BACKGROUND: Home-Based Newborn Care (HBNC) is a cost-effective strategy introduced by the Government of India to ensure postnatal care for mothers and neonates in rural and tribal regions. HBNC is implemented through field-level healthcare providers known as ASHA (Accredited Social Health Activist). The baseline situation of the health system and resources is necessary to ascertain effective HBNC implementation.

Methods: This cross-sectional study was carried out in a tribal district of India. For assessing health system preparedness for HBNC, district-level records, verification of HBNC kits, and baseline knowledge and skill assessment of ASHAs were conducted. For the field-level HBNC implementation component, process evaluation of HBNC among ASHAs was carried out in the selected villages.

Results: Human resources, capacity building, and logistics-related components in the district were adequate with regard to HBNC. Kit verification showed deficiencies in essential items, e.g., soap, digital wristwatch, and sling bag for weight measurement. Knowledge regarding the frequency of HBNC visits, initiation of breastfeeding, and complications in postnatal mothers was found satisfactory among ASHAs (95.6%). In the skill component, 47.5% of ASHAs could correctly count respiratory rate, while none could enlist the steps of correct positioning and attachment in breastfeeding. In the process evaluation of HBNC, major findings included the inability of ASHAs to identify appropriate actionable measures based on observations during HBNC visits.

Conclusion: This study highlights the importance of adequate resources, regular capacity building of healthcare providers, along with supportive supervision, for effective HBNC implementation in the community.

KEYWORDS: Home-Based Newborn Care, Tribal health, Maternal and Child Health