Health

KEY POINTS

Neo-natal Mortality Rate

·        It is the number of resident newborns in a specified geographic area dying at less than 28 days of age divided by the number of resident live births for the same geographic area for a specified time period and multiplied by 1,000.

UN SDG for NMR

·        All countries will aim to reduce neo-natal mortality (NMR) to at least as low as 12 per 1,000 live births by 2030.

·        According to World Bank statistics, India moved from 33 (NMR) in 2010 to 28 in 2015.

Issues

·        Low number of operational C-section points in most districts.

·        This implies longer travel times for women in labour, creating distress and overburdening facilities, which in turn cannot provide adequate care, thereby endangering the newborn.

·        Lack of specialized care required for conditions like asphyxia, prematurity or sepsis.

·        Most of the clinical staffs were incompetent of basic technical skills and even if competent, they don’t practise them.

·        The quality of nurse and pregnant women interactions is often poor.

·        Coverage of antenatal visits by front-line workers is alarmingly low.

·        Complex and multiple registers often under-report or over-estimate the neo-natal deaths.

Solutions

·        Need for 2-3 emergency obstetric points (C-section points) in every district.

·        Special newborn care units (SNCUs) with round the clock monitoring should be increased.

·        SNCUs need to be integrated with newborn stabilization units at secondary facilities like community health centres through a strong referral system.

·        Development agencies like UNICEF conduct specialized training programmes for clinical staff.

·        States should mandate such training and the practice of these basic protocols.

·        Field data collection processes need to be simplified as like wherever possible, technology like mobile apps should be used.

·        Availability of basic diagnostic equipment, expansion of front-line worker capacity and their increased accountability towards data coverage and quality of antenatal visits are vital to achieve SDG goal set for NMR.