Lok Sabha Question No. 222 (STARRED), answered on 2023-08-04
Subject: Setting up of Newborn Stabilisation Units
Ministry: HEALTH AND FAMILY WELFARE
Asked by: Krupal Balaji Tumane, Bhavana Gawali (Patil)

## GOVERNMENT OFINDIA MINISTRY OF HEALTH AND FAMILY WELFARE DEPARTMENTOFHEALTH AND FAMILYWELFARE

## LOKSABHA STARRED QUESTION NO. 222 TO BE ANSWERED ON THE 4 TH AUGUST, 2023

## SETTING UP OF NEWBORN STABILISATION UNITS

## †*222. SHRI KRUPAL BALAJI TUMANE: SHRIMATI BHAVANAPUNDALIKRAO GAWALI:

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

- (a) the number of Newborn Stabilisation Units (NBSUs) set up by the Government in the country, State/UT-wise, district-wise including Maharashtra;
- (b) whether the Government proposes to set up NBSUs in various States to take care of sick newborns, if so, the details thereof along with the districts identified for this purpose;
- (c) whether NBSUs have been started in the Government and private hospitals, medical colleges and community health centres in the country;
- (d) if so, the details thereof, State-wise/UT-wise including Maharashtra and if not, the reasons therefor;
- (e) the role of Accredited Social Health Activist (ASHA) workers in helping and improving child upbringing practices;
- (f) whether Infant Mortality Rate (IMR) has declined in the country; and
- (g) the details of the preventive measures taken by the Government to further reduce the IMR?

## ANSWER THE MINISTER OF HEALTH AND FAMILY WELFARE (DR MANSUKH MANDAVIYA)

- (a) to (g) A Statement is laid on the Table of the House.

## STATEMENT REFERRED TO IN REPLY TO LOK SABHA STARRED QUESTION NO. 222 FOR 4 TH AUGUST, 2023

(a) to (d) 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 New-born Stabilization Units (NBSUs) at First Referral Units (FRUs)/ Community Health Centres (CHCs) level for care of sick and low birth weight babies.

As per the report of States/UTs, under National Health Mission 2,774 New-born Stabilization Units (NBSUs) are functional in the country. As per the information received from the State of Maharashtra -199 NBSUs are functional at Rural Hospitals and Sub-district level facilities in the State of Maharashtra. State/ UT wise details of NBSUs is placed at Annexure I. The district wise details of NBSUs are maintained at State/ UT level.

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

 Home visits as per schedule, under Home Based New-born Care (6/7 visits up to 42 days of birth) and Home-Based Care of Young Children (HBYC) program (5 Quarterly home visits up to 15 months of age) to improve childcare practices and to identify sick new-born and young children in the community for referral to nearest health facilities for management.

 Mobilise 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 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.

(f) As per Sample Registration System Report of Registrar General of India, Infant Mortality Rate has declined from 39 per 1000 live births in 2014 to 28 per 1000 live births in 2020.

(g) 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 programmatic interventions to reduce Infant Mortality Rate are placed at Annexure II.

## Annexure I

| State/ UT wise details of functional NBSUs   | State/ UT wise details of functional NBSUs   | State/ UT wise details of functional NBSUs   |
|----------------------------------------------|----------------------------------------------|----------------------------------------------|
| S. No.                                       | Name of the State/UT                         | Total No. of functional NBSUs                |
| 1                                            | Andaman and Nicobar Islands                  | 6                                            |
| 2                                            | Andhra Pradesh                               | 157                                          |
| 3                                            | Arunachal Pradesh                            | 16                                           |
| 4                                            | Assam                                        | 145                                          |
| 5                                            | Bihar                                        | 41                                           |
| 6                                            | Chandigarh                                   | 3                                            |
| 7                                            | Chhattisgarh                                 | 178                                          |
| 8                                            | Dadra &Nagar Haveli and Daman &Diu           | 1                                            |
| 9                                            | Delhi*                                       | 0                                            |
| 10                                           | Goa                                          | 2                                            |
| 11                                           | Gujarat                                      | 262                                          |
| 12                                           | Haryana                                      | 66                                           |
| 13                                           | Himachal Pradesh                             | 31                                           |
| 14                                           | Jammu and Kashmir                            | 65                                           |
| 15                                           | Jharkhand                                    | 34                                           |
| 16                                           | Karnataka                                    | 165                                          |
| 17                                           | Kerala                                       | 64                                           |
| 18                                           | Ladakh                                       | 5                                            |
| 19                                           | Lakshadweep**                                | 0                                            |
| 20                                           | Madhya Pradesh                               | 195                                          |
| 21                                           | Maharashtra                                  | 199                                          |
| 22                                           | Manipur                                      | 3                                            |
| 23                                           | Meghalaya                                    | 14                                           |
| 24                                           | Mizoram                                      | 6                                            |
| 25                                           | Nagaland                                     | 16                                           |
| 26                                           | Odisha                                       | 49                                           |
| 27                                           | Puducherry                                   | 6                                            |
| 28                                           | Punjab                                       | 86                                           |
| 29                                           | Rajasthan                                    | 284                                          |
| 30                                           | Sikkim                                       | 3                                            |
| 31                                           | Tamil Nadu                                   | 142                                          |
| 32                                           | Telangana                                    | 42                                           |
| 33                                           | Tripura                                      | 9                                            |
| 34                                           | Uttar Pradesh                                | 335                                          |
| 35                                           | Uttarakhand                                  | 37                                           |
| 36                                           | West Bengal                                  | 107                                          |
|                                              | TOTAL                                        | 2774                                         |

Source: State/ UT functionality Report

* Delhi has 30 functional Special Newborn Care Units (SNCUs) / Neonatal Intensive Care Units (NICUs)

**Lakshadweep has 1 functional SNCU

## Annexure II

The details of interventions to reduce Infant Mortality Rate are mentioned below:

-  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.

 Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) provides pregnant women a fixed day, free of cost assured and quality Antenatal Care on the 9 th day of every month. Further, Extended PMSMA (e-PMSMA) strategy is implemented to ensure quality ANC to pregnant women, especially to high-risk pregnancy (HRP) women and individual HRP tracking till a safe delivery is achieved by means of financial incentivization for the identified high risk pregnant women and accompanying ASHA for extra 3 visits over and above the PMSMAvisit.

 Janani Shishu Suraksha Karyakaram (JSSK) aims to eliminate out-of-pocket expenses for pregnant women and sick infants by entitling them to free delivery, including caesarean section, free transport, diagnostics, medicines, other consumables, diet and blood in public health institutions.

-  Rashtriya Bal Swasthya Karyakram (RBSK): Children from 0 to 18 years of age are screened for 32 health conditions (i.e. Diseases, Deficiencies, Defects and Developmental delay) under Rashtriya Bal Swasthya Karyakram (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 (IDCF) program 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.
-  Mother and Child Protection (MCP) Card and Safe Motherhood Booklet are distributed to the pregnant women for educating them on nutrition and diet, breastfeeding, child immunization, danger signs, early childhood development and to create awareness about various government schemes related to Maternal and Child health.
-  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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