Reducing neonatal mortality in India

Approximately 800,000 babies per year die in their first month of life in India, accounting for more than 50% of all child deaths. Of those deaths, 300,000 occur in the first 24 hours. Progress on neonatal survival, and particularly early neonatal survival, has been slower than progress in other age groups.

The USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project started working in India in August 2013. The project worked in six USAID-supported states to build improvement capacity by enhancing the commitment and capability of leaders at the national, state, and district levels. In addition, the project worked to develop the improvement capacity of health care workers at national, state, district, and community levels, in public and private facilities, and along the continuum of reproductive health, maternal, neonatal, child, and adolescent health (RMNCH+A).

Interventions lead to reduction in neonatal mortality

While ASSIST works across the RMNCH+A continuum, the project focuses on the intrapartum and early neonatal period, as this is the most efficient strategy to save lives.

Overall perinatal mortality has decreased 5.0% in the intervention period (2013-2015) compared to the six- month baseline period before the project’s start. This is due to a 13.6% reduction in neonatal mortality and a 2.6% reduction in stillbirths.  These results were highlighted in USAID’s 2016 edition of Acting on the Call: Ending Preventable Maternal and Child Deaths:

“Our findings speak to the lifesaving impact that these focused efforts are having. In India, we saw a 13 percent reduction in neonatal mortality in USAID-supported facilities targeted with a quality improvement methodology.”

Simply training and monitoring healthcare professionals for new interventions in healthcare do not necessarily lead to sustained improvements. The ASSIST team’s work to scale up successful interventions to other sites offered demonstrable evidence that quality improvement methods and practices contributed directly to sustainable changes in maternal and newborn care.  

The government in Chamba, having seen positive results in ASSIST-supported sites, requested assistance to scale up interventions to other facilities. Training in intrapartum and neonatal care led to irregular results in improvement; it wasn’t until the team introduced quality improvement cycles that improvements became sustainable over time.

ASSIST continues to work in India to implement impactful, sustainable changes in maternal and newborn health and trains healthcare specialists and government leaders to apply science to strengthen and improve systems.

Learn more

ASSIST has published several case studies and change idea documents over the life of the project’s work in India, including:


A staff nurse provides antenatal care services to pregnant woman in Mewat District, Haryana, India
Antenatal care services in Mewat District, Haryana, India
December 15, 2016
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