Home-based newborn care (HBNC) under the national health mission in urban India - A cross country secondary analysis

Abstract

Background: There is a paucity of evidence in the coverage of the home-based newborn care (HBNC) program delivered through the National Urban Health Mission (NUHM). Hence, an analysis was undertaken to identify gaps and progress in its implementation and inform policy and strategies to achieve universal access to newborn services.

Objectives: The study aimed to evaluate and understand the status of the HBNC program in urban areas of India through a health systems approach.

Methods: Cross-sectional intra-country study was undertaken based on facility records and supporting literature available in the public domain. After categorizing the states into four groups, the programme's status in urban areas was analysed and presented in median and interquartile ranges. Statistical significance in the difference between the medians across the groups was checked using the Kruskal Wallis test.

Results: Overall, the median full HBNC coverage was less than one-fifth (< 20%) of the total reported live births (P = 0.17). Excepting the union territories (UTs), the median coverage was found to be less than one-fifth (< 20%) of the reported institutional deliveries (P = 0.16) and more than half (> 50%) of the reported home deliveries (P = 0.83) in urban areas. The differences in the medians across the groups were not statistically significant.

Conclusion: The differential coverage calls for strengthening referral linkages to specialized newborn care facilities, ensuring skilled personnel at varying levels of facilities, and improving the engagement of frontline workers in urban communities under the NUHM.

Keywords: Frontline workers; home-based newborn care; maternal health; neonatal mortality; post-natal care.