NCH_Review_Regional Level (003).pptx

Newborn Child Health in public settings

1. Newborn Child Health Regional Review

2. What Indicators project? SRS 2020 SRS 2019

3. Child Mortality Trend in Bihar Source : SRS

4. 54% reduction 52% reduction 46% reduction 60% reduction 56% reduction 34% reduction NCH Indicators and Target Child Health Indicator India Bihar NHP 2017 SDG 2030 Neonatal Mortality Rate 20 (SRS, 2020) 21 (SRS, 2020) 16 by 2025 <12 Infant Mortality Rate 28 (SRS, 2020) 27 (SRS, 2020) 28 by 2019 - Under 5Mortality Rate 32 (SRS, 2020) 30 (SRS, 2020) 23 by 2025 ≤25

5. NCH: Key Programs

6. Special Newborn Care Unit (SNCU)

7. SNCU: Admission and Outcome profile Total Admission in the previous quarter in the Region (Sum of all districts) (Jul-Sep 2022) : 200

8. Case type and Outcome

9. Birth weight and Outcome Total Admission during the period: 200

10. Duration of Stay and Rational use of Antibiotics

11. Delivery Point and SNCU Linkage

12. Performance: SNCU wise Period: Jul-Sep 2022

13. SNCU : HR Availability As per DoH , Bihar (Letter No. 466 Dated 12.08.2014) Posts of 1 Paediatrician, 3 GMO and 13 Grade - A Nurse have been created for each SNCU.

14. SNCU Performance: Outcome No. of Treated Cases: 100 No. of Treated Cases: 100 No. of Treated Cases: 100

15. SNCU: Bed Utilization Desirable No. of Admission= 6 admissions per bed per month

16. Outcome of Low Birth weight (<1800gm) babies

17. Outcome of Good weight (>2500gm) babies

18. SNCU: Rational use of antibiotics

19. Functionality and utilization of CPAP machine Sl. No. Name of SNCU No. of CPAP Machine Available No. of CPAP Machine Functional No. of babies with birth weight <1800gm No. of babies with <34 Weeks of gestation No. of babies with RDS admitted during the period No. of babies with RDS managed using CPAP during the period 1 2 3 4

20. SNCU Performance: Other key areas Review Point SNCU-1 SNCU-2 SNCU-3 SNCU-4 1. Daily Round of Paediatrician in all 3 shifts (Yes/No) Morning Shift Yes Yes Yes No Evening Shift Yes Yes Yes No Night Shift Yes Yes Yes No Round Register maintained properly No Yes Yes No 2. Equipment Mapping of equipment completed Yes Yes Yes No 3. Availability of drugs and logistics No Stockouts during the period (Yes/No) Yes Yes Yes No 4. Availability of Lab investigations (Serum bilirubin, Plasma glucose, Serum creatinine, Blood count, Platelet, C reactive protein, Prothrombin time, Blood gas analysis with PH measurement analysis.) All Lab investigations available Yes Yes Yes Yes

21. Newborn Stabilization Unit (NBSU) Performance Period: Jul-Sep 22

22. NBSU: Admission Profile Sl. No. Name of NBSU Admission Sl. No. Name of NBSU LBW (<2500gm) Birth Weight (<1800gm) Jaundice Cases Others 1 NBSU-1 2 NBSU-2 3 NBSU-3 4 NBSU-4 5 NBSU-5 6 NBSU-6 7 NBSU-7

23. NBSU: Outcome Profile Sl. No. Name of NBSU Admission Vs Outcome Admission Sl. No. Name of NBSU Functional (Yes/No) Total Admission Discharge Referred LAMA Death 1 NBSU-1 10 4 (80%) 3 (30%) 2 (20%) 1 (10%) 2 NBSU-2 3 NBSU-3 4 NBSU-4 5 NBSU-5 6 NBSU-6 7 NBSU-7

24. Newborn Care Corner (NBCC)

25. NBCC: Admission Profile Sl. No. Name of District Weight and Maturity Sl. No. Name of NBSU Total Live Birth LBW (<2500gm) Birth Weight ( ≤ 2000gm) Birth Weight <1800gm) <34 Weeks <37 Weeks Cases managed at NBCC Cases Referred to higher centre Desired Action Initial management at NBCC followed by quality HBNC Initial management at NBCC followed by quality HBNC Referral after stabilization 1 District-1 2 District-2 3 District-3 4 District-4 5 District-5 6 District-6 7 District-7

26. Management of neonatal complications at NBCC

27. NBCC: Do’s and Don’ts Do’s Always wash your hands before handling the baby Rooming in of baby with the mother Keep the baby with the mother Keep the baby warm Take extra care to maintain baby’s temperature is preterm and LBW baby Keep the cord dry and clean Breast fed the baby exclusively Early initiation of breast feeding is essential for a good reflex action Any signs/symptoms of complications must be referred and attended to by a doctor The care provider should observe every 2 hours in the first 6 hours and every 6 hours from 6-24 hours after delivery If the newborn is LBW then at least three additional visits should be ensured Don’ts Do not keep all babies as a routine under the radiant warmer Do not delay breast feeding beyond half an hour as that may lead to rapid decrease in suckling reflex of the rapid decrease in suckling reflex of the baby Do not use prelacteals even water Do not apply anything on the cord Do not bathe the newborn for 24hrs after birth Do not forget to undertake routine checkup

28. Nutritional Rehabilitation Centre (NRC)

29. NRC: ELA Vs Admission

30. NRC: Average Duration of Stay

31. NRC: Availability of Diet and Drugs Sl. No. Name of NRC Diet being provided as per the guideline Drugs and other logistics available as per the guideline 1 NRC-1 Yes Yes 2 NRC-2 No Yes 3 NRC-3 Yes Yes 4 NRC-4 Yes Yes 5 NRC-5 Yes No

32. Home Based Newborn Care (HBNC)

33. HBNC: Performance

34. HBNC: Supportive Supervision

35. HBNC Availability of HBNC Kit Quality of home visit by the ASHA using HBNC Kit Supportive Supervision by ASHA Facilitators Timely payment Review of the program at all levels

36. Home Based Young Child Care (HBYC)

37. Training of ASHAs on HBYC

38. HBYC: Visit by ASHA and Payment

39. Child Death Review (CDR)

40. CDR Reporting: Timely, Completeness, Correctness Review of reported cases as per the CDSR guideline Online Reporting on the MPCDSR Portal

41. CDR: Reporting and Review

42. MusQan: Gap Assessment Sl. No. Name of District Credential (Login ID and Password) Received from the state (Yes/No) Online Reporting started (Yes/No) 1 District-1 Yes Yes 2 District-2 Yes No 3 District-3 Yes Yes 4 District-4 No No 5 District-5 Yes Yes

43. MusQan Progress Update

44. Progress on MusQan initiative Sl. No. Name of District Facility identified for QI as per MusQan Baseline Assessment Completed using MusQan Checklist Nodal Officer Nominated (Yes/No) 1 District-1 Yes Yes Yes 2 District-2 Yes No Yes 3 District-3 Yes Yes Yes 4 District-4 No No Yes 5 District-5 Yes Yes Yes