Neonatal care in India: A new way for a new generation

Neonatal care in India: A new way for a new generation

India is at the crossroads

of change. The

indicators are

everywhere. More and

more Indians are

making the Fortune 500

list, and the country’s

many IT and industrial

successes have

generated much

admiration and

discussion around the

globe. In the

international world of

art, culture, and entertainment, Indian literature and movies are now making

headlines with unprecedented frequency. However, while there is much in these

developments to be optimistic and confident about, if India truly wants to be a

success story, it must look ahead to the needs of the generation to come.

As it stands now, a quarter of all maternal

and newborn deaths in the world occur in

India. This means that an estimated

78,000 mothers die giving birth every

year, and a million babies die within their

first month of life. The tragic fact is that

India has the highest estimated number of

maternal deaths in any country.

Part of the problem is limited access to

hospital and institutional support. In India,

65 percent of all births occur at home,

often without the assistance of a skilled

birth practitioner. Additionally, skewed

gender dynamics in Indian society do not

always make it possible for a pregnant

woman to be given her supply of

nutritional supplements or to avail of

adequate care. Expectant women live, and usually work, with their husbands and

mothers-in-law. By tradition, they eat last and least, so many go though pregnancy

underweight and undernourished. As a result, many mothers are unhealthy and give

birth to unhealthy children.

But perhaps even more dangerous, is the lack of awareness about this issue despite

endemic newborn and pregnancy-related deaths across the country. The majority of

the country’s population is struggling for the basics of survival, and the health of

mothers and their newborns is simply not seen as a priority.

So, how is a problem of this magnitude

tackled?

While the current picture is bleak, there is

hope in the form of the numerous people

and organizations who each day work

tirelessly tackling this issue. The Indian

government has recently launched a series

of innovative policies and schemes to

address this ongoing tragedy—for instance,

the National Rural Health Mission’s goal is

to improve the availability of and access to

quality healthcare for those on the lowest

rung of the socio-economic ladder. The

soon-to-be-launched National Urban Health

Mission has also given high priority to the

issue of maternal and newborn health in the

country. These are encouraging signs of

change for the better.

However, many challenges remain. While

the government is building new hospitals

and maternity homes, and offering free

supplies of vaccines and iron and folic acid

tablets, supply gaps will inevitably remain in a country of India’s size. Also, if a

change in attitude to maternal and newborn health is not achieved, then these new

healthcare facilities and nutritional supplies run the risk of being seriously under-

utilized. The motivation for behavioral change must come from within communities

and individuals themselves.

There is an important role here for the voluntary and nonprofit sector. Synergizing

the efforts of both local and international agencies, they can help to empower local

communities and this has the potential to save many, many lives.

One such organization is PATH, a global nonprofit organization that is running a

five-year program in India called Sure Start. The project works with rural

communities in Uttar Pradesh and among settlements of marginalized people in

Maharashtra’s sprawling cities.

Organizations such as PATH are implementing pragmatic maternal and newborn

programs and using innovative methods to effect lasting change. These include

building networks of community health workers to assist birth attendants and visit

mothers within the first few days of birth, training workers to recognize danger

signs during pregnancy and delivery, and developing savings programs to help

cover the cost of newborn and

maternal complications and referrals

In this way, these projects work in

tandem with the Indian government’s

efforts and help to develop

community-level systems for

improved services.

So often, development is a story of the need

for breakthrough innovation or for massive

shifts in government policy and budget

priorities. But let’s not forget what can be

achieved when people decide that things

have to get better and start working

together to achieve that end. In thousands

of villages across India, people are

awakening to the crisis in maternal and

newborn care and are now changing their

behavior to protect the health and wellbeing

of their women and children. Even the

smallest changes, when properly directed,

have already proven to have a large and

lasting impact for the good.

More about Sure Start Project:

Sure Start Website: http://www.path.org/projects/sure-start.php

Facebook:http://www.facebook.com/pages/Sure-Start-Project-by-

Path/178629192101

Twitter: http://twitter.com/pathsurestart

Flickr: http://www.flickr.com/photos/pathsurestart/sets/72157622703699725/

Slideshare: http://www.slideshare.net/pathsurestart

Videos:

http://www.youtube.com/watch?v=1ngzs0Pg9jQ

http://www.youtube.com/watch?v=EE9PVk3jGV0

http://www.youtube.com/watch?v=MdyKvbMwbOU

http://www.youtube.com/watch?v=TCtJj7D9MA4