Reproductive and Child Health Program

REPRODUCTIVE AND
CHILD HEALTH PROGRAM

BY : DENCY DENNIS
JISSY PAUL.E
INTRODUCTION
The reproductive and child health program was formally
launched by govt. of India on 15th oct 1997, as per the
recommendation of international conference on
population and development (ICPD)held in Cairo in 1994.
DEFINITION
In ICPD at Cairo, Fathallah defined Reproductive health as “A
state of complete, physical, mental and social well-being and not
merely the absence of disease or infirmity in all matters relating
to reproductive system and its function and process.”
Reproductive health therefore implies that people are able to
have a satisfying and safe sex life and they have the capability to
reproduce and the freedom to decide if, when and how often to
do so.
OBJECTIVES:
1.To promote the health of the mother’s and children to
ensure safe motherhood and child survival
2.The intermediate objective is to reduce IMR & MMR.
3.The ultimate objective is population stabilization, through
responsible reproductive behaviour .
Vertical Programmes Integrated Service Delivery
Camp Oriented Client Oriented
Target Oriented Goal Oriented
Quantity Oriented Quality Oriented

INTERVENTION AND CONCEPT TO RCH
 Prevention and management of unwanted

pregnancies.
 Maternal care (safe motherhood).
 Child survival
 Prevention and management of RTIS/STD
 Prevention of HIV/AIDS
COMPONENTS OF RCH
 Following services are included n the reproductive health area as
proposed by govt. of India.
MAIN COMPONENTS:
 Family planning
 Child survival and safe motherhood program
 Prevention/management of RTI/STD and AIDS
 client approach to health care
OTHER ACTIVITIES
 Providing counselling, information and communication
services on health, sexuality, and gender difference.
 Referral services for all above intervention
 Growth, monitoring, nutrition, education, reproductive
health services for adolescents etc.
RCH PACKAGES FOR VARIOUS SERVICES
 For maternal services (safe motherhood): The service components are
obstetric care, infection control and nutrition.
 For child services (child survival): The essential care of the newborn,
including care of the risk newborn by prompt referral service
- Infection control measures
-Nutritional promotions
 Reproductive health
- Fertility control
- MTP services (for prevention and management of unwanted
pregnancies)
- Adolescent
- HIV/AIDS
RCH-PHASE – I
 RCH I HAS INTEGRATED ALL SERVICES IN CSSM
 Newer intervention in RCH I:
 Essential Obstetric care.
 24hour delivery services at PHC & CHC
 Emergency obstetric care.
 Prevention of RTI/STDs and AIDS
 District Surveys
ESSENTIAL OBSTETRIC CARE
1. Early registration of pregnancy (within 12-16 weeks )
2. Provision of safe delivery at home or institution.
3. Provision of three ANC visits by ANM or MO
4. Provision of three PNC check-up’s (these components in RCH program is more relevant
to Assam, Bihar, Rajasthan, Orissa, Uttar-Pradesh& M.P where high maternal mortality
& morbidity is present.)
EMERGENCY OBSTETRIC CARE

5. Complications in pregnancy are not always predictable
6. Involvement of NGO’s for universal training of Dais for conduction of delivery.
24 HOUR DELIVERY SERVICES AT PHC & CHC
1. To promote institutional deliveries
2. To promote the round the clock deliveries facility at health centers.
3. Additional honorarium to the staff to encourage round the clock services.
MEDICAL TERMINATION OF PREGNANCY

4. To reduce maternal mortality & morbidity from unsafe abortion
5. Supply of MTP equipment
6. Provision for engaging doctor’s trained in MTP to visits PHC’s on fixed
dates to perform MTP.
CONTROL OF REPRODUCTIVE TRACT INFECTIONS (RTI) & STD.
1. It has been planned & implemented in close collaboration with national AIDS control
Organization (NACO).
2. NACO is supporting to set up STD clinics up to district level
3. Each district will be assisted by two laboratory technicians on contract basis for testing
blood, urine for RTI / STD test.
IMMUNIZATION
4. Provide vaccines for polio, tetanus, DPT, DT, Measles & TB.
CHILD SURVIVAL COMPONENT
 Essential newborn care
 Oral rehydration therapy
 Acute respiratory disease control
 Prevention & control of Vitamin A deficiency in children
 Prevention & control of anemia in children
ESSENTIAL NEWBORN CARE

 Primary goal to reduce perinatal &neonatal mortality.
 Components are :resuscitation of newborn asphyxia, prevention of infection etc.
 Strategies: train medical & other health personnel in essential newborn care.
ORAL REHYDRATION THERAPY:
 Oral rehydration therapy program started in 1986-87 is being implemented through
RCH
 Adequate nutritional care of the child with diarrhea & proper advice to mother on
feeding are important components of this program.
ACUTE RESPIRATORY DISEASE CONTROL PREVENTION & CONTROL OF VITAMIN A

DEFICIENCY
 Peripheral health workers are being trained to recognize & treat
pneumonia.
 5 doses of VIT. A are given to all children under 3 years of age .
RCH 2
RCH 2 was started from 1st April 2005 up to 2009. The
RCH 2 vision articulates , “improving access , use &
quality of RCH services , especially for poor and
undeserved population”.
AIMS
• To reduce infant mortality rate.
• To reduce maternal mortality rate
• Total fertility rate and to increase couple protection
rate and immunization coverage specially in rural
areas.
OBJECTIVES
• To improve the management performance
• To expand RCH services to rural areas
• To monitor and evaluate the services
• To improve the quality, coverage and effectiveness of the
existing family welfare services and essential RCH services.
COMPONENTS
• Population stabilization
• Maternal health
• Infant and child health
• Adolescent health
• Control of RTI/STI’s
• Strengthening of RCH outreach services
• Training and HMIS
• Other priority areas
POPULATION STABILIZATION
• By incorporating the newer choices of contraception

methods eg: centchroman.
• By increasing trained personals.
• Social marketing of contraceptive to be strengthened
MATERNAL HEALTH
ESSENTIAL OBSTETRICAL CARE:
Improving quality of services
• Three or more check ups
• Two doses of TT
• IFA Tablet
• Counselling
EMERGENCY OBSTETRICAL CARE

• First referral unit and safe abortions.
INFANT AND CHILD HEALTH
EFFECTIVE NEWBORN HEALTH INTERVENTION
Reduction of IMR and strengthening of new born care
Organizing counselling services
IMNCI
ADOLESCENT HEALTH
• Referral services
• HIV/AIDS/STDs preventive education and management
• Nutritional counselling
• Management of menstrual disorders and education
CONTROL OF RTI/STI
• Enroll newly married couple
• Promote spacing methods
• Contraceptives and counselling
STRENGTHENING OF RCH OUTREACH
SERVICES
• Construction and reconstruction of HSC

• Provisions for telephones,gas connections,supply of
equipments etc
• Clinical setup in 70 phc
TRAINING AND HMIS
• Skill upgradation training with focus on improving
/upgrading the skills of health care providers
• Introduction of HMIS for planning and monitoring health
services.
STRATEGIES
• Training of PHC doctors in life saving anesthetic skills for

emergency obstetric care a FRUs
• Setting up of blood storage centres at FRUs
• Janani suraksha yojana
• Vandemataram scheme
• IMNCI
• SNCU
• NBSU
TRAINING
• Training of MBBS Doctors in Life Saving

Anaesthetic Skills for Emergency Obstetric Care.
• 18 weeks training course
• The First Training Programme
Conducted at AIIMS for Chhattisgarh
• Training to be conducted in phases
and limited to the requirement at
FRUs.
BLOOD BANK FACILITIES
• Management of obstetric emergencies is

sometimes not possible due to non-availability
of blood.
• The Drugs and Cosmetics Act was therefore
modified to facilitate establishment of blood
storage centres.
• 24hours safe blood supply facilities are
established
JSY
• To promote Institutional Deliveries

To reduce overall
Maternal Mortality Ratio
Infant Mortality Rate
• A safe motherhood intervention, replacing the
“National Maternity Benefit Scheme”, under NRHM
100 % centrally sponsored
• Integrates cash assistance with delivery
& post-delivery care.
VANDE MATARAM SCHEME
It is a voluntary scheme wherein any obstetric and

gynaec specialist, maternity home can
volunteer.
• Enrolled doctors will display ‘vandemataram
logo’
at their clinics.
• Iron and folic acid tablets, oral pills, TT injections,
etc will be provided for free distribution.
IMNCI-Integrated Management of
Neonatal and Childhood Illness.
• It offers a comprehensive packages for most common

infections such as sepsis,measles,malaria,diarhoea and
malnutrition
• It brings health and nutrition interventions such as
breastfeeding,complementary feeding,vitamin A
supplements.
• It mainly aims at improving health and nutritional status of
children thereby improving health system and community
practices.
• It also provides training course for management of sick
children and home visits for infants.
SNCU-Special Newborn Care Unit
• SNCU is a neonatal unit in thr vicinity of the labor room which

is to provide special care for sick newborns. Any facility more
than 3,000 deliveries/year should have SNCU.
• AIMS-
• Essential newborn care
• Early identification of postpartum complications and sepsis.
• Management of LBW babies
• Support the family for adoption of healthy practices and build
confidence and skills of the mother in nursing the baby.
NBSU-Newborn Stabilization Unit
• NBSU is a facility within or in close proximity of the

maternity ward.
• All CHC needs to have a neonatal stabilization unit,in
addition to the newborn corner.
• As of march,1737 NBSUs are functional in country.
QUALITY INDICATORS
Following are the quality indicators used to monitor and

evaluate RCH programme through monthly reports:
1. Number of antenatal cases registered
2. Number of pregnant women who had 3 antenatal checkups
3. Number of high risk pregnant women referred
4. Number of pregnant women who had 2 doses of TT
5. Number of pregnant women under prophylaxis and treatment of
anaemia
6. Number of deliveries by trained and untrained a ttendants
7. Number of cases with complications referred to PHC/FRU
8. Number of newborn with birth weight recorded
9. No. of women given 3 post natal check-ups
10. No. of RTI/STD cases detected, treated and
referred
11.No. of children fully immunized
12.No. of adverse reactions reported after
immunization
13.No. of cases of ARI and diarrhea under 5yrs
14.No. of cases motivated and followed for
contraception.
REFERENCES-
• PREVENTIVE AND SOCIAL MEDICINE

K PARK-21st edition
Health Programmes in India
page.no.411-414
• OTHER RESOURCES

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REPRODUCTIVE AND

CHILD HEALTH PROGRAM

Camp Oriented Client Oriented

Target Oriented Goal Oriented

Quantity Oriented Quality Oriented

 Prevention and management of unwanted

EMERGENCY OBSTETRIC CARE

MEDICAL TERMINATION OF PREGNANCY

ESSENTIAL NEWBORN CARE

ACUTE RESPIRATORY DISEASE CONTROL PREVENTION & CONTROL OF VITAMIN A

• By incorporating the newer choices of contraception

EMERGENCY OBSTETRICAL CARE

• Construction and reconstruction of HSC

• Training of PHC doctors in life saving anesthetic skills for

• Training of MBBS Doctors in Life Saving

• Management of obstetric emergencies is

• To promote Institutional Deliveries

It is a voluntary scheme wherein any obstetric and

• It offers a comprehensive packages for most common

• SNCU is a neonatal unit in thr vicinity of the labor room which

• NBSU is a facility within or in close proximity of the

Following are the quality indicators used to monitor and

• PREVENTIVE AND SOCIAL MEDICINE

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