Operational Challenges in Home-Based Newborn Care (HBNC) Program Delivery in Delhi: A Qualitative Study.

Area of Science:

• Public Health
• Healthcare Management
• Neonatal Care

Background:

• The Home-Based Newborn Care (HBNC) program aims to improve newborn health outcomes through community-based interventions.
• Effective implementation of the HBNC program is vital for reducing neonatal mortality and morbidity.

Purpose of the Study:

• To identify and analyze the operational challenges encountered during the implementation of the HBNC program in Delhi.
• To gather qualitative insights from various stakeholders involved in the HBNC program.

Main Methods:

• Qualitative study involving interviews with diverse stakeholders, including healthcare providers (ASHAs, ANMs, medical officers) and program managers.
• Data collected from all 11 districts of Delhi, managed using NVivo 11 software.
• Inductive content analysis applied to understand stakeholder perspectives on program challenges.

Main Results:

• Stakeholders demonstrated satisfactory knowledge of the HBNC program but highlighted a lack of specific, regular training.
• Key challenges included distrust in HBNC kit quality, ineffective referral systems, and insufficient field supervision for ASHAs.
• Beneficiary migration, cultural practices, and administrative workload also impacted program performance.

Conclusions:

• Regular, targeted training for ASHAs is essential for enhancing HBNC service delivery.
• Ensuring quality assurance and testing of HBNC kits is critical.
• Establishing a supportive supervision framework and robust referral linkages for sick newborns is necessary for program success.