ARTH conducted a study on “Impact of promoting referral for newborns with danger signs and strengthening first referral level facilities on newborn survival”. The study was carried out in 8 districts of southern Rajasthan in collaboration with Department of Medical, Health and Family Welfare, Rajasthan, World Health Organization and UNICEF.
The primary objective of the study was to evaluate the effectiveness of an intervention comprising:
Strengthening Community Health Centres (first referral level facilities) for improved management of labour, essential newborn care at birth ( Newborn Care Corner in labour rooms) and management of severely ill newborns ( establishment of Newborn Stabilization Units), in reducing neonatal mortality, in a setting where IMNCI (community and facility level) was implemented.
Promoting referral for newborns with danger signs in the community by establishing 24*7 Navjeevan Helpline service that provides emergency transport to sick newborns upto Community Health Centers and assistance at CHC in getting required treatment.
Outcomes included Neonatal mortality Rate, Still births occuring at CHCs, proportions of newborns with danger signs taken to a referral facility and sick newborns who were admitted and received treatment.
1. A baseline survey was conducted in 16 CHC clusters in 2009-10 so as to determine the perinatal and neonatal health status including mortality rates.
2. IMNCI refresher training was conducted for 571 ASHAs in selected clusters to build their capacity for identifying danger signs in newborns and referred them to CHC by utilizing helpline service.
3. The intervention has facilitated establishment of Newborn Stabilization units in 8 CHCs through NRHM including improvements in physical infrastructure, equipment, supplies, drugs and strengthening of human resources to provide sick newborn care at CHCs.
4. Navjeevan Helpline (9001 153 153) was established in 8 intervention clusters to provide timely referral transport for sick newborns up to the CHC along with community mobilization activities to promote utilization of the helpline. The helpline also coordinates with 108 ambulance service of NRHM, Rajasthan.