Partners
Sir Padam Pat Mother & Child Health Institute (JK Lone Hospital) and Oslo Universitetssykehus HF, Ullevål (OUS)
Countries
India
Years
2013 - 2016
Budget
15,681,677 NOK

About the project

Short description: The project aims to improve the care of sick and premature newborns, in line with international standards Description: The exchange program aims to reduce neonatal morbidity and mortality by improving basic neonatal nursing care and improve the quality of the State Newborn Care Resource Centre that is to be established through Norway India Partnership Initiative. Focus areas are basic neonatal nursing care such as Kangaroo Mother Care (KMC), nutrition, breastfeeding, human milk bank and hygiene. The project also intends to increase multicultural understanding within newborn health care.

Results

At Kalawati Saran Children’s Hospital, only half of the children received breast milk through breast feeding or cup fed expressed milk prior to the project. This was mostly due to transferring of newborns to other hospitals than where their mother took residence, that the mothers were suffering from illness or because the hospital division were lacking staff.

The main objective is to reduce child mortality through holistic nursing and implementing breastfeeding and breastmilk as the only nutrition for newborn children, in line with WHO’s international recommendations. This can be achieved through focusing on an overall and evidence-based approach of nursing, medical care and treatment.

All the newborn children at the hospital in Kolkata and most in Jaipur are now receiving breast milk from their own mother, or donated breast milk from the banks. Per regulations and protocols, the hospitals now have their own staff who operates milk banks. Several nurses received training as lactation consultants and are working determinant to offer the best counselling as possible, to newborns and their mothers.

The newborn division at Kalawati Saran Children’s Hospital opened their milk bank 7th June 2017, and will continue taking the leading role of developing quality health care for newborns in the public sector in India. For the babies, this entails better nutrition and protection against infections, development of their brain, lungs and skin. The breast milk also reduces the risk of premature diseases such as damage on intestines, and lingers stress and increase their well-being. The impact on mothers producing breast milk provide both short term and long term health benefits. The excrete of breastfeeding hormones leads to better contraction of the uterus after giving birth and reduces bleedings and infections. Research show that breast feeding protects both mother and child against diseases such as cancer in the long run.

The newborn division in the hospital have opened up for parents, primarily mothers, to visit the ward where their newborn child is, to participate in the care of the child and to have skin-to-skin contact. This also relieves the nurses in their highly demanding job, and is a positive bi-effect of this project. Nevertheless, there has been some challenges affiliated with hygiene when letting parents connect with their sick newborns. Despite meeting these challenges, the benefits outweigh the disadvantages.

Why

The Millennium Goal on reducing child mortality witnessed an immense progress on its vaccination programme that in particular made a difference in helping children survive their 5th birthday. Despite this progress, the statistics on newborns surviving their first week of life remained unaltered.  

India’s numbers on rescuing the lives of sick newborns are devastating. Insufficient child care and challenging hygienical circumstances which leads to bleedings, infections and lack of oxygen that threaten both the child and mother, are common. Cost-efficient measurements such as skin-to-skin contact and breast feeding, protects newborn children against infections and temperature loss. By exposing mother and child to skin contact, so-called Kangaroo Mother Care (KMC), at an early stage, the surface of the babies skin is colonized by its mother’s bacterial flora and leaving no space for harmful microbes.  The mothers breast milk is not only providing nutrition for the newborn child, but is also full of specially designed antibodies that keeps the newborn safe from infections. This can entail life or death for a newborn child. Breast milk act as both nutrition and medicine. Skin contact and gentle care also reduces stress and contribute to stabilize body temperature in newborns. In return, this prevent unnecessary misuse of calories, and therefore blood sugar levels are better and the baby can use its energy on growing and healing instead.

What

Through the past 8 years, Oslo University Hospital have collaborated with public hospitals in India, supported by FK Norway. The projects focuses on educating nurses, doctors, management and improving technical personnel skills. Mutual exchange of nurses and doctors, knowledge and competence in addition to training have shown great results.

The FK Norway model consist of reciprocal exchange of personnel, ideas, knowledge and competence. The participants exchange to work in their partners’ organization. The aim of the project is to meet local needs that is in line with the partners’ wishes. The programme is aiming at creating young leaders, that can develop and cope with future health system needs. The age limit for applicants is 35 years. It is also a need for high level experience and competence in these projects, attended by resource personnel and volunteers.

The collaboration agreement runs for three years and personnel exchanges are on 6-12 months’ contracts.

The project is documenting its progress through research publications and annual reports. The primary objective is to reduce child mortality and improve health outcomes through simple measurements.

Who

Collaborating partners: Oslo University Hospital, Sir Padam Pat Mother and Child Health Institute (JK Lone Hospital) in Jaipur and Lady Hardinge Medical Collage & Kalawati Saran Childrens Hospital New Delhi. The partnership with IPGMER and SSKM Hospital in Kolkata was completed in May 2013. Kalawati Saran Children Hospital joined the project in February 2017. One of the supporting partners in this project is the Royal Norwegian Embassy in New Delhi who have been collaborating with the NIPI-programme/Norad since October 2013.

Learnings

The partners demonstrate the importance of leadership and support from local authorities as decisive to carry out the project. To break the stereotypical hierarchy of perceiving nursing as less significant, requires cooperation with doctors and other medical personnel. Hence, dialogue with partners and close follow-up on the participants is important.

How much:

The resources appointed to FK Norway is linked to expenses of the exchange of personnel. There are no free resources in this programme, except a small budget to cover equipment needed to reach the objectives of the project. Oslo University Hospital support a considerable additional amount, to cover wages and equipment. The NIPI programme have also contributed on possessing competence from the Norwegian milk bank at OUS.

FK Norway support:

2013/2014: 2 531 22 NOK

2014/2015: 2 531 043 NOK

2015/2016: 3 239 369 NOK

2016/2017: 3 805 056 NOK

Sources:

Narrative and financial reporting to FK Norway from partners.

Published news articles from OUS communication division.

Meeting minutes from visiting the partners.

Presentations from partner representatives and participants in the project.

Pictures received from partners.