Community based child programme

1. COMMUNITY BASED PROGRAMMES
FOR CHILDREN
Presented by-
Rohit Tongariya
Anmtc, Katihar

2. Learning Objectives
At the end of the session, the learner will be able to-
1.Describe community based programme for children.
2. Describe role & responsibilities of CHO in community based programme for children.

3. Introduction-
• Multiple interventions at community and facility level are needed to
enable optimal growth and development of children.
• CHO should be aware of the key initiatives that are targeted for
children.

4. Need for community-based programmes for children
• National Health Policy (2017) and Sustainable Development Goal- 3
(Good Health and Well-being for people) lays emphasis on improving
the health of both mother and children by reducing some of the
preventable causes associated with maternal and child mortality.
Even with significant decline in child mortality over the last decade,
there continues to be challenges related to child health and nutrition
indicators that need our targeted attention.

6. Home Based Newborn Care (HBNC) Programme
Under this programme, all newborns
are visited as per the at home by
ASHAs in her area to provide
essential newborn care, prevention
of neonatal complications, early
identification of neonatal illnesses
and provision of appropriate care
and referral and support the
mother/caregiver to adopt healthy
practices. She conducts six visits in
case of institutional delivery and
seven visits in case of home delivery
in the first 42 days of life.

7. The structured schedule of home visits undertaken by ASHAs for providing
essential newborn care are given below.

9. Mothers Absolute Affection (MAA) programme

11.  In 2018, Government of India launched POSHAN (Prime Minister Overarching Scheme for
Holistic Nourishment) Abhiyaan, to address malnutrition challenges in India.
 POSHAN Abhiyaan is a multiministerial convergence mission with the vision to ensure attainment
of malnutrition free India by 2022 (“kuposhan-mukt” India).
 The Ministry of Women and Child Development (MWCD) is implementing POSHAN Abhiyaan
in collaboration with various key Ministries and Departments.

12. Goals of POSHAN Abhiyaan
To achieve improvement in nutritional status of children 0-6 years,
adolescent girls, pregnant women and lactating mothers in a time
bound manner.

13. • Anemia Mukt Bharat (AMB) strategy, Intensified Diarrhoea Control
Fortnight (IDCF), Mother’s Absolute Affection Programme (MAA),
Immunization, Home Based Newborn Care (HBNC) and Home-Based
Care of Young Children (HBYC) are the important components of the
POSHAN Abhiyaan implemented by MoHFW.

15. Pillars of POSHAN Abhiyaan

17. • Under NHM, MoHFW has launched Home Based Care for the Young Child (HBYC) programme
under POSHAN Abhiyaan as convergent action with the Ministry of Women and Child
Development to strengthen health and nutrition status of young children.
• The objective of Home-Based Care for Young Child is to:
Reduce child deaths and illnesses;
Improve nutritional status of young children; and
Ensure proper growth and early childhood development of young children.

18. • As part of HBYC initiative, ASHA undertakes five additional home visits after the 42nd day, in
addition to the 6/7 visits for HBNC. ASHA will visit the child on completion of 3 months, 6
months, 9 months, 12 months and 15 months.
• In addition, the quarterly follow-up home visits schedule starting from 3rd month onwards till one
year of life for low birth weight babies, SNCU and NRC discharged children that ASHAs are
already making will be integrated into this HBYC schedule.
• Home visits will allow ASHAs to increase contacts with the child and parents/caregivers during the
first fifteen months of life. This will help to identify problems early and support families in taking
the appropriate action, whether through improved home care practices or through referral to
appropriate health facilities. .
• The additional home visits by ASHAs deliver interventions in four key domains namely nutrition,
health, child development and WASH (water, sanitation and hygiene, including safe faeces
disposal).
• ASHA receives an incentive of INR Rs. 250/- for five additional home visits for each young child
(Rs. 50 per visit/child). In case of more than one child like twins/triplets, the amount of incentive
will be provided per child. ASHA fills the HBYC card after completion of specified activities and
get them validated by ASHA Facilitator or the ANM/MPW-F.

19. Area specific actions under HBYC

20. Roles and responsibilities of CHO towards ensuring
newborn and child care services under HBNC and HBYC
1. As the in-charge of the SHC-HWC, foremost role is to keep staff updated, motivated and
supervised, so that the staff can perform their duties effectively. In case the SHC-HWC is a
delivery point it is important to provide supervision to see the care around birth.
2. Ensure and validate the records of newborn in the MCP card at the time of institutional delivery
and arrange for the birth certificate to be issued.
3. In case of the danger signs in young infant and child, perform pre-referral stabilization and
facilitate referral. If there are no danger signs manage as per IMNCI protocols and follow up.
You will read about it in subsequent chapters.

21. 4. Support and supervise the MPW or ASHA Facilitators in undertaking joint home visits with
ASHAs in resolving challenges faced by ASHAs in providing care under HBNC and HBYC
programme, with special focus on marginalized and vulnerable population and resistant families.
You will also accompany the ASHA and MPWs to beneficiary households where additional
support is required for motivating families to adopt healthy child practices.
5. An updated line list of all newborns and children till 15 months of age in your catchment area
should be available with ASHAs, MPWs and yourself. Amongst these, identify and pay extra
attention to newborns, young infants or children who are high-risk as described above, refer to
appropriate health facility for further management and follow-up/constantly track them to ensure
adherence to treatment plan and ensuring recovery.

22. 6. During your interaction with mothers/caregivers counsel them regarding her physical well-being,
nutritional support during lactation, use of modern method of contraception, keeping the new born
warm, eye/cord care, promotion of exclusive breastfeeding for the first six months of a child’s life, age-
appropriate complementary feeding practices for all children aged 6–24 months, responsive feeding,
continuation of feeding during illness, importance of hand-washing, using clean drinking water and its
storage, safe sanitation and hygiene practices, age-specific immunization, appropriate play and
communication with the child, etc. for proper growth and development.
7. Mobilize the lactating mothers and their children for registration at the nearby AWC to receive ‘Take
Home Ration’ (THR) for themselves and their children beyond 6 months of age and additional THR to
malnourished children.
8. Update the records of new born and children in RCH Portal and other IT applications/registers that have
been developed for tracking of HBNC and HBYC.
9. As a CHO, you also need to be familiar with all the key tasks that are to be undertaken at the
community level by ASHA, MPW and AWW to ensure care for the newborn and child.

25. This was launched on 16th November 2019 to accelerate action to reduce deaths due to Childhood
Pneumonia.
1. National Childhood Pneumonia Management Guideline on treatment and management of
Childhood Pneumonia
2. Skill building and training of service providers for identification and standardized
management of Pneumonia; and
3. 360-degree communication SAANS Campaign to ensure greater awareness on Childhood
Pneumonia among families and parents in order to trigger behaviour change and improve
care seeking.
The SAANS initiative encompasses a three-tiered strategy:
One of the key outcomes of all the community-based programs is early detection of sick children.
Counselling on key rearing practices also include making the family aware of the danger signs
and importance of early care seeking. Free referral of infant up to one year of age is entitled under
JSSK.