NEW DELHI: To strengthen newborn and child healthcare services in the country, the Centre has launched a national programme, which provides home-based and community-based care for a child from birth to 36 months.
The focus of the programme is on survival, optimal nutrition and growth, early childhood development, and mother’s health and well-being.
The national initiative, Samagra Shishu Bal Swasthya Karyakram-- comprehensive care during the first three years-- integrates Home-Based Newborn Care (HBNC) and Home-Based Care for Young Child (HBYC) programmes into a single programme.
Launched by Union Health Minister JP Nadda on Monday, the initiative recognises the critical importance of the first 28 days for newborn survival and the first three years for optimal brain development, while strengthening child survival, nutrition, healthy growth and early childhood development.
The first 28 days of a child is considered the most vulnerable phase for mortality reduction. Stats have shown that the first week accounts for nearly 70% of neonatal deaths, while the postnatal period is critical for maternal health and well-being, thus requiring timely identification, follow-up, referral and management of newborns and young children.
One of the key features of the programme is the introduction of a risk-stratified approach for newborns and young children identified as 'At-risk' due to conditions such as low birth weight, prematurity, delayed initiation of breastfeeding, discharge from newborn care units, malnutrition, recurrent illness or developmental delays.
Under the programme, these children will receive intensified follow-up through additional home visits tailored to their level of risk.
The 'At-risk' newborns will also receive up to nine home visits during the first 42 days of life, while 'At-risk' children will receive up to eight home visits up to the age of 36 months.
The 196-page guidelines further address emerging challenges associated with the digital era by recognising excessive screen exposure and reduced physical interaction during early childhood as potential risks to brain development, emotional well-being and social skills.
It thus promotes age-appropriate play, physical activity and mental stimulation throughout the first three years of life to support children's cognitive, physical, emotional and social development.
The programme further strengthens continuity of care through coordinated home visits by Accredited Social Health Activists (ASHAs), Auxiliary Nurse Midwives (ANMs), Community Health Officers (CHOs) and Anganwadi Workers (AWWs).
Joint home visits by ANMs and CHOs have been incorporated on Day 3 and Day 7 for 'At-risk' newborns, and during the third and sixth months for 'At-risk' children.
These coordinated interventions are designed to facilitate timely assessment, counselling and referral whenever required.
To strengthen early identification and management of vulnerable children, the programme introduces Well-Baby Sessions at every Village Health, Sanitation and Nutrition Day (VHSND) and a monthly Shishu Shivir at Ayushman Arogya Mandirs.
These platforms will facilitate regular screening, developmental assessment and comprehensive management of newborns and young children within the community.
Recognising the close interdependence between maternal and child well-being, the programme incorporates postpartum maternal mental health screening as an integral component of community-based care.
ASHAs will undertake early screening and facilitate timely referral for further assessment and support whenever necessary.
The programme also mainstreams Nurturing Care for Early Childhood Development (ECD) by promoting responsive caregiving, early learning opportunities, age-appropriate play, child safety and active family engagement during every home visit and community interaction.
The programme envisages the extensive use of digital technologies to enhance service delivery, monitoring and continuity of care.
Decision-Support Systems (DSS), child-wise digital tracking, referral mechanisms and alert systems will strengthen follow-up and case management of 'At-risk' newborns and children.
These digital systems will be integrated with national digital health platforms, including the JANANI Portal, U-WIN Portal, MPCDSR Portal, RBSK 2.0 Portal and POSHAN Tracker, enabling seamless data exchange through ABHA and Baal-ABHA IDs.
The programme also includes tailored strategies to strengthen home-based care in urban areas, particularly for children residing in slums, migrant settlements and other underserved communities.
Officials said the launch of the programme marks a significant milestone in the government's efforts to strengthen the continuum of maternal, newborn and child healthcare through a nurturing, inclusive and digitally enabled approach.