Evaluation of antenatal to neonatal continuum care services affecting neonatal health in a tertiary health-care setup

Abstract

Background:Maternal and child mortality and morbidity continue to be high despite existence of various national health programmes in India. Annually 41% of all Under 5 mortality is comprised of neonates, 3/4 of who die within the first week of life. Even though effective programmes are existing, optimum utilization is still a question. So the present study was planned to assess utilisation of maternal and neonatal health services and its influence on neonatal health.Objectives:1. To assess the utilization of MCH services before admission to SNCU. 2. To analyse the process of implementation of IMNCI before referral and during the admission. 3. To observe the impact on neonatal health and give necessary recommendations.Methodology:The information regarding utilization of MCH services was obtained by conducting in depth interviews with the responsible adults accompanying the sick neonate. The Pre-treatment and referral slips were verified and compared with that of the prescribed guidelines laid down by the IMNCI for young infants (0-2 months) at SNCU.Results and Discussion:Some of the important observations were mentioned here. 100% women had TT immunization whereas 72% had the full ANC, 58.7% had full course of IFA, 76% had utilized JSY benefits and 48.34% had their PNC. 84% neonates had required immunization, 59.01% were on exclusive breast feeding. 38.9% were paid home visits, only 42% had an idea about the danger signs of neonatal period. 23% sick babies were treated under IMNCI guideline. Among them 98% given initial treatment, only 34% given proper diagnosis/classification, 56% were given adequate advice.

Knowledge and awareness of breastfeeding, weaning practices and newborn care in pregnant women in urban areas

“…5 In this study, 92% of the women stated they would exclusively breastfeed their child for a period of 6 months to a year. This finding is similar to the one conducted by Begum et al 8 On the contrary, some studies have shown fewer percentages of mothers breastfeeding their children exclusively until 6 months of age. [2][3][4] The beneficial effect of exclusive breastfeeding in the prevention of infectious diseases is well documented.…”

“…There is a need for better health care services for them. A similar conclusion was reached in studies by Begum et al, Parashar et al and Zulfia khan et al [8][9][10] Parashar et al in their study found that community-based behavior change communication (BCC) had a favourable effect on pregnant women and improved their knowledge, understanding of neonatal care finding women were more receptive during pregnancy. 7 Their study showed significant improvement in women post intervention with regard to knowledge of danger signals, physiological variants, management of breastfeeding-related problems, and awareness of skin-to-skin technique for the management of hypothermic baby.…”

“…A study by Jarina Begum et al also found a similar result with 100% of the women receiving their TT immunization which they attributed to the increasing awareness toward immunization. 8 While all women in this study agreed that vaccinating the newborn is important, 23% of them were unfamiliar with the national immunization schedule a more than half of them (61%) could not name any of the vaccines (BCG, OPV, hepatitis B) that are to be given at birth. This could be due to lack of information or illiteracy.…”

“…A high percentage of newborns were found to be immunised in other studies. 7,8 This study highlights that fact that vital information about newborn care is not being made available to pregnant women which could leave them under-equipped to manage the health of their newborn. There is a need for better health care services for them.…”

A Study on Essential Newborn Care Practices Among Postnatal Mothers in Urban Slums of Guntur

“…This is attributed by lack of knowledge regarding MCH care in the community or by unawareness toward different services available to them. 9 The rate of institutional deliveries is higher as compared to home deliveries. In the present study, 94.5% were delivered in hospital, 20 similar findings were found in other studies.…”