For newborns, the answer is hospital plus home

In India, newborn mortality rates have been increasing, with many infants succumbing to their illnesses in hospitals. On August 24, 2026, three newborns perished in a fire at a government women's hospital in Amravati, Maharashtra. This incident is part of a recurring trend of newborn deaths in government institutions, which began in 2017.

Government hospitals have seen a rise in both the absolute number of deliveries and the number of sick newborns admitted to Special Newborn Care Units (SNCUs) over the past decade. Overcrowding, changing case mix, infrastructure failures, infection and staffing problems are the primary reasons for these deaths. The first solution to address this issue lies in strengthening home-based neonatal care (HBNC) through trained community health workers (ASHAs).

Over 8,00,000 ASHAs have been trained to provide care at home, reducing the burden on SNCUs and preventing overcrowding. However, not all newborns with severe conditions require home care, so a three-part strategy is recommended. First, decongest neonatal units by expanding HBNC. Second, strengthen neonatal care units with adequate staffing, functioning equipment, reliable oxygen and electricity supplies, and strict infection-prevention measures.

Finally, make neonatal units inherently safe by implementing fire safety systems, electrical and oxygen-system safety measures, emergency evacuation drills, and independent safety audits. By adopting this strategy, India can improve newborn survival rates without compromising the quality of care provided in hospitals.