Home-based newborn care program braving the brunt of COVID-19 pandemic: A mixed-method study.

Abstract

Maternal and newborn care are crucial in India's public healthcare system, yet high maternal and neonatal mortality rates persist. The home-based newborn care (HBNC) program was introduced to enhance maternal and child healthcare. This study compares HBNC services before and during the COVID-19 pandemic until December 2021, focusing on changes in service utilization and challenges faced by accredited social health activist (ASHA) workers. A mixed-method approach was used in Chakdaha, Nadia district, West Bengal. Quantitative data from 2019 to 2021 were extracted from health records to analyze HBNC indicators, including deliveries, maternal education, breastfeeding rates, and home visits. Qualitative insights were gathered from ASHA workers to explore pandemic-related challenges. Data were analyzed using descriptive statistics and thematic analysis. Over 2019-2021, 556, 621, and 606 deliveries were recorded, respectively. The study highlighted both the positive outcomes and challenges faced by ASHA workers during the pandemic. More than 95% of the infants were breastfed within 24 hours. Health education reached more mothers than deliveries, and ASHA home visits met standards. However, reductions in visits occurred in certain remote geographic areas due to transportation and supply shortages. ASHA workers faced operational challenges, including cultural barriers, increased workload, resource shortages, and logistical constraints affecting service delivery during the COVID-19 pandemic. Despite global disruptions, HBNC services showed resilience in maintaining essential care for neonates and mothers. ASHA workers played a critical role amidst challenges, highlighting the need for ongoing support and resources to sustain HBNC effectiveness amid evolving healthcare landscapes.