Union Minister for
Health & Family Welfare recently said that in order to strengthen
neonatal services in the country, funds are provided to States for establishing
and running Special Newborn Care Units (SNCU), Newborn Stabilization Units
(NBSU) and Newborn Baby Care Corners (NBCC).
Funds have also been allocated to States for
implementing Janani Shishu Suraksha Karyakram (JSSK) which
provides for free care and transport of sick newborn for first 30 days of
birth. As per SRS 2010 report of Registrar General of India, Neo-natal
Mortality Rate is 33 per thousand live births in India.
IMPORTANT DEFINITION
- Perinatal
mortality only
includes deaths between the foetal viability (22 weeks gestation) and the
end of the 7th day after delivery.
- Neonatal
mortality only
includes deaths in the first 28 days of life.
- Postneonatal
mortality only
includes deaths after 28 days of life but before one year.
- Child
mortality includes
deaths within the first five years after birth.
What
basically is Neonatal mortality ?
**Early neonatal mortality refers
to a death of a live-born baby within
the first seven days of life, while late neonatal mortality covers
the time after 7 days until before 28 days.
**The sum of these two represents the neonatal
mortality. Some definitions of the PNM include only the early neonatal
mortality.
**Neonatal mortality is affected by the quality
of in-hospital care for the neonate.
Neonatal mortality and postneonatal mortality (covering the remaining 11 months
of the first year of life) are reflected in theInfant
Mortality Rate.
Various contributing factors for
neonatal mortality include
(a) Home delivery by unskilled persons
(b) Lack of essential new born care for
asphyxia and hypothermia
(c) Poor child care practices
(d) Lack of early detection of sick
newborn
(e) Inadequate/Delayed referral
mechanisms
(f) Inadequate infrastructure in govt.
hospitals for specialized care of sick newborn.
The medical
causes of neonatal deaths in India are Infections
(29%) such as Pneumonia, Septicemia and Umbilical Cord infection; Prematurity
(24%) i.e birth of newborn before 37 weeks of gestation and Asphyxia
(19%) i.e. inability to breathe immediately after birth that leads
to lack of Oxygen.
What
is Perinatal Mortality Rate ?
The PNMR refers to the number of perinatal
deaths per 1,000 total births. It is usually reported on an annual basis. It is
a major marker to assess the quality of health care delivery. Comparisons
between different rates may be hampered by varying definitions, registration
bias, and differences in the underlying risks of the populations.
PNMRs vary widely and may be below 10 for
certain developed countries and more than 10 times higher in developing
countries . The WHO has not published contemporary data.
What is SRS (Sample Registration System)?
**The Sample
Registration System (SRS) is a large-scale demographic survey in India
for providing reliable annual estimates of birth rate, death rate and other
fertility & mortality indicators at the national and sub-national levels.
**The field investigation consists of
continuous enumeration of births and deaths in selected sample units by
resident part time enumerators, generally anganwadi workers & teachers, and
an independent survey every six months by SRS supervisors.
**The data obtained by these two independent
functionaries are matched.
** The unmatched and partially matched events
are re-verified in the field and thereafter an unduplicated count of births and
deaths is obtained.
**The sample unit in rural areas is a
village or a segment of it, if the village population is 2000 or more. In
urban areas, the sampling unit is a census enumeration block with
population ranging from 750 to 1000.
**At present, SRS is
operational in 7,597 sample units (4,433 rural and 3,164 urban) spread across
all States and Union territories and covers about 1.5 million households and
7.27 million population.
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