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REPRODUCTIVE AND CHILD HEALTH PROGRAMME. Historical Background. 1952- National Family Planning Programme 1977- National Family Welfare Programme 1985- Universal Immunization Programme 1992- Child Survival And Safe Motherhood Programme 1997- RCH (Phase-1) 2005- RCH (Phase-11).
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Historical Background • 1952- National Family Planning Programme • 1977- National Family Welfare Programme • 1985- Universal Immunization Programme • 1992- Child Survival And Safe Motherhood Programme • 1997- RCH (Phase-1) • 2005- RCH (Phase-11)
RCH Programme- I Definition “People have the ability to reproduce and regulate their fertility, women are able to go through pregnancy and child birth safety, the outcome of pregnancies is successful in terms of maternal and infant survival and wellbeing and couples are able to have sexual relations free of fear of pregnancies and of contracting diseases”. (Fathalla,1989)
RCH Programme- I • Immediate Objective- To promote health of mother and children. • Intermediate Objective- To reduce IMR and MMR. • Ultimate Objective- Population Stabilization
RCH Programme- I Intervention / Strategies:- • Prevention $ Management of unwanted pregnancies • Maternal Care • Child Survival • Prevention $ Management of RTIs $ STIs • Prevention of HIV / AIDs
RCH Programme- I Management Strategies :- • Bottom- up Planning • Decentralized Training • Management information and Evaluation System (MIES) $ • IEC and Community Participation
RCH Programme- II AIM • To reduce Infant Mortality Rate (IMR), Maternal Mortality Rate (MMR), Total Fertility Rate (TFR), To increase Couple Protection Rate (CPR), and Immunization coverage, specially in rural areas.
Lacunae of RCH-I • Poor out reach service • Inadequate financial resources • Inadequate human resources • MIES was lacking • Effective network of FRU was lacking • Poor infrastructure • Quality of PHC’s $CHC’s service was poor • Poor Neonatal and Adolescent health care • Minimum community participation • Regional variation
RCH Programme- II, Objectives • To improve the management performance • To develop human resources intensively • To expand RCH services to tribal areas also • To improve the quality, coverage and effectiveness of the existing services and more focused on empowered action group (EAG) states • To monitor and evaluate services
Components of RCH-II • Population Stabilization • Maternal Health • Newborn Care and Child Health • Adolescent Health • Control of RTIs / STIs • Urban and Tribal Health • Monitoring and Evaluation • Other Priority areas
Components of RCH-II Population Stabilization- Strategies • By incorporating the newer choices of contraception methods e.g:-Centchroman • By increasing trained personals • By converging the service at grass root level • By public private partnership • Social marketing of contraceptives to be strengthened • Involving Panchayat Raj Institutions, Urban Local Bodies $ NGO’s • By increasing incentives
Components of RCH-IIMaternal Health- Strategies Essential Obstetrical Care • Three or More Checkups • Two doses of TT • IFA Tablet • Counseling Emergency Obstetrical Care • First Referral Unit
Components of RCH-II New Born Care and Child Health Effective Newborn Health Intervention • During Antenatal Period • Labor, Birth, $ the first 1- 2 hours • Early Newborn Care • Late Newborn Care
Components of RCH-II New Born Care and Child Health OBJECTIVES • Skilled care at birth • Package of preventive, promotive and curative intervention • Strengthen IMNCI services
Components of RCH-II New Born Care and Child Health Strategies • IMNCI plus • Strengthening of health infrastructure and FRUs • Ensuring referral service of sick neonates and utilization of referral funds • Permitting ANMs to administer selected antibiotics like Gentamycin and co-trimoxazole by AWW
Cont….. • Availability of drugs and supplies • Good supervision and monitoring • Efficiency of the administrative/ financial system • Community based intervention • Promoting breast feeding practices • Vit A, Iron and Folic Acid Supplimentation • Strengthening the quality of UIP
Components of RCH-IIAdolescent Health Subcentre • Enroll newly married couple • Provision of spacing methods • Routine antenatal care and institutional delivery • Referral service • HIV/ AIDS /STIs preventive education • Nutritional Counselling
Cont….. PHC $ CHC • Contraceptive • Management of menstrual disorder • HIV/ AIDS /STIs preventive education and management • Counseling
Components of RCH-IIControl of RTIs /STIs • Controlled by syndromic approach
Components of RCH-II Urban Health Urban Health Centers- 1:50,000 Population • Medical Officer- 1 • ANMs- 3-4 • Lab Assistant- 1 • Public Health Nurse- 1 • Clerk- 1 • Chowkidar- 1 • Peon- 1
Components of RCH-II Tribal Health • Community Level • Sub centre • PHC • Block PHC / CHC
Components of RCH-IIMonitoring and Evaluation MIES • Planning • Monitoring / Information • Quality Assessment • Evaluation • Validation
Newer Schemes and Services • Training of MOs • Training of traditional birth attendents • Prasoothiaraike • JananiSurakshaYojana Scheme • Vandemataram Scheme • Safe abortion service Medical Method-Mifepristone $ Misoprostol Manual Vaccum Aspiration
Evaluation 1.RCH Programme was launched in the year……….. (1972, 1996, 1997, 1994) 2. In PHC,…….. $.............. arethe two drugs used for medical abortion. (Mifepristone and Misoprostone, Mifepristone and Oxytocin’ Meperidine and Misoprostone)
Cont…. • RCH –II was started from 1st April………. Up to……… (2005-2009, 2005-2025, 2005-2050)
ASSIGNMENT • Write an assignment on JananiSurakshaYojana and the role of ASHA in this scheme.