Anganwadi worker's participation in rural newborn care.

ABSTRACT

PIP: The Rural Neonatal Care Program was initiated in January 1988 in Ganjad Primary Health Center, Dahanu, India, with the training of dais in care of the newborn. Later in the year training was conducted for anganwadi workers, who would follow-up newborn care until the child was 6 years of age. The anganwadi worker was a link between the dai and health worker and the health center. Home visits were made on the day of birth. The infant was measured and an health assessment made. If the infant was preterm or low birth weight and with a foot length of between 6.5 and 7 cm, repeat home visits were made to assess the breast feeding progress, the infant activity level, and general signs of health, as reflected in warm and pink feet. Training was conducted at monthly meetings at the block level, at the primary health care level, and during field visits to show how to care for hypothermic babies. A training manual and record book were developed and used. Footprints were made, and referrals were made to the hospital for those with feet under 6.5 to 7 cm. General observations were that birth registration improved, and infants were more easily identified for immunization. Newborn referral improved, and infant mortality declined. There was an important role for the anganwadi worker in providing continuity of care, identification of referrals, and training in the home for how to keep a baby warm. The number of referrals averaged 1-2 per month and 1-2 with special home attention. The training of the anganwadi worker in newborn care was included in the normal course of training and cost about Rs. 110 per worker.