07 May 2013
India tops ‘Born to Die same Day’ list
An effective model on providing home-based care to newborns, which was devised by a doctor from Maharashtra and is showing good results in other countries, is yet to be implemented in entirety in the state. Initiated by public health expert Dr Abhay Bang, the model has shown success in the remote Gadchiroli district of Maharashtra’s Vidarbha region.
Now, the ‘State of the World’s Mothers’ which is yet to be released by international non-profit organisation, Save the Children, has lauded this model.
It has stated that some of the world’s poorest countries like Bangladesh, Nepal and Malawi have adapted Dr Bang’s model and achieved remarkable results. However, India, which recognised the model as being worthy of implementation in 2008, is dragging its feet in implementing it.
In Maharashtra, 15 of every 1,000 newborns die within the first week. This could have been reduced had the model been implemented.
Dr Bang’s model includes training health workers who consistently monitor a woman during pregnancy and provide the necessary medical support at the time of delivery and post-birth. Maharashtra has ducked the national average of 24 newborn deaths per 1,000 births. Across India, Kerala has the lowest death rate at 5 per 1,000 live births while Madhya Pradesh is the worst at 32 deaths.
Dr Bang told dna that the model is being followed in 39 villages of Gadchiroli since 1996. “One community health worker monitors close to 20 pregnant women at any point of time. From identifying pregnancy early to taking care of the mother’s health and delivering the child, the health worker is trained in constant follow-up and to manage birth complications and infection management in newborns,” said Dr Bang.
Also, based on Dr Bang’s model, the union health ministry in 2011 issued elaborate guidelines mandating that basic life-support drugs and equipment be made available in the most remote primary health centres of the country.
However, the report by Save the Children makes revelations about how, in India, this model has not scaled up due to the lack of intensive supervision and training of health workers five years since the Union health ministry announced that the model be adopted.
It also points out that though Dr Bang’s model has been adopted by the government, two critical elements for a newborn’s survival — management of birth asphyxia and gentamicin injections to prevent infection — have not been integrated in the model. The report cites this as the reason the model has not had the desired impact.
Joint director for the National Rural Health Mission in Maharashtra, Dr Satish Pawar, admitted that in the national model, workers were not being trained to resuscitate newborn in case the baby cannot breathe or to inject them with gentamicin in case of infection.