Program Overview: An extension of the Home-Based Newborn Care (HBNC) program, launched under the National Health Mission (NHM) by the Ministry of Health and Family Welfare (MoHFW), India.
Target Age Group: Children from 3 months up to 15 months of age.
Rationale:
To bridge the critical gap in healthcare delivery between the end of the neonatal period (42 days) and the preschool period.
Core Objectives:
Reduce child mortality and morbidity (specifically targeting diarrhea and pneumonia).
Promote appropriate complementary feeding and prevent early-onset malnutrition.
Ensure complete and age-appropriate immunization.
Promote Early Childhood Development (ECD).
Enhance Water, Sanitation, and Hygiene (WASH) practices at the household level.
Service Delivery And Visit Schedule
Primary Provider: Accredited Social Health Activist (ASHA).
Visit Frequency: 5 dedicated household visits per child.
Schedule: At the 3rd, 6th, 9th, 12th, and 15th months of life.
Convergence: ASHA coordinates her activities with the Anganwadi Worker (AWW) and Auxiliary Nurse Midwife (ANM) during Village Health Sanitation and Nutrition Days (VHSND).
Incentive: The ASHA worker receives a performance-based incentive of Rs. 250 per child (Rs. 50 per completed visit), disbursed after ensuring all programmatic components are fulfilled.
Key Components Of HBYC Visits
1. Nutrition And Growth Monitoring
Exclusive Breastfeeding (3rd-month visit): Reinforcing the absolute need for exclusive breastfeeding up to 6 months of age without any prelacteal or water supplementation.
Complementary Feeding (6th month onwards):
Counseling on the timely initiation of complementary feeds precisely at 6 months.
Educating caregivers on the MACS principles: appropriate Meal frequency, Amount, Consistency, and feeding locally available iron-rich and energy-dense Snacks.
Promoting active and responsive feeding practices.
Growth Monitoring: Weight measurement and plotting on WHO growth charts to detect growth faltering early.
MUAC Screening: Routine screening using Mid-Upper Arm Circumference tape (from 6 months) to detect Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM).
2. Early Childhood Development (ECD)
Play And Stimulation: Educating parents on using safe, clean, household items as toys to promote cognitive and fine motor development.
Communication: Encouraging caregivers to engage in continuous talking, singing, and interacting with the child to stimulate language and socio-emotional development.
Developmental Screening: Active observation for age-appropriate milestones and identifying early developmental “red flags” for prompt referral to District Early Intervention Centers (DEIC) under the Rashtriya Bal Swasthya Karyakram (RBSK).
3. Health And Illness Prevention
Immunization And Supplementation:
Tracking the child’s immunization status and identifying drop-outs.
Mobilizing families to bring children for due vaccines during VHSND.
Ensuring the administration of prophylactic biannual Vitamin A and bi-weekly Iron-Folic Acid (IFA) syrup (National Iron Plus Initiative) starting at 6 months.
Illness Management:
Educating caregivers on identifying the danger signs of acute respiratory infections (ARI) and severe dehydration.
Distributing prophylactic ORS packets and Zinc tablets for immediate home management of acute gastroenteritis.
4. WASH Practices
Hand Hygiene: Demonstrating and emphasizing the importance of handwashing with soap at critical times (before preparing food, before feeding the child, and after defecation).
Safe Water: Counseling on boiling, chlorinating, or safely storing drinking water.
Sanitation: Promoting the immediate and hygienic disposal of child feces and actively discouraging open defecation in the household vicinity.
Referral Criteria Under HBYC
The ASHA is trained to immediately refer the child to a Primary Health Center (PHC), First Referral Unit (FRU), or Nutrition Rehabilitation Center (NRC) if she detects:
Severe wasting (MUAC < 11.5 cm) or the presence of bilateral pitting pedal edema.
Danger signs such as lethargy, active convulsions, or an inability to breastfeed/drink.
Severe chest indrawing or tachypnea (fast breathing).