Newborn Care Week is celebrated every year in the country from 15 to 21 November. The aim for celebrating the week is to raise awareness about the importance of the newborn care for child survival and development. The neonatal period (the first 28 days of life) is the crucial period for child survival; as this period carries the highest risk of deaths per day than any other period during the childhood. The first month of life is also a foundational period for lifelong health and development. Healthy babies grow into healthy adults who can thrive and contribute to their communities and societies. Every year 2.6 million babies die in the first 28 days of life; most in the first week and additional 2.6 million stillbirths occur each year. As per the latest Sample Registration System Report (SRS) 2024 of Registrar General of India (RGI), Infant Mortality Rate (IMR) is 24 per 1000 live births, Under 5 Mortality Rate (U5MR) is 28 per 1000 live births and Neonatal Mortality Rate (NMR) is 18 per 1000 live births. Labour, birth and the immediate postnatal period are the most critical for newborn and maternal survival. And 75% of newborn deaths can be prevented with known, effective health measures provided at birth and during the first week of life. Main causes of newborn death Prematurity Complications during birth Severe infections Causes of newborn deaths in India The major causes of newborn deaths in India are pre-maturity/preterm (35%); neonatal infections (33%); intra-partum related complications/ birth asphyxia (20%); and congenital malformations (9%). Newborn care All newborns require essential newborn care to minimize the risk of illness and maximize their growth and development. Warmth, normal breathing, mother's milk, and prevention of infection are the basic needs of normal baby at birth. These basic needs indicate that a baby's survival is totally dependent upon her mother and other caregivers. Therefore it is important to provide proper care to all the neonates immediately after birth. This care will also prevent many newborn emergencies. Care of newborns includes: Immediate and thorough drying, skin to skin contact of the newborn with the mother, cord clamping and cutting after the first minutes after birth, early initiation of breastfeeding, and exclusive breastfeeding. Newborns who do not start breathing on their own by one minute after birth should receive positive pressure ventilation with room air by a self-inflating bag and mask. After the first hour of life, newborns should receive eye care, vitamin K, and recommended immunizations (birth dose of OPV and Hepatitis B vaccine, BCG). They should be assessed for birth weight, gestational age, congenital defects and signs of newborn illness. Special care should be provided for sick newborns, those who are preterm and/or low birth weight, and those who are exposed or infected by HIV or have congenital syphilis. Progress of newborn health interventions in India The Ministry of Health and Family Welfare (MoHFW), Government of India has made vital policy decisions to combat major causes of newborn deaths, with special attention to safe motherhood interventions, sick newborns, babies born too soon (premature/preterm) and babies born too small (small for gestational age). The porgrammes include Child Survival and Safe Motherhood Programme (CSSM) in 1992; Reproductive and Child Health Programme Phase I (RCH I) in 1997, followed by RCH II in 2005; the National Rural Health Mission (NRHM) in 2005 which, along with the National Urban Health Mission, became part of the National Health Mission in 2013; the Call to Action for Child Survival and Development, and the subsequent Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH+A) strategic framework in 2013. India newborn care action plan (INAP) and RMNCH+A MoHFW has developed the India Newborn Action Plan (INAP) in response to the global Every Newborn Action Plan (ENAP) in 2014. INAP aims to significantly reduce preventable newborn deaths and stillbirths and to bring down the neonatal mortality rate and still born rate to “single digits” by 2030. The INAP is implemented within the existing RMNCH+A framework. Its strength is built on its six pillars of intervention packages, which include: pre-conception and antenatal care; care during labour and child birth; immediate newborn care; care of healthy newborn; care of small and sick newborn; and care beyond newborn survival. The details of interventions to improve child health outcomes all across the country to achieve the Sustainable Development Goals relating to child survival, are placed as below: Promotion of institutional deliveries through cash incentive under Janani Suraksha Yojana (JSY); Under Janani Shishu Suraksha Karyakram (JSSK), pregnant mother and sick infants up to one year of age are entitled to free treatment in public health institutions along with the provision of free transport, diagnostics, medicines, blood and consumables; Special New-born Care Units (SNCUs)/ Neonatal Intensive Care Units (NICUs) are established at District Hospital and Medical College level, Newborn Stabilization Units (NBSUs) are established at First Referral Units (FRUs)/ Community Health Centres (CHCs) for care of sick and small babies. Mother Newborn Care Units (MNCUs) have been established to ensure 'zero separation', enabling 24×7 integrated care of sick and small newborns together with their mothers while promoting family participatory care. Kangaroo Mother Care (KMC) has been implemented at facility and community level to low birth weight/ pre-term infants that includes early and prolonged skin-to-skin contact with the mother or family member and exclusive and frequent breastfeeding. Under Home Based New-born Care (HBNC) and Home-Based Care of Young Children (HBYC) program, home visits are performed by Accredited Social Health Activists (ASHAs) to improve child-rearing practices and to identify sick newborn and young children in the community. Building on these initiatives, the Ministry of Health and Family Welfare has recently released the Samagra Shishu Bal Swasthya Karyakram (SSBSK), a unified national programme that integrates HBNC and HBYC into a single continuum of home and community-based care for every child from birth to 36 months, with the vision of "पहले तीन साल सम्पूर्ण देखभाल". Mothers' Absolute Affection programme (MAA), launched in 2016, promotes early initiation and exclusive breastfeeding for first six months; Promotion of ORS and Zinc for management of diarrhoea in children under STOP Diarrhoea Campaign; Early screening, identification and management of pneumonia under Social Awareness and Actions to Neutralize Pneumonia Successfully (SAANS); Under Universal Immunization Programme, provision of 11 vaccines to protect children against 12 vaccine-preventable diseases; In addition, Rashtriya Bal Swasthya Karyakram (RBSK) provides child health screening and early intervention services for defects, diseases, deficiencies and delays to improve the quality of survival. Recently, MoHFW released the RBSK 2.0 Operational Guidelines, expanding the programmatic framework to include emerging child health priorities. Under this initiative, the Ministry also released the Guidance Document on Diabetes Mellitus in Children, which provides a standardized national framework for the screening, diagnosis, treatment and long-term management of diabetes among children. Source : National Health Mission