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8/7/2019 neonatal mortality- A community Approach
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Neonatal Mortality- ACommunity Approach
Dr Neeraj
Dr Shankar
Dr Jalam Singh
Dr Devendra
Dr Sameer
8/7/2019 neonatal mortality- A community Approach
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Neonatal mortality rate
Neonatal mortality rate: The number of children dying under 28 days of agedivided by the number of live births that
year
8/7/2019 neonatal mortality- A community Approach
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Back ground
44 countries mothers from the richest quintile arethree times more likely to have a birth attendantthan those in the poorest quintile
In north India, three fifths of rural women do nothave any antenatal care
four million infants die in the neonatal period, anda similar number are stillborn
Reducing maternal and neonatal mortality in the poorest communities,Anthony Costello,David Osrin, Dharma Manandhar, BMJ2004;329:1166doi:10.1136/bmj.329.7475.1166
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Primary causes of neonatal deaths inPrimary causes of neonatal deaths in
IndiaIndia
(Source: National Neonatology Forum(Source: National Neonatology Forum
and Saving Newborn’s lives, 2004)and Saving Newborn’s lives, 2004)
Diarrhoea
20%
ARI
25%
Sepsis
26%
Asphyxia
10%
Prematurity
8%
Others
11%
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Early Childhood MortalityRates
39
18
57
18
74
0
10
20
30
40
50
60
70
80
Neonatal
mortality
Postneonatal
mortality
Infant
mortality
Child
mortality
Under-five
mortality
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Childhood Mortality Ratesby Sex
37
21
58
23
79
41
15
56
14
70
0
10
20
30
40
50
60
70
80
90
Neonatal
Mortality
Postneonatal
Mortality
Infant Mortality Child Mortality Under-five
Mortality
Female Male
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Infant Mortality Rates byDemographic Characteristics
72
56
50
77
80
62
47
64
37
30
50
86
0 10 20 30 40 50 60 70 80 90 100
40-49
30-39
20-29
< 20
MOTHER'S AGE AT BIRTH
7 or more
4-6
2-3
1
BIRTH ORDER
4 years or more
3 years
2 years
< 2 years
PREVIOUS BIRTH INTERVAL
I f t M t lit R t i I di
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Infant Mortality Rates in India-Rural Urban divide
114
110
105 105 104
97 96 95 94
91
80 80 79
74 74 7472
7172
7068
64
60
119
1 14 1 14 1 14 113
107105 104
102
98
86 8785
82
80 8077 77 77
75 7472
69
82
80
62
65 66 66
59
62 61 62
58
50
53 53
45
52
46 45 44 4442
40
48
40
60
80
100
120
1 9 8 0 8 1 8 2 8 3 8 4 8 5 8 6 8 7 8 8 8 9 9 0 9 1 9 2 9 3 9 4 9 5 9 6 9 7 9 8 9 9 ' 0
0 ' 0
1 ' 0 2
Total
RuralUrban
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CareCare
atatbirthbirth
PrevnPrevn
&&
TxTx
mildmild
illnessillness
TxTx
seriousserious
illnessillness
I n p a
t i e n t
O u t p
a t i e n tFacility
Home H o m e
C o m
m u n i t y
I m m
u n i z
a t i o
n
Functioning Health System
BCC & Community mobilization
Newborn &Newborn &
Child HealthChild Health
Child Health strategyChild Health strategy
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Some Approaches……
Improving the health and nutrition of mothers-to-beand providing quality reproductive health services
improving access to antenatal care during pregnancy
Improved management of normal delivery by skilled
attendants
Access to emergency obstetric and neonatal care(EmOC) when needed
Timely post natal care for both mothers and newborns
C it A h
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Community Approach- The Essential
Interventions Drying the newborn and keeping the baby
warm.
Initiating breastfeeding as soon as possible
after delivery and supporting the mother tobreastfeed exclusively.
Giving special care to low-birth weightinfants
diagnosing and treating newborn problemslike asphyxia and sepsis.
C it A h
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Community Approach- The Essential
Interventions...
Visit by Community health worker withfollow up (with in 24 Hr & 2-3 in 1st wk)
Co-ordination of Community and Facility
based care intersect oral coordination with other
departments
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Ray of hope…..
BCC & Community Mobilization
Increasing partnership – Ownership andaccountability