Towards Newborn Survival: Challenges and Priorities

Contents
List of Figures
List of Tables
Chapter 1: Newborn Health: An Introduction
	Background
	The Significance of the Study Area: Bihar
	Objectives
	Data and Method
	Criteria for Selection of Study Area
	Description of the Study Area and Profile
		Site Description
	Profile of the Households and Eligible Women Surveyed
	Description of the Surveyed Community (Villages/Wards)
	Overview of the Book
	References
Chapter 2: Determinants of Newborn Survival in India
	Introduction
	Trends in Neonatal Mortality
	Determinants of Neonatal Mortality
	Demand-Side Factors Associated with Neonatal Mortality
		Social Class
		Parental Education
		Household Deprivations
		Demographic Factors
	Supply of Health Services and Neonatal Mortality
	Identification of Risk Factors of Newborn Survival: Results from Probit Analysis
	Discussion
	References
Chapter 3: Neonatal Mortality in Bihar: Critical Reflections
	Introduction
	The Economy and the Social System of Bihar
	Demography and Health Status
	Status of Healthcare Resources in the State
	Newborn Deaths in Bihar: Trends and Differentials
	Differentials in Neonatal Deaths by Socio-demographic and Service-Related Attributes
	Summary
	References
Chapter 4: Access Barriers to Antenatal Care and Facility Delivery
	Introduction
	Status of and Differentials in Antenatal Service Utilisation
	Socioeconomic Differentials Among ANC Service Recipients
	Choice of Place of Delivery: Home Versus Institutions
	Barriers to Institutional Care: ANC Services and Facility Delivery
	Demand-Side Barriers
		Socioeconomic Inequality and Use of MNH Services
		Role of Gender and Intra-household Decision-Making
		Tradition and Culture
		Health Behaviour: Preference Versus Perception
	System-Level Barriers
		Community-Level Interactions and Service Utilisation
	Influence of Distance
		Cost of Services and Inequality in Health Spending
		Quality of Care at Institutions
	Discussion
	References
Chapter 5: Quality of Care at Public Health Institutions: Identifying Gaps
	Introduction
	Clients’ Satisfaction with Quality of Care (Experiences of Care)
	Provision of Care Around Childbirth and Hospital Stay
	Discussion
	References
Chapter 6: Newborn Care Practices and Barriers to Service Utilisation
	Introduction
	Utilisation of Postnatal Services by Place of Delivery
	Status of Newborn Care Practices
	Skin-to-Skin Care
	Thermal Care
	Cord Care
	Early Initiation of Breastfeeding
	Colostrum and Prelacteal feeding
	Barriers to Postnatal Care Services
	Poor Perceived Need
	Community Literacy/Lack of Awareness
	Socioeconomic Inequality in Postnatal Care Practices
	Beliefs and Practices
	Shorter Length of Stay at Facilities
	Inadequate Pre-discharge Counselling
	Inadequate Reach of Interventions
	Discussion
	References
Chapter 7: Access to Sick Newborn Care Services: Efficiency, Adequacy, and Equity
	Introduction
	Admission in SNCU: Profile and Outcomes
	Cost of SNCU Services
	Neonatal Deaths and Quality of Care at SNCU
	Barriers to SNCU Care
		Gender Discrimination
		Poverty and High Out-of-Pocket Expenses
		Socioeconomic Inequity in SNCU Service Utilisation
	Discussion
	References
Chapter 8: Direct Benefit Transfer and Newborn Health
	Introduction
	Coverage of DBT: Status and Differential
	Socioeconomic Differentials in Utilisation of DBT
	Out-of-Pocket Expenditure and Maternal and Newborn Care
	Barriers Affecting Utilisation of Programmes
		Lack of Awareness
		Insufficient Amount and High OOPE
		Economic Inequality in OOPE
		Administrative Difficulties
	Delay in Payment and Absence of Prepayment
	Discussion
	References
Chapter 9: Conclusion and Way Forward
	Summary of Evidence
	The Way Forward
		Inclusion of Vulnerable and Underserved Groups
	Enhancement of Coverage and Stringent Monitoring of CCT Schemes
	Emphasis on Behavioural Change Interventions
		Family-Centric Approach
		Women Empowerment and Intensified IEC Campaigns
		Strengthened Community Engagement
		Transformative Measures for Eliminating Gender Disparities
		Promotion of Home-Based Newborn Care Practices
	Strengthening of the Health System
		Scaling Up of Infrastructure
		Increase in Health Budget
		Tracking and Screening of Every Pregnancy
		Standardisation of Training and Mentoring of Providers
		Disease-Specific Interventions in the National Health Programmes
	References
Index