Impact of an integrated nutrition and health programme on neonatal mortality in rural northern India
Abdullah H Baqui, Emma K Williams, Amanda M Rosecrans, Praween K Agrawal, Saifuddin Ahmed, Gary L Darmstadt, Vishwajeet Kumar, Usha Kiran, Dharmendra Panwar, Ramesh C Ahuja, Vinod K Srivastava, Robert E Black, Manthuram Santosham
Volume 86, Number 10, October 2008, 796-804
Table 1. Intervention components of the neonatal care package
| Period | Strategies related to newborn health | Behaviours promoted to mothers/families |
|---|---|---|
| Home visitation by auxiliary nurse-midwife, aganwadi worker and change agent to provide counselling on preventive care, nutrition, preparedness for child birth, and health-care utilization for complications.Food supplements provided to poor families at anganwadi centre. | • Early registration of pregnancy with aganwadi worker and auxiliary nurse-midwife• At least three antenatal check-ups• Two doses of tetanus toxoid immunization per pregnancy• Daily iron-folic acid supplements for 3 months• Reduction of pregnant women’s workload (rest at least 2 hours/day)• Consumption of an additional meal or snack per day and micronutrient rich foods• Birth preparedness: identification of trained provider and a clean delivery site, savings for emergency, arrangement for transport if needed• Obtaining disposable delivery kit or prepare delivery kit• Identify and seek care for danger signs in mothers and neonates | |
| Encourage families to call auxiliary nurse-midwife or trained traditional birth attendant to attend delivery. | • Practice five cleans: clean surface for delivery, clean hands, new blade, clean cord tie, clean cloth to wrap neonate• Breastfeed within 1 hour of delivery• Thermal care: dry and wrap neonate immediately after birth, delay first bath for 3 days• Seek trained care promptly in case of danger signs for mother or baby | |
| Visit by community-based worker as soon as possible after birth to provide counselling on breastfeeding, essential newborn care (thermal care, hygiene, clean cord care), maternal and newborn danger signs and health-care utilization; follow-up visits for sick, premature or low-birth-weight neonates. | • Essential newborn care: early and exclusive breastfeeding, cord care and thermal care• Apply no substance to the cord stump• Detect danger signs and seek care from trained health providers. |
anganwadi, government child-care and mother-care centre.