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REPRODUCTIVE AND CHILD HEALTH PROGRAMME

REPRODUCTIVE AND CHILD HEALTH PROGRAMME. Learning objectives. At the end of the class students will be able to :understand the historical background of RCH program Define RCH List the aims and objectives of RCH Explain the components of RCH Describe the RCH phase I and II.

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REPRODUCTIVE AND CHILD HEALTH PROGRAMME

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  1. REPRODUCTIVE AND CHILD HEALTH PROGRAMME

  2. Learning objectives • At the end of the class students will be able to :understand the historical background of RCH program • Define RCH • List the aims and objectives of RCH • Explain the components of RCH • Describe the RCH phase I and II

  3. 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)

  4. 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)

  5. RCH Programme- I • Immediate Objective- To promote health of mother and children. • Intermediate Objective- To reduce IMR and MMR. • Ultimate Objective- Population Stabilization

  6. Components of RCH Phase I

  7. Service Package: for mothers • Essential obstetric care • Early registration • Minimum 3 ANC by ANM or Medical officers • Safe delivery • 3 PNC • Referral

  8. Emergency obstetric care • Strengthen FRUs • Supply of kits and skilled manpower • TBA (Traditional Birth Attendants) Dai training • NGOs involved: More local specific • 24-hr Delivery services atPHCs/CHCs: • Promote institutional deliveries Additional honorarium to staff • Safe deliveries

  9. Contd. • Deliveries by trained personnel in safe and hygienic surroundings are encouraged • Institutional deliveries are encouraged for women having complications. • In case of complication referrals are made to First Referral Units for Management of obstetric emergencies.

  10. Conti.. • Three postnatal checkups are given to mothers after the delivery. • Spacing of at least three years between children are encouraged.  

  11. For children • Essential newborn care like keeping the baby warm, checking the baby’s weight and giving the baby mother’s first milk are encouraged. • Babies that are premature or have low birth weight are provided special care. • Babies with any complications refereed to the health center. • Exclusive breast-feeding are encouraged for the first three months.

  12. Contd. • Immunization are administered to every child meticulously to prevent death and disabilities. • Vitamin A Prophylaxis • ORT. • Acute respiratory infection in children treated by cotrimoxazole tablets. • Treatment of Anemia

  13. For Eligible Couples • Promoting use of contraceptive methods among eligible couples is important to prevent unwanted pregnancies. Couples should be able to choose from various contraceptive methods including condoms,oral pills, IUDs,male and female sterilization • Safe services for medical termination of pregnancies should be encouraged for women desiring abortions  

  14. Conti.. • Other New Services • Treatment of RTI/STI is given. • Promotion activities for adolescents health.

  15. For adolescents • Menstrual hygiene • Iron and Folic acid supplementation at school • Swatch Galati

  16. RCH Programme- I Intervention / Strategies:- • Prevention $ Management of unwanted pregnancies • Maternal Care • Child Survival • Prevention $ Management of RTIs $ STIs • Prevention of HIV / AIDs

  17. RCH Programme- I Management Strategies :- • Bottom- up Planning • Decentralized Training • Management information and Evaluation System (MIES) $ • IEC and Community Participation

  18. 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.

  19. RCH Programme- II -Goals

  20. 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

  21. RCH Programme- II, Objectives • To improve the management performance • To develop human resources intensively • To expand RCH services to tribal areas also

  22. Conti… • 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

  23. 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

  24. 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 increasing incentives

  25. Conti… • By public private partnership • Social marketing of contraceptives to be strengthened • Involving Panchayat Raj Institutions, Urban Local Bodies $ NGO’s

  26. 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

  27. 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

  28. 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

  29. 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

  30. Conti.. • Permitting ANMs to administer selected antibiotics like Gentamycin and co-trimoxazole by AWW • Availability of drugs and supplies • Good supervision and monitoring • Efficiency of the administrative/ financial system

  31. Cont….. • Community based intervention • Promoting breast feeding practices • Vit A, Iron and Folic Acid Supplimentation • Strengthening the quality of UIP

  32. Components of RCH-IIAdolescent Health Sub-centre • Enroll newly married couple • Provision of spacing methods • Routine antenatal care and institutional delivery • Referral service • HIV/ AIDS /STIs preventive education • Nutritional Counselling

  33. Cont….. PHC $ CHC • Contraceptive • Management of menstrual disorder • HIV/ AIDS /STIs preventive education and management • Counseling

  34. Components of RCH-IIControl of RTIs /STIs • Controlled by syndromic approach

  35. 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

  36. Components of RCH-II Tribal Health • Community Level • Sub centre • PHC • Block PHC / CHC

  37. Components of RCH-IIMonitoring and Evaluation MIES • Planning • Monitoring / Information • Quality Assessment • Evaluation • Validation

  38. Newer Schemes and Services • Training of MOs • Training of traditional birth attendents • Prasoothiaraike • JananiSurakshaYojana Scheme • Vandemataram Scheme • n

  39. Conti… • Safe abortion service Medical Method-Mifepristone $ Misoprostol Manual VaccumAspiratio

  40. Recapitulation • Define RCH ? • Explain RC H program phase –I? • Describe RCH program phase II?

  41. Conclusion The Reproductive and Child Health (RCH) Programme was launched in October 1997. The main aim of the programme is to reduce infant, child and maternal mortality rates.

  42. Evaluation 1.RCH Programme was launched in the year……….. (1972, 1996, 1997, 1994) 2. In PHC,…….. $.............. are the two drugs used for medical abortion. (Mifepristone and Misoprostone, Mifepristone and Oxytocin’ Meperidine and Misoprostone)

  43. Cont…. • RCH –II was started from 1st April………. Up to……… (2005-2009, 2005-2025, 2005-2050)

  44. Bibliography • 1.Park J E & K Park, Text Book of P & S.M., M/s BanarsidasmBhanot, Jabalpur • 2. Mahajan B K and M/C.Gupta, Text Book of P & S.M., Jaypee Publications • 3 .SwatiBhave ,Bhave's Textbook of Adolescent Medicine Paperback – 2 • 4. David MN Paperny, Handbook of Adolescent Medicine and Health Promotion, FSAHM University of Hawaii, USA • 5 S. Neinstein Lawrence, Adolescent Health Care, A Practical Guide Fifth Edition • 6. Gulani K. K, community health nursing, principles and practices . • 7. Stanhope community health nursing 1st edition.mosbyphiladelhia.

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