Melinda Gates with a child in Rae Bareli, Uttar Pradesh, running the health campaign. The mother of the child in Melinda’s arms has seven children

New Delhi, March 27: Under a thatched roof in Uttar Pradesh’s Rampur-Bhuligadha village, Melinda Gates, co-chair of the Bill and Melinda Gates Foundation, chatted this week with Sunita and her mother-in-law, joining an effort to save newborn babies.

In a meeting that lasted about 25 minutes, Gates observed health workers talk to Sunita — who is expecting her first child in a month — about the need to abandon cultural practices that are contributing to India’s neonatal mortality.

Rampur-Bhuligadha is among a cluster of 300 villages in Rae Bareli district where the Gates Foundation is supporting a project to educate new mothers about clean childbirth, exclusive breastfeeding and newborn care. The campaign run by Saksham, a non-government organisation, has led to a 54 per cent drop in the rate of deaths among newborn babies over 18 months.

The Gates Foundation has now committed $9.9 million (Rs 44.7 crore) to expand the campaign in Uttar Pradesh.

Traditional practices in these villages carry a high risk of infection. A newborn baby is placed on the ground, a birth attendant washes the newborn, sometimes scrubbing its fragile skin causing abrasions, and mothers wait before breastfeeding.

“The mothers know breast-feeding is important — but they wait three days (after birth),” Gates said after a field visit to Uttar Pradesh. “Until then, the newborn baby might receive goat’s milk, or water, or even tea.”

Saksham’s health workers have been asking birth attendants to place the newborn baby on the mother’s chest for skin-to-skin contact, wrap the baby to keep it warm and promote exclusive breastfeeding as early as possible.

“A newborn baby needs warmth, love and food,” said Vishwajeet Kumar, the director of the Saksham project in Lucknow. “The skin-to-skin contact on the mother’s chest is the only position that provides all three to the baby — it gravitates to the breast.”

Public health experts estimate that nearly 900,000 babies die each year across India in the first month after birth — a vast majority of them from infections. In the cluster of 300 villages covered by Saksham, neonatal mortality — deaths among newborn babies up to 28 days old — dropped from 81 per 1,000 newborn babies to 40 per 1,000 newborn babies after 18 months of the project.

“We’ve got to spread such practices — and women themselves can do this,” Gates said. “One mother-in-law in the village recalled how she had lost six of her eight children — she said they didn’t know it was wrong to cut the umbilical cord with a sickle.”

The foundation has also pledged Rs 113 crore support to increase access to skilled birth attendants and promote newborn and maternal care through village and health sanitation bodies and health workers.

“Our funding has to be catalytic,” Gates said, articulating the foundation’s policy of supporting initiatives to demonstrate what can be achieved in the health care sector for governments to eventually take over.

The foundation has so far committed $1 billion (RS 4,520 crore) for several projects in India, including HIV prevention, polio eradication, children’s immunisation, public health and tobacco control.