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Review
. 2016 Dec;36(s3):S24-S31.
doi: 10.1038/jp.2016.187.

Newborn healthcare in urban India

J Sharma  1 , D Osrin  2 , B Patil  3 , S B Neogi  1 , M Chauhan  1 , R Khanna  3 , R Kumar  4 , V K Paul  5 , S Zodpey  1
Affiliations
Review

Newborn healthcare in urban India

J Sharma et al. J Perinatol. 2016 Dec.

Abstract

The rapid population growth in urban India has outpaced the municipal capacity to build essential infrastructures that make life in cities safe and healthy. Local and national governments alike are grappling with the challenges of urbanization with thousands migrating from villages to cities. Thus, urbanization in India has been accompanied by a concentration of poverty and urban public healthcare has emerged as one of the most pressing priorities facing our country. Newborn mortality rates in urban settings are lower than rural areas, early neonatal deaths account for greater proportion than late neonatal deaths. The available evidence suggests that socio-economic inequalities and poor environment pose major challenges for newborn health. Moreover, fragmented and weak public health system, multiplicity of actors and limited capacity of public health planning further constrain the delivery of quality and affordable health care service. Though healthcare is concentrated in urban areas, delay in deciding to seek health care, reaching a source of it and receiving appropriate care affects the health outcomes disproportionately. However, a few city initiatives and innovations piloted in different states and cities have brought forth the evidences of effectiveness of different strategies. Recently launched National Urban Health Mission (NUHM) provides an opportunity for strategic thinking and actions to improve newborn health outcomes in India. There is also an opportunity for coalescence of activities around National Health Mission (NHM) and Reproductive, Maternal, Newborn and Child Health+Adolescent (RMNCH+A) strategy to develop feasible and workable models in different urban settings. Concomitant operational research needs to be carried out so that the obstacles, approaches and response to the program can be understood.

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Conflict of interest statement

Benazir Patil and Rajesh Khanna are affiliated to Saving Newborn Lives, Save the Children, India (Sponsor of the Supplement). Remaining authors declare no competing interests.

Figures

Figure 1
Figure 1
Neonatal Mortality Rates by rural and urban residence. Adapted with permission from Registrar General of India. Sample Registration System (SRS) Statistical Report, New Delhi. Available from http://www.censusindia.gov.in/2011-common/Sample_Registration_System.html. Copyright 2013, Office of the Registrar General and Census Commissioner, India. Copyright 2013, Office of the Registrar General and Census Commissioner, India.
Figure 2
Figure 2
Early Neonatal Mortality Rates by rural and urban residence. Adapted with permission from Registrar General of India. Sample Registration System (SRS) Statistical Report, New Delhi. Available at http://www.censusindia.gov.in/2011-common/Sample_Registration_System.html. Copyright 2013, Office of the Registrar General and Census Commissioner, India.
Figure 3
Figure 3
Neonatal Mortality Rates by urban residence in selected states. Adapted with permission from Registrar General of India. Sample Registration System (SRS) Statistical Report, New Delhi. Available at http://censusindia.gov.in/2011-common/Sample_Registration_System.html. Copyright 2013, Office of the Registrar General and Census Commissioner, India.
Figure 4
Figure 4
Urban Institutional Delivery percentage, in 9 Empowered Action Group ( EAG) states. Adapted with permission from Office of the Registrar General & Census Commissioner- Ministry of Home Affairs, Govt. of India. Annual Health Survey (2012-13). Available at: http://www.censusindia.gov.in/2011-Common/AHSurvey.html. Copyright 2013, Office of the Registrar General and Census Commissioner, India.
Figure 5
Figure 5
Urban percentage of newborns breastfed within one hour of birth, in 9 EAG states. Adapted with permission from Office of the Registrar General & Census Commissioner- Ministry of Home Affairs, Govt. of India. Annual Health Survey (2012-13). Available at: http://www.censusindia.gov.in/2011-Common/AHSurvey.html. Copyright 2013, Office of the Registrar General and Census Commissioner, India.
Figure 6
Figure 6
Proportion of newborns with low birth weight (<2500 g), in urban areas in nine EAG states. Adapted with permission from Office of the Registrar General & Census Commissioner- Ministry of Home Affairs, Govt. of India. Annual Health Survey (2012-13). Available at: http://www.censusindia.gov.in/2011-Common/AHSurvey.html. Copyright 2013, Office of the Registrar General and Census Commissioner, India.
Figure 7
Figure 7
Urban Health Care delivery model. Reused with permission from National Health Mission, National Urban Health Mission (NUHM) Framework, Ministry of Health and Family Welfare, Govt. of India, New Delhi. Copyright 2013: Child Health Division, Ministry of Health and Family Welfare.
Figure 8
Figure 8
Reproductive, Maternal, Newborn and Child Health+Adolescent (RMNCH+A) service package for urban areas.
See this image and copyright information in PMC

References

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