroo mother care (KMC) position, suction and bag and mask ventilation (BMV) skills on manikins.Results:135 healthcare workers participated. The mean (SD) score of current SAKHIs (23.89 (1.9) was significantly higher than former SAKHIs (currently ASHAs) (17.97 (2.92), former SAKHIs (currently not engaged in HBNC) (16.73 (2.95) and ASHAs not worked as SAKHIs in the past (16.19 (3.19) [all P < 0.001]. Similar trend was seen in all skill sets. The skills of ASHAs not worked as SAKHIs previously were abysmal, with no ASHA being able to perform BMV and KMC skills, and only 4 (7.5%) who could perform suctioning. A typical trend was observed with current SAKHIs faring best followed by former SAKHIS (currently ASHAs), former SAKHIs (currently not in HBNC), and ASHAs not worked as SAKHIs faring worst.Conclusion:The skills and knowledge of ASHA workers are far deficient compared to SAKHIs despite similar training components, potentially hampering neonatal mortality reduction. Quality of training and supportive supervision mechanism of ASHAs should be explored.