"Recurring Newborn Deaths in Government Hospitals Demand Systemic Reform"
SNCU (Special Newborn Care Unit)
district-hospital unit providing intensive care for premature, low-birth-weight, and critically ill newborns.
HBNC (Home-Based Newborn Care)
community-level care for stable newborns delivered by trained ASHAs at the family's home.
India's neonatal health policy has evolved through successive national programmes anchored in the constitutional guarantee of the right to life under Article 21, which the Supreme Court has interpreted to include the right to health. The National Health Mission (NHM), launched in 2005, created the structural framework for improving maternal and child health outcomes. Within it, the Janani Suraksha Yojana (JSY) provided cash incentives to women who delivered in health institutions, aiming to shift births from unattended home settings to supervised facilities. This strategy succeeded dramatically. The share of institutional deliveries rose from 39% in 2005-06 to 90% in 2023-24, according to NFHS-6 data. The absolute number of women delivering in institutions rose from 109 lakh in 2005 to 194 lakh in 2024-25.
To handle sick and vulnerable newborns, the government established Special Newborn Care Units (SNCUs) in district hospitals across the country. These units provide intensive care for premature, low-birth-weight, and critically ill newborns. Alongside facility-based care, India also built a community-level system. Around 8 lakh Accredited Social Health Activists (ASHAs) were trained to deliver Home-Based Newborn Care (HBNC), using modules derived from the landmark Gadchiroli field trial. This dual architecture, hospital care for severe cases, community care for stable ones, was always the intended design. In practice, however, the community layer has been underutilised while the facility layer has become dangerously overloaded.
The Gadchiroli model is the scientific foundation for India's HBNC programme. In the 1990s, the Society for Education, Action and Research in Community Health (SEARCH) conducted a field trial in Gadchiroli, Maharashtra, demonstrating that trained community health workers could deliver effective neonatal care at home. The trial, published in The Lancet in 1999, showed a 62.2% reduction in neonatal mortality. Subsequent data published in the Journal of Perinatology in 2005 showed that between 1996 and 2003, 97% of low-birth-weight and preterm babies with birth weights above 1,800 g and gestational ages above 34 weeks were managed at home with a very low case-fatality rate. These findings shaped the MoHFW's 2011 HBNC guidelines, which trained ASHAs to identify neonatal infections, support breastfeeding and warmth, and manage stable low-birth-weight babies at home. …
'Besides being a moral imperative of a Welfare State, primary health structure is a necessary precondition for sustainable development.' Analyze.
In order to enhance the prospects of social development, sound and adequate health care policies are needed particularly in the fields of geriatric and maternal health care. Discuss.
Consider the following statements:
Statement-I: India's public sector health care system largely focuses on curative care with limited preventive, promotive and rehabilitative care.
Statement-II: Under India's decentralized approach to health care delivery, the States are primarily responsible for organizing health services.
Which one of the following is correct in respect of the above statements?
Consider the following statements regarding India's neonatal health infrastructure:
1.Institutional deliveries in India rose from 39% in 2005-06 to 90% in 2023-24 as per NFHS-6.
2.Admissions to Special Newborn Care Units (SNCUs) rose by 28% between 2021-22 and 2023-24.
3.Home-Based Newborn Care (HBNC) is intended as a substitute for SNCU-level intensive care for all newborns.
How many of the above statements are correct?
Consider the following statements regarding Accredited Social Health Activists (ASHAs) and Home-Based Newborn Care (HBNC) in India:
1.ASHAs are trained to identify and manage neonatal infections at home.
2.The HBNC training modules used for ASHAs were developed from the Gadchiroli field trial experience.
3.HBNC is appropriate for newborns with severe prematurity, respiratory distress, or severe sepsis.
Which of the statements given above is/are correct?
Match the following neonatal health programmes/schemes with their primary implementing mechanism:
List I (Programme/Scheme) — List II (Primary Mechanism)
A.Janani Suraksha Yojana (JSY) — 1. Cash incentive for institutional delivery
B.Home-Based Newborn Care (HBNC) — 2. ASHA-delivered community-level care for stable newborns
C.Special Newborn Care Unit (SNCU) — 3. District-hospital intensive care for sick/premature newborns
D.NFHS-6 — 4. National household survey measuring health and demographic indicators
The Gadchiroli field trial, which forms the evidence base for India's Home-Based Newborn Care (HBNC) programme, was conducted by which organisation, and what was the approximate reduction in neonatal mortality it demonstrated?
Which of the following best explains why the success of the Janani Suraksha Yojana (JSY) has paradoxically contributed to overcrowding in Special Newborn Care Units (SNCUs)?
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