Lok Sabha Question No. 4932 (UNSTARRED), answered on 2022-04-01
Subject: Newborn Care Units
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Goddeti Madhavi, M V V Satyanarayana

## GOVERNMENT OF INDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENT OF HEALTH AND FAMILY WELFARE

## LOK SABHA UNSTARRED PARLIAMENT QUESTION 4932 TO BE ANSWERED ON 1 ST  APRIL 2022

## NEW-BORN CARE UNITS

## 4932:  SHRIMATI GODDETI MADHAVI: SHRI M.V.V. SATYANARAYANA:

Will the MINISTER of HEALTH AND FAMILY WELFARE be pleased to state:

- (a) Whether Facility Based New born Care Units are proposed to be set up in every district hospitals and medical colleges and New-born Stabilization Units at CHCs for care of sick and small babies;
- (b) If so, the details thereof, State/UT-wise including Andhra Pradesh;
- (c) If not, the reasons therefor;
- (d) The role played by ASHAs in helping and improving child rearing practices;
- (e) Whether Infant Mortality Rate as per National Family Health Survey-5 has fallen in some States/UTs; and
- (f) If so, the details thereof, State/UT-wise and corrective measures taken/to be taken by the Government to further reduce IMR?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE (DR. BHARATI PRAVIN PAWAR)

(a) to  (c):  Under the National Health Mission, based on the proposals submitted by States/ Union Territories in the Annual Programme Implementation Plans (PIPs),support is provided for  establishing  Neonatal  Intensive  Care  Units  (NICUs)  /  Sick  New-born  Care  Units (SNCUs)  at  Medical  College  and  District  Hospital  level,  New-born  Stabilization  Units (NBSUs) at First Referral Units (FRUs)/ Community Health Centres (CHCs) level for care of sick and small babies.

As per the information received from the State of Andhra Pradesh, 8 District Hospitals, 11 Medical Colleges and 21 CHCs have functional SNCU and 86 CHCs have functional NBSU.

The State/ UT wise details of Newborn Facilities are placed at annexure I.

- (d): Under National Health Mission, ASHAs are performing following activities for childcare
-  Home visits are conducted as per scheduled visit under Home Based New-born Care and  Home-Based Care  of  Young  Children  (HBYC)  program  to  improve  child  care practices  and  to  identify  sick  new-born  and  young  children  in  the  community  for referral to nearest health facilities for management.
-  Mobilize  eligible  new-borns  and  children  to  immunization  sessions  and  support Auxiliary Nurse Midwives (ANMs) in conduct of immunization.
-  Identify  houses  with  0  to  5  years  old  children  and  distribute  Oral  Rehydration Solution (ORS) packets and Zinc tablets and educate mothers on preparation of ORS.
-  Increase awareness among families and community members on early identification of  childhood  pneumonia and also refer severe cases to the nearest health facility in coordination with ANMs.
-  Distribute Iron and Folic Acid (IFA) syrup to mothers of children 6 to 59 months of age  and  also  ensure  IFA  supplementation  twice  in  a  week  to  prevent  anaemia  in children.
-  Identify  sick  children  with  Severe  Acute  Malnutrition  (SAM)  in  coordination  with Anganwadi  workers  and  ANMs  for  referral  to  Nutrition  Rehabilitation  Centres (NRCs).
-  Promote early initiation of breastfeeding, exclusive breastfeeding for first six months among infants and appropriate Infant and Young Child Feeding (IYCF) practices.

(e) and (f): As per National Family Health Survey (NFHS) - V factsheets, Status of Infant Mortality Rate at State/ UT level is placed at Annexure II.

The  Ministry  of  Health  and  Family  Welfare  (MoHFW)  is  supporting  all  States/UTs  in implementation of Reproductive, Maternal, New-born, Child, Adolescent health and Nutrition  (RMNCAH+N)  strategy  under  National  Health  Mission  (NHM)  based  on  the Annual Programme Implementation Plan (APIP) submitted by States/ UTs to reduce Infant Mortality Rate. The details of interventions are placed at Annexure III.

## Annexure I

| Status of Facility Based Newborn Care in States/ UTs   | Status of Facility Based Newborn Care in States/ UTs   | Status of Facility Based Newborn Care in States/ UTs   | Status of Facility Based Newborn Care in States/ UTs   |
|--------------------------------------------------------|--------------------------------------------------------|--------------------------------------------------------|--------------------------------------------------------|
| S. No                                                  | State/UTs                                              | No. of SNCUs / NICUs                                   | No. of NBSUs                                           |
| 1                                                      | Bihar                                                  | 43                                                     | 41                                                     |
| 2                                                      | Chhattisgarh                                           | 23                                                     | 134                                                    |
| 3                                                      | Himachal Pradesh                                       | 16                                                     | 49                                                     |
| 4                                                      | Jharkhand                                              | 19                                                     | 27                                                     |
| 5                                                      | Madhya Pradesh                                         | 56                                                     | 62                                                     |
| 6                                                      | Odisha                                                 | 40                                                     | 45                                                     |
| 7                                                      | Rajasthan                                              | 61                                                     | 286                                                    |
| 8                                                      | Uttar Pradesh                                          | 85                                                     | 237                                                    |
| 9                                                      | Uttarakhand                                            | 6                                                      | 47                                                     |
| 10                                                     | Arunachal Pradesh                                      | 5                                                      | 12                                                     |
| 11                                                     | Assam                                                  | 28                                                     | 196                                                    |
| 12                                                     | Manipur                                                | 5                                                      | 4                                                      |
| 13                                                     | Meghalaya                                              | 5                                                      | 17                                                     |
| 14                                                     | Mizoram                                                | 5                                                      | 3                                                      |
| 15                                                     | Nagaland                                               | 3                                                      | 16                                                     |
| 16                                                     | Sikkim                                                 | 2                                                      | 3                                                      |
| 17                                                     | Tripura                                                | 6                                                      | 7                                                      |
| 18                                                     | Andhra Pradesh                                         | 50                                                     | 119                                                    |
| 19                                                     | Goa                                                    | 3                                                      | 1                                                      |
| 20                                                     | Gujarat                                                | 50                                                     | 150                                                    |
| 21                                                     | Haryana                                                | 27                                                     | 66                                                     |
| 22                                                     | Karnataka                                              | 42                                                     | 176                                                    |
| 23                                                     | Kerala                                                 | 17                                                     | 61                                                     |
| 24                                                     | Maharashtra                                            | 59                                                     | 179                                                    |
| 25                                                     | Punjab                                                 | 24                                                     | 59                                                     |
| 27                                                     | Tamil Nadu                                             | 74                                                     | 147                                                    |
| 26                                                     | Telangana                                              | 29                                                     | 46                                                     |
| 28                                                     | West Bengal                                            | 69                                                     | 307                                                    |
| 29                                                     | A &NIslands                                            | 1                                                      | 6                                                      |
| 30                                                     | Chandigarh                                             | 3                                                      | 3                                                      |
| 31                                                     | Dadra &Nagar Haveli and Daman &Diu                     | 2                                                      | 2                                                      |
| 32                                                     | Delhi                                                  | 20                                                     | 0                                                      |
| 33                                                     | Jammu &Kashmir                                         | 30                                                     | 64                                                     |
| 34                                                     | Ladakh                                                 | 2                                                      | 3                                                      |
| 35                                                     | Lakshadweep                                            | 2                                                      | 0                                                      |
| 36                                                     | Puducherry                                             | 4                                                      | 6                                                      |

| Status of Infant Mortality Rate (IMR) at State/ UT level   | Status of Infant Mortality Rate (IMR) at State/ UT level   | Status of Infant Mortality Rate (IMR) at State/ UT level   |
|------------------------------------------------------------|------------------------------------------------------------|------------------------------------------------------------|
|                                                            | NFHS IV (2015-16)                                          | NFHS V (2019-21)                                           |
| Andhra Pradesh                                             | 34.9                                                       | 30.3                                                       |
| Andaman and Nicobar Islands                                | 9.8                                                        | 20.6                                                       |
| Arunachal Pradesh                                          | 22.9                                                       | 12.9                                                       |
| Assam                                                      | 47.6                                                       | 31.9                                                       |
| Bihar                                                      | 48.1                                                       | 46.8                                                       |
| Chandigarh                                                 | Not Available                                              | Not Available                                              |
| Chhattisgarh                                               | 54.0                                                       | 44.3                                                       |
| Dadra &Nagar Haveli and Daman &Diu                         | 33.4                                                       | 31.8                                                       |
| Goa                                                        | 12.9                                                       | 5.6                                                        |
| Gujarat                                                    | 34.2                                                       | 31.2                                                       |
| Haryana                                                    | 32.8                                                       | 33.3                                                       |
| Himachal Pradesh                                           | 34.3                                                       | 25.6                                                       |
| Jammu& Kashmir                                             | 32.4                                                       | 16.3                                                       |
| Jharkhand                                                  | 43.8                                                       | 37.9                                                       |
| Karnataka                                                  | 26.9                                                       | 25.4                                                       |
| Kerala                                                     | 5.6                                                        | 4.4                                                        |
| Ladakh                                                     | 35.3                                                       | 20.0                                                       |
| Lakshadweep                                                | 27.0                                                       | 0.0                                                        |
| Madhya Pradesh                                             | 51.2                                                       | 41.3                                                       |
| Maharashtra                                                | 23.7                                                       | 23.2                                                       |
| Manipur                                                    | 21.7                                                       | 25.0                                                       |
| Meghalaya                                                  | 29.9                                                       | 32.3                                                       |
| Mizoram                                                    | 40.1                                                       | 21.3                                                       |
| Nagaland                                                   | 29.5                                                       | 23.4                                                       |
| NCT of Delhi                                               | 31.2                                                       | 24.5                                                       |
| Odisha                                                     | 39.6                                                       | 36.3                                                       |
| Puducherry                                                 | 15.7                                                       | 2.9                                                        |
| Punjab                                                     | 29.2                                                       | 28.0                                                       |
| Rajasthan                                                  | 41.3                                                       | 30.3                                                       |
| Sikkim                                                     | 29.5                                                       | 11.2                                                       |
| Tamil Nadu                                                 | 20.2                                                       | 18.6                                                       |
| Telangana                                                  | 27.7                                                       | 26.4                                                       |
| Tripura                                                    | 26.7                                                       | 37.6                                                       |
| Uttar Pradesh                                              | 63.5                                                       | 50.4                                                       |
| Uttarakhand                                                | 39.7                                                       | 39.1                                                       |
| West Bengal                                                | 27.5                                                       | 22.0                                                       |

## Interventions for improving Infant Mortality Rate (IMR):

-  Facility  Based  New-born  Care: Sick  New-born  Care  Units  (SNCUs)  are established at District Hospital and Medical College level, New-born Stabilization Units (NBSUs) are established at First Referral Units (FRUs)/ Community Health Centres (CHCs) for care of sick and small babies.
-  Community  Based  care  of  New-born  and  Young  Children: Under  Home Based  New-born  Care  (HBNC)  and  Home-Based  Care  of  Young  Children (HBYC) program, home visits are performed by ASHAs to improve child rearing practices and to identify sick new-born and young children in the community.
-  Mothers' Absolute Affection (MAA): Early initiation and exclusive breastfeeding for first six months and appropriate Infant and Young Child Feeding (IYCF) practices are promoted under Mothers' Absolute Affection (MAA).
-  Social Awareness and Actions to Neutralize Pneumonia Successfully (SAANS) initiative implemented since 2019 for reduction of childhood morbidity and mortality due to Pneumonia.
-  Universal Immunization Programme (UIP) is implemented to provide vaccination  to  children  against  life  threatening  diseases  such  as  Tuberculosis, Diphtheria, Pertussis,  Polio,  Tetanus,  Hepatitis  B,  Measles,  Rubella,  Pneumonia and Meningitis caused by Haemophilus Influenzae B. The Rotavirus vaccination has  also  been  rolled  out  in  the  country  for  prevention  of  Rota-viral  diarrhoea. Pneumococcal Conjugate Vaccine (PCV) has been introduced in all the States and UTs.
-  Rashtriya Bal Swasthya Karyakaram (RBSK): Children from 0 to 18 years of age are screened for 30 health conditions (i.e. Diseases, Deficiencies, Defects and Developmental  delay)  under  Rashtriya  Bal  Swasthya  Karyakaram  (RBSK)  to improve  child  survival.  District  Early  Intervention  Centres  (DEICs)  at  district health facility level are established for confirmation and management of children screened under RBSK.
-  Nutrition Rehabilitation Centres (NRCs) are set up at public health facilities to treat  and  manage  the  children  with  Severe  Acute  Malnutrition  (SAM)  admitted with medical complications.
-  Intensified  Diarrhoea  Control  Fortnight  /  Defeat  Diarrhoea  (D2) initiative implemented for promoting ORS and Zinc use and for reducing diarrhoeal deaths.
-  Anaemia Mukt Bharat (AMB) strategy as a part of POSHAN Abhiyan aims to strengthen the existing mechanisms and foster newer strategies to tackle anaemia which  include  testing  &  treatment  of  anaemia  in  school  going  adolescents  & pregnant women, addressing non-nutritional causes of anaemia and a comprehensive communication strategy.
-  Capacity Building: Several capacity building programs of health care providers are taken up for improving maternal and child survival and health outcomes.