Extending continuum of care to sick newborns at home
Sick Newborn Care Units (SNCUs), part of Government of India’s Facility Based Newborn Care initiative, aim to reduce neonatal deaths by providing intensive care to the most vulnerable newborns. Post-discharge, these infants typically move into the care of community health workers (like ASHAs) with limited competence to identify danger signs among newborns or adequate skills and knowledge for counselling mothers on essential newborn care, thus, increasing the chances of morbidity and mortality. The lack of a follow up system for these newborns leads to nearly 10% newborns dying after discharge within the first year of life (UNICEF).
Sick Newborn Care Plus (SNCU+) is a low cost innovation that extends the continuum of care to sick newborns at home after discharge from SNCU, by involving a trained health worker, i.e. the Auxiliary Nurse Midwife (ANM), in following up and caring for these infants.
The ANM, along with the ASHA, makes three home visits to newborns discharged from SNCU within the first 42 days of life to provide special care and ensure compliance with:
- Discharge instructions
- Kangaroo Mother Care guidelines
- Quality feeding for low birth weight newborns
- Early Child Care & Development (ECCD) for improving sensitivity and responsiveness of mothers
- Early identification of signs of sickness
SNCU+ also provides a platform for operationalizing some of the Government’s key initiatives such as use of injectable Gentamicin to prevent infection in vulnerable infants and focus on improving the quality of life rather than just ensuring survival of newborns.
- Training package prepared for health workers and supervisors developed
- Monitoring and analysing progress with line-listing in online data management system, Child Health Info
- System of reward introduced for high performing ANMs to raise the motivation of the cadre – In 2015, 212 ANMs received reward and recognition under SNCU+ across the NIPI states
- As of 2016, 3,923 (43%) against 9,123 infants discharged from SNCUs were visited by ANMs for SNCU+