Vol. 6, Issue 1 (2020)
The current article of Uttar Pradesh (UP) is about the ASHAs who are the daughters-in-law of a family that resides in the same community that they serve as the grassroots health worker since 2005 when the NRHM was introduced in the Empowered Action Group (EAG) states. UP is one such Empowered Action Group (EAG) state. The current study explores the actual activities done by Recently Delivered Women (RDW) on three activities related to newborn care. These are dry, wrap, colostrum feeding and cord cutting of the newborn. From the catchment area of each ASHA, two RDWs were selected who had a child in the age group of 3 to 6 months during the survey. The action profiles of the RDWs on these aspects of newborn care are reflected upon to give a picture that represents the entire state of UP. The relevance of the study assumes significance as data on the modalities of actual actions done by the RDWs for their last delivery are not available even in large scale surveys like National Family Health Survey 4 done in 2015-16. The current study gives an insight in to these activities separately. The current study is basically regarding the summary of three actions on newborn care done & replied by RDWs during their post- natal stage. When late or poor newborn care actions are taken by the RDWs and their family members, it shows up poorly in the Neonatal Mortality Rate (NMR) & there by impacting the Infant Mortality Rates (IMR) in India and especially in UP. The current IMR in India is 33 where as it is 41 in UP which means 8 points higher per 1000 livebirths (SRS, May 2019). Similarly, the current NMR in India is 23 per 1000 livebirths (UNIGME,2018). As NMR data is not available separately for states, the national level data also hold good for the states and that’s how for the state of UP as well. These mortalities are the impact indicators and such indicators can be reduced through long drawn processes that includes effective and timely actions on newborn care by RDWs in their deliveries. This is the area of actions detailing that the current study throws out in relation to placental delivery. A total of four districts of Uttar Pradesh were selected purposively for the study and the data collection was conducted in the villages of the respective districts with the help of a pre-tested structured interview schedule with both close-ended and open-ended questions. In addition, in-depth interviews were also conducted amongst the RDWs and a total 500 respondents had participated in the study. The results showed that 98% RDWs in Gonda and all the RDWs in the other 3 districts replied that they dried their baby immediately and before placental delivery. Regarding wrapping, only 1% RDW in Gonda wrapped the baby after an hour or more after placental delivery. Rest of the RDWs in all the 4 districts wrapped the baby immediately before placental delivery. The results also showed that the ASHAs were not following up effectively for Early Initiation of Breast Feeding (EIBF) in the 3 districts other than Banda. This EIBF indicator also showed poor performance of ASHAs in Gonda and Barabanki districts. For cord cutting indicator, the practices of RDWs showed that among the deliveries conducted by the ANMs and the home deliveries, the cutting of the cord was delayed in relation to placental delivery.
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