Effectiveness of introducing home-based newborn care (HBNC) voucher system in Golaghat District of Assam

Problem considered India carries the single largest share (around 25-30%) of neonatal deaths in the world.: Neonatal deaths constitute two-thirds of infant deaths in India; 45% of the deaths occur within the first two days of life.(1) Methods: The primary objective was to assess the effectiveness of use of voucher system in HBNC in Golaghat District of Assam with a secondary objective to assess awareness and utilization of different maternal and child health related services. A community-based before/after intervention study was conducted in Golaghat District of Assam. Two-stage cluster sampling was used. All ASHAs (accredited social health activist) of the selected beneficiaries were assessed. All mothers who delivered were given a set of 6 HBNC double perforated numbered vouchers following baseline study and capacity building of ASHA. When the ASHA visits the baby and examines it using the standard recording format, mother/caregiver handed over the appropriate number of the voucher. The ASHA received the HBNC incentive only after all the six vouchers were submitted. Endline survey was done after 6 months of intervention. Rates, ratios and proportions were determined and chi-square test was done to assess the difference in knowledge and practices. Results: A total of 582 and 650 caregivers and 174 and 182 ASHAs were assessed in baseline and endline. Only 68.2% know about birth preparedness, while 90.9% know about young infant and child feeding; 77.7% know about family planning and reproductive tract infection (RTI/STI) and 77.3% know the importance of safe delivery, while all know about immunization; 54.5% know about essential newborn care, 81.8% know the importance of home visit and all were unsatisfied with their incentives. Significant improvement was found in HBNC