Norway India Partnership on health saving newborns

Evaluation findings from the Norway India Partnership Initiative (NIPI) show that NIPI has brought newborn health higher up on India’s health agenda.

Establishment of Sick Newborn Care Units at district hospitals and follow up of newborns at home have saved many lives. The partnership has been successful in Rajasthan, Bihar, Madhya Pradesh and  Odisha.

Releasing NIPI evaluation report on Maternal and
Child Health in New Delhi recently, the Ambassador of Norway to India, H.E. Mr Eivind Homme, emphasised that “one key reason for the good results is the very close cooperation between the two governments.’’ He said, ``NIPI has worked together with NRHM since the beginning, and we are proud to continue these joint efforts and close dialogue also in the next phase of the programme”.

Established in 2006 through a joint statement by the Prime Ministers of India and Norway, the vision of NIPI is to provide catalytic, strategic support that would make a vital and sustainable difference to scaling up of quality child health services in India under the NRHM.

The evaluation found that after six years, NIPI has largely achieved its goals. Several of the activities introduced by NIPI have been scaled up across the four states of Bihar, Madhya Pradesh, Odisha and Rajasthan through NRHM.

Some activities have even reached national level like home based newborn care where ASHAs visit newborns at home during the first six weeks of life.

The Secretary of the Ministry of Health and Family Welfare, Mr Keshav Desiraju, highlighted that “with the opportunities NRHM provides to the public health system, it is important to learn from the findings that we heard today.’’ `` Evaluations make us improve our programmes and achieve better results for the health of women and children in our country,’’ he said.

The report says the budget for Phase 1 was US $ 85 million for a period of five years, beginning 2006. ``While the NIPI contribution formed a modest supplement to the total NRHM budget, the funds were intended to complement national efforts on child and maternal health and accelerate the implementation of NRHM activities by providing strategic, catalytic and flexible support.’’

The report says that NIPI has largely achieved its objectives of being strategic, catalytic, innovative and flexible, particularly in the case of the UNOPS supported interventions. The key highlights of the report are:

*NIPI funding has been strategic by virtue of supporting a continuum of care approach, encompassing interventions at the community and facility levels.

*NIPI has been catalytic by accelerating some existing processes that would either have taken longer to materialize or would not have been implemented at scale

*NIPI has provided a flexible pool of funds for need-based spending
NIPI has been innovative by introducing new and first time interventions

The report says the four state reviews suggest a certain level of inefficiency and duplication of efforts by implementing partners. ``For example, in Rajasthan and Bihar, although both UNICEF and UNOPS were supporting the development of Sick Newborn Care Units with NIPI funds in their respective districts, there was limited coordination between them. Our view is that the implementing partners, particularly UNICEF and UNOPS who have field offices/ operations, could have benefitted by planning their NIPI interventions in coordination and developing synergies across their areas of work in the NIPI focus districts.’’

The report says: ``Our interaction with Yashodas in the four states suggests they have provided significant support to the mothers and newborns during the post natal period at the facilities – eg. Supporting and comforting the mother on arrival at the health facilities, immediate and exclusive breastfeeding, counselling on zero dose immunization, keeping the baby warm among others.’’

The report lists the specific issues which the ASHAs faced in engaging mothers at home.

In Rajasthan, ASHAs commented that very often mothers do not let them examine their babies as they fear they would cast an ``evil eye.‘But they faced no issues in engaging with mothers in Bihar.

But in Jehanabad, mothers did not understand the importance of home visits as they thought they were performing this job for money only.

ASHAs in Odisha and M.P. too did not face much difficulty in terms of access to mothers and babies.

The report highlights further that there is a need for greater documentation and dissemination of good practices and results, to ensure that other states can learn from the experiences of NIPI .

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