Effect of Virtual Newborn Adoption Program by Interns on Early Neonatal Outcomes and Breastfeeding Compared to Standard Postnatal Care – A Randomised Control Trial Study at a Rural Medical College (2025–2026)

1. Background and Rationale

1.1 Global and National Context

India accounts for approximately 20% of global neonatal deaths, with an estimated 0.6 million neonatal deaths annually (UNICEF, 2023). The National Family Health Survey-5 (2019-21) reported that while institutional deliveries have increased to 88.6%, structured post-discharge follow-up remains inadequate, particularly in resource-constrained settings.

1.2 Problem Statement

The critical transition period from hospital to home (first 6 weeks postpartum) represents a vulnerable window where 60% of neonatal complications manifest. Current standard care typically involves a single routine follow-up visit at 6 weeks, potentially missing early warning signs of feeding difficulties, weight loss, jaundice, or infection.

1.3 Innovation and Significance

Structured intern-led follow-up programs represent a scalable, cost-effective intervention that can bridge the gap between hospital discharge and routine paediatric care. By leveraging medical interns under supervision, hospitals can extend their care continuum without significant resource burden. The crucial role of interns is central to our proposed care model. Their dedicated twice-daily bedside visits and weekly virtual follow-ups enable intensive, personalized monitoring and systematic delivery of comprehensive counselling. This consistent, intern-led engagement significantly elevates the level of care beyond standard postnatal practices, directly contributing to improved adherence to optimal feeding and enhanced newborn well-being.

1.4 Literature Gap

While telemedicine and structured follow-up have shown promise in high-resource settings, evidence from Indian tertiary care hospitals using intern-led programs is limited. This study addresses this evidence gap

Expected Outcome & Application(s)

(the result that the researcher hopes to deliver after the successful completion of the project viz., approval/disapproval of hypothesis, contribution to knowledge, filling gaps in existing work, extending understanding of particular topics etc. and state how the outcome of the proposed study will be applied clinically)

The study is expected to demonstrate that an intern-led structured virtual follow-up program significantly improves exclusive breastfeeding rates, promotes better early weight gain, and enhances maternal confidence and satisfaction with postnatal care compared to standard practices. Additionally, it is anticipated that this approach will enable earlier detection of neonatal complications, thus reducing preventable morbidity during the vulnerable postnatal period. Successful results would support the hypothesis that integrating structured virtual follow-up bridges critical gaps in post-discharge care.

Clinically, the findings will provide evidence for implementing low-cost, scalable, and sustainable intern-led virtual follow-up models in tertiary and district hospitals across India. The program can serve as a template to strengthen breastfeeding promotion, early newborn monitoring, and maternal education within existing health systems, especially in resource-limited and rural settings. Ultimately, this will contribute to improved neonatal survival, reduced healthcare burden, and inform policy guidelines at state and national levels