Curbing newborn deaths in the developing world

Around the world, almost three million newborns die in their first month of life every year. Ninety-nine percent of these deaths take place in developing countries. Yet, most can be prevented with proven and cost-effective interventions such as delivering Home-Based Newborn Care (HBNC) packages to vulnerable populations at the community level. These interventions are straightforward, such as home visits during the first 28 days of life, using sterile blades to cut umbilical cords, teaching mothers the importance of immediate breastfeeding, treating infections, and keeping newborn babies warm. Here we profile the group in rural India that pioneered HBNC packages 15 years ago as a way to reduce neonatal mortality rates. Its work has since been adapted by additional humanitarian organizations and governments and spread throughout India and to countries in Africa and South Asia.


This organization founded three decades ago by two Indian physicians delivers maternal and newborn health care to nearly 40 villages in western India. Rural women trained as Village Health Workers (VHWs) provide basic care for expecting mothers and newborn children, as well as health education to women in their communities. VHWs are trained to identify and treat neonatal morbidities such as asphyxia, prematurity, low birth weight, sepsis, hypothermia, and infection.

VHWs educate pregnant mothers, are present at birth, and then visit new mothers and their babies in their homes repeatedly during the first crucial weeks of life, equipped with a neonatal care kit that includes simple but life-saving equipment such as blankets, a resuscitation bag and mask, soap, a thermometer, weighing scale, and medications to manage infections. In addition to diagnosing problems, VHWs monitor the baby’s growth and ensure that the mother has support in healthy behaviors such as early breastfeeding, keeping the baby warm, and maintaining good hygiene. SEARCH also plays an important role as a training site—the organization has developed a range of teaching materials, used to train the trainers of 800,000 VHWs (called ASHAs) of the Government of India, and the NGO workers from within India and around the world onsite in Gadchiroli, Maharashtra.


Newborn deaths, as measured by neonatal mortality rate, decreased by 70% in SEARCH villages compared to control areas during an evaluation between the years 1993 and 2003.  Additionally, maternal morbidities in SEARCH intervention areas were reduced by 49%.


When compared with other interventions targeting newborn health, HBNC is one of the most cost-effective: the cost per newborn life saved is approximately $150; amount per mother-newborn pair served is approximately $7. Donors can give to SEARCH through the US-based 501c3 Indians for Collective Action (find SEARCH in the drop-down menu). Or visit the “contact us” page of the SEARCH website for an address to send a check.


Similar programs established around the world include JSI Research & Training Institute (Nepal), BRAC (Bangladesh), and Save the Children’s Saving Newborn Lives Initiative (Bangladesh, Democratic Republic of Congo, Ethiopia, India, Nepal, Nigeria, Malawi and Uganda).


In many parts of the world, there are complex traditional local beliefs, taboos, and practices surrounding pregnancy and childbirth. It is crucial that organizations take these into account when adapting HBNC for different populations. To ensure that HBNC is accepted and utilized by community members, it is equally important that organizations choose health workers that are acceptable to the community. Look for programs that are already focused on maternal and children’s health, as they are well-positioned to integrate HBNC packages into their roster of offerings.

For more information on this model and our analysis, see our profile of SEARCH in our Child Survival toolkit available for free online at