Activity

Length z-scores at 2 y but not at birth were positively correlated with mothers’ (r=0.21, P=0.002) and fathers’ height (r=0.22, P=0.001).

Nearly two-thirds of healthy term infants experienced either catch-up or catch-down in weight and length first 2 years of life. Infants’ birthweight and length at birth, caloric intake, and parents’ heights are important determinants of their growth patterns.

Nearly two-thirds of healthy term infants experienced either catch-up or catch-down in weight and length first 2 years of life. Infants’ birthweight and length at birth, caloric intake, and parents’ heights are important determinants of their growth patterns.

To generate evidence on the current situation of hospital care (emergency, inpatient and outpatient), for managing children presenting with diarrhea and pneumonia at 13 district hospitals in India.

Facility-based assessment of district hospitals.

13 district hospitals in four states of Bihar, Madhya Pradesh, Odisha and Rajasthan.

Staff nurses and doctors.

None.

An assessment was done across 13 district hospitals in four states by a group or trained assessors using an adapted quality assurance tool developed by Government of India where each aspect of care was scored (maximum score 5). Emergency services and triage, case management practices, laboratory support, and record maintenance for diarrhea and pneumonia were assessed.

Separate diarrhea treatment unit was not earmarked in any of the DHs surveyed. Overall score obtained for adequate management of diarrhea and pneumonia was 2 and 2.2 which were poor. Pediatric beds were 6.8% of the total bed strength against the recommended 8-10%. There was a 65 percent short-fall in the numbers of medical officers in position and 48 percent shortfall of nurses. There were issues with availability and utilization of drugs and equipment at appropriate places with cumulative score of 2.8. Triage for sick children was absent in all the facilities.

The standards of pediatric care for management of diarrhea and pneumonia were far from satisfactory. This calls for improvement of pediatric care units and implementation of operational guidelines for improving management of diarrhea and pneumonia.

The standards of pediatric care for management of diarrhea and pneumonia were far from satisfactory. This calls for improvement of pediatric care units and implementation of operational guidelines for improving management of diarrhea and pneumonia.

An innovation of structured community based followup of SNCU discharged babies by ANM and ASHA was piloted under Norway India Partnership initiative. The current study describes the survival status and other outcomes among newborns discharged from SNCUs and followed at community level in first 42 days of life.

It is a retrospective cohort study on newborns discharged from SNCUs from 13 districts across four states of India. Routine health systems data have been utilized to record key parameters like birth weight, sex, weights during follow-ups, any illnesses reported, status of feeding and survival status. These were compared between normal and low birth weight babies. Newborns discharged from special newborn care units (SNCUs) and followed up at community level at 24 hours, 7 days after first visit, and at 6 weeks of life.

Follow up of 6319 newborns were conducted by the ANM (25.4%), ASHAs (4.7%) or both (69.8%); 97% of the babies were followed-up at all the visits. The median duration of follow- ups were 1 day post-discharge, 13th day and 45th days of life. Majority (97%) of them were breastfed, and were warm to touch at the time of the visit. More than 11% of the babies needed referral at every visit. Mortality rate in the cohort of babies discharged from SNCUs till 6 weeks of follow up was 1.5%. Among normal birth weight newborns, it was 0.4% while it was 2.02% among LBW babies. The proportion of girls among those who died increased from 20% in the first follow up to 38.1% at second follow up and 41% at 6 weeks.

Babies with LBW were at higher risk of death as compared to babies with normal birth weight. Follow-up at critical timepoints can improve survival of small and sick newborns after discharge from SNCUs.

Babies with LBW were at higher risk of death as compared to babies with normal birth weight. Follow-up at critical timepoints can improve survival of small and sick newborns after discharge from SNCUs.

To study special newborn care units (SNCUs) in terms of family participatory care (FPC) quality initiative as per Government of India guidelines in select public health facilities, and to document the perspectives of the doctors and mothers.

Cross-sectional.

SNCUs with functional FPC units in the states of Odisha, Madhya Pradesh and Rajasthan.

38 SNCUs; doctors and nurses in-charge of the unit; and two eligible mothers per unit, one inside the step-down unit and second outside the step-down unit whose newborns were admitted to special new-born care unit, having a stable baby weighing above 1500 g.

The states implemented FPC as per Government of India guidelines using National Health Mission funds across special newborn care units. This assessment involved onsite observation and interviews of key providers.

Proportion of facilities providing regular counselling sessions, enabling support to mothers, recording FPC information; perspectives of health providers on improvement of breastfeeding and kangaroo mother care; proportion of eligible mothers practicing FPC, exclusively breastfeeding, and providing kangaroo mother care services.

Out of 38 SNCUs, we found that FPC sessions for mothers were happening in 36 (95%) facilities. ML198 cost SNCUs provided enabling support to mothers on FPC (74.2%), held regular sessions for the families (70.6%), nurses assisted mothers and family members for breastfeeding and kangaroo mother care (76.4%) and FPC information were recorded (70.6%).

The assessment of facilities where FPC was implemented showed that SNCUs were equipped to implement FPC in public health settings.

The assessment of facilities where FPC was implemented showed that SNCUs were equipped to implement FPC in public health settings.