2. NBH-2 Newborn health in India  25 million (2.5 crore) births per year - Accounts for 20% of global births  0.9 million (9 lakh) die in neonatal period - Accounts for about 25% of global deaths Teaching Aids: ENC India accounts for highest births & neonatal deaths globally

3. NBH-3 Neonatal mortality rate (NMR)  Current (NFHS-3): 39/1000 live births (2005-06) Teaching Aids: ENC Accounts for almost 2/3rd of IMR & ½ of U5-MR

4. NBH-4 NMR - State wise NMR is not uniform across the country Teaching Aids: ENC

5. NBH-5 Differences in NMR NMR is high in rural areas and in those who are poor Teaching Aids: ENC Rural - UrbanPoor - Rich

6. NBH-6 Causes of neonatal deaths Infections, asphyxia and prematurity are the leading causes of neonatal deaths Source: ICMR, 2006 Teaching Aids: ENC

7. NBH-7 Timing of neonatal deaths Nearly 3/4th of neonatal deaths occur within 7 days, mostly during first 24 hours Teaching Aids: ENC

8. NBH-8 Perinatal indices  Perinatal mortality rate (NFHS-3): 48.5 per 1000 pregnancies  Still-birth rate: 19.2 per 1000 pregnancies  Perinatal mortality rate also varies between the states (from 11 /1000 in Kerala to 63/1000 pregnancies in Assam ) Teaching Aids: ENC

9. NBH-9  About 50% of deliveries occur at home  Only 46.6% attended by skilled birth attendants*  Higher the institutional births, lower is the NMR Place of birth * doctors, nurses, and midwives Teaching Aids: ENC StateInstitutional birthsNMR Kerala99.311.5 Uttar Pradesh20.647.6

10. NBH-10 Decline of NMR  Rapid decline in eighties  69 in 1980  53 in 1990  Stagnation since nineties  48 in 1995  44 in 2000  39 in 2005-06 Teaching Aids: ENC

11. NBH-11 Why static NMR?  Govt. programmes focused mainly on post neonatal period - Diarrheal Disease Control - ARI - Immunization  Focus of essential newborn component was on a limited number of government facilities  Lack of skilled persons for managing newborns Teaching Aids: ENC

12. NBH-12 Way forward NPP: National population policy 1 XI Plan 2 National Plan of Action for Children 2005 Teaching Aids: ENC CurrentNPP 2010Targets IMR53 (2008)<3028 (2012) 1 NMR36 (2007)<2018 (2010) 2 MMR254 (2004-06)<100 Hospital births 34%80% Achieving National Goals

13. NBH-13 Way forward  Importance to newborn health  Reproductive and Child Health – II (2005-10) - IMNCI: Community & facility - Skilled care at birth -Essential newborn care for health professionals - Home based newborn care - Up gradation of health facilities Teaching Aids: ENC

14. NBH-14 Way forward  National Rural Health Mission (NRHM) - ASHAs in each village to improve maternal and child health services - Strengthening of health facilities -Creation of SCNUs - Janani Suraksha Yojana (JSY): To promote institutional deliveries Teaching Aids: ENC