Model Answer
0 min readIntroduction
Home-based Newborn Care (HBNC) is a crucial community-level intervention under India's National Health Mission (NHM), designed to extend essential healthcare services to newborns, especially in rural and remote areas where access to institutional care may be limited. Launched in 2011 and revised in 2014, HBNC aims to significantly reduce neonatal mortality and morbidity by providing postnatal care and promoting healthy newborn practices directly within households. This program leverages frontline health workers like Accredited Social Health Activists (ASHAs) to bridge the gap between health facilities and communities, ensuring that critical care reaches newborns during the vulnerable initial weeks of life.
Major Objectives of Home-based Newborn Care (HBNC)
The Home-based Newborn Care (HBNC) program is strategically designed to address key contributors to neonatal mortality and morbidity in India. Its major objectives include:- Reducing Neonatal Mortality and Morbidity: The primary goal is to decrease the number of newborn deaths and illnesses by ensuring timely and appropriate care. This is particularly vital as a significant proportion of infant deaths occur in the neonatal period (first 28 days of life).
- Provision of Essential Newborn Care (ENC): To ensure that all newborns receive fundamental care practices such as exclusive breastfeeding, cord care, maintenance of body temperature, and hygiene practices.
- Early Detection and Management of Complications: To identify danger signs in newborns early, especially those who are preterm or low birth weight, and facilitate prompt referral to appropriate health facilities like Sick Newborn Care Units (SNCUs) or Newborn Stabilization Units (NBSUs).
- Promoting Healthy Practices: To educate and counsel mothers and families on optimal newborn care, including exclusive breastfeeding, appropriate complementary feeding (after six months), immunization, and hygiene.
- Support for High-Risk Babies: To provide additional care and follow-up for preterm, low birth weight, and sick newborns, including those discharged from health facilities.
- Postpartum Care for Mothers: To provide counseling on postpartum care, recognize and manage postpartum complications, and facilitate referral for mothers, as well as counsel on family planning.
- Building Family Confidence: To empower families with the knowledge and skills necessary to care for their newborns and to recognize when professional medical help is needed.
Responsibilities of 'ASHA' in Home-based Newborn Care
Accredited Social Health Activists (ASHAs) are the cornerstone of the HBNC program, acting as crucial links between the community and the healthcare system. Their responsibilities are comprehensive and cover various aspects of maternal and newborn health:- Scheduled Home Visits: ASHAs are mandated to conduct a series of home visits to all newborns.
- For institutional deliveries, six visits are scheduled on days 3, 7, 14, 21, 28, and 42 after birth.
- For home deliveries, an additional visit is made within 24 hours of birth, followed by visits on days 3, 7, 14, 21, 28, and 42.
- Additional visits are conducted for preterm, low birth weight, ill babies, and those discharged from SNCUs.
- Essential Newborn Care Promotion: During visits, ASHAs actively promote:
- Exclusive Breastfeeding: Counseling mothers on the importance of exclusive breastfeeding for the first six months and assisting with proper latching and feeding techniques.
- Cord Care: Educating on clean cord care to prevent infections.
- Thermal Care: Advising on keeping the baby warm, especially for low birth weight infants (e.g., KMC - Kangaroo Mother Care).
- Hygiene Practices: Promoting handwashing before touching the baby and general household hygiene.
- Identification and Management of Danger Signs: ASHAs are trained to:
- Examine newborns for signs of prematurity, low birth weight, and any unusual observations.
- Identify danger signs such as difficulty in feeding, lethargy, fever, hypothermia, fast breathing, chest indrawing, or convulsions.
- Provide first-level care at home and ensure prompt referral to the nearest health facility (PHC/CHC/SNCU) if danger signs are observed. They also inform families about free treatment and transport under schemes like Janani Shishu Suraksha Karyakram (JSSK).
- Counseling and Education:
- Maternal Health: Counseling mothers on postpartum care, recognition of postpartum complications, and enabling their referral for appropriate care.
- Family Planning: Counseling mothers and families on adopting suitable family planning methods.
- Immunization: Informing parents about the due dates for vaccinations and encouraging timely immunization.
- Growth Monitoring: Advising on regular growth monitoring and appropriate action for growth faltering.
- Early Childhood Development: Teaching caregivers age-appropriate play and communication with the infant.
- Record Keeping and Reporting: ASHAs are responsible for maintaining records of their visits and observations in the Mother and Child Protection (MCP) card and specific HBNC forms, which are crucial for monitoring the program's effectiveness and for their incentive payments.
- Follow-up: Ensuring follow-up for sick newborns after they are discharged from health facilities to ensure compliance with medication and care.
Conclusion
The Home-based Newborn Care program, implemented through the dedicated efforts of ASHAs, is a vital component of India's strategy to improve child health outcomes. By extending essential care, promoting healthy practices, and facilitating early detection and referral of complications directly within the community, HBNC significantly contributes to reducing neonatal and infant mortality and morbidity. The comprehensive responsibilities entrusted to ASHAs underscore their indispensable role in strengthening primary healthcare delivery, ensuring that vulnerable newborns receive timely and critical support, and ultimately helping India move closer to achieving its Sustainable Development Goals for maternal and child health.
Answer Length
This is a comprehensive model answer for learning purposes and may exceed the word limit. In the exam, always adhere to the prescribed word count.