From theory to practice: Association between community health workers' home visit and neonatal morbidity in a rural area of North India

Abstract

Background: Averting the hospital admissions for morbidity by timely providing home-based care or referral in case of neonatal illness is important outcome of home visits by Accredited social health activists (ASHA) in India. Objective: To determine the association between number of home visits by ASHA and identification of neonatal morbidity in 28 days of life in a north Indian Village. Methods: It was a cross sectional survey including live births between August 2020 and January 2021 from a village in North India as study population. Taking estimated live births of the area the minimum study sample included was 120 to be covered in 2 months duration. Results: Among the 121 infants included in study the informants reported that 95% ASHA visited the home during neonatal period with 56.5% visits 4–6 times to single neonate. Any type of illness during neonatal period was reported by 21.5% informants. 69.2% (18/26) were visited by ASHA during the illness of neonate. 61.1% were referred by ASHA to nearest primary health center (11/18). 15.3% (4/26) underwent hospitalization for their illness and were cured. ASHA visiting a neonate 7–10 times in a month had 68% higher chances of identifying the signs of illness in the neonate (Adj OR (95% CI): 1.68 (0.12–23.26)). Conclusion: The community-based care by ASHA does reduce the risk of mortality however community has the right to choose the type of health facility and care for their newborns.

Keywords

• ASHA
• Hospitalization
• Home based newborn care
• Post-natal visits