This book offers a comprehensive study of the complexities of newborn survival in resource-poor regions, using the state of Bihar (India) as a case study. It provides important lessons for other low-performing countries, in similar socioeconomic contexts, where newborn survival is a major challenge.
The volume opens with a brief account of the trends and regional variations in neonatal mortality. The empirical verification of socio-cultural, economic and health system barriers and the state interventions that affect newborn survival are subsequently explored. Innovative strategies are then proposed to scale up maternal newborn and child health (MNCH) services and improve neonatal health outcomes.
Addressing this issue through appropriate policy action is essential to achieving Sustainable Development Goal-3, "Good Health and Well-being". This book will therefore appeal to public health scholars, professionals and policymakers interested in improving outcomes in low-income regions.
Author(s): Sandhya R. Mahapatro
Publisher: Palgrave Pivot
Year: 2022
Language: English
Pages: 162
City: Singapore
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
