DR. MAHESWARI JAIKUMAR
EVOLUTION OF MCH SERVICES
1885- Association for medical aid by the
women to the women of India.
Established by countess of Dufferin.
1918- Lady Reading Health School. Delhi. (HV).
1992- Lady Chelmsford League was formed to
develop MCH services.
1931- Indian Red Cross Society established.
Victoria Memorial Scholarship fund
1938- Indian Research Fund
Association for assessing
causes of IMR,MMR.
1946- Bhore Committee report.
1931- Madras State – MCH Welfare.
1951- BCG vaccination prog.
1952. PHC established
1953- NFPP started.
1962- Mudhaliar Committee
1970- AIHPPP started.
1971- MTP Act passed.
1974-75-ICDS prod enunciated.
1976- National Prog for
Prevention of Blindness
1977- MPHW scheme launched
1978- EPI launched.
1983- NHP launched.
1985- UIP launched.Separate dept of
women & child development
launched under Min of HRD.
1987- Safe Motherhood Campaign
launched by the World Bank.
1990- ARI Cont Prog –pilot project.
1992- Infant Milk Substitute,Feeding
bottles & Infant Food (Regulation
of Production,Supply &
1994- Prenatal Diagnostic Technique &
Prevention of Misuse Act.In force
1995- ICDS,PPP launched. (Dec-20 Jan
1996- PPP, Family Welfare Prog
made target free approach.
2000- RCH Out Reach Scheme.
2005- RCH II.
• “People have the ability to reproduce
and regulate their fertility, women are
able to go through their pregnancy and
child birth safely, the outcome of
pregnancies is successful in terms of
maternal and infant survival and well
being and couples are able to have
sexual relations, free of pregnancy and
of contracting disease”
• The concept of RCH is framed
keeping with the evolution of an
integrated approach to the
programme aimed at improving the
health status of young women and
young children…. In terms
1. Family Welfare Programme.
2. Universal Immunization Programme.
3. Child Survival and Safe Motherhood
Prog.(incl Oral Rehydration)
4. ARI Control Prog.
THE NEED IS AN INTEGRATION OF THE
AFORE SAID COMPONENTS (RCH is
• The Reproductive and Child Health
(RCH) Programme was launched in
• The main aim of the programme is
to reduce infant, child and maternal
• To improve the implementation and
management of policy by using a
participatory planning approach and
strengthening institutions to maximum
utilization of the project resources.
• To improve quality, coverage and
effectiveness of existing Family Welfare
• To gradually expand the scope and
coverage of the Family Welfare services
to eventually come to a defined package
of essential RCH services.
• Progressively expand the scope and
content of existing FW services to
include more elements of a defined
package of essential
• Give importance to disadvantaged
areas of districts or cities by
increasing the quality and
infrastructure of Family Welfare
• ESSENTIAL OBSTETRIC CARE.
• EMERGENCY OBSTETRIC CARE.
• 24 Hr DELIVERY SERVICES at PHCs/HSCs.
• MEDICAL TERMINATION OF
• CONTROL OF RTI/STD/AIDS.
• DRUG & EQUIPMENTS PROVISION.
• To bring about a change in mainly three
critical health indicators such as :
• Reduction in Total Fertility Rate, Infant
Mortality Rate and Maternal Mortality
• To realizing the outcomes envisioned in
the Millennium Development Goals, the
National Population Policy 2000, and
the Tenth Plan Document, the National
Health Policy 2002 and Vision 2020
SALIENT FEATURES OF RCH - II
• Adoption of Sector vide approach
which effectively extends the program
reach beyond RCH to the entire Family
• Building State ownership by involving
states and UT’s from the outset in
development of the program.
• Decentralization through development of
District and State level need based plans.
• Flexible programming with a view to
moving away from prescriptive scheme
based micro planning and instead allowing
States to develop need based work plans
with freedom to decide upon program
• Capacity building at the District, state and
the Central level to ensure improved
program implementation. In particular, the
emphasis being on strengthening financial
management systems and monitoring and
evaluation capabilities at different levels.
• Adoption of the logical frame works as a
program management tour to support and
outcome driven approach.
• Performance based funding to ensure
adherence to program
objectives, reward good performance
and support weak performers through
enhance technical performance.
• Pool financing by the development
partners to simplify and rationalized the
process of assessing external assistance.
• Convergence, both inter sectoral as well
as intra sectoral to optimize utilization
of resource as well as infra structural
• Expand services to the entire sector
of Family Welfare beyond RCH
• Holding States accountable by
involving them in the development
of the programme
• Decentralization for better
• Allowing states to adjust and
improve programmes features
according to their direct needs.
• Improving monitoring and
evaluation processes at the
District, state and the Central level
to ensure improved program
• Give performance based funding, by
rewarding good performers and
supporting weak performers.
• Pool together financial support from
• Encourage coordination and
convergence, within and outside the
sector to maximize use resources as
well as infra structural facilities.
• ESSENTIAL OBSTETRIC CARE.(Institutional
delivery, Skilled attendant at delivery)
• EMERGENCY OBSTETRIC CARE.
• STRENGTHENING REFERRAL SYSTEM.
• NEW INITIATIVES (MBBS doctors in the
provision of adequate & timely emergency
obstetric care. & blood storage at FRUs)
INTERVENTIONS AT DISTRICT
• Child Survival Interventions.
• Safe Motherhood Interventions.
• Implementation of Target Free
• High Quality Training at all levels.
• IEC Activities.
• Specially designed RCH package for
urban slums & tribal areas
• Dist Sub Projects under Local Capacity
• RTI/STD Clinics at Dt Hosp.
• Facility for safe abortions at PHC.
• Enhanced Community Participation
through Panchayats, Women’s Groups &
• Adolescent Health & Reproductive
INTERVENTIONS AT STATE LEVEL
• Screening & Treatment of RTI/STD.
• Emergency Obstetric Care at selected
• Essential Obstetric care at PHCs.
• Improved delivery services& emergency
• Facility for transport & referral for