Addressing the public health challenge of birth defects in India

Birth defects consisted of a group of diverse clinical conditions categorized on the basis of a congenital presentation and a partly orwholly genetic etiology. Although individually rare, birth defects affect 2-3% of all births in India. As India has the largest global annualbirths, in absolute numbers, India may harbor the largest number of affected children worldwide. There is a need of strategic researchand interventions to bring down the rate of birth defects and associated economic burden and also a need to actively screen and identifythem at early stage so necessary intervention (medical or surgical) could be initiated so as to reduce lifelong disability as a result ofsuch defects. The recent child health screening and early intervention service initiative by the Government of India, the Rashtriya BalSwasthya Karyakram under the National Health Mission is the first attempt in the direction toward providing services for some ofthe more prevalent birth defects and has the potential to alleviate suffering of affected children especially from rural areas. The datacollected from this program could help policy makers to allocate sufficient funds aimed at treatment of birth defects and also developbehavior change communication strategies for prevention of the same

Improving child survival under National Health Mission in India: Where do we stand?

India contributes to around one-fifth of the global under-five mortality and also maternal mortality besides one-third of the neonatalmortality. Since any reduction in child mortality in India is crucial for the global decline, therefore, the Indian Government decidedto undertake massive correction of the health system. This led to the launch of National Rural Health Mission in the year 2005. Sincethen, significant progress has been made and child mortality rates have shown a sharp decline. On comparing the progress made by theworld toward Millennium Development Goals, India fares better by showing a decline of 46.5% in comparison to 41% for the entireworld during the same period. In order to assess the state-wise reduction, data from sample registration system of the Registrar Generalof India which is available for most of the States/Union Territories (UTs) have been analyzed. States such as Maharashtra, Tamil Nadu,and Kerala have shown an impressive decline but some states such as Himachal Pradesh, Punjab, Mizoram, and Delhi still have a longway to go to reach the state specific goals and targets. Any further decline would only be possible by addressing inter-district variationsthat are still lagging behind and focused efforts need to be made, in order to reach these desired goals. This analysis would be valuablein planning future program implementation plans

Newborn Survival Case Study in Rwanda - Bottleneck Analysis and Projections in Key Maternal and Child Mortality Rates Using Lives Saved Tool (LiST)

Background and Objective: The Newborn Survival Case study in Rwanda provides an analysis of the newborn health and survival situation in the country. It reviews evidence-based interventions and coverage levels already implemented in the country; identifies key issues and bottlenecks in service delivery and uptake of services by community/beneficiaries, and provides key recommendations aimed at faster reduction in newborn mortality rate. Methods: This study utilized mixed method research including qualitative and quantitative analyses of various maternal and newborn health programs implemented in the country. This included interviewing key stakeholders at each level, field visits and also interviewing beneficiaries for assessment of uptake of services. Monitoring systems such as Health Management Information Systems (HMIS), maternal and newborn death audits were reviewed and data analyzed to aid these analyses. Results: Policies, protocols, various guidelines and tools for monitoring are already in place however, implementation of these remains a challenge e.g. infection control practices to reduce deaths due to sepsis. Although existing staff are quite knowledgeable and are highly motivated, however, shortage of health personnel especially doctors in an issue. New facilities are being operationalized e.g. at Gisenyi, however, the existing facilities needs expansion. Conclusion and Global Health Implications: It is essential to implement high impact evidence based interventions but coverage levels need to be significantly high in order to achieve higher reduction in newborn mortality rate. Equity approach should be considered in planning so that the services are better implemented and the poor and needy can get the benefits of public health programs. Key words: Bottleneck Analysis • Lives Saved Tool • Rwanda • Maternal and Newborn Health • Neonatal Mortality Copyright © 2017 Khurmi et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited