Neonatal mortality

Union Minister for Health & Family Welfare recently said that in order to strengthen neonatal services in the country, funds are provided to States for establishing and running Special Newborn Care Units (SNCU), Newborn Stabilization Units (NBSU) and Newborn Baby Care Corners (NBCC). 

Funds have also been allocated to States for implementing Janani Shishu Suraksha Karyakram (JSSK) which provides for free care and transport of sick newborn for first 30 days of birth. As per SRS 2010 report of Registrar General of India, Neo-natal Mortality Rate is 33 per thousand live births in India.

 IMPORTANT DEFINITION

• Perinatal mortality only includes deaths between the foetal viability (22 weeks gestation) and the end of the 7th day after delivery.
• Neonatal mortality only includes deaths in the first 28 days of life.
• Postneonatal mortality only includes deaths after 28 days of life but before one year.
• Child mortality includes deaths within the first five years after birth.

What basically is Neonatal mortality ?

**Early neonatal mortality refers to a death of a live-born baby within the first seven days of life, while late neonatal mortality covers the time after 7 days until before 28 days. 

**The sum of these two represents the neonatal mortality. Some definitions of the PNM include only the early neonatal mortality. 

**Neonatal mortality is affected by the quality of in-hospital care for the neonate. Neonatal mortality and postneonatal mortality (covering the remaining 11 months of the first year of life) are reflected in theInfant Mortality Rate.

Various contributing factors for neonatal mortality include 

(a) Home delivery by unskilled persons 

(b) Lack of essential new born care for asphyxia and hypothermia 

(c) Poor child care practices 

(d) Lack of early detection of sick newborn 

(e) Inadequate/Delayed referral mechanisms 

(f) Inadequate infrastructure in govt. hospitals for specialized care of sick newborn.

 The medical causes of neonatal deaths  in India are Infections (29%) such as Pneumonia, Septicemia and Umbilical Cord infection; Prematurity (24%) i.e birth of newborn before 37 weeks of gestation and Asphyxia (19%)  i.e. inability to breathe immediately after birth that leads to lack of Oxygen.

What is Perinatal Mortality Rate ?

The PNMR refers to the number of perinatal deaths per 1,000 total births. It is usually reported on an annual basis. It is a major marker to assess the quality of health care delivery. Comparisons between different rates may be hampered by varying definitions, registration bias, and differences in the underlying risks of the populations.

PNMRs vary widely and may be below 10 for certain developed countries and more than 10 times higher in developing countries . The WHO has not published contemporary data.

What is SRS (Sample Registration System)?

 **The Sample Registration System (SRS) is a large-scale demographic survey in India for providing reliable annual estimates of birth rate, death rate and other fertility & mortality indicators at the national and sub-national levels.

**The field investigation consists of continuous enumeration of births and deaths in selected sample units by resident part time enumerators, generally anganwadi workers & teachers, and an independent survey every six months by SRS supervisors.

**The data obtained by these two independent functionaries are matched.

** The unmatched and partially matched events are re-verified in the field and thereafter an unduplicated count of births and deaths is obtained.

**The sample unit in rural areas is a village or a segment of it, if the village population is 2000 or more. In urban areas, the sampling unit is a census enumeration block with population ranging from 750 to 1000.

**At present, SRS is operational in 7,597 sample units (4,433 rural and 3,164 urban) spread across all States and Union territories and covers about 1.5 million households and 7.27 million population.

Source : IAS Our Dream