Abstract of Dissertation

Keyword : New born care; Infant Mortality; Quality of Care; New born health Facilities

Objective : ï‚· To observe the quality of care at Newborn Care Corner in six TSU focus blocks of Faizabad district (Uttar Pradesh), and compare some parameters with FBNC Operational guidelines by Ministry of Health & Family Welfare. ï‚· To assess the knowledge of service provider (ANM & SN) regarding Newborn Health at the identified facilities.

Background : Prevention of maternal and infant mortality is one of the prime responsibilities of every nation. Given the Current Indian scenario and target of IMR and MMR (National, State and District). The MDG 4 aims to reduce child mortality. NMR contributes to nearly 66% of IMR and 50% of U5MR in India. Hence it is a major focus of GOI to reduce NMR. Four out of five newborn deaths result from 12 three treatable conditions: Complications during childbirth (including birth asphyxia), newborn infections, and complications from prematurity. NBCC can help in achieving that.

Methodology : Study design: Descriptive cross sectional study Study location: Faizabad district, Uttar Pradesh Sampling: Random sampling 40 Delivery points of six TSU focus blocks were randomly selected. All ANM’s & SN’s of randomly selected delivery points were interviewed. Sample Size: 40 for Facility Assessment & all SN/ANM’s (52) of randomly selected delivery points were interviewed based on questionnaire. Data collection: Checklist was used for the assessment of delivery points. A semi-structured questionnaire was used as a data collection tool through face to face interviews.

Findings : Sixty five percent of the providers were NSSK trained and only seven percent of them were trained in IMNCI.Sixty seven percent SN/ANM said birth asphyxia to be the major cause of neonatal mortality. 27 percent said neonatal sepsis, two percent said birth trauma, 42 percent said Pneumonia, twenty one percent said diarrhea and two percent said Respiratory Distress as the major causes of Neonatal Mortality and ten percent of them don’t know the reasons for neonatal mortality. About 60 percent of ANM/SN knows the use of Radiant Warmer, and 40 percent do not have any idea about Radiant Warmer. Sixty percent of providers were able to demonstrate how to operate Radiant Warmer correctly, and 40 percent were incorrect in their technique. Seventy five percent of respondents knows whom to give and how to give. 40 percent knows the benefits and 32 percent know correct dosage of Vit. K and the route. Sixty percent of the providers have heard about NBCC. When asked about equipment and accessories required at NBCC, 33 percent said Radiant Warmer, 38 percent said resuscitation pump, 10 percent said Phototherapy unit, 35 percent said Stethoscope, 33 percent said baby tray and 30 percent said towel. Nineteen percent of the respondents said they don’t know.

Recommendations : All the SN and ANM of identified randomly selected delivery points were assessed for their knowledge regarding newborn care. Knowledge regarding Vit.K, management of Asphyxia, and danger signs of new born to referral was less in the service providers, whereas delivery points were not well equipped according to the requirements for NBCC. Hence, there is a need to enhance the knowledge of SN and ANM, as well as need to equip the delivery points with better facilities, which will ultimately improve the quality of care & the outcomes.