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Ministry of Health and Family Welfare

Government of India
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Neonatal Mortality Rate shows stagnation; need to act

IMR high in Bihar, Chhattisgarh, Madhya Pradesh, Orissa,
Rajasthan, Uttar Pradesh and Assam
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O Integrated Management of Neonatal and Childhood Illness
(IMNCI)
O Improve Health Workers· skills
O Address issues in health system
O Improve Family and Community practices

O Newborn Care Interventions

O Navjaat Shishu Suraksha Karyakram (NSSK)
O Home Based Newborn And Child Care (HBNC)
O Facility Based Newborn Care ² By Establishing SNCUs, NBSUs And NBUs

O Childhood Immunisation and Vitamin A Supplementation

O Standard Case Management for ARI and Diarrhea

O Management of Severe Acute Malnutrition

O School Health Program

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States Districts Up to District sTarget Total Districts Total Districts

2009-10 2010-11 In States
Non Ne High 171 86 257 311
Focus
Ne States 44 28 72 88
Non High 131 52 183 221
Focus
Union Terr. 10 4 14 22
Grand Total 356 170 526 642

States With < 30% Of Districts Implementing IMNCI-

Chhattisgarh, Himachal Pradesh, MP, Arunachal Pradesh,
Meghalaya, AP, Punjab, West Bengal





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No. OF SNCUs No. OF NBSUs No. OF NBCs

States Upto 09- Target 10- Upto 09-10 Target 10- Upto 09-10 Target 10-
10 11 11 11

Non Ne High 88 99 165 462 1662 1608

Focus
Ne States 3 36 62 412 438 288

Non High 106 149 270 622 2104 3695

Focus
Union Terr. 16 7 4 1 0 6

Grand Total 213 291 501 1497 4204 5597

 
  
  

 
D Training on Basic Newborn Care and Resuscitation
D One trained person during every delivery

Targets For 2010-11 For NSSK Trainings

States Medical Officers Staff Nurses Total

Non NE High 456 1536 1992

Focus
NE States 104 78 182
Non High Focus 520 520 1040

Union Territory 36 140 176

Grand Total 1116 2274 3390
 
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D Home Based Care for - Neonates and Mothers

ÿ Home visits by health workers
ÿ Promotion of Exclusive Breast Feeding
D ASHA Module 6 And 7 Have Been Developed
ÿ HBNC has been developed for Use of ASHAs in Rajasthan, Bihar,
Madhya Pradesh and Orissa
ÿ Uttar Pradesh integrated HBNC with IMNCI as Comprehensive Child
Survival Programme (CCSP) in 18 districts

States Should Develop Plan For Implementing A

Comprehensive Newborn Care Through HBNC
 





Status
D Malnutrition is an underlying cause in >55% of under-5 deaths

D Prevalence of Sever Acute Malnutrition ² 6.4% (NFHS ² 3, 05-06)

Strategy
D Nutrition Rehabilitation Center established for management Of
Severe Acute Malnutrition
ÿ Madhya Pradesh (121) and Maharashtra (438) Have Functioning NRC
ÿ Bihar, Rajasthan and Chhattisgarh have initiated the process

States Are Urged To Address The Issue Of

Malnutrition By Planning Establishment Of NRC
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‰ Under-five mortality attributed to diarrheal disorders ² 15%

‰ Percentage of children with diarrhea taken to a health
facility or provider ² 60%
‰ Children <5 years with diarrhea in the last 2 weeks
received some kind of oral rehydration therapy - 39%
‰ 26% received oral rehydration salt (ORS) packets
‰ 20% received gruel
‰ 16% received antibiotics, which are not normally
recommended for treating childhood diarrhea
‰ Only 0.3% children suffering from diarrhea received Zinc
supplements
More than one-quarter did not receive any kind of
treatment
Highest and Lowest Use of ORS
 



 




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In 17 out of 29 states, less than one third children

with diarrhea received ORS.
Treatment of Acute Respiratory Infections

‰ Under-five mortality attributed to ARI: 19%

‰ Children <5 years with ARI taken to a health
facility or provider ² 69%
‰ Children <5 years with ARI received
antibiotics ² 12.5%

Almost one-third did not receive any kind of

treatment
Percent children <5 yrs with ARI taken to a
health provider (State-wise)
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NFHS - 3; 2005-06
 Immunization Division, MOHFW, Govt. of India

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Chandigarh, West Bengal, Karnataka, Sikkim, Kerala,

High Punjab, Pondicherry, Himachal Pradesh, Tamil Nadu,
(>70%) Lakshadweep, A & N Islands, Daman & Diu and Goa
 
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Most recent virus
! 28 May 2010
Birbhum, WB
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    Improve coverage in NIDs and



 

 







SNIDs


   

   
Special strategy to reach



   migrant population

   
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D Measles second opportunity (69% national
coverage) Hepatitis B States

Hepatitis B Pilot Districts

ÿ 14 states for catch-up campaign
Hepatitis B Pilot Cities
ÿ 21 states for second dose under RI

D Hepatitis B
ÿ Already in 10 states selected

ÿ Expansion of Hepatitis B vaccine in the

remaining states in phased manner

D Pentavalent
ÿ Introduction of Hib-containing
pentavalent in select states is under
consideration

Immunization Division, MOHFW, Govt. of India

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D Scaling up of IMNCI (ANM) / F-IMNCI (MOs)/
Immunization must be accelerated to improve
coverage at facility level
ÿ Supportive Supervision after training
ÿ Improve availability of ORS, Zinc, Antibiotics
D Additional strategy at community level for improving
continuum of care:
ÿ Scale up implementation through ICDS (AWW)
ÿ Utilize ASHA in managing Diarrhea and ARI ² like home-
based Newborn care
o Emphasis on monitoring of service utilization
o Strengthen cold chain system
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