nursing

1. Reproductive health and child health
programme
The Reproductive Health and Child Health Programmeis implemented in the
state since 1997.theprogrammeis monitored by the State Family Welfare
Bureau which is located at Pune.
In the year 1994, theinternational conferenceon population and development
(ICPD) held the discussion at Cairo. The reasons for notreaching the goals set
for the Population Controlwere analysed . subsequentsample studies
indicated that there are some areas where the earlier programmehas not
reached. Therefore, the entire strategy was changed and the following issues
were given priority.
1. Women’s empowerment
2. Adolescent health
3. Reproductive rights
4. Reproductive health
5. Quality of care
Based on these priorities, the ReproductiveHealth and Child Health
Programme(RCH) was formulated by governmentof India. Maharashtra
State has started implementing the programmesince 1997- 98.
Definition of ReproductiveHealth and Child Health
- People have the ability to reproduceand regulate their family.
- Women are able to go through pregnancy and child birth safety.
- The outcome of pregnancy is successfulin terms of maternal and infant
wellbeing.
- Couple are able to have sexual relations free of fear of unwanted
pregnancy and the contracting sexually transmitted diseases.
- After forty care.
Components of RCH Programme:
 Women’s health, safemotherhood
 Child health (child survivaland child development)

2.  Adolescent Health (sexually development, adolescent education and
vocational component)
 Effective family planning ( Ensuring informed choice, counselling ,
gender equality and greater male participation)
 Prevention, detection and management of ReproductiveTract Infection ,
sexually transmitted infections, HIV/AIDS and cancer of the
reproductivesystem.
 Prevention and management of infertility and the other reproductive
disorders
 Prevention, detection and management of genetic and environmental
disorders.
Other activities
 Providing counselling, information and communication services on
health, sexuality and gender difference.
 Referral services for all above intervention.
 Growth monitoring, nutrition education, reproductivehealth services for
adolescent etc.
RCH packages for various services:
 For maternal services( safemotherhood): the service component is
obstetrics care, infection control and nutrition .
 For child services ( child survival) : the essential care of the new born,
including care of the risk new born by prompt referralservices.
- Infection control measures.
- Nutritional promotions.
 Reproductive health:
-fertility control
- MTP services
-Adolescent
-HIV/AIDS
Family welfare programme
a. Sterilization

3. The sterilization programmeis well established in the state. There are
operating facilities available for sustained programme. In the year 2000-
2001, 109% sterilizations wereperformed againstthe expected level of
achievement. The highlight of the performanceis that 40% sterilizations
were performed on two issues. This indicates quality of the programme
and the acceptability by the community.
b. Urban family welfare programme
The 2001 census has registered the urban population of 42%. To
implement the health programmein the urban area, proper health
infrastructureis not available.
c. Postpartum programme
The postpartum programmeis maternity centre-based Family Welfare
Programme. There are 5 types of centre recognized on the basis of the
workload of obstetrics cases, abortion and MTP cases. The acceptors of
performanceare direct and indirect. The institution is expected to
complete the target of sterilization, cu-T.
d. Award scheme
In order to motivate the health staff, an award schemeoffering cash
incentive has been started from August2000. Theaward scheme is for
medical officers, ANMand for panchayatsamitis. The selection
committee of district collector, CEO, ZP, DHO and district RCH officer will
select the health staff for the award.
e. Revised Savitribai Phule Kanya Kalyan Yojana
The scheme is revised from 1st
May 2000 and is applicable for
- Couples below poverty line.
- Couples accepting sterilization with only one daughter and no son will
receive rs.10,000 as fixed deposit, and daughter will receive it after
completing 18 years. An additional amount of rs.5000 willbedeposit as
five-year fixed deposit for the girl completing 10th
standard.
RCH Programme Phase I

4.  Under the RCH programmephase1 , various provision was madeto
improvethe status of maternal and child health. These include:
 Provision of essential and emergency care.
 Provision of equipment and drugs kit to selected PHCs and the selected
FRUs in all districts.
 Provision for additional ANM, staff nurseand laboratory technician for
selected districts.
 Provision for 24 hours delivery services at PHCs and CHCs.
 Referral transportin caseof obstetrics complication.
 Immunization and oral rehydration therapy.
 Prevention and control of vitamin A deficiency in children.
 Integrated management of childhood illness (IMCI).
 District surveys for focused intervention to educed IMRand MMR.
 New initiative undertaken during phase1 of RCH are:
- Setting up of blood storageunit at FRUs
- Training of MBBS doctors in anaesthetics skilled for emergency
obstetrics care at FRUs.
Lacunae of RCH Phase 1
They are as follows:
 The outreach services werenot available to the vulnerableand needy
population.
 The management of financial resources wereinadequate.
 The human resources such as doctors, nurses, health worker, etc were
deficient.
 The management information and evaluation system werelacking.
 The effective network of first referralunit was lacking.
 Quality of services in PHCs and CHCs was poor.
 Lack of community participation.
RCH programme phase II
 Itwas started fromApril 1st
2005 up to 2009.

5.  The RCH vision articulates , “improving access, useand quality of RCH
services, especially for the poor and underserved population.”
Aimsof RCH 2
To reduce infant mortality rate, maternal mortality rate, total fertility rate, and
to increase couple protection and immunization coverageespecially in rural
areas.
Objectivesof RCH 2
 To improvethe management performance.
 To develop human resources intensively.
 To expand RCCH areas.
 To monitor and evaluate the services.
 To improvethe quality, coverageand effectiveness of the existing family
welfare services with special focus on the above mentioned EAG states.
Components of RCH 2
 Population stabilization
 Maternal health
 New born care
 Child health
 Adolescent health
 Control of RTIs/STIs
 Urban health
 Tribal health
 Monitoring and evaluation
 Other priority areas.
Bibliography
Basavanthappa BT, community health nursing 1st
edition, 1998, Jaypee
brothers, Delhi, page no. 319- 321.

6. Kumari Neelam, Essentials of Community Health Nursing, 1st
Edition
2011, PV books Jalandhar, Page no. 225- 226