Lok Sabha Question No. 1405 (UNSTARRED), answered on 2023-02-10
Subject: Newborn Stabilization Units
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Krupal Balaji Tumane, Bhavana Gawali (Patil)

(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 - 13 SNCUs at Teaching Hospitals, 11 SNCUs at District Hospitals, 7 SNCUs at Sub District Hospitals, 5 SNCUs at MCH Centres and 25 SNCUs at CHCs are functional. In addition to this, 126 NBSUs at CHC level and 37 NBSUs at Sub District Hospital level facilities are functional.

As  per  the  information  received  from  the  State  of  Maharashtra  -  32  SNCUs  at  District Hospitals, 13 SNCUs at Sub District Hospitals, 1 SNCU at Rural Hospital and 3 SNCUs at Corporation  Hospitals  are  functional.  Apart  from  this,  186  NBSUs  are  functional  at  Rural Hospitals and Sub-district level facilities.

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

## LOK SABHA UNSTARRED QUESTION NO. 1405 TO BE ANSWERED ON 10 TH  FEBRUARY 2023

## NEWBORN STABILIZATION UNITS

## 1405:  SHRI KRUPAL BALAJI TUMANE: SHRIMATI BHAVANA PUNDALIKRAO GAWALI:

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

- (a) whether facility based newborn care units are proposed to be set up in Newborn Stabilization Units  (NBSUs)  in  each  district  hospitals,  Medical  Colleges  and  Community  Health  Centres (CHCs) for taking care of sick newborns and if so, the details thereof;
- (b) whether the said Units have been set up in all the district hospitals, Medical Colleges and CHCs in the country particularly in Maharashtra and Andhra Pradesh;
- (c) if so, the details thereof and if not, the reasons therefor;
- (d) the role played by the ASHA workers in improving the newborn care practices;
- (e) whether as per NFHS-5 the infant mortality rate has decreased in some States/UTs and if so, the details thereof, State/UT-wise; and
- (f) the necessary corrective steps taken/proposed to be taken in this regard?

## ANSWER THE MINISTER OF STATE IN THE MINISTRY OF HEALTH AND FAMILY WELFARE

## (DR. BHARATI PRAVIN PAWAR)

(d): Under National Health Mission, ASHAs perform following activities for childcare

-  Perform home visits as per schedule under Home Based New-born Care and HomeBased Care of Young Children (HBYC) program to improve childcare 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 conducting regular 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  anemia  in children.
-  Identify  sick  children  with  Severe  Acute  Malnutrition  (SAM)  in  coordination  with Anganwadi  workers  and  ANMs  for  referral  to  Nutrition  Rehabilitation  Centers (NRCs).
-  Promote early initiation of breastfeeding, exclusive breastfeeding for first six months among infants and appropriate Infant and Young Child Feeding (IYCF) practices.

(e)

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

(f)

The Ministry of Health and Family Welfare (MoHFW)  supports  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 to reduce Infant Mortality Rate are as follows:

-  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 Newborn  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 newborn 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.

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## Annexure I

| 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                                                       |