This document provides an overview of maternal and child health services and family welfare services in India. It defines maternal and child health services according to the WHO as services that promote, prevent, treat or rehabilitate care for mothers and children. The key aims of maternal and child health services in India are outlined as reducing infant, maternal and child mortality rates and morbidity. Key indicators for assessing maternal and child health outcomes are also presented. The document then discusses the various aspects of maternal and child health services like antenatal care, intranatal care, postnatal care, and integrated management of neonatal and childhood illnesses. It concludes with an overview of strategies, importance and the role of community health nurses in family welfare services in India.

1. Ms. JUHI PRAKASH
NURSING TUTOR
M.SC. (Community Health Nursing)

2. DEFINITION
 According to WHO Maternal and child health services
can be defined as “promoting, preventing, therapeutic
or rehabilitation facility or care for the mother and
child.

3. AIMS
 Reducing IMR, MMR and child and maternal
morbidity rates
 Child survival
 Promoting reproductive health and safe motherhood
 Checking nutrition status in children and mothers
 Early diagnosis and treatment

4. Contd.
 Ensuring physical and mental growth and
development
 Improving the health status of mother and children.

5. INDICATORS
 MMR ( Maternal Mortality Rate)
 IMR ( Infant Mortality Rate)
 NMR ( Neonatal Mortality Rate)
 Under 5 mortality rate
 Child survival rate

6. Activities of MCH services
 Complete health check up and care of the child and
mother from conception to birth
 Studying health problems of mothers and children.
 Providing health education to parents for taking care
of children
 Training to professionals and assistant workers.

7. ASPECTS OF MCH SERVICES
 Antenatal Care
 Intranatal Care
 Postnatal Care

8. ANTENATAL CARE
 Promote & protect the health of the mother during
pregnancy
 Identify high risk cases and to provide treatment.
 Identify complication and prevent it.
 Eliminate tension & anxiety associated with delivery.
 Teach mother about nutrition, personal hygiene, child
care & environmental sanitation

9. Contd.
 Immunize mother with TT
 Distribution of iron & folic acid
 Advice regarding method of family planning

10. INTRANATAL CARE
 Delivery with minimum injury to mother & baby
 Ready to face complication of labour, APH,
Convulsion, malpresentation etc.
 Care of baby at delivery, resuscitation, care of cord,
eyes must be provided.
 Institutional delivery is necessary.

11. POSTNATAL CARE
 Prevent complication of post natal period
 Provide care to mother and baby.
 Give advice regarding bre ast feeding, weaning
and communication.
 Provide health education regarding child safety, diey,
care of baby, family planning service etc
 Follow up care of new born baby.

12. Recent Trends in MCH Care
1. Integration of care
2. Risk approach
3. Manpower changes
4. Primary health care
5. Reproductive and child health
 NRHM/NUHM
 RCH

13.  RCH programmes includes following schemes:
Janani Suraksha Yojana (JSY)
Vandemataram scheme
ASHA
SBA
Home based New-Born Care ( HBNC)
IMNCI

14. Functions of SBA
 During Pregnancy
Monitor and progress of pregnancy
Detect complications
Provide preventive measures
Advise women on health, nutrition and life style on
pregnancy.

15.  During childbirth
Monitor progress of labour
Manage abnormalities, breech deliveries

16.  Postnatal Period
Help mother and babies in breastfeeding
Manage complications like PPH, infection
Counselling on postnatal contraception to mothers

17.  Preventing mother to child transmission of HIV
Help in HIV testing
Provide ART
Provide family planning counselling
Give counselling on infant feeding and safe sex
practices

18. CHILD HEALTH SERVICES
 OBJECTIVES
Decreasing child death and infant mortality rate
Complete protection of child
Nutritious diet to children
Overall growth of children
Increasing health level of children through school
health services and other programmes

19. INTEGRATED
MANAGEMENT OF
NEONATAL AND
CHILDHOOD
ILLNESSES
(IMNCI)

20. Objectives
 To reduce death in children
 To reduce the frequency of illness
 To bring down the severity of illness & disability
 To contribute in improvement of growth and
development of children

21. Classifications
 Pink colour code suggests hospital referral or
admission
 Yellow colour code indicates initiation of specific
treatment
 Green colour code is for call for home management

23. FAMILY
WELFARE
SERVICES

24. INTRODUCTION
 Family planning means planning by individuals or
couples to have only the children they want, when they
want them. This is responsible parenthood. family
welfare includes not only planning of births ,but they
welfare of whole family by means of total family health
care. The family welfare programme has high priority
in India, because its success depends upon the quality
of life of all citizen.

25. HISTORY OF FAMILY WELFARE
PROGRAMME
1. It was started in the year 1951.
2. In 1977,the govt. of India redesignated the “national
family planning programme” as the “national family
welfare programme”, and also changed the name of
the ministry of health and family planning to
ministry of health and family welfare.
3. It is a reflection of the government’s anxiety to
promote family planning through the total welfare of
the family.

26. 4. It is aimed at achieving a higher end, i.e., to improve
the quality of life of the people.
5. India is the first country in the world, that
implemented the family welfare programme at govt.
level.
6. Health is a part of concurrent list but center provides
100% assistance to states for this programme.
7. Government has concentrated on this programme in
various five-year plans though higher priority was
accorded to it after 4th five year plan.

27. 8. Due to bad effects of emergency and faulty
propaganda, family planning suffered major set
back, during 1977- 1979.
9. It was decided in national health policy 1983,that Net
Reproduction Rate (NRR) should be 1 by the year
2000.
10. The 7th five year plan placed more emphasis on the
use of spacing methods between the births of two
children.
11. Family welfare programme has been remained the
important aspects of each five year plan, national
health

28. CONCEPT OF FAMILY WELFARE
PROGRAMME
1. The concept of welfare is basically related to quality
of life.
2. As such it includes education, nutrition, health,
employment, women’s welfare and rights ,shelter,
safe drinking water-all vital factors associated with
the concept of welfare.
 It is a Centrally sponsored programme. For this, the
states receive 100 per cent assistance from Central
Government.

29. The emphasis is on a child family.
Also, the emphasis is on spacing methods along with
terminal methods
The current policy is to promote family planning on
the basis of voluntary and informed acceptance with
full community participation.
The services are taken to every doorstep in order to
motivate families to accept the small family norm

30. AIMS AND OBJECTIVES OF FAMILY
WELFARE PROGRAMME
THE GOVERNMENT OF INDIA IN THE MINISTRY OF
HEALTH AND FAMILY WELFARE HAVE STARTED
THE OPERATIONAL AIMS, AND OBJECTIVES OF
FAMILY WELFARE PROGRAMME AS FOLLOWS
 To promote the adoption of small family size norm, on
the basis of voluntary acceptance.
To promote the use of spacing methods.
To ensure adequate supply of contraceptives to all
eligible couples within easy reach.

31.  To arrange for clinical and surgical services so as to
achieve the set targets
Participation of voluntary organizations/local
leaders/local self government, in family welfare
programme at various levels
Using the means of mass communication and
interpersonal communication to overcome the social
and cultural hindrances in adopting the programme or
extensive use of public health education for family
planning.

32. GOALS OF THE FAMILY WELFARE
PROGRAMME
• Family welfare programme has laid down the following
long term goals to be achieved by the year 2000 AD:
 Reduction of birth rate from 29 per 1000 (in 1992) to 21 by
2000 AD
 Reduction of death rate from 10 (in 1992) to 9 per 1000.
 Raising couple protection rate from 43.3 (in 1990) to 60 per
cent.
 Reduction in average family size from 4.2 (in 1990) to 2.3.
 Decrease in Infant mortality rate from 79 (in 1992) to less
than 60 per 1000 live births.
 Reduction of Net Reproduction Rate from 1.48 (in 1981) to 1

33. IMPORTANCE OF FAMILY WELFARE
PROGRAMME
 The year 2010-11 ended with 34.9 million family planning
acceptors at national level comprising of 5.0 million
Sterilizations, 5.6 million IUD insertions, 16.0 million
condom users and 8.3 million O.P (oral pills). users as
against 35.6 million family planning acceptors in 2009-10.
 Over the decades, there has been a substantial increase in
contraceptive use in India.
 IUD Insertions: During the year 2010-11, 5.6 million IUD
insertions were reported as against 5.7 million in 2009-10.
Assam, Bihar, Gujarat, Jharkhand, Uttar Pradesh,
Arunachal Pradesh, Delhi, Goa, Meghalaya, Mizoram,
Sikkim, D&N Haveli reported better performance in 2010-11

34. Condom Users and O.P. (Oral Pills) Users: Based on
the distribution figures reported, there were 16.0
million equivalent users of Condoms and 83.07 million
equivalent users of Oral Pills during 2010-11.
Number of Births Prevented: Implementation of
various Family Planning measures prevented 16.335
million births in the country during 2010-11 as
compared to 16.605 million in 2009-10. The cumulative
total of births avoided in the country up to 2010-11 was
442.75 million

35. STRATEGIES OF FAMILY WELFARE
PROGRAMME (FWP)
 Integration with health services: Family welfare
programme (FWP) has been integrated with other
health services instead of being a separate service.
 Integration with maternity and child health: FWP has
been integrated with maternity and child health
(MCH). Public are motivated for post delivery
sterilization, abortion and use of contraceptives.
 Concentration in rural areas: FWP are concentrated
more in rural areas at the level of subentries and
primary health centers. This is in addition to hospitals
at district, state and central levels.

36.  Literacy: There is a direct correlation between
illiteracy and fertility. So stress and priority is given for
girl's education. Fertility rate among educated females
is low.
 Breast feeding: Breast feeding is encouraged. It is
estimated that about 5 million births per annum can
be prevented through breast feeding.
 Raising the age for marriage: Under the child marriage
restraint bill (1978), the age of marriage has been
raised to 21 years for males and 18 years for females.
This has some impact on fertility

37.  Minimum needs programme: It was launched in the Fifth
Five Year Plan with an aim to raise the economical
standards. Fertility is low in higher income groups. So
fertility rate can be lowered by increasing economical
standards.
 Incentives: Monetary incentives have been given in family
planning programmes, especially for poor classes. But these
incentives have not been very effective. So the programme
must be on voluntary basis.
 Mass media: Motivation through radio, television, cinemas,
news papers, puppet shows and folk dances is an important
aspect of this programme.

38. ROLE OF COMMUNITY HEALTH
NURSE IN FAMILY WELFARE
SERVICES
Community health nurse has a vast role to play in family
welfare services.
Survey work
Collecting demographic facts.
Making list of homes and finding out housing
location.
Collecting information about pregnant mothers,
eligible couples, infants and children below the school
going

39. EDUCATIONAL FUNCTIONS AND
MOTIVATION
 Explaining the importance and necessity of family
planning to masses.
Using various techniques of teaching and
communication to propagate the message of family
planning to common man.
Motivating the eligible couple to use contraceptives
and educating them about its uses.
Motivating people for family planning operation or
permanent contraception.

40. MANEGERIAL FUNCTIONS
1. conducting clinics
• Deciding the date and place of clinics.
• Arranging equipments and other resources at clinics.
• Arrangements and distribution of contraceptives.
• Insertion and removal of IUDS

41. 2. organizing family planning camps
• Arranging family planning operations(sterilization
male/female)through special camps.
• Making arrangements at the camps and
• following aseptics techniques.
• Motivating eligible couples and preparing them for the
operation .
• Assisting the doctor in operation.

42. 3. maintaining the records
• Keeping the eligible couple register update.
• Maintaining the register of sterilization cases,
contraceptives users ,and pregnant mothers.
• Maintaining other records related to family planning

43. BIBLIOGRAPHY
 Basavanthappa BT, Community health nursing,1st ed
,1998,jaypee brothers, delhi,page no.-319 -321.
 Chalkey A. M., A text book for the health worker,1st
ed,1985,N.A,I. Limited ,publishers,New Delhi, page no.-
330-340.
 Kumari Neelam ,essentials of community health
nursing,1st ed ,2011, PV books, Jalandhar, page no.-225-227
 Park k. ,essentials of community health nursing,4th ed,
2004,m/s Banarasidas Bhanot Publishers,Jabalpur,page no.
225-226
 Swarnkar k. Community health nursing ,2nd ed 2008,N.R.
Brothers,indore, page no.639-642