This document discusses reproductive, maternal, newborn, child and adolescent (RMNCH+A) health in India. It outlines the key objectives, strategies and initiatives of the RMNCH+A approach, which aims to address major causes of mortality among women and children by providing continuum of care across life stages. The approach focuses on family planning, maternal health, newborn care, child health, adolescent health and declining sex ratios. It details programs implemented across these areas and monitoring mechanisms in place to track performance. The conclusion emphasizes that RMNCH+A looks to address delays in healthcare access and utilization through its strategic continuum of care framework.

1. REPORODUCTIVE,
MATERNAL,
NEWBORN, CHILD
AND ADOLESCENT
HEALTH (RMNCH+A)
Presented By:
Pratibha
M.Sc. Nursing 2nd year
NINE, PGIMER
SEMINAR ON

2. OBJECTIVES:
 Reproductive health
 Introduction to RMNCH+A
 Need of RMNCH+A
 Goals of RMNCH+A
 Key strategies of RMNCH+A
 Health system strengthening in RMNCH+A
 Monitoring and evaluation system in RMNCH+A
 Recent initiatives in RMNCH+A
 Challenges in RMNCH+A

9. REPRODUCTIVE MATERNAL NEWBORN CHILD HEALTH
+ADOLESCENT HEALTH
Reproductive
&
Child Health
RMNCH+A
APPROACH

10. INTRODUCTION OF RMNCH+A
APPROACH:
RMCH+A approach has been launched in
2013 and it essentially looks to address
the major causes of mortality among
women and children as well as the delays
in accessing and utilizing health care and
services. The RMNCH+A strategic
approach has been developed to provide
an understanding of ‘continuum of care’ to
ensure equal focus on various life stages.

11. RMNCH +A STANDS FOR:
What does RMNCH+A stands
for :
 RMNCH: Reproductive,
Maternal, New-born, Child &
Adolescent Health : Links
maternal and child survival to
other components (family
planning, adolescent health,
gender & PC & PNDT) •
 Plus denotes(+A): Inclusion
of adolescence as a distinct
‘life stage’ in the overall
strategy.

12. NEED
 The RMNCH+A appropriately directs the States to
focus their efforts on the most vulnerable
population and disadvantaged groups in the
country.
 It also emphasizes on the need to reinforce efforts
in those poor performing districts that have already
been identified as the high focus districts.

16. RMNCH+A STRATEGY
The RMNCH+A strategy is based on provision of
comprehensive care through the five pillars, or
thematic areas, of reproductive, maternal,
neonatal, child, and adolescent health, and is
guided by central tenets of equity, universal care,
entitlement, and accountability.

20. KEY STRATEGIES – RMNCH+A
Family Planning
• Expansion of the basket of FP
Choices.
• Home Delivery of Contraceptives by
ASHAs,
• Fixed Day Static Services at all facilities
• Enhanced Compensation Scheme
• National Family Planning Indemnity
Scheme,
• Emphasis on Post Partum and Post
Abortion FPservices.

26. Maternal Health
• Early registration of pregnancy
• ANC services, detection and follow-up of high
risk cases using MCTS
• Encouraging institutional deliveries, improving
access by setting up delivery points & FRUs –
Over 20000 delivery points & 2200 FRUs
• Capacity Building Of HR
• Maternal Death Review
• Comprehensive Abortion Care
• Maternal & Child Health Wings – 515
sanctioned .

31. CONT…
Janani Shishu Suraksha
Karyakram-
Free and Zero Expense
delivery including C-section,
free care in case of ante-
natal & post-natal
complications for pregnant
women and infants
Nearly 1.3 crore women are
availing for free entitlements
every year.

32. CONT…
Janani Surksha Yojana
Cash assistance to eligible
pregnant women who give
birth in a government health
facility.
In the year 2016- 17, the
number of JSY beneficiaries
was 1,04,59,547.

36. CHILD HEALTH
• Essential newborn care at facility -
Specialized units for stabilization
and care of sick newborn babies
(712 SNCUs, 2321 NBSUs &
18323 NBCCs)
• Home based newborn care
• Promotion of breastfeeding and
timely initiation of complementary
feeding

37. CONT…
• Management of cases of severe acute
malnutrition at Nutrition Rehabilitation
Centres (965 NRCs)
• Micronutrient supplementation
• Screening and management of children
with 4 Ds-RBSK program.
• In year 2016-17, 29.8 Crore children were
screened, 1.35 Crore identified with any of
the Ds and 97.6 lakhs were referred to
secondary/tertiary care facilities.

42. ADOLESCENT HEALTH
 The data shows that adolescents and youth
have limited awareness about sexual and
reproductive health matters.
 For instance, only 15% of young men and
women (15–24 years) reported receiving
any family life or sex education.

45. CONT…
Rashtriya Kishor Swasthya
Karyakram
Being implemented to reach 253 millions
adolescents (ages 10-19 years) in country
in a phased manner.
 Adolescent Friendly Health Clinics (AFHCs).
 Weekly Iron Folic Acid Supplementation
(WIFS).
 Menstrual Hygiene Scheme (MHS).
 Peer Educator Programme.

51. DECLINE IN SEX RATIO AND
PC&PNDT ACT
 The Pre-conception and Pre-natal Diagnostic techniques
(Prohibition of Sex Selection) Act, 1994 (PC& PNDT Act)
was enacted in 1996 and further amended in 2003.
 Prohibits sex selection before and after conception and
imposes penalty.
 Policy making bodies both at national and state levels-
(Central/ State Supervisory Boards)
 Implementation lies with the States though State and
District Appropriate Authorities assisted by Advisory
Committees.

52. CONT…
 Monitoring mechanisms are in place at all
levels- (Multidisciplinary National/ State/
District Inspection and Monitoring
Committees)
 2370 court cases have been filed, 304
Convictions have been secured and following
conviction the medical licenses of 114 doctors
have been suspended/ cancelled and 1416
ultrasound machines have been sealed for
violations of the law.

68. CONCLUSION
 RMNCH+A approach essentially looks to address the
major causes of mortality among women and children as
well as the delays in accessing and utilizing health care
and services.
 The RMNCH+A strategic approach document has been
developed to provide an understanding of ‘continuum of
care’ to ensure equal focus on various life stages.
 New initiatives included are use of Score Card to track
the performance, National Iron + Initiative to address the
issue of anemia across all age groups and the
Comprehensive Screening and Early interventions for
defects at birth , diseases and deficiencies among
children and adolescents.

69. REFERENCES
 A Strategic Approach to Reproductive, Maternal, Newborn,
Child and Adolescent Health(RMNCH+A) in India. Ministry of
Health & Family Welfare Government of India February 2013
 Revised operating manual for preparation and monitering of
RCH-II & immunization component of NRHM state programme
implementation plans (PIPs)
 Ministry of Health & Family Welfare Government of India.
November 2010
 Guidelines for Preparation of Annual Programme
Implementation Plan National Rural Health Mission. 2013-
2014