Monday, July 25, 2016

'Healthy Start' campaign kick started to curb maternal mortality in India

Infant health worker Pinki weighing a child as part of a regular check-up

One in five newborn deaths within the first month of birth, could be prevented by ensuring access to clean water and providing a clean birthing environment, a new survey has found.

The survey commissioned by WaterAid India entitled ‘Healthy start campaign’ cited that Sepsis, a leading cause of infection in newborns, is associated with unclean practices at and after birth.

“Evidence also suggests that poor water, sanitation and hygiene in health care facilities is associated with high in-hospital maternal mortality,” the survey read in part.

 With 167 maternal deaths per 100,000 live births and 28 newborn deaths per 1,000 live births, India has one of the highest rates of maternal and infant mortality in the world. Studies have shown that many deaths in the first month of life result from diseases and conditions that are preventable.

Though the link between lack of safe water, sanitation and hygiene (WASH) and disease was established in the last century, most of India’s healthcare facilities continue to have inadequate WASH facilities. Almost 140,000 children under the age of five die every year in India from causes linked to lack of clean water and adequate sanitation, and poor hygiene practices.

WaterAid, globally, envisions everyone, everywhere to have access to clean water, sanitation and hygiene by 2030. In India, WaterAid assessed the situation of WASH in 343 healthcare facilities across 12 districts in six states.

The findings draw attention towards the poor status of WASH in healthcare facilities. There is not only severe lack of WASH facilities in the healthcare institutions but wherever present, most of them are either dysfunctional or inconveniently situated for the expectant or lactating mother.

Healthy Start is a campaign by WaterAid India with an overall goal to contribute towards preventing a significant number of neonatal and maternal deaths through safe WASH in healthcare services.

Its major objectives include influence change in neonatal and maternal healthcare for a shift from curative to preventive health services; strengthen the health delivery system to ensure adequate and safe WASH in healthcare facilities; and increase demand for safe WASH services by communities in healthcare facilities.

The government’s National Rural Health Mission (launched in 2005 as NRHM) brought the issues related to newborn healthcare into limelight. Since then, there have been several programmes and schemes launched to promote maternal and neonatal healthcare with an emphasis on institutional delivery ensuring a safe and professional birthing environment for the expectant mother and the newborn.

For example, the Janani Suraksha Yojana (implemented in 2005) has led to an exponential increase in institutional delivery, currently estimated at 80 per cent of all deliveries. The Janani Shishu Suraksha Karyakram (started in 2011) introduced a special provision for both facility based and home based newborn care to ensure neonatal care in Primary Health Centres, Community Health Centres and District Hospitals. 

Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH+A) approach introduced in 2013 places an emphasis on ensuring a continuum of care from pre-pregnancy to childhood with specific components for each segment.

The Swachh Bharat Mission (SBM), launched in 2014 with an aim to make India open defecation free by 2019 has increased its ambit to address healthcare facilities as well. The specific national initiative programme ‘KAYAKALP’ launched by the Ministry of Health and Family Welfare in May 2015 as a part of SBM promotes cleanliness, hygiene, infection control, and sustainable practices related to WASH in healthcare institutions.

This offers a unique opportunity to ensure that every newborn and mother is protected from preventable diseases and thereby enable that every start of life is a Healthy Start.

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