This is a Joint initiative of Ministry of Health and Family Welfare and Ministry of Women and Child Development. Under National Health Mission, Home-Based Care for Young Child Programme (HBYC) is rolled out as an extension of the Home Based New Born Care programme (HBNC) which is currently implemented across the country. Under HBNC, home visits by ASHAs to the infants ends at 42nd day after birth and there exists a gap in the household contact of ASHAs with the child beyond this period except the ones for immunization.
Addressing this gap in health system contact is crucial. Therefore, additional home visits by ASHAs between 3rd and 15th months were proposed under HBYC to fill this gap.
Under Home Based Care of Young Child (HBYC) programme, the additional five home visits will be carried out by ASHA/AWW, from 2-3 month onward ASHAs/AWWs will provide quarterly home visits (3rd, 6th, 9th, 12th and 15th month). The quarterly home visits schedule for low birth weight babies, SNCU & NRC discharges will now be harmonized with the new HBYC schedule.
Goals of the Program
- Promoting good CHILD NUTRITION by appropriate infant and young child feeding practices.
- Early initiation of breast feeding within one hour of birth,
- Exclusive breast feeding for the first 6 months of life,
- Appropriate and adequate complementary feeding from 6 months of age with continuation of breastfeeding.
- Ensuring age appropriate immunization.
- Ensuring optimal early childhood development.
- Ensuring reduction in child morbidity and mortality by appropriate health care seeking behaviour.
The purpose of the additional home visits by ASHAs/AWWs are promotion of evidence based interventions delivered in four key domains namely nutrition, health, child development and WASH (water, sanitation & hygiene).
Implementation of the Programme
HBYC Programme is being implemented in Tamilnadu since September 2018 in the aspirational districts (Ramanathapuram and Virudhunagar) and the following activities have been undertaken.
UNDER PHASE 1:
- 22 blocks (11 blocks in Ramanathapuram district and 11 blocks in Virudhunagar district).
- HBYC guidelines prepared in consultation with the DPH&PM and issued by NHM.
- HBYC guidelines customized and communicated to two Districts i.e. Ramanathapuram and Virudhunagar under Phase 1 (TAMIL VERSION).
- HBYC training at State / District / Block / Facility level at Ramanathapuram and Virudhunagar completed so as to implement the programme in aspirational district initially. Report on training status:
Training Period: Jan 2019 to Mar 2019
No of Batches Conducted: 129
No of Functionaries trained: 3837
From April 2019 to 31 March 2020, about 30,204 children in the age group of 3 months to 15 months have benefitted in the 2 Aspiration Districts (Phase1).
- Incentives to ASHA and AWW are being given.
The AWW/ASHAs are provided with performance based incentive. Under this programme, performance based incentive of Rs 250/- for 5 visits will be provided to the AWW/ASHAs. In areas where ASHA are not available, the AWW will be paid incentives based on their performance.
UNDER PHASE 2:
- For Scaling up of HBYC 21 HUDs were selected for phase 2 in additional to HUDs of aspirational districts.
- In the 39th Executive Meeting (Agenda No: 54/39/2020) The Mission Director NHM was permitted to extend the HBYC Programme in the 10 more districts (In addition to Aspirational districts) instead of 21 HUDs proposed through DPH&PM in coordination with the Directorate of ICDS.
- The Districts selected are prioritized based on the high Infant Mortality Rate (IMR) in the Health Unit District. The Following districts were selected.
- By SHN/CHN/BMO/DMCHO/DDHS for ASHA/VHN services and CDPO, PO for AWW Services.
- At least one visit in every month.
- VHN should undertake joint home visits with ASHAs and AWW to at least 10% new born in her sub centre area.
- Activity of VHN should be monitored by Medical Officer and reviewed at district level.
Monitoring and Evaluation
Monitoring and reporting being done by officials attached with Maternal and Child Health wing under Directorate of Public and Preventive Medicine.
The progress of implementation of the HBYC Programme will be closely monitored at the State Level on monthly basis. The Implementing Districts are expected to report every month the details of the trainings and home visits conducted under HBYC in the structured format. Quarterly data would be submitted to MoFHW, GoI. The data collection system will maintain child wise tracking of young child provided HBYC home visits and will be linked with RCH portal of Government of India.
The Outcome of the HBYC visits would be measured in terms of child health and nutrition indicators which are specified in the team based incentive system for front line workers by MoHFW. In addition, evaluation of HBYC will be integrated as part of review and monitoring of Child Health activities