Nethera Kiza S.

Imperial
MSN Student
Methods of Research
Article: Essential Newborn Nursing

Nurses play critical roles in perinatal-neonatal care at all levels of the health
system: from being skilled attendants at birth, to treating sick neonates; from counseling
mothers about breastfeeding to advising home care of a low birth weight baby; and from
helping mother of a low birth weight neonate in Kangaroo Mother Care, to transporting a
preterm newborn. Global initiative calls for promoting institutional deliveries and care of
the small and sick neonates at small hospitals. Most of hospitals will be operationalized
for round-the-clock delivery of services by ensuring continuous nursing coverage hence
nurses need to be aware about knowledge and practice of essential newborn care.
However, newborn component and training is extremely weak in the pre-service
programs at nursing schools in India. As a result, an overwhelming majority of nurses
recruited for the government facilities are not in a position to provide optimum newborn
care. Furthermore, the existing in-service programs for nurses do not address optimally
the training needs in newborn care. Besides, there is a general paucity of good training
materials on essential newborn nursing. This initiative aims at addressing these problems.
AIIMS have developed a training module on Essential Newborn Nursing through a
detailed process of consultation, revision, and pre-testing.
Background

Neonatal Health: a key priority

Each year, of the 26 million infant born in India, 1.2 million do not survive to complete the

first four weeks of life. Many countries in the region have a high neonatal mortality rate, among the
highest in the world. India contributes 30 percent of the global burden of 4 million deaths, highest for
any nation.
One of the major reasons for the stagnant infant mortality in recent years is the fact that we
have not made adequate progress in neonatal survival. A high and static neonatal mortality is a major
child health challenge facing our country.

Role of nurses in newborn care at small hospitals (district hospitals, FRUs, CHCs and PHCs )
Nurses play a critical role in providing newborn care at district and sub-district facilities.

They, and not the physicians, conduct newborn deliveries at these facilities. They also provide care to
sick neonates brought from the community. Nurses are the interface with the community and the
family in regard to the promotion of healthy newborn care practices. Nurses perform critical newborn
care procedures and look after the neonatal equipment. It is not an overstatement to argue that nurses
form the backbone of newborn care at DHs, FRUs, CHCs and PHCs, and play a more important role
than the physicians.

Need for training of the nurses

Although the national/ provincial governments have taken major initiatives in providing

neonatal care training to physicians and health workers working at small hospitals in recent years,
practically no steps have been taken to train the nurses working at these facilities.
In a recent global review on resource materials on newborn health supported by Saving
Newborn Lives (SNL), it was noted that there is a paucity of suitable training materials on newborn
nursing (Dhaka HNP meeting 2003). The newborn care curriculum in the pre-service training course
of the nurses is often scanty, archaic and theoretical. Hence, if in-service training is not provided, the
nurses will not in a position to discharge the expected responsibilities in the priority area of newborn
health.
There is no structured in-service training program in newborn care for nurses in the country.
Some individuals and academic institutions have, from time to time, been conducting continuing
education of nurses. The National Neonatology Forum of India also has been in organizing nursing
workshops at the time of annual conventions. However, most of these programs are directed to nurses
of the tertiary care nurseries. The needs of the government sector nurses working at facilities in the
small hospitals have not been addressed systematically. It is in this background that AIIMS took lead
in developing a high quality training module on essential newborn nursing for nurses working at small
hospitals.
Source: WHO Collaborating Center for Training and Research in Newborn Care, Department of
Pediatrics, All India Institute of Medical Sciences, New Delhi, India
http://www.newbornwhocc.org/essential.html
Summary
Nurses play critical roles in perinatal-neonatal care at all levels of the health system.
Hospitals are round-the-clock for delivery of services to ensure continuous nursing coverage hence the
need to be aware about knowledge and practice of essential newborn care. 1.2 million out of 26 die

within the first four weeks of life contributing to 30% of the global neonatal mortality rate. Practically,
no steps have been taken to train the nurses working at these facilities. The needs of the government
sector nurses working at facilities in the small hospitals have not been addressed systematically.
Reflection
Handling critical patients should have an in-depth training for every health care provider. It
is needed to enhance newborn care practices that could result in lowering the number of infant deaths.
India, being the highest nation which contributes to these deaths, should be aggressive and vigilant in
uplifting its country. The government should provide funds in give importance to train their nurses in
proper essential newborn care practices and even in resuscitation to save more lives and give quality
health care these newborns deserve.