ISSN - 0973-0958

Pediatric Oncall Journal View Article

Linking Home Based New Born Care to the Existing Government Health system in Tamil Nadu - Pilot Study
Sathya Jeganathan1, Vanaja2, Rajasekaran3, Tony Germans1.
1Neonatal Intensive Care Unit,Department of Pediatrics, Chengalpattu Medical College, Chengalpattu, Tamil Nadu,
2Deputy Director of Health Services, Saidapet HUD, Kanchipuram District, Tamil Nadu, India,
3Deputy Director of Health Services, Kanchipuram HUD, Kanchipuram District, Tamil Nadu, India.
National Rural Health Mission (NRHM) of India is taking various steps both at the community and institutional level to reduce neonatal mortality rate (NMR). Despite the various programs, provision of continuum of care for the neonates is a major challenge. To address the issue of care of neonates at home, the Gadcharoli study by Bang et al is a major breakthrough and paved the way for reducing NMR in developing countries. The feasibility of incorporating home based neonatal care (HBNC) in the health system without disturbing Integrated Management of Neonatal and Childhood Illness (IMNCI) is studied.
Aim: To develop HBNC package to suit the existing health care system of Tamil Nadu with referral linkage to neonatal intensive care unit (NICU).
Methods: The HBNC module was proposed by a team of experts considering the existing health care system in the intervention area. Two blocks in the Kanchipuram district of Tamil Nadu, South India were selected for the intervention from January – December 2011. HBNC volunteers were trained in the IMNCI based module. The HBNC team was linked to the NICU through separate phone line and neonates were transported by the neonatal ambulance team. Through private public partnership the EKAM Non-Governmental Organization (NGO) supported NICU facilities and hand in hand assisted the HBNC care in the villages.
Results: A population of 93,467 was covered and a cohort of 740 neonates were followed up in the community. Twenty one mothers who delivered low-birth weight babies were given Kangaroo Mother Care (KMC) in the villages under the supervision of HBNC volunteers. Twenty two neonates with danger signs were identified and transported by neonatal ambulance to the NICU facility. HBNC team supported the Primary Health Centre (PHC) activities and 883 children benefited.

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