Kasthuri with her twin boy and girl outside her home in Kilpudupettai, Walajah
By Sumithra Thangavelu
Walajah, Tamil Nadu, April 2006: When 26-year-old Kasthuri gave birth to twins in January this year, she was more scared than happy. Her baby girl weighed only 1.8 kilograms, though her boy was healthy at 2.5 kilograms. “My daughter looked so tiny. I wondered if I could do anything to help her survive”, she says.
Today, sitting in the veranda of her home in Kilpudupettai, Kasthuri is more confident than scared. In three months, her daughter has rapidly gained weight thanks to a simple regimen: home-based care under the UNICEF-supported Integrated Management of Neonatal and Childhood Illnesses (IMNCI) programme.
In India, approximately 2.6 million children under 5 years die every year from common preventable childhood illnesses. Most of the deaths occur in the first month, first week and first one or two days of life simply because their parents can’t identify symptoms of illness or don’t take them to hospitals on time. Poverty and poor access to health services further prevents them from seeking help.
In Tamil Nadu, UNICEF-trained health and nutrition workers have taken up the challenge to reverse this trend. Mothers are taught to identify symptoms and follow best practices during pregnancy, empowering them with information to save a life. “By promoting basic healthy practices like breastfeeding and hand washing, the rate of child mortality and morbidity is bound to fall”, says Mr. Prakash Gurnani, UNICEF Health and Nutrition Officer.
In Walajah alone, 39 babies with low birth weight were saved from untimely death between August 2005 and April 2006 simply because their parents had timely counselling at hand.
Punitha listens to advise from a health funtionary from the PHC, Mussoorie where she gave birth to twins
Home-based care and prompt referrals are the cornerstones in IMNCI. Priority is given to special care and support to newborns up to 2 months, including verifying immunization and malnutrition status and feeding patterns. Unlike in the past, postnatal care is the focus, enabling early detection of illness in both mother and child.
A common cause of infant mortality in Tamil Nadu is Low Birth Weight (LBW). “Anemia, early marriage and short birth intervals are driving such a trend”, says Shantha Bai, a Sector Health nurse in the village of Ammoor in Walajah. Under IMNCI, such babies are constantly monitored, evaluated and treated.
The “Kangaroo Care” method – a temperature-management technique whereby mothers (or anyone in the family) place the low-birth-weight baby on the body for skin-to-skin contact, hugely increasing their chances of survival - is particularly effective in Tamil Nadu. Ms. Krishnaveni, District Project Officer, Vellore, says that IMNCI has enabled grassroots workers to treat more problems by themselves, thus facilitating timely care.
IMNCI also seeks greater integration between Health and Nutrition workers. Workers from both sectors help identify the sickly and health supervisors arrange for treatment. “So more mothers and infants get quicker access to care” says Ms. Curie Florence, Child Development Project Officer, Walajah.
Little Karen from the village of V C Motoor in Vellore has benefited from the system amalgamation. This malnourished child weighed just 1.7 kilograms at birth. In 6 months, he is a healthy 4.5 kilograms.
Vijayalakshmi, an Anganwadi worker, improved Karen’s chances of survival with every bit of advice she gave his mother, and by constant coordination with the health workers.
“A child who otherwise would have died has been saved. Survival rates among newborn babies are increasing. IMNCI is creating tremendous change in childcare service”, says Mr. Somasundaram, Deputy Director, Health Services, Vellore.