Abstract :
The National IMR ( Infant Mortality rate) is regressing but ENMR (Early Neonatal Mortality rate) is not showing reduction in the same way as Late Neonatal Mortality or Post Neonatal Mortality. The crux of the Problem is mostly around Birth Asphyxia, Neonatal Infection (Sepsis) and prematurity. With adequate perinatal services most of them could have been prevented. Stress is laid upon birth asphyxia; because it causes death or disability in survivors. Sepsis treated early or if prevented produce good dividend and the survivors are not very much handicapped. Improved perinatal services like ante-natal care for the mothers and introduction of Neonatal resuscitation supposed to have reduced ENMR. However it does not look like effective, may be due to lack of appropriate application. Full term normal birth weight neonates dying of Birth Asphyxia could be prevented with assisted delivery in time. Sepsis can be prevented with properly chosen prophylactic antibiotic therapy. Prematurity without the above two adversities is bound to result in less neonatal loss, seen over the years. In low birth weight babies with or without prematurity, the probable cause might be placental insufficiency due to various maternal causes, these can be tackled with proper follow up and better obstetric care protocol. As the deliveries now are mostly institutionalized and ASHAs give adequate follow up to the expectant mothers it will be easy to tackle the issue of complicated delivery with timely referral to the nearby properly staffed hospitals. As a conservative estimate, with alteration of the present system and support, the neonatal mortality rate could be reduced by 11, from the present 41 to 30 straight away.
Keyword :
Early neonatal mortality rate, Late Neonatal mortality rate,infant mortality rate , HIE (Birth Asphyxia), Sepsis, Prematurity.