TNAI JOURNAL

In India, an estimated 25 million babies are born per year, and of these, 24 percent (6 million) succumb to death – a deplorable situation indeed. Efforts at government and voluntary levels have made some dent to improve the child survival, and infant mortality rate (IMR) has dropped significantly, yet much remains to be done. The Indian Population policy recognises a strong link between high IMR and excessive population growth. This policy endeavours to achieve the target of four-fifth (80%) deliveries at institutions and 100 percent deliveries by trained personnel, so as to bring down the IMR to 30 per 1000 by the year 2010. National Neonatology Forum (NNF) in collaboration with the Ministry of Family Health and Welfare (MOFHW), Government of India and UNICEF is celebrates Newborn Week every year during 15 – 21 November, throughout the country. The objective is, to enhance awareness about adopting ways and means to improve child survival. The current IMR in our country is 70 per 1000 live births, which means out of every 1000 newborn babies born 70 die in the first year of life. Two-third of the new borns die in the first month after birth. Of approximately 250 lakh infants born in India annually, 12 lakh die in the first month of life. Most crucial phase is the 0-4 weeks of life (called the neonatal period), the first week being particularly significant, since twothird of all newborn deaths occur during the first week of life. In view of high death rate in	the newborn period, it is imperative that concerned efforts should be made to educate the health personnel and the public to improve health of the newborn. National Neonatology Forum, with representation from neonatologists, paediatricians, nurses and social scientists and with support of the government, UNICEF and NGOs celebrates this week to spread awareness about improving the health of newborn. Common Causes of Deaths among the Newborn The common causes of newborn deaths in our country are: Infection - 52%; Asphyxia or lack of oxygen to foetus and newly born baby - 20%; Premature deliveries 15%; and Congenital malformations, birth defects and other miscellaneous causes - 13%. However, it is happy to note that most of these are preventable to a large extent. Reasons for Low Birth Weight Babies Babies born with a birth weight of less than 2500 gm are labelled low birth weight babies (LBWB), those with birth weight less than 1500 gm are very low birth weight babies (VLBW) and those with a weight of less than 1000 gm are extremely low birth weight (ELBW). Unfortunately, in India nearly one-third of all newborn babies have low birth weight. The common causes of low birth weight babies are: (i) Poor nutritional status of mother, (ii) High blood pressure, (iii) Anaemia, (iv) Infections	(v) Tobacco use by mother, (vi) Low maternal literacy, (vii) Pregnancy at young age, (viii) Frequent pregnancies, and (vii) Poor care during pregnancy Many of the above predisposing factors for LBW babies can be prevented by health education. Maternal nutrition plays an important role in newborn health. Keeping this in mind the emphasis is on increasing awareness amongst the public, health personnel regarding the importance of nutritional status and health of the girl child. Some of the measures being undertaken to improve the outcome are as follows. With the objective done to improve the outcome of newborn babies, following are the suggestive measures: Education of expectant mothers about various problems during pregnancy. Basic minimum care during pregnancy, nutrition counselling and supplementation of iron and vitamins. Institutional deliveries to be encouraged, else these may be conducted by trained medical personnel. Providing essential care to all newborn babies. Early diagnosis of problems in newborns and early referral to hospitals for opti-

mum care and treatment. Training in the basics of essential newborn care, along with doctors, nurses, trained birth attendants (TBA’s) and community health workers is therefore imperative. Health talks shall be organised for expectant mothers. Operationalisation of district newborn care is a programme started by Government of India with the help of	WHO and technical assistance from NNF. The basic equipment for essential newborn care has been provided to district, sub district hospitals and primary health centres (PHCs). The National Neonatology Forum of India conducts a series of awareness programmes, in different parts of the country, as part of National Newborn Week.	Among all the Indian states, Kerala comes closest to the world standard with neonatal deaths standing at 10 per 1,000 live births. States such as Tamil Nadu, Karnataka and Maharashtra also witness less than 40 deaths per 1,000 live births and are showing a declining trend. Madhya Pradesh and Orissa, however, continue to show a high trend by maintaining a rate well above the national average.