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Special Newborn Care Plus Project in India: Preliminary Findings from Community-Based Follow-up of Newborns
Harish Kumar1, Ashfaq Ahmed Bhat2, Varun Alwadhi3
1VRIDDHI, IPE Global Ltd., New Delhi, India.
Insights
Community follow-up of newborns after special newborn care unit discharge significantly improves survival rates. Low birth weight babies face higher mortality risks, highlighting the need for targeted interventions and consistent monitoring.
Area of Science:
- Neonatal care
- Public health interventions
- Community health programs
Background:
- Structured community-based follow-up for Special Newborn Care Unit (SNCU) discharged infants was piloted.
- This initiative aimed to improve outcomes for newborns after hospital discharge.
Purpose of the Study:
- To describe the survival status and outcomes of newborns discharged from SNCUs.
- To evaluate community-level follow-up during the first 42 days of life.
Main Methods:
- Retrospective cohort study of 6319 newborns discharged from SNCUs across four Indian states.
- Utilized routine health system data for tracking birth weight, feeding, illnesses, and survival.
- Follow-up visits were conducted at 24 hours, 7 days, and 6 weeks post-discharge.
Main Results:
- 97% of infants completed all follow-up visits.
- Overall mortality rate was 1.5% by 6 weeks.
- Low birth weight (LBW) babies had a 2.02% mortality rate compared to 0.4% for normal birth weight babies.
- Over 11% of infants required referral at each follow-up visit.
Conclusions:
- Low birth weight is a significant risk factor for mortality in discharged SNCU infants.
- Community-level follow-up at critical time points enhances survival for small and sick newborns post-SNCU discharge.
Objective:
An innovation of structured community based followup of SNCU discharged babies by ANM and ASHA was piloted under Norway India Partnership initiative. The current study describes the survival status and other outcomes among newborns discharged from SNCUs and followed at community level in first 42 days of life.
Methods:
It is a retrospective cohort study on newborns discharged from SNCUs from 13 districts across four states of India. Routine health systems data have been utilized to record key parameters like birth weight, sex, weights during follow-ups, any illnesses reported, status of feeding and survival status. These were compared between normal and low birth weight babies. Newborns discharged from special newborn care units (SNCUs) and followed up at community level at 24 hours, 7 days after first visit, and at 6 weeks of life.
Results:
Follow up of 6319 newborns were conducted by the ANM (25.4%), ASHAs (4.7%) or both (69.8%); 97% of the babies were followed-up at all the visits. The median duration of follow- ups were 1 day post-discharge, 13th day and 45th days of life. Majority (97%) of them were breastfed, and were warm to touch at the time of the visit. More than 11% of the babies needed referral at every visit. Mortality rate in the cohort of babies discharged from SNCUs till 6 weeks of follow up was 1.5%. Among normal birth weight newborns, it was 0.4% while it was 2.02% among LBW babies. The proportion of girls among those who died increased from 20% in the first follow up to 38.1% at second follow up and 41% at 6 weeks.
Conclusions:
Babies with LBW were at higher risk of death as compared to babies with normal birth weight. Follow-up at critical timepoints can improve survival of small and sick newborns after discharge from SNCUs.
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