Improvements in Essential Newborn Care and Newborn Resuscitation Services Following a Capacity Building and Quality Improvement Program in Three Districts of Uttar Pradesh, India.
Background
Neonatal death remains a global challenge contributing to 45% of underfive deaths. With rising institutional delivery, to accelerate decline in neonatal mortality rate (NMR) improvement in the quality of perinatal care requires attention.


Objectives
This implementation research targeted improving service delivery readiness for quality of newborn care at public health facilities in three districts of Uttar Pradesh, India, with high NMR.


Materials and Methods
This before-after study assessed the facility readiness and quality of newborn services at 42 health facilities. The changes in 26 signal functions for routine and emergency obstetric and newborn care were tracked.


Results
There was marked improvement in newborn service availability: skilled birth attendants (51%), resuscitation (30%), and kangaroo mother care (27%) at these facilities. A multifold rise in newborn resuscitation efforts and documentation (n = 4431 vs. n = 144 in preintervention period) with high success rate (98.6%) was observed. There was also improvement in obstetric care services including partograph use (31%) and active management of third stage of labor (46%). However, several infrastructural indicators (electricity, water supply, toilets, and sanitation) remained unchanged.


Conclusion
Overall improvements were observed in the majority of the signal functions for perinatal care and newborn resuscitation efforts. There was a limited impact on the infrastructural and supervision components.
['Das|Manoja Kumar|MK|', 'Chaudhary|Chetna|C|', 'Mohapatra|Sadhu Charan|SC|', 'Srivastava|Vinod Kumar|VK|', 'Khalique|Najam|N|', 'Kaushal|Santosh Kumar|SK|', 'Khanna|Rajesh|R|', 'Chatterji|Surojit|S|']
newborn care resuscitation Capacity building quality of care