In India, newborns are dying. Now, they are dying in hospitals. This was not the first such episode in government newborn care units, and it will not be the last — unless we view it not as an isolated event, but as a trend.
On August 24, 2026, three newborns lost their lives in an accidental fire at the government women’s hospital in Amravati, Maharashtra.
Earlier, they used to die at home without medical care.
Overcrowding, inadequate nurse-to-baby ratios, equipment shortages and poor infection-prevention practices can turn a neonatal unit into a setting where hospital-acquired infections can spread rapidly. India already has another solution. The trained CHWs identified and managed neonatal infections at home, supported breastfeeding and warmth, and managed low-birth-weight and preterm babies. ASHAs, if adequately trained, supervised and supported, can provide many components of newborn care. This could take a considerable load off SNCUs and help reduce overcrowding. Of course, a baby with severe prematurity, respiratory distress, shock, severe sepsis, serious birth asphyxia or another danger sign needs immediate facility-based treatment. HBNC is not a substitute for neonatal intensive care. But not every newborn who needs care requires a hospital bed. Second, strengthen neonatal care units. Ensure adequate numbers of doctors and nurses, appropriate nurse-to-baby ratios, functioning equipment, reliable oxygen and electricity supplies with backup systems, along with rigorous infection-prevention measures.
Therefore, India does not have to invent a new system. These are episodes of clustered newborn deaths in the government institutions (that were identified by ChatGPT)/in the format of Year/Government hospital/Newborn deaths — 2017 BRD Medical College, Gorakhpur 17; 2017 Government hospital, Ahmedabad 18; 2019 JK Lon Hospital, Kota 10; 2020 JK Lon Hospital, Kota 9; 2020 Government hospital, Shahdol 8; 2021 District Hospital, Bhandara One fire 10; 2021 Kamla Nehru Children’s Hospital, Bhopal One fire 4; 2021 Government Medical College, Ambikapur 4; 2022 Medical College, Ambikapur 4; 2023 Government Medical College, Nanded 12; 2024 Maharani Laxmi Bai Medical College, Jhansi One fire 10; 2025 District Women’s Hospital, Budaun 4; 2026 District Women’s Hospital, Amravati One fire 3 Infection and staffing problems would be the fourth reason. More than two decades ago, the Gadchiroli field trial conducted by the Society for Education, Action and Research in Community Health (SEARCH) demonstrated that trained community health workers (CHWs) could provide effective home-based neonatal care (HBNC), resulting in a 62.2% reduction in neonatal mortality in the rural area (The Lancet, 1999). Subsequent data from Gadchiroli, published in the Journal of Perinatology in 2005, showed that between 1996 and 2003, 97% of low-birth-weight and preterm babies — including those with birth weights above 1,800 g and gestational ages of more than 34 weeks — were managed at home, with a very low case-fatality rate. The principles of the Gadchiroli model have already become a part of India’s public health system (MoHFW, 2011). Around 8,00,000 Accredited Social Health Activists (ASHAs) have been trained to provide HBNC, using training modules developed from the Gadchiroli experience.
The success of the Janani Suraksha Yojana (JSY) is unquestionable. Institutional delivery can help save mothers and babies. But the next phase of India’s newborn-health strategy must recognise that getting mothers into hospitals is only the first step. Every mother will give birth to a baby who needs care. But not every newborn who needs care requires a hospital bed. The future of newborn care should not be hospital versus home; it should be hospital plus home.
