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Evaluation of Antenatal to Neonatal Continuum Care Services Affecting Neonatal Health in a Tertiary Health-Care Setup
Jarina Begum1, Syed Irfan Ali1, Radha Madhab Tripathy2
1Department of Community Medicine, KIMS Medical College, Amalapuram, Andhra Pradesh, India.
Insights
Maternal and child health service utilization in India is suboptimal, impacting neonatal health outcomes. Improving antenatal care, immunization, and infant care practices is crucial for reducing infant mortality.
Area of Science:
- Public Health
- Neonatal Medicine
- Health Services Research
Background:
- High maternal and child mortality persists in India despite national health programs.
- Neonates account for 41% of under-5 deaths, with most occurring within the first week of life.
- Suboptimal utilization of existing maternal and child health (MCH) services is a significant concern.
Purpose of the Study:
- To evaluate the utilization of MCH services prior to Special Newborn Care Unit (SNCU) admission.
- To analyze the implementation process of the Integrated Management of Neonatal and Childhood Illness (IMNCI) strategy.
- To assess the impact of these services on neonatal health and provide recommendations.
Main Methods:
- In-depth interviews with adults accompanying sick neonates to gather data on MCH service utilization.
- Verification of pre-treatment and referral slips against IMNCI guidelines for young infants.
- Assessment of service delivery before referral and during SNCU admission.
Main Results:
- While TT immunization was 100%, full antenatal care (ANC) was 72% and full iron-folic acid (IFA) supplementation was 58.7%.
- Only 48.34% utilized postnatal care (PNC), 84% received essential immunization, and 59.01% practiced exclusive breastfeeding.
- Awareness of danger signs was low (42%), and only 23% of sick babies were treated under IMNCI guidelines, with diagnostic and advisory gaps.
Conclusions:
- Significant gaps exist in the utilization of essential maternal and neonatal health services, including ANC, PNC, and IFA supplementation.
- Inconsistent application of IMNCI guidelines and low awareness of neonatal danger signs hinder effective care.
- Recommendations are needed to improve service uptake and adherence to evidence-based protocols to enhance neonatal health outcomes.
Background:
Maternal and child mortality and morbidity continue to be high despite existence of various national health programmes in India. Annually 41% of all Under 5 mortality is comprised of neonates, 3/4 of who die within the first week of life. Even though effective programmes are existing, optimum utilization is still a question. So the present study was planned to assess utilisation of maternal and neonatal health services and its influence on neonatal health.
Objectives:
1. To assess the utilization of MCH services before admission to SNCU. 2. To analyse the process of implementation of IMNCI before referral and during the admission. 3. To observe the impact on neonatal health and give necessary recommendations.
Methodology:
The information regarding utilization of MCH services was obtained by conducting in depth interviews with the responsible adults accompanying the sick neonate. The Pre-treatment and referral slips were verified and compared with that of the prescribed guidelines laid down by the IMNCI for young infants (0-2 months) at SNCU.
Results And Discussion:
Some of the important observations were mentioned here. 100% women had TT immunization whereas 72% had the full ANC, 58.7% had full course of IFA, 76% had utilized JSY benefits and 48.34% had their PNC. 84% neonates had required immunization, 59.01% were on exclusive breast feeding. 38.9% were paid home visits, only 42% had an idea about the danger signs of neonatal period. 23% sick babies were treated under IMNCI guideline. Among them 98% given initial treatment, only 34% given proper diagnosis/classification, 56% were given adequate advice.
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