A New Paradigm in Neonatal Care

Zooming in on a Home-Based Approach in Gadchiroli, India

Abstract

Neonatal mortality accounts for the highest amount of under-five deaths worldwide, particularly in developing countries. The Society for Education, Action, and Research in Community Health (SEARCH) sought to address neonatal mortality in Gadchiroli, India. In 1993, SEARCH created the Home-Based Neonatal Care (HBNC) model in order to improve neonatal outcomes. The goal of the HBNC intervention was to deliver primary neonatal care to reduce the neonatal mortality rate (NMR) by at least 25%, and the sepsis-related NMR by at least 40% in 3 years. This case study provides a description of the HBNC, and analyzes the cost-effectiveness, outcomes, and future implications of the intervention. Compared to the 47 control villages, the HBNC improved NMR in the 39 trial villages during the study period, between 1993 and 2003. In response to the positive outcomes of the trial, a nationwide scale up was implemented in 2011, administered by the Indian government. The HBNC intervention was cost-effective and addressed the needsof the community in a culturally sensitive way. The HBNC has the potential to be reproduced in other regions with a high NMR. However, since each region is different, context-specific modifications should be taken into consideration.