Bulletin of the World Health Organization

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
Prenatal 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
Delivery 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
0–27 days postnatal 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.

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