Coverage of home-based newborn care and screening by ASHA community health workers: Findings from a household survey in Chhattisgarh state of India.

Background and Objectives: Community health workers known as Accredited Social Health Activists (ASHAs) provide home visits for home-based newborn care (HBNC) in India. The objectives of the study were to assess coverage of HBNC, to assess current practices of newborn care by the care providers and to assess status of screening of sick newborns by ASHAs in rural Chhattisgarh. Methods: The study was a quantitative cross-sectional study. Multi-stage random sampling was applied to draw a representative sample from rural Chhattisgarh. The survey collected primary data of 1928 newborns by interviewing the caregivers. Descriptive statistical analysis using cross tabulations was performed. Confidence intervals at 95% were computed for key indicators. Results: ASHAs were present during 84.3% of the deliveries. 74.1% newborns received the designated six home visits from ASHAs whereas 3.6% newborns did not receive any visits. Coverage of different important messages ranged from 74% to 90%. Around 95% of newborns were screened by ASHAs for signs of sickness. ASHAs identified 12.9% of newborns as sick. Of the identified sick newborns, 48.1% were referred by ASHAs to health facilities, whereas 34.7% were treated directly by ASHAs by using amoxicillin. Early initiation of breastfeeding was reported for 85.4% of newborns and skin-to-skin contact was practiced for 63.6%. Conclusions: ASHAs were able to achieve an adequate coverage of HBNC in rural Chhattisgarh. Uptake of desired newborn care practices by caregivers was found. Identification of sick newborn was also adequate. Further research is recommended to identify factors facilitating the coverage under HBNC.