Utilization of postnatal care for newborns and its association with neonatal mortality in India: an analytical appraisal

Abstract

Background: 39% of neonatal deaths in India occur on the first day of life, and 57% during the first three days of births. However, the association between postnatal care (PNC) for newborns and neonatal mortality has not hitherto been examined. The paper aims to examine the association of PNC for newborns with neonatal mortality in India.

Methods: Data from District Level Household Survey, waive three (DLHS-3) conducted in 2007-08 is utilized in the study. We used conditional logit regression models to examine the association of PNC with neonatal mortality. The matching variables included birth order and the age of the mother at the birth of the newborn.

Results: The findings suggest no association between check-up of newborns within 24 hours of birth and neonatal mortality. However, the place where the newborns were examined was significantly associated with neonatal mortality. Moreover, findings do reveal that children of mothers who were advised on 'keeping baby warm (kangaroo care) after birth' during their antenatal sessions were significantly less likely to die during the neonatal period compared to those children whose mothers were not advised about the same.

Conclusions: The findings are relevant because 'keeping baby warm' is one of the most cost-effective and easiest interventions to save babies from dying during the neonatal period. Though randomized controlled trials have already demonstrated the effectiveness of 'keeping baby warm', for the first time this has been found effective in a large-scale population-based study. The findings are of immense value for a country like India where the neonatal mortality rates are unacceptably high.