Home >politics >policy >Monitor deaths of all newborns: health ministry to states

The centre on Monday directed all states to separately monitor the deaths of sick inborn and outborn newborns across hospitals. The term ‘inborn’ refers to newborns born in the hospital where they are under treatment, while ‘outborn’ refers to those born elsewhere but are under treatment at a particular hospital.

The order comes days after a trail of infant deaths occurred at the Baba Raghav Das (BRD) medical college in Gorakhpur, Uttar Pradesh (UP).

The Union ministry of health and family welfare has also directed the states to carry out 100% maternal death audit to understand the causes behind maternal deaths.

“We have urged the states to focus on labour room protocols for intra partum care (during labour and immediately after the birth) and carry out 100% maternal death audit for understanding cause of maternal death and monitoring of inborn and outborn deaths of sick newborns separately," C.K. Mishra, secretary, Union health ministry said in New Delhi on Monday.

The health ministry recently convened a national review meeting of the National Health Mission (NHM). The authorities emphasized strengthening of health systems, particularly making special newborn care units (SNCUs) at first referral units (FRUs) and newborn care corners (NBCCs) functional with the requisite human resources and equipment backed by a trained team for providing quality services.

“Neonatal mortality in India is very high. Majority of deaths occur within 24 hours of birth. At least 20% of the deliveries in India take place at home. In UP, child births at home are about 50-60%. UP is a large state and hospitals are scattered unevenly, not reachable to all. Many sick babies die during transportation," said Dr Ajay Khera, public health specialist and deputy commissioner in-charge (child and adolescent health) Union health ministry.

“At least 15-20% babies are preterm or low birth, dying due to asphyxia and infection. Over 1.5 lakh children die due to pneumonia, another 1.5 lakh due to diarrhoea. As children in UP are malnourished and have weak immunity, they catch diseases faster. Over 40,000 to 50,000 children die due to vaccine-preventable diseases such as acute encephalitis syndrome (AES), measles, etc," he said.

A recent study “State of newborn health in India" by the Union health ministry, published in Journal of Perinatology revealed that neonatal mortality rate (NMR) declined from 52 per 1000 live births in 1990 to 28 per 1000 live births in 2013, but the rate of decline has been slow and lags behind that of infant and under-five child mortality rates.

The slower decline has led to increasing contribution of neonatal mortality to infant and under-five mortality. Among neonatal deaths, the rate of decline in early neonatal mortality rate (ENMR) is much lower than that of late NMR. The high level and slow decline in early NMR are also reflected in a high and stagnant perinatal (immediately before and after birth) mortality rate.

“There is interplay of different demographic, educational, socioeconomic, biological and care-seeking factors, which are responsible for the disparities and the high burden of neonatal mortality. We will have to improve the quality of care in health facilities on an urgent basis," said Dr Khera, one of the authors of the study.

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