ASHA, RECOLLECTION, PLACE- A TRIAD IN HOME BASED NEWBORN CARE MESSAGE FORRECENTLY DELIVERED WOMENIN UTTAR PRADESH, INDIA

The response profiles of the Recently Delivered Women on the newborn care period on the messages related to newborn care in the first month of life of the baby are dwelled upon to evolve a picture representing the entire state of UP through this article. The relevance of the study assumes significance as detailed data on the modalities of each of the messages on newborn care are available but not exclusively for the first month period of the life of the baby. The details of the Home Based Newborn Care related messages 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 each of these messages with atria analysis, the first being the recollection capacity of the RDWs, the second is whether ASHA gave the particular message 7 the third is if the RDW received the message at home. The current study is basically regarding the summary of this triad approach during the newborn care period. The newborn care period after each delivery deals with 70% of the time of the postnatal period & the entire neonatal period. Therefore, it does impact the Maternal Mortality Rate& Ratio (MMR) & the Neonatal Mortality Rates (NMR) in India and especially in UP through the unsafe Maternal & Neonatal practices in the first month period after delivery. The current MM Rate of UP is 20.1 & MM Ratio is 216 whereas the MM ratio is 122 in India (SRS, 2019). The Sample Registration System (SRS) report also mentions that the Life Time Risk (LTR) of a woman in pregnancy is 0.7% which is the highest in the nation (SRS, 2019). This means it is very risky to give birth in UP in comparison to other regions in the country (SRS, 2019). This risk is at the peak in the first month period after each delivery. Similarly, the current NMR in India is 23 per 1000 live births (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 visits to RDWs especially in the first month of the life of the baby. This would help in making their post-natal& neonatal stage safe. This is the area of newborn care message profile detailing that the current article discusses in relation to the recent delivery of the respondents. 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 apre-tested structured interview schedule with both close-ended and open-ended questions. The current article deals with 14 close ended questions with options, three aspects foreach of the HBNC messages. In addition, in-depth interviews were also conducted amongst the RDWs and a total 500 respondents had participated in the study. Among the districts related to this article, the results showed that the triad profile of each message varied widely across the 4 districts. The first message was on initiating breastfeeding within an hour of birth. Here except Barabanki district, rest three districts showed better results. The next message was feeding only breast milk to the newborn up to 6 months. For this message, except for Saharanpur district, all the three other districts fared poorly. For the message on maintaining warmth of the baby to continue to keep the baby warm, Barabanki district had less than 60% of RDWs replying on the message in all the three aspects of the message. For the message on not to apply anything on the cord again Barabanki district had about half achievement in all the three aspects of the message and in rest of the districts it was more than half in all the aspects of the message. Regarding identification of danger signs, the place component was poor in Barabanki district. In the rest of the aspects of this message in all the three districts more than half of RDWs replied on the message. About the message of weighing the newborn, it was more than 65% in the rest of the districts except Barabanki district where it was poor in all the three aspects of the message. Similarly, for the message on delaying bathing up to one week, it was less than 50% across in Barabanki district and less than 60% in Gonda district in receiving the message from ASHA and at home. The message on telling the RDW to take to a health facility in case of health problem of a newborn showed that the ASHAs in Barabanki district had done the message delivery very poorly. Similarly, the ASHAs of Barabanki district had done poorly for the message on contraception/family planning services. In all the three aspects of the message on caring equally for boy or girl, the ASHAs of Barabanki district had delivered the message to just about more than half of RDWs in all the three aspects of the message. Regarding the message on skin to skin care, the ASHAs of Barabanki district lagged behind among the ASHAs of 4 districts in delivering the message. In Barabanki and Gonda districts, about 60% RDWs replied in all the three aspects of the message on maternal nutrition. Finally, it was evident that only with the use of job aides the message delivery could be effective but ASHAs particularly in Barabanki and Gonda districts did not cover all the RDWs to deliver messages through job aides on newborn care.