Improving urban newborn health: Challenges and the way forward

One-third of India's urban population resides in slums and squatters, their vulnerability being characterized by poverty and powerlessness. Newborn care is sub-optimal among India's urban poor, yet scarcely documented. Neonates born in urban poor settings are at high risk of death owing to multitudinous factors. This paper discusses the situation of neonatal care and survival among the urban poor across states which are at different levels of social development. Challenges in addressing needs of the newborns in urban poor settings operate at community as well as program level and need to be addressed simultaneously. The paper describes these challenges and suggests a way forward in light of the existing opportunities and lessons from successful experiences. The following emerge imperative for improving newborn care among the urban poor in India: i) development of comprehensive lead programs through close partnership among academic agencies like National Neonatology Forum, NGOs, socially committed private doctors, hospitals and city governments; ii) improving demand, promoting household practices, service outreach through trained slum-based health volunteers and women group and encouraging slum-level health funds as a community risk pooling measure; iii) enhancing competence of slum-based TBAs to improve home delivery practices and encourage hospital deliveries by linking them to affordable facilities; iv) investment in building human resource capacity at all levels for providing improved newborn healthcare; v) partnership with the private sector (private/charitable health facilities and non-government organizations) and academia for enhancing service delivery and for advocating for greater attention to the urban poor newborn; vi) making the invisible visible and reaching the unreached and more vulnerable clusters.