Recording and materials from the webinar on family participatory care in India

Arti Devi pats her 8 hour old child at the post natal ward, of Community Health Center Kachhwan, in Uttar Pradesh, India, in September 2017. ©UNICEF/Prashanth Vishwanathan

25.09.2018

The Network for Improving Quality of Care for Maternal, Newborn and Child Health hosted a webinar on 24 September on ‘Family participatory care in India: partnering with families to care for small and sick newborns’.

Prof. Arti Maria, Head of Neonatology at Dr Ram Manohar Lohia Hospital, New Delhi, India, has pioneered this approach in which the parents and close relatives of small and sick newborns are trained in simple care practices and become full partners in care.  She explained how the idea started, how changing the attitudes of healthcare workers, who can be weary of sharing some of their power, was the main obstacle to the approach being adopted, and how involving fathers in the care of their newborn proved to be critical.

Dr Harish Kumar, Senior Programme Director at Jhpiego India, presented the scale up model for the family-participatory care approach and how it works both at facility and community levels to change attitudes of health workers, teach parents care practices for their sick and small newborns, and try to ensure a continuum of care once the baby is discharged. He talked about the work in the facilities to implement family-centred care, and how state and national governments were involved at every step.

Dr P.K Prabhakar, Deputy Commissioner for Child Health at the Ministry of Health & Family Welfare, Government of India explained how the family-participatory care approach evolved from an innovation in one tertiary facility to a nation-wide initiative that is about to be implemented in over 800 SNCUs across India.  

Listen to the webinar recording

Access Prof. Maria’s, Dr Kumar’s and Dr Prabhakar’s presentations

Listen to a Quality Talks podcast episode with Prof. Arti Maria: Building trust between families and health care workers to care for sick and small newborns in India

The webinar’s Q&A can be found below in the comments section.

Comments

More teaching institutions should now start with family-centred care. This will certainly send  the right message to peripheral public health facilities for taking up family-centred care as soon as possible

ANSWER - Dr Harish Kumar

I agree that family-centred care is a win-win strategy but quality needs to be ensured.

What was the duration of skin to skin contact to be considered as continuation of kangaroo mother care at home? Is any skin to skin contact or at least 8 hrs of skin to skin contact with exclusive breastfeeding considered as continuation of kangaroo mother care at home? And at which day post discharge is it assessed?

ANSWER - Dr Harish Kumar

We used the WHO definition that at least 1 hr of skin to skin contact is provided to qualify as kangaroo mother care. We used at least 7 days post discharge in all eligible cases (the eligibility criteria was that baby should be less than 2.5 kg ).

I am interested in knowing how the home-based care takes place and who is the personnel conducting the program - as my area of interest is on reducing morbidity, i.e the developmental outcome in the at-risk newborns. And how does one get registered for the program?

ANSWER - Dr Prabhakar

Home Based Newborn Care (HBNC) through ASHA was implemented in the year 2011 under the National Rural Health Mission by the Ministry of Health and Family Welfare GOI. Incentivized scheduled visits were designed to visit the mother and newborn up to the first 42 days of life by ASHA covering the most vulnerable period in a newborn’s life. The schedule of the visits is 3rd, 7th, 14th, 21st, 28th and 42nd days after birth and an additional visit on day 1, in case of home delivery. She is provided with HBNC kit and trained in the skills through a training package.

ASHAs during these home visits provide counselling to the mothers on early initiation of breastfeeding, nutrition counselling, family planning and promoting other healthy behaviours etc. In addition, ASHAs assess danger signs in mother and newborn, measures the newborn’s temperature, weighs and records respiratory rate and refers the children to the nearest facility for further examination and treatment in case of danger signs.

The completion of activities is confirmed through recordings in MCP cards & ASHA checklist

Home Based Young Care (HBYC) - The early years of a child’s life lay the foundation for development in all areas, physical, social and cognitive, and therefore offers the most critical window of opportunity for optimum human development. To, a policy decision was taken to extend home based care to the early childhood period by launching the

The Home Based Care for young Children (HBYC) programme extends home-based care to the early childhood period to address the very important issues of child nutrition and early childhood development and prevent childhood illnesses (such as diarrhoea & pneumonia) and deaths resulting from them. The two programs (HBNC & HBYC) together will establish a platform of home based care across the continuum of care. As part of HBYC, ASHAs will now make quarterly additional home visits to all children at 3rd month,6th month,9th month,12th month and at 15 months of age. The key frontline workers of the Ministry of Women and Child Development and Ministry of Health & Family Welfare that is ASHA, Anganwadi worker and ANM shall work in conjunction to deliver the services under HBYC for young children to survive and thrive.

The involvement of male members of the family should be encouraged.

ANSWER - Dr Harish Kumar

Yes the male members should also be actively involved as was done in our project sites.

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