HBNC_ Home Based Newborn Care

Home Based New Born Care (HBNC) programme was launched aiming to reduce Neonatal mortality and morbidity rates especially in rural, remote areas where access to care is largely unavailable or located faraway.
Under this programme, ASHA to make visits to all newborns according to specified schedule up to first 42 days of life. This includes six visits in case of institutional deliveries and seven visits in case of home deliveries (1st Day) on 3rd, 7th, 14th, 21st, 28th and 42nd days after birth. Additional visits for babies who are pre-term, low birth weight or ill and SNCU discharged babies will be conducted.
ASHAs are being paid incentive of Rs. 250/- per newborn after completion of scheduled home visits.
During the visit, ASHA will do the following activities:

Information and skills to the mother and family on how to do better care of newborn, on special care for low weight babies, on how to identify danger signs and promote exclusive breastfeeding and immunization
Examining every newborn for prematurity and low birth weight, identification of illness, anything unusual in baby, provision of appropriate care at home, refer to ANM or nearest health facilities as defined in the protocols
Follow up for sick newborns after they are discharged from facilities
recording of weight of the newborn in Mother Child Protection (MCP) card
ensuring BCG, 1st dose of OPV and DPT vaccination
both the mother and the newborn are safe till 42 days of the delivery, and
registration of birth has been done
Counseling the mother on postpartum care, recognition of postpartum complications and enabling referral
Counseling the mother for adoption of an appropriate family planning method

Note:
Condition:

Show this HBNC section only for beneficiaries whose Age is 0 to 42 Days and HBNC History records
Once HBNC is selected, show below subsections (forms)
HBNC Visit Card: contains Table - 1
HBNC: Part – I: contains Table - 2
HBNC: Part – 2: contains Table - 3
HBNC: Home Visit Form contains Table – 4 for 1st, 3rd, 7th, 14th, 21st, 28th and 42nd days
HBNC: Home Visit Form (Table - 4): should be common for all 1st, 3rd, 7th, 14th, 21st, 28th and 42nd days
Add ASHA incentives of 250 per case for Providing HBNC up to 42 days after birth / discharge from SNCU

Table:1

S. No	Name of the Data Field	Field Type	Value/options	Validation/ Logic/ Condition
Mother-Newborn Home Visit Card
1	ASHA's Name			Auto populate form ASHA's profile
2	Village Name
3	Health Subcenter Name	Textbox
4	Block Name	Textbox
5	Mother's Name	Textbox		Auto populate form beneficiary details of this Child's Mother
6	Father's Name	Textbox		Auto populate form beneficiary details of this Child's Mother
7	Date of Delivery	Calendar		Auto populate form Mother's delivery details
8	Place of Delivery	Spinner	Choose: Home Subcenter PHC CHC	Auto populate form Mother's delivery details
9	Baby Gender	Spinner	Choose:MaleFemaleTransgender	Auto populate form Infant Registration section
10	Type of Delivery	Spinner	Choose from: Normal Assisted Cesarean	Auto populate form Mother's delivery details
11	Still Birth	Radio Button	Choose: Yes No	If "Yes" is selected here, then disable below all fields from S. No. 12 and Table – 2, 3 & 4 are Not Applicable (disable)
12	Breast feeding Started	Spinner	Choose from: Within 1 Hour 1 – 4 Hour 4.1 Hours to 24 Hours After 24 Hours
13	Date of Discharge of Institutional Delivery	Calendar		Not greater than Today's Date Discharge Date should be taken after or equal date of Delivery
14	Discharge Date of Mother	Calendar		Not greater than Today's Date Discharge Date should be taken after or equal date of Delivery
15	Discharge Date of Baby	Calendar		Not greater than Today's Date Discharge Date should be taken after or equal date of Delivery
16	Birth Weight (Kg)	Custom Number Picker	Accept numeric (integer) value up to one decimal place only Values from 0.5 to 7.0
17	Birth Registration	Spinner	Choose:YesNo

First Examination of New Born
(Examine one hour after the birth but in any case, within six hours from the birth. If ASHA is not present on the day of delivery. Fill this section on the day of visit & write the date of her visit)
Table: 2

S. No	Name of the Data Field	Field Type	Value/options	Validation/ Logic/ Condition
	Part – I
1	Date of Home Visit			Day1 (one hour after birth)
2	Is the Baby alive?	Radio Button	Choose: Yes No	If above field 'Still Birth' is "Yes", then select "No" And, then note the Date, time and place of Death below (In case of still birth/Newborn death, do not perform further examination of baby but complete the examination of the mother as per home visit form on day 1,3,7,14,21,28,42) Show Alert: Cause of Death to be reported to ANM/MPW/PHC for infant death review.
3	Date and Time of Death	Date and Time picker		Show only above value is "No" Not greater than Today's Date Date should be taken after or equal date of Delivery
4	Place of Death		Choose: Home Subcenter PHC CHC Other
5	Other Place of Death	Textbox		Show only above value is "Other"
6	Is the baby preterm?	Radio Button	Choose: Yes No
7	How many weeks have been born (Gestational Age)	Spinner	Is conditionally Mandatory Choose: 24 – 34 Weeks 34 – 36 Weeks 36 – 38 Weeks	Enable only if above value is "Yes" Is Mandatory, if "Yes" is selected above If Baby is born in less than 35 weeks Show Alert: Please pay attention at Baby
8	Date of First examination	Date and Time picker		Not greater than Today's Date Date should be taken after or equal date of Delivery
9	Is the Mother alive?	Radio Button	Choose: Yes No	If "No", then note the Date, time and place of Death below. (in case Mother is dead, do not perform further examination of mother but complete the examination of the baby as per home visit form on day 1,3,7,14,21,28,42) Show Alert: Report to ANM/PHC for Maternal Death review
10	Date and Time of Death	Date and Time picker		Show only above value is "No" Not greater than Today's Date Date should be taken after or equal date of Delivery
11	Place of Death		Choose: Home Subcenter PHC CHC Other
12	Other Place of Death	Textbox		Show only above value is "Other"
13	Does Mother have any problems	Multi-select Spinner	Choose: Excessive Bleeding Unconscious Fits	If yes, Show Alert: Please refer immediately to Facility
14	What was given as the first feed to Baby after birth?	Spinner	Choose from: Mother Milk Water Honey Mishri water Goat Milk Other
15	Other	Textbox		Show only above value is "Other"
16	At what time was the baby first breastfed?	Time picker		Alpha-numeric including special characters
17	How did the baby take feed?	Spinner	Choose from: Forcefully Weakly Could not breastfeed but had to be fed with spoon Could neither breast-feed nor could take milk given by spoon
	Does the mother have breastfeeding problem?	Radio Button	Choose: Yes No
	Write the problem, if there is any problem in breast feeding, help the mother to overcome it	Textbox		Show only above value is "Yes"

Table: 3

S. No	Name of the Data Field	Field Type	Value/options	Validation/ Logic/ Condition
1	Part 2: Baby first health check-up
2	Date of Home Visit			Show DOB Day 1 (within one hour after birth)
3	Temperature of the baby	Textbox
4	Baby Eyes condition	Spinner	Choose: Normal Swelling oozing pus
5	Is umbilical cord bleeding	Spinner	Choose: Yes No
6	If yes, either ASHA, ANM/MPW or TBA can tie again with a clean thread. Action taken?	Spinner	Choose: Yes No
7	Baby Weight
8	Weighing matches with the colour?	Spinner	Choose: Yes No
9	Color on scale	Spinner	Choose: Red Yellow Green
	Enter the Baby physical condition
10	All limbs limp	Spinner	Choose: Yes No
11	Feeding less/stop	Spinner	Choose: Yes No
12	Cry weak/ stopped	Spinner	Choose: Yes No
13	Routine Newborn Care: whether the task was performed	Spinner	Choose: Yes No
14	Dry the baby	Spinner
15	Keep warm, do not bathe, wrap in cloth, keep closer to mother	Spinner	Choose: Yes No
16	Initiate exclusive breast feeding	Spinner	Choose: Yes No
17	Keep the cord clean and dry	Spinner	Choose: Yes No
18	Anything unusual in baby?	Spinner	Choose: Curved limbs cleft lip other
19	Other	Textbox		Show only above value is "Other"

HOME VISIT FORM - (Examination of Mother and New Born)
Use this questioner from 1^st, 3rd, 7th, 14th, 21st, 28th and 42nd days after birth.
Table: 4

S. No	Name of the Data Field	Field Type	Value/options	Validation/ Logic/ Condition
Ask and Examine
A. Ask Mother
1	Date of ASHA's visit
2	Is the baby alive?		Choose: Yes No
3	No. of times mothers takes a full meal in 24 hours	Custom Number Picker	Default Value 0 Accepts values from 0 to 6	If the mother does not eat full stomach or eat less than 4 times Action taken by ASHA: show Alert: Please advise Mother to meal at least 3 times a Day
4	Bleeding: how many pads are changed in a day	Custom Number Picker	Default Value 0 Accepts values from 0 to 20	If more than 5 pads: Action taken by ASHA: show Alert: Refer the Mother to the Facility.
5	During the winter season, is the baby kept warm? (Closer to the mother, dressed well and wrapped properly)	Spinner	Choose from:YesNo	Action taken by ASHA: show Alert: Advise the mother to do so, if not being done.
6	Is the baby being fed properly (whenever hungry or at least 7-8 times in 24 hours)	Spinner	Choose from:YesNo	Action taken by ASHA: show Alert: Advise the mother to do so, if not being done.
7	Is the baby crying incessantly or passing urine less than 6 times a day?	Spinner	Choose from:YesNo	Action taken by ASHA: show Alert: Advise mother to feed the baby after every 2 hours

8	Temperature of Mother	Textbox	Accept Numeric value Character limit 3	Action taken by ASHA: show Alert: Temperature up to 102°F (38.9°C) - treat with paracetamol, and if the temperature is above it, refer to hospital
9	Foul smelling discharge and fever more than 100°F (37.8°C).	Spinner	Choose from:YesNo	Action taken by ASHA: show Alert: If yes, refer the mother to a hospital
10	Is mother speaking abnormally or having fits?	Spinner	Choose from:YesNo	Action taken by ASHA: show Alert: If yes, refer the mother to a hospital
11	Mother has no milk since delivery or if perceives breast milk to be less.	Spinner	Choose from:YesNo	Action taken by ASHA: show Alert: Ask the mother to feed the baby more often and counsel her for proper attachment and positioning during breast feeding.
12	Cracked nipples/painful and /or engorged breast	Spinner	Choose from:YesNo	Action taken by ASHA: show Alert: In case of cracked nipples, advise the mother to keep the breast clean and lubricated.

13	ASHA should wash hands with soap and water before touching the baby during each visit
14	Are the eyes swollen or with pus?	Spinner	Choose from:YesNo	Action taken by ASHA: show Alert: If there is pus in the eye then antibiotic ointment can be applied.
15	Baby Weight (Kg)	Textbox	Accept Numeric value Character limit 4	show Alert: If the weight of the baby is less than 2.5 kg, then advise the mother to provide extra warmth to the baby and feed the baby more frequently. If the weight is less than 1.8 kg then refer the baby to Sick New born care unit at the nearest health facility and also conduct extra home visits as per the high risk baby form. If the baby (low birth weight or normal) is not gaining weight then refer to SNCU at the nearest health facility.
16	Temperature of Baby	Textbox	Accept Numeric value Character limit 3	If the temperature is < 97 degree F^o then advice the mother to keep the baby warm by increasing the room temperature, providing skin to skin contact, putting the baby in a warm bag and frequently feeding the baby. If the temperature is < 95.9 degree F^o, then give the above mentioned advice and once the baby is warmer then clothe the baby and place in a pre warmed bed close to the mother. If the temperature is > 99 degree F⁰ (fever) then look for signs of sepsis. In case signs of sepsis are not present manage only with 1/4th of a spoon of paracetamol and immediately refer to the SNCU at the nearest health facility.
17	Yellowness in the Eye/Palm/Sole/Skin (Jaundice)	Spinner	Choose from:YesNo
18	Baby Immunization Status	Multiselect Checkbox	Choose: BCG Hepatitis-B OPV 0	If for Day one is selected true, then auto populate for all remaining days
D. Referral of Mother & Baby
19	Baby referred for any reason?	Radio button	Choose from:YesNo	if yes then write date, reason and place of referral
20	Date of referral	Date picker		Show only above value is "Yes" Not greater than Today's Date Date should be taken after or equal date of Delivery
21	Place of referral		Is conditionally Mandatory Choose: Sub-Centre PHC CHC Sub-District Hospital, District Hospital, Medical College Hospital In Transit Private Hospital Accredited Private Hospital Other
	Other Place of referral	Textbox		Show only above value is "Other"
	Mother referred for any reason?	Radio button	Choose: Yes No	if yes then write date, reason and place of referral
	Date of referral	Date picker		Show only above value is "Yes" Not greater than Today's Date Date should be taken after or equal date of Delivery
	Place of referral		Is conditionally Mandatory Choose: Sub-Centre PHC CHC Sub-District Hospital, District Hospital, Medical College Hospital In Transit Private Hospital Accredited Private Hospital Other
	Other Place of referral	Textbox		Show only above value is "Other"
	E. Check now for the following signs of sepsis: if the sign is present mention-Yes, if absent, mention-No
	All limbs limp	Radio button	Choose: Yes No	Consider first three signs as criteria for diagnosing sepsis only if the sign was absent previously and then it newly developed. If any one feature of sepsis is present on the same day, diagnose as sepsis and start with first dose of Amoxicillin as per the weight of the baby and refer the newborn immediately to SNCU at the nearest health facility: Less than 2.0 Kg - 2m1 Between 2.0 to 3.0 kg-2.5 ml Between 3.0 to 4.0 kg- 3m1 Between 4.0 to 5.0 kg-4m1
	Feeding less/stopped	Radio button	Choose: Yes No
	Cry weak / stopped	Radio button	Choose: Yes No
	Distended abdomen or mother says baby vomits often	Radio button	Choose: Yes No
	Mother says the baby is 'cold to touch' or baby has fever with a temperature > 99 degree F⁰ (37.2 degree C)	Radio button	Choose: Yes No
	Chest in drawing	Radio button	Choose: Yes No
	Respiratory rate more than 60 per minute	Radio button	Choose: Yes No
	Pus on umbilicus	Radio button	Choose: Yes No
	For providing HBNC service up to 42 days after birth for a Baby <ac:structured-macro ac:name="unmigrated-wiki-markup" ac:schema-version="1" ac:macro-id="9a867b2c-ff37-4b52-b689-c2636e353a23"><ac:plain-text-body><![CDATA[ASHA receives Rs. 250 as an incentive. [FMR Code 3.1.1.1.3]; S. No. 1 in claim from				]]></ac:plain-text-body></ac:structured-macro>
	ASHA's Signature with Date
	Supervisor	Spinner	Choose: ASHA Facilitator ANM MPW
	Supervisor's Name	Textbox		Alphabets only Character limit 100
	Supervisor remarks / Comments	Multiline Textbox		Alpha-numeric, special characters Character limit 500
	Supervisor's Signature with Date of	Calendar

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