NEONATAL DEATHS IN

ODISHA

DR. SUDHIRA KUMAR PARIDA.

DEFINITION

• Deaths occuring during the neonatal period

i.e., within 28 completed days of birth.

• Calculated as no. of neonatal deaths in a given

yr / 1,000 live births in that yr.

IMPORTANCE

• Over 2/3rd of IMR &

• ½ of U5MR

• 90% of neonatal deaths-within 1st 14 days of

life

• ½ of neonatal deaths-within 1st 7 days

PROBLEM STATEMENT

SRS 2010:

• NNMR- 42 (R-43,U-32)

• Early NNMR-33 (R-35,U-21)

AHS 2011:

• 31(Angul) - 75(Balangir)

• In rural areas of districts - significantly higher than that in urban areas

NNMR 10-19 20-29 30-39 40-49 50-59 60-69 70-79

No.ofdistricts:

- - 17 10 2 - 1

IMR & NNMR

0

10

20

30

40

50

60

70

IMR NNMR

61

33 (54% of IMR: R-55%,U-50%)

9 (14.8% 0f IMR)

[SRS 2010]

U5MR & NNMR

0

10

20

30

40

50

60

70

80

90

U5MR NNMR

78

42 ( 54% of U5MR )

[SRS 2010]

CAUSES

Others11%

2

PREMATURITY & LBW29%

SEVERE INFECTION25%

BIRTH ASPHYXIA & TRAUMA23%

CONG. MALFORMATIONS

8%

NT2%

D%

NNMR

EARLY NNMR

• Prematurity & congenital

anomalies

• Asphyxia

LATE NNMR

• Infection

• Diarrhoea

DETERMINANTS

ANC

0%

20%

40%

60%

80%

100%

120%

at least 1 2+ 3+ full

98

77

58.4

37.5

[COVERAGE EVALUATION SURVEY 2009]

CONSUMPTION OF IFA DURING

PREGNANCY

%

30 days16%

None10%

100 days47%

31-90 days27%

[COVERAGE EVALUATION SURVEY 2009]

PLACE OF DELIVERY

%

Institutional75.5%

At home24.5%

[COVERAGE EVALUATION SURVEY 2009]

Duration of stay at health facility

1 day44%

1 day28%

2 days12%

3 days8%

4+ days8%

[COVERAGE EVALUATION SURVEY 2009]

DELIVERY ATTENDED BY SBA

0

10

20

30

40

50

60

70

80

90

SBA none

21%

79%

[COVERAGE EVALUATION SURVEY 2009]

INSTITUTIONAL DELIVERIES & JSY

0.00% 20.00% 40.00% 60.00% 80.00%

Institutional deliveries

JSY 60.7 %

75.5 %

[COVERAGE EVALUATION SURVEY 2009]

BF AFTER CHILD BIRTH

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

< 1 hr 1-23 hr ³ 24 hr No BF

[COVERAGE EVALUATION SURVEY 2009]

63.7

27.2

8.8

0.3

INTERVENTIONS

BEFORE PREGNANCY

• Delayed child-bearing

• Well-timed, well-spaced & wanted

pregnancies

• Well- nourished & healthy mother

• Female literacy

DURING PREGNANCY(ANC)

• Early registration

• TT

• IFA

• Good diet

• Counseling on birth preparedness & BF

• Identification of major risk factors of

obstructed labor.

INTRAPARTUM & IMMEDIATE

NEWBORN CARE

• PROM-Antibiotics

• Complications- EmOBC

• SBA

• 5 ”C’’s

• Prevention of hypothermia

• Early EBF

• Cord & eye care

• Neonatal resuscitation

• Spl. care for LBW

EARLY NBC

• EBF

• Temp maintenance

• Optimal cord care & hygiene

• Immunisation

• Care for LBW baby

• Management of sickness

LATE NBC

• EBF

• Cord care & hygiene

• Care for LBW baby

HEALTH PROGRAMMES

• JSY

• UIP

• IMNCI

• Mamta dibas

• Pustikar dibas

• JSSK

• Mamta scheme

• E-janani

PROGRESS

• ASHAs - in 40,000 villages

• 380 JSY Express

• JSY + Mamta dibas : 26 lakh women

• JSSK - 382 health centre

• ASHA Gruha

• Maa gruha - tribal & outreach area

• 1482 MCH centres

• 394 Health centres -24 7

• 56 Blood banks

• 20 Blood preservation centres

REFERENCES

• SRS 2010

• AHS 2011

• UNICEF’s Coverage evaluation survey 2009

• PARK’S textbook of preventive & social

medicine. 21st edition

• Textbook of preventive & social medicine :

sunderlal

• RCH module for MO(PHC).