The document provides an overview of the Reproductive and Child Health (RCH) Program in India. It describes the various components of the program including family planning, child survival, safe motherhood, sexually transmitted diseases/reproductive tract infections, and adolescent health. It outlines the goals, target groups, services, and new initiatives of the RCH program. Key aspects of the program include expanding access to maternal and child healthcare, reducing maternal and child mortality, and achieving population stabilization. The document also discusses monitoring indicators and strategies for evaluating the impact of the RCH program.
This document discusses key concepts in health economics. It begins by defining health economics as the branch of economics concerned with issues related to efficiency, effectiveness, value and behavior in the production and consumption of health and health care services. It then examines topics like the costs of health care including capital, operating and opportunity costs. It also explores the demand and supply of health care, health care markets and financing, health plans and budgets. The document emphasizes the importance of cost containment and optimal resource utilization in health economics.
Menopause is the permanent cessation of menstruation that occurs naturally as part of aging when the ovaries stop producing estrogen and progesterone, and a woman can no longer get pregnant. Counseling women about menopause aims to address questions/concerns, provide education, facilitate informed decision making, and enhance confidence. The counseling process involves building rapport, exploring issues, and committing to actions. A survey found that over 75% of postmenopausal women received counseling on hormone replacement therapy, with no differences found between managed care and other insurance types. More efforts are needed to educate underserved women.
An intensive material on recent advances on contraception including the current contraceptive methods and a brief overview on immunocontraception and contraceptive vaccines
The document discusses the history and development of India's National Family Welfare Programme. It began in 1952 as a modest family planning program that established clinics and distributed educational materials. During the Third Five Year Plan from 1961-1966, family planning was declared a priority and the program shifted its focus from clinics to community outreach and education. Major developments over subsequent decades included the introduction of the Lippes Loop intrauterine device in 1965, strengthening the healthcare infrastructure during the Fourth Five Year Plan from 1969-1974, and establishing the Medical Termination of Pregnancy Act in 1972.
With having many challenges surrounding the nurse midwives in India, she still delivers good obstetrician care and can bringing good health of mother and child. can decrease ratio of LSCS. looking for many established centers/clinics/hospitals/birthing centers which runs by midwives independently in India
The document discusses developing checklists to improve safety across the childbirth continuum. It found that surgical checklists reduced deaths by 0.7%, complications by 4%, and surgical site infections by 2.8% across sites. Checklists are proposed to prompt key moments, define essential tasks, highlight issues, increase communication, and facilitate dialogue. A task force will develop checklists that have high impact, are simple, feasible to test and scale globally, and linked to goals of reducing maternal and neonatal mortality. A proposed program involves checklists for during pregnancy, at delivery, and postpartum to catch issues at different points along the childbirth process.
A retained placenta occurs when the placenta is not expelled from the uterus within 30 minutes of childbirth. Risk factors include previous retained placentas, uterine injuries or surgeries, preterm births, induced labor, and multiple pregnancies. Causes can include failure of the placenta to separate fully from the uterine wall or abnormal placenta attachments like placenta accreta. Treatment involves controlled cord traction, manual removal in the operating room if needed, or hysterectomy for deeply embedded placentas. Complications can be life-threatening bleeding, infections, or shock if not properly managed.
The document provides guidelines for nursing management of women undergoing obstetric operations. It outlines:
1) Equipment and monitoring required in recovery, including vital signs monitoring every 5 minutes for 30 minutes;
2) Criteria for safe transfer to the postnatal ward once stable, including pain level below 1;
3) Post-operative observations every 30 minutes for 2 hours then every 2 hours for 24 hours, including vital signs, pain, temperature and wound/loss monitoring.
This document discusses key concepts in health economics. It begins by defining health economics as the branch of economics concerned with issues related to efficiency, effectiveness, value and behavior in the production and consumption of health and health care services. It then examines topics like the costs of health care including capital, operating and opportunity costs. It also explores the demand and supply of health care, health care markets and financing, health plans and budgets. The document emphasizes the importance of cost containment and optimal resource utilization in health economics.
Menopause is the permanent cessation of menstruation that occurs naturally as part of aging when the ovaries stop producing estrogen and progesterone, and a woman can no longer get pregnant. Counseling women about menopause aims to address questions/concerns, provide education, facilitate informed decision making, and enhance confidence. The counseling process involves building rapport, exploring issues, and committing to actions. A survey found that over 75% of postmenopausal women received counseling on hormone replacement therapy, with no differences found between managed care and other insurance types. More efforts are needed to educate underserved women.
An intensive material on recent advances on contraception including the current contraceptive methods and a brief overview on immunocontraception and contraceptive vaccines
The document discusses the history and development of India's National Family Welfare Programme. It began in 1952 as a modest family planning program that established clinics and distributed educational materials. During the Third Five Year Plan from 1961-1966, family planning was declared a priority and the program shifted its focus from clinics to community outreach and education. Major developments over subsequent decades included the introduction of the Lippes Loop intrauterine device in 1965, strengthening the healthcare infrastructure during the Fourth Five Year Plan from 1969-1974, and establishing the Medical Termination of Pregnancy Act in 1972.
With having many challenges surrounding the nurse midwives in India, she still delivers good obstetrician care and can bringing good health of mother and child. can decrease ratio of LSCS. looking for many established centers/clinics/hospitals/birthing centers which runs by midwives independently in India
The document discusses developing checklists to improve safety across the childbirth continuum. It found that surgical checklists reduced deaths by 0.7%, complications by 4%, and surgical site infections by 2.8% across sites. Checklists are proposed to prompt key moments, define essential tasks, highlight issues, increase communication, and facilitate dialogue. A task force will develop checklists that have high impact, are simple, feasible to test and scale globally, and linked to goals of reducing maternal and neonatal mortality. A proposed program involves checklists for during pregnancy, at delivery, and postpartum to catch issues at different points along the childbirth process.
A retained placenta occurs when the placenta is not expelled from the uterus within 30 minutes of childbirth. Risk factors include previous retained placentas, uterine injuries or surgeries, preterm births, induced labor, and multiple pregnancies. Causes can include failure of the placenta to separate fully from the uterine wall or abnormal placenta attachments like placenta accreta. Treatment involves controlled cord traction, manual removal in the operating room if needed, or hysterectomy for deeply embedded placentas. Complications can be life-threatening bleeding, infections, or shock if not properly managed.
The document provides guidelines for nursing management of women undergoing obstetric operations. It outlines:
1) Equipment and monitoring required in recovery, including vital signs monitoring every 5 minutes for 30 minutes;
2) Criteria for safe transfer to the postnatal ward once stable, including pain level below 1;
3) Post-operative observations every 30 minutes for 2 hours then every 2 hours for 24 hours, including vital signs, pain, temperature and wound/loss monitoring.
The document summarizes the management of the second stage of labor. It describes:
1) Events that occur in the second stage, including full dilation of the cervix, rupture of membranes, and stronger uterine contractions that help push the baby down the birth canal.
2) General measures taken during the second stage like monitoring the patient and preparing for delivery by cleaning the perineal area.
3) The process of delivery, including maintaining flexion of the baby's head during crowning, performing an episiotomy if needed, and regulating the slow delivery of the head and shoulders before delivering the trunk.
4) Clamping and cutting the umbilical cord after full delivery.
This document describes the procedure for manual removal of the placenta (MRP). MRP is performed when the placenta fails to deliver within 30 minutes of childbirth. It involves inserting fingers into the uterus to locate and detach the placenta from the uterine wall while supporting the fundus. Once detached, the placenta is withdrawn from the uterus while continuing to provide counter-traction. Oxytocin is administered to encourage uterine contraction and prevent hemorrhage. The placenta is examined for completeness and the uterus is checked for contraction to ensure the procedure was successful. Potential complications include shock, postpartum hemorrhage, puerperal sepsis, and inversion or hysterectomy.
Newborn infants undergo several physiological adaptations after birth. The foramen ovale and ductus arteriosus close as pulmonary vascular resistance decreases and oxygen levels in the lungs increase. Temperature regulation is important as newborns have a narrow temperature range and lack body fat. They rely on caregivers to prevent heat loss through proper drying, skin-to-skin contact, and room temperature. Liver function also adapts as the immature liver transitions to breaking down bilirubin from red blood cells.
Breastfeeding provides significant health benefits to both infants and mothers by reducing the risk of various illnesses. The document discusses the physiology of lactation, including the roles of prolactin and oxytocin in milk production and ejection. It also covers common breastfeeding problems like low milk supply, mastitis, and breast abscess, providing diagnostic criteria and treatment recommendations. Maintaining proper latching, frequent feeding to stimulate supply, and emptying the breast are emphasized as ways to support breastfeeding success and maternal recovery from issues.
Definition-
The destructive operations are designed to diminish the bulk of the fetus so as to facilitate easy delivery through the birth canal
types
Craniotomy
Eviceration
Decapitation
Cleidotomy
CRANIOTOMY
Definition
It is an operation to make a perforation on the fetal head to evacuate the contents followed by extraction of the fetus
DECAPITATION
Definition
It is a destructive operation whereby the fetal head is severed from the trunk and the delivery is completed with the extraction of the trunk and that of the decapitated head per vaginam
CLEIDOTOMY
Definition
The operation consist of reduction in the bulk of the shoulder girdle by division of one or both the clavicles
Indications
Dead fetus with shoulder dystocia
Procedure
The clavicles are divided by the embryotomy scissors or long straight scissors introduced under the guidance of left two fingers placed inside the vagina
Teaching and supervision of health team membersKanchan Mehra
The document discusses teaching and supervision of various health team members. It provides details on the training and roles of community health workers, including village health guides, local dais, anganwadi workers, ANM workers, and ASHA workers. It also discusses hospital team members like doctors, physician assistants, nurses, pharmacists, technologists, therapists, and other support staff. Finally, it examines models of supervision for health team members, including external, group, community, and peer supervision. The objectives, prerequisites, optimal frequency, implementation considerations, and scale-up considerations are outlined for each supervision model.
Cord prolapse occurs when the umbilical cord slips below the presenting fetal part and out of the birth canal. It has an incidence of 1 in 300 deliveries and is more common in parous women. Risk factors include abnormal cord insertion, prematurity, and procedures that increase pressure on the cord before engagement. Clinical signs include bradycardia after rupture of membranes and variable or prolonged decelerations unresponsive to treatment. Management involves relieving pressure on the cord, positioning the mother, monitoring the fetus, and rapid delivery of the baby, usually by C-section.
Skilled Birth Attendant (SBA) training aims to improve maternal and newborn health outcomes by developing the skills of birth attendants. The document outlines SBA training conducted in Rajasthan, which focuses on managing normal pregnancies and deliveries, identifying and managing complications, and essential newborn care. It describes a 3-level training approach, monitoring efforts, and the goal of having skilled attendants at all levels to reduce maternal and infant mortality rates.
Role of midwife and independent nurse midwifery practitionerPinki sah
The document discusses the role of midwifery practices and independent nurse midwifery practitioners. It explains that midwives provide antenatal care, attend births, and provide postnatal care. They act as caregivers, coordinators, leaders, communicators, managers, educators, counselors, family planners, advisers, record keepers, and supervisors. It also defines independent nurse midwifery practitioners as registered nurses who provide midwifery care while maintaining accountability. It outlines the standards required for midwifery practice according to the American College of Nursing.
Role & responsibilities of mid level healthcare providersHarsh Rastogi
Role & responsibilities of mid level healthcare providers
Mid-level health providers (MLHPs) are health workers trained at a higher education institution for at least 2-3 years.
MLHP is a health provider who:
Who is trained, authorized and regulated to work autonomously,
Who receives pre-service training at a higher education institution for at least 2-3 years, and
Whose scope of practice includes (but is not restricted to) being able to diagnose, manage and treat illness, disease and impairments (including perform surgery, where appropriately trained), prescribe medicines, as well as engage in preventive and promotive care.
Intrauterine fetal demise can occur at any gestation. A case study describes a 29 year old woman at 37 weeks gestation who reported loss of fetal movement. Diagnosis of fetal demise was confirmed by ultrasound showing no fetal cardiac activity. Evaluation of fetal demise includes maternal studies, fetal autopsy when permitted, placental and cord examination. Management involves inducing labor as soon as possible to avoid risks of delayed delivery. Counseling supports the patient and reviews the pregnancy and delivery to guide management of future pregnancies.
Partograph is a composite graphical recording of progress of labour and salient condition of mother and fetus. For progress of labor and conditions of the mother and the fetus. It was developed and extensively tested by the world health organization (WHO)
This document provides an overview of shock in obstetrics, including definitions, classifications, pathophysiology, diagnosis, and management. It discusses the main types of shock seen in obstetrics such as hypovolemic (hemorrhagic), septic, cardiogenic, distributive, and anaphylactic shock. For each type, it outlines the causes, clinical features, and specific management approaches. Initial management focuses on maintaining airway, breathing, and circulation while treating the underlying cause.
This document discusses strategies for engaging men in sexual and reproductive health services. It notes that men can act as bridges transmitting infections to regular partners and emphasizes increasing awareness of prevention messages and condom use for men with infections. Specific strategies proposed include public awareness campaigns targeting men, condom promotion, and linking family planning and STI services to enable partner referral and treatment. The document also discusses challenges engaging men and approaches to address those challenges.
This document discusses drugs used in pregnancy, labor, and the postpartum period. It provides information on folic acid, iron, calcium, antihypertensive drugs, diuretics, tocolytic agents, and oxytocics. Key drugs discussed include labetalol, nifedipine, methyldopa, hydralazine, furosemide, isoxsuprine, ritodrine, and oxytocin. Dosages, indications, contraindications, and nursing considerations are provided for many of the drugs.
The document summarizes the recommendations of the Sarojini Varadappan committee from 1989 regarding improving nursing conditions in India. The committee recommended: 1) Standardizing employment procedures and creating more nursing posts; 2) Reducing weekly working hours to 40, implementing straight shifts, and providing leave for extra hours; 3) Developing centralized support services in hospitals to reduce nurses' workload. It also provided guidance on pay/allowances, promotions, education, and community healthcare. The goal was to professionalize nursing and address issues like staffing shortages, long hours, and lack of support.
This document discusses several minor disorders that can occur in newborns, including oral thrush, ophthalmic neonatorum, omphalitis, neonatal mastitis, nasopharyngitis, excessive crying, abdominal distention, constipation, diarrhea, vomiting, neonatal jaundice, sore buttocks, and napkin rashes. For each disorder, the document defines the condition, describes signs and symptoms, and provides recommendations for management and treatment. The overall document serves to educate mothers and medical staff on common minor health issues in newborns and appropriate care responses.
Normal labor occurs spontaneously at term with the fetus presenting head first. It progresses through three stages: cervical dilation, birth of the fetus, and delivery of the placenta. The first stage consists of latent, active, and transitional phases defined by cervical dilation rates. Monitoring labor using a partogram allows for early detection of abnormalities like prolonged dilation or stalled progress. Midwifery care focuses on comfort, monitoring, and addressing any complications to achieve a healthy delivery.
The Janani Suraksha Yojana (JSY) program was launched in 2005 as a replacement for the National Maternity Benefit Scheme with the objectives of reducing maternal and infant mortality rates by encouraging institutional deliveries. It provides cash assistance integrated with antenatal and postnatal care, targeting women below the poverty line in both rural and urban areas. The cash benefits provided vary between low and high performing states. The Janani Shishu Suraksha Karyakram (JSSK) was introduced in 2011 to provide cashless delivery and newborn care services.
The document discusses the Reproductive and Child Health (RCH) program in India. It aims to integrate existing programs related to family planning, maternal and child health, and reproductive health. The RCH program incorporates components for family planning, child survival and safe motherhood, prevention of sexually transmitted diseases/infections, and adolescent health. It aims to promote maternal and child health, reduce mortality, and achieve population stabilization through a client-oriented and decentralized approach.
The document discusses reproductive health and maternal and child health care in India. It defines reproductive health and outlines key milestones in MCH care such as establishment of training for birth attendants in 1880 and adoption of the family planning program in 1952. The document also summarizes the Reproductive and Child Health Program Phase 1 and 2, which adopted a holistic, community-based approach. The strategies of RCH-II aimed to reduce maternal and infant mortality through improved access to skilled care, immunization, and cash incentive programs like Janani Suraksha Yojana.
The document summarizes the management of the second stage of labor. It describes:
1) Events that occur in the second stage, including full dilation of the cervix, rupture of membranes, and stronger uterine contractions that help push the baby down the birth canal.
2) General measures taken during the second stage like monitoring the patient and preparing for delivery by cleaning the perineal area.
3) The process of delivery, including maintaining flexion of the baby's head during crowning, performing an episiotomy if needed, and regulating the slow delivery of the head and shoulders before delivering the trunk.
4) Clamping and cutting the umbilical cord after full delivery.
This document describes the procedure for manual removal of the placenta (MRP). MRP is performed when the placenta fails to deliver within 30 minutes of childbirth. It involves inserting fingers into the uterus to locate and detach the placenta from the uterine wall while supporting the fundus. Once detached, the placenta is withdrawn from the uterus while continuing to provide counter-traction. Oxytocin is administered to encourage uterine contraction and prevent hemorrhage. The placenta is examined for completeness and the uterus is checked for contraction to ensure the procedure was successful. Potential complications include shock, postpartum hemorrhage, puerperal sepsis, and inversion or hysterectomy.
Newborn infants undergo several physiological adaptations after birth. The foramen ovale and ductus arteriosus close as pulmonary vascular resistance decreases and oxygen levels in the lungs increase. Temperature regulation is important as newborns have a narrow temperature range and lack body fat. They rely on caregivers to prevent heat loss through proper drying, skin-to-skin contact, and room temperature. Liver function also adapts as the immature liver transitions to breaking down bilirubin from red blood cells.
Breastfeeding provides significant health benefits to both infants and mothers by reducing the risk of various illnesses. The document discusses the physiology of lactation, including the roles of prolactin and oxytocin in milk production and ejection. It also covers common breastfeeding problems like low milk supply, mastitis, and breast abscess, providing diagnostic criteria and treatment recommendations. Maintaining proper latching, frequent feeding to stimulate supply, and emptying the breast are emphasized as ways to support breastfeeding success and maternal recovery from issues.
Definition-
The destructive operations are designed to diminish the bulk of the fetus so as to facilitate easy delivery through the birth canal
types
Craniotomy
Eviceration
Decapitation
Cleidotomy
CRANIOTOMY
Definition
It is an operation to make a perforation on the fetal head to evacuate the contents followed by extraction of the fetus
DECAPITATION
Definition
It is a destructive operation whereby the fetal head is severed from the trunk and the delivery is completed with the extraction of the trunk and that of the decapitated head per vaginam
CLEIDOTOMY
Definition
The operation consist of reduction in the bulk of the shoulder girdle by division of one or both the clavicles
Indications
Dead fetus with shoulder dystocia
Procedure
The clavicles are divided by the embryotomy scissors or long straight scissors introduced under the guidance of left two fingers placed inside the vagina
Teaching and supervision of health team membersKanchan Mehra
The document discusses teaching and supervision of various health team members. It provides details on the training and roles of community health workers, including village health guides, local dais, anganwadi workers, ANM workers, and ASHA workers. It also discusses hospital team members like doctors, physician assistants, nurses, pharmacists, technologists, therapists, and other support staff. Finally, it examines models of supervision for health team members, including external, group, community, and peer supervision. The objectives, prerequisites, optimal frequency, implementation considerations, and scale-up considerations are outlined for each supervision model.
Cord prolapse occurs when the umbilical cord slips below the presenting fetal part and out of the birth canal. It has an incidence of 1 in 300 deliveries and is more common in parous women. Risk factors include abnormal cord insertion, prematurity, and procedures that increase pressure on the cord before engagement. Clinical signs include bradycardia after rupture of membranes and variable or prolonged decelerations unresponsive to treatment. Management involves relieving pressure on the cord, positioning the mother, monitoring the fetus, and rapid delivery of the baby, usually by C-section.
Skilled Birth Attendant (SBA) training aims to improve maternal and newborn health outcomes by developing the skills of birth attendants. The document outlines SBA training conducted in Rajasthan, which focuses on managing normal pregnancies and deliveries, identifying and managing complications, and essential newborn care. It describes a 3-level training approach, monitoring efforts, and the goal of having skilled attendants at all levels to reduce maternal and infant mortality rates.
Role of midwife and independent nurse midwifery practitionerPinki sah
The document discusses the role of midwifery practices and independent nurse midwifery practitioners. It explains that midwives provide antenatal care, attend births, and provide postnatal care. They act as caregivers, coordinators, leaders, communicators, managers, educators, counselors, family planners, advisers, record keepers, and supervisors. It also defines independent nurse midwifery practitioners as registered nurses who provide midwifery care while maintaining accountability. It outlines the standards required for midwifery practice according to the American College of Nursing.
Role & responsibilities of mid level healthcare providersHarsh Rastogi
Role & responsibilities of mid level healthcare providers
Mid-level health providers (MLHPs) are health workers trained at a higher education institution for at least 2-3 years.
MLHP is a health provider who:
Who is trained, authorized and regulated to work autonomously,
Who receives pre-service training at a higher education institution for at least 2-3 years, and
Whose scope of practice includes (but is not restricted to) being able to diagnose, manage and treat illness, disease and impairments (including perform surgery, where appropriately trained), prescribe medicines, as well as engage in preventive and promotive care.
Intrauterine fetal demise can occur at any gestation. A case study describes a 29 year old woman at 37 weeks gestation who reported loss of fetal movement. Diagnosis of fetal demise was confirmed by ultrasound showing no fetal cardiac activity. Evaluation of fetal demise includes maternal studies, fetal autopsy when permitted, placental and cord examination. Management involves inducing labor as soon as possible to avoid risks of delayed delivery. Counseling supports the patient and reviews the pregnancy and delivery to guide management of future pregnancies.
Partograph is a composite graphical recording of progress of labour and salient condition of mother and fetus. For progress of labor and conditions of the mother and the fetus. It was developed and extensively tested by the world health organization (WHO)
This document provides an overview of shock in obstetrics, including definitions, classifications, pathophysiology, diagnosis, and management. It discusses the main types of shock seen in obstetrics such as hypovolemic (hemorrhagic), septic, cardiogenic, distributive, and anaphylactic shock. For each type, it outlines the causes, clinical features, and specific management approaches. Initial management focuses on maintaining airway, breathing, and circulation while treating the underlying cause.
This document discusses strategies for engaging men in sexual and reproductive health services. It notes that men can act as bridges transmitting infections to regular partners and emphasizes increasing awareness of prevention messages and condom use for men with infections. Specific strategies proposed include public awareness campaigns targeting men, condom promotion, and linking family planning and STI services to enable partner referral and treatment. The document also discusses challenges engaging men and approaches to address those challenges.
This document discusses drugs used in pregnancy, labor, and the postpartum period. It provides information on folic acid, iron, calcium, antihypertensive drugs, diuretics, tocolytic agents, and oxytocics. Key drugs discussed include labetalol, nifedipine, methyldopa, hydralazine, furosemide, isoxsuprine, ritodrine, and oxytocin. Dosages, indications, contraindications, and nursing considerations are provided for many of the drugs.
The document summarizes the recommendations of the Sarojini Varadappan committee from 1989 regarding improving nursing conditions in India. The committee recommended: 1) Standardizing employment procedures and creating more nursing posts; 2) Reducing weekly working hours to 40, implementing straight shifts, and providing leave for extra hours; 3) Developing centralized support services in hospitals to reduce nurses' workload. It also provided guidance on pay/allowances, promotions, education, and community healthcare. The goal was to professionalize nursing and address issues like staffing shortages, long hours, and lack of support.
This document discusses several minor disorders that can occur in newborns, including oral thrush, ophthalmic neonatorum, omphalitis, neonatal mastitis, nasopharyngitis, excessive crying, abdominal distention, constipation, diarrhea, vomiting, neonatal jaundice, sore buttocks, and napkin rashes. For each disorder, the document defines the condition, describes signs and symptoms, and provides recommendations for management and treatment. The overall document serves to educate mothers and medical staff on common minor health issues in newborns and appropriate care responses.
Normal labor occurs spontaneously at term with the fetus presenting head first. It progresses through three stages: cervical dilation, birth of the fetus, and delivery of the placenta. The first stage consists of latent, active, and transitional phases defined by cervical dilation rates. Monitoring labor using a partogram allows for early detection of abnormalities like prolonged dilation or stalled progress. Midwifery care focuses on comfort, monitoring, and addressing any complications to achieve a healthy delivery.
The Janani Suraksha Yojana (JSY) program was launched in 2005 as a replacement for the National Maternity Benefit Scheme with the objectives of reducing maternal and infant mortality rates by encouraging institutional deliveries. It provides cash assistance integrated with antenatal and postnatal care, targeting women below the poverty line in both rural and urban areas. The cash benefits provided vary between low and high performing states. The Janani Shishu Suraksha Karyakram (JSSK) was introduced in 2011 to provide cashless delivery and newborn care services.
The document discusses the Reproductive and Child Health (RCH) program in India. It aims to integrate existing programs related to family planning, maternal and child health, and reproductive health. The RCH program incorporates components for family planning, child survival and safe motherhood, prevention of sexually transmitted diseases/infections, and adolescent health. It aims to promote maternal and child health, reduce mortality, and achieve population stabilization through a client-oriented and decentralized approach.
The document discusses reproductive health and maternal and child health care in India. It defines reproductive health and outlines key milestones in MCH care such as establishment of training for birth attendants in 1880 and adoption of the family planning program in 1952. The document also summarizes the Reproductive and Child Health Program Phase 1 and 2, which adopted a holistic, community-based approach. The strategies of RCH-II aimed to reduce maternal and infant mortality through improved access to skilled care, immunization, and cash incentive programs like Janani Suraksha Yojana.
The document discusses India's RMNCH+A (Reproductive, Maternal, Newborn, Child Health + Adolescence) strategy. It outlines the history and evolution of family welfare programs in India. The current goals are to reduce infant mortality, maternal mortality, and total fertility rate by 2017. The strategy focuses on providing a continuum of care through various levels of the health system across different life stages. Key interventions include reproductive health services, antenatal care, skilled birth attendance, postnatal care, and improving health systems and monitoring. The strategy aims to strengthen primary healthcare and community participation to improve maternal and child health outcomes across India.
Reproductive and child health phase IIManoj Vaidya
RCH Phase-II outlines new initiatives to improve reproductive and child health in India, including making First Referral Units functional, training MBBS doctors in life-saving skills, and establishing blood storage facilities. The Janani Suraksha Yojana cash incentive program aims to increase institutional deliveries. Other initiatives proposed include the Rural Health Care Mission, establishing referral transport, and designating Accredited Social Health Activists. Infection management and environment plans will be implemented, and safe abortion practices like medical and MVA methods will be supported. Quality indicators are used to monitor programs through monthly reporting.
The document discusses maternal health and efforts to improve it. It notes that while maternal mortality has declined globally in recent decades, it remains high in many developing countries. It outlines several indicators of maternal health in India that have improved between 2005-06 and 2014-15, such as antenatal care and institutional births. However, maternal mortality still varies greatly between states. The document proposes strengthening maternal health through expanding programs that provide antenatal, delivery and postnatal care, especially in rural areas, as well as improving infrastructure and monitoring systems.
The document discusses the Reproductive and Child Health (RCH) Programme in India. Some key points:
- The RCH Programme was launched in 1997 with the objectives of reducing maternal, infant, and under-5 mortality as well as promoting adolescent health.
- The programme aimed to achieve targets such as an infant mortality rate below 60 per 1000 live births and a maternal mortality rate below 400 per 100,000 live births.
- RCH Phase 2 was launched in 2005 with a focus on achieving the Millennium Development Goals and expanding access to essential obstetric and newborn care services.
- The strategies under RCH include improving antenatal, delivery and postnatal services; increasing
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.
At the 2016 CCIH Annual Conference, Dr. Tonny Tumwesigye of the Uganda Protestant Medical Bureau discusses how UPMB incorporated fertility awareness methods into its Family Planning services to expand options for families.
The National Family Welfare Programme was launched in 1952 to promote family planning and improve quality of life. It aims to encourage small family sizes and use of spacing methods. Key strategies include integrating family welfare services with health services, focusing on rural areas, and using mass media campaigns. The programme monitors indicators like contraceptive use, antenatal care coverage, and immunization rates. Maternal and Child Health programmes were also launched to reduce mortality and morbidity rates by providing reproductive health services, nutrition programmes, and disease prevention.
The document outlines key strategies for improving maternal health in India, including using the Mother and Child Tracking System (MCTS) to ensure early registration of pregnancy and full antenatal care, detecting and line listing high-risk pregnancies like severely anemic mothers to ensure management, and equipping delivery points with facilities for basic and comprehensive obstetric and newborn care available 24/7. It also discusses reviews of maternal, perinatal and child deaths to understand gaps in health services and strategies to strengthen health infrastructure for maternal and newborn care.
High impact interventions in rmnch+a(mch)partSudha Goel
The document outlines India's RMNCH+A (Reproductive, Maternal, Newborn, Child and Adolescent Health) strategy to improve maternal and child health outcomes. It discusses key interventions across the life cycle continuum of care, from adolescence through pregnancy, childbirth, postnatal care for mothers and newborns, and into childhood. The strategy is based on implementing high-impact interventions through a 5x5 matrix across each thematic area (maternal health, newborn care, etc.) and strengthening the overall health system. The goals are to reduce India's infant mortality rate, maternal mortality ratio, and total fertility rate by 2017.
The NRHM aims to provide accessible and quality healthcare to rural populations. It focuses on reducing maternal and infant mortality rates through programs like ICDS, CSSM, JSY and RCH. ICDS provides nutrition and health services to children aged 0-6 years. CSSM aims to improve MCH services and reduce MMR and IMR. JSY provides cash incentives for institutional deliveries. RCH integrates programs related to fertility, MCH and reproductive health. Expanded immunization programs aim to immunize all children and pregnant women.
New Microsoft Office PowerPoint Presentation(1).pdfkarishmakc1
Maternal and child health aims to improve the health and wellbeing of mothers, children, and adolescents. Its objectives include reducing mortality and morbidity during pregnancy, childbirth, and childhood. Key components are family planning, maternal and child healthcare services, and health system strengthening. Globally, the maternal mortality ratio has declined but many deaths are still preventable. In Nepal, the maternal mortality ratio has also decreased but goals remain to further reduce rates. The Safe Motherhood program focuses on increasing access to skilled birth attendants and emergency obstetric care through various community-based and facility-based initiatives.
The document summarizes the Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA), a program launched by the Indian government to provide free and comprehensive antenatal care to pregnant women. The key goals of PMSMA are to improve antenatal care quality and coverage, and reduce maternal and neonatal mortality rates. On the 9th of every month, the program provides services like diagnostic tests, screenings, management of conditions, and counseling at designated public health centers supplemented by private healthcare practitioners. Identification of high-risk pregnancies and improving care for at-risk groups are emphasized.
Presentation1 on Reproductive & Child HealthShan Damrolien
The Reproductive & Child Health Programme was launched in 1997 to integrate and strengthen existing family planning and child and maternal health services. The program aims to provide high quality, client-centered care to improve reproductive health. Key strategies include upgrading facilities, increasing access to obstetric and newborn care, treating reproductive tract infections, and encouraging community participation through local organizations. The second phase of RCH, launched in 2005, focuses on increasing institutional deliveries and emergency obstetric care through training and infrastructure improvements. Progress is monitored using indicators like antenatal care coverage, immunization rates, and access to treatment for common childhood illnesses.
The document discusses the Reproductive and Child Health (RCH) Programme in India. It provides definitions of reproductive health and outlines key milestones in developing the RCH Programme such as integrating family welfare services in 1983 and launching the Child Survival and Safe Motherhood Programme in 1992 which was later replaced by RCH Phase I in 1997. The goals, components and services of the RCH Programme are described with a focus on maternal, newborn and child health.
This document provides an overview of the Reproductive, Maternal, Neonatal, Child and Adolescent Health (RMNCH+A) initiative in India. It discusses the background and goals of reducing infant mortality, maternal mortality, and fertility rates. It outlines the key interventions and coverage targets of the initiative, including increasing institutional deliveries and access to healthcare. The document also describes various components of reproductive health, maternal health, and their related programs in India such as Janani Suraksha Yojana, Village Health and Nutrition Days, and Pradhan Mantri Surakshit Matritva Abhiyan.
The document outlines Nepal's Safe Motherhood Programme which aims to reduce maternal and neonatal morbidity and mortality through various strategies and activities. The major strategies include promoting birth preparedness, expanding 24-hour birthing facilities, and emergency obstetric care services. Key activities involve community-level maternal and newborn interventions, expanding service delivery sites, emergency referral funds, and programs to provide free delivery services and newborn supplies. The goals are to address delays in seeking and receiving care and improve access to institutional deliveries and emergency obstetric services.
High impact interventions in rmnch+a(mch) for itcSudha Goel
1) The document outlines India's RMNCH+A (Reproductive, Maternal, Newborn, Child Health + Adolescence) strategy, which takes a comprehensive, life cycle approach to improving maternal and child health outcomes.
2) It describes 25 high-impact interventions across 5 thematic areas (maternal health, newborn care, child health, family planning and nutrition) that are implemented at the community and facility levels as part of the "continuum of care".
3) The goals of the strategy are to reduce India's infant mortality rate, maternal mortality ratio, and total fertility rate by 2017 through improved coverage and quality of these priority interventions.
The document discusses extrapyramidal disorders and basal ganglia disorders. It provides information on:
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Mirror neurons are neurons that fire both when an individual performs an action and when they observe the same action being performed by another. Mirror therapy uses a mirror to create the visual illusion that a paralyzed or weakened limb is moving normally. It activates the patient's mirror neuron system and has been shown to improve motor function and reduce pain in various conditions such as stroke, complex regional pain syndrome, phantom limb pain, and Parkinson's disease. The mechanism involves activation of the motor cortex through visual feedback that stimulates neuroplasticity and motor learning. Precautions include ensuring a coherent mirror image and avoiding risks of injury or distraction.
This document provides information on limb length measurement and discrepancies. It defines true and apparent limb length measurement and describes various methods to measure limb lengths, including using a tape measure between bony landmarks or blocks under the shorter limb. Causes of limb length discrepancies include fractures, infections, bone diseases, tumors and more. Supra-trochanteric and infra-trochanteric shortening are distinguished and different measurement techniques are outlined for each.
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This document discusses the management of infertility. It begins with definitions and classifications of infertility. Evaluation involves a medical history and physical exam for both males and females. Common causes of infertility in males include infection, trauma, and exposure to toxins, while common causes in females include disorders of ovulation, fallopian tube damage or blockage, endometriosis, and uterine issues. Treatment options discussed include counseling, lifestyle changes, ovulation induction with clomiphene or aromatase inhibitors, gonadotropins, intrauterine insemination, in vitro fertilization, and intracytoplasmic sperm injection. The goal is to stimulate follicle development and ovulation or perform fertilization procedures to increase the chances of conception.
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5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
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Debunking Nutrition Myths: Separating Fact from Fiction"AlexandraDiaz101
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The key to a good grip on asthma is proper knowledge and management strategies. Understanding the patient-specific symptoms and carving out an effective treatment likewise is the best way to keep asthma under control.
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Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
Are you looking for a long-lasting solution to your missing tooth?
Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
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Your smile is beautiful.
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Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
2. Dr. Mahendra kumar verma 2
Lesson Objectives
To Learn about the various components of RCH
program
To know about the goals. objectives target groups,
service components and RCH program
To know about the services/activities under the
program
To know about the new initiatives in the program
3. Dr. Mahendra kumar verma
3
Components
The RCH program incorporated the earlier
existing programs i.e. National Family
Welfare Program and Child Survival and
Survival & Safe Motherhood Program (
CSSM) and added two more components
one relating to sexually transmitted disease
and the other relating to reproductive tract
infections. The program was formally
launched on 15 October 1997.
4. Dr. Mahendra kumar verma 4
Components:
FAMILY PLANNING
CHILD SURVIVAL
AND SAFE
MOTHERHOOD
PREVENTION/
MANAGEMENTOF
RTI/STD/AIDS
CLIENT
APPROACH
TO HEALTH
CARE
Adolescent
Health Care
and Family
Life
Education
5. Dr. Mahendra kumar verma 5
RCH PROGRAM
Family
Planning
Improved
method mix
Private sector
inclusion
Address quality
Collaborate
with NACO in
condom
distribution
Maternal Health
•Quality ANC
•Institutional
Deliveries
•Skilled Birth
Attendance
• EmObstetric care
•Home based post-
partum & NBC
•Quality safe abortion
services
•RTI/STI
Child Health)
•Intensify existing
services :
Immunization,
NBC
Micronutrient
Supply
CDD
ARI
• IMNCI.
Adolescent
health
•Anemia
•Awareness about
RH issues
6. Dr. Mahendra kumar verma 6
RCH Program (cross cutting Issues)
Human
Resources
Anesthetists
Obstetricians
Lady doctors
Contractual
ANMs
Staff Nurses in
24 Hrs PHCs
Counselor
IEC
•Branding
•Involving
Professional
Agencies
•Media
•Inter-personal
Communication
•Celebrity
involvement
ISC
•Awareness
about RH
issues
•Anemia
MIS
•Output based
Monitoring
•Triangulation
of Data
•CES/DHS
9. vDr. Mahendra kumar verma
9
Target Oriented Goal Oriented
Performance by
Numbers
Performance by
Quality
• Top Down
• Target Driven
• Bottom up
• Client Need Based
• Community
Participation
• To the Govt. System • To the Clients,
Community
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Program Objectives
Promotion of MCH to ensure safe
mother hood and child survival
Reduction of maternal and child
morbidity and mortality
Attainment of population stabilization
11. Dr. Mahendra kumar verma 11
Highlights of the program
Integration of all programs related fertility regulation,
maternal and child health and reproductive health.
Services are client oriented, demand driven through
decentralized participatory process and target free
approach
Up-gradation of facilities : creation of First referral
units
Provision of specialist services for STD and RTI
Provision of out reach services for vulnerable groups
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Categories:
Differential approach
Based on CBR and female literacy rate,
Category A:58 districts
Category B:184 districts
Category C:265 districts
All the districts covered in a phased manner
over a period of 3yrs
13. Dr. Mahendra kumar verma
13
Service Package: for mothers
Essential obstetric care
Early registration
Minimum 3 ANC
Safe delivery
3 PNC
Referral
More relevant for Assam, Bihar,Rajasthan,
Orissa,UP, MP
14. Dr. Mahendra kumar verma 14
Emergency obstetric care
Strengthen FRUs
Supply of kits and skilled manpower
TBA (Traditional Birth Attendants) Dai training
NGOs involved: More local specific
24-hr Delivery services at
PHCs/CHCs:
Promote institutional deliveries Additional
honorariumto staff
Safe deliveries
15. Dr. KANUPRIYA CHATURVEDI 15
Contd.
Deliveries by trained personnel in safe and hygienic
surroundings are encouraged
Institutional deliveries are encouraged for women
having complications.
In case of complication referrals are made to First
Referral Units for Management of obstetric
emergencies.
Three postnatal checkups are given to mothers after
the delivery.
Spacing of at least three years between children are
encouraged.
16. Dr. Dr. Mahendra kumar verma
16
For children
Essential newborn care like keeping the baby
warm, checking the baby’s weight and giving
the baby mother’s first milk are encouraged.
Babies that are premature or have low birth
weight are provided special care.
Babies with any complications refereed to
the health center.
Exclusive breast-feeding are encouraged for
the first three months.
17. Dr. Mahendra kumar verma
17
Contd.
Immunization are administered to every child
meticulously to prevent death and disabilities.
Vitamin A Prophylaxis
ORT.
Acute respiratory infection in children treated by
cotrimoxazole tablets.
Treatment of Anemia
18. Dr. Mahendra kumar verma 18
For Eligible Couples
Promoting use of contraceptive methods among
eligible couples is important to prevent unwanted
pregnancies. Couples should be able to choose from
various contraceptive methods including
condoms,oral pills, IUDs,male and female
sterilization
Safe services for medical termination of pregnancies
should be encouraged for women desiring abortions
Other New Services
Treatment of RTI/STI is given.
Promotion activities for adolescents health.
19. Dr. Mahendra kumar verma 19
Drug and equipment kits: Mid-wifery kit &
drug kit
Kit-E – Laparotomy set
Kit-F - Mini– Laparotomy set
Kit-G – IUD insertion set
Kit-H – Vasectomy set
Kit- I – Normal delivery set
Kit- J – Vacuum extraction set
Kit- k – Embryotomy set
Kit- L – Uterine evacuation set
Kit-M – Equipment for anesthesia
Kit-N- Neonatal resuscitation set
Kit-O- Equipment and reagent for blood test
Kit-P – Donor blood transfusion set
20. Dr. Mahendra kumar verma 20
Goals set for various national /int. policies
21. Dr. Mahendra kumar verma 21
RCH Program: Phase II
RCH Phase II began from 1 April 2005. The components
being:
Essential obstetrical care
Emergency obstetrical care
Strengthening referral system Strengthening project
management
Strengthening infrastructure
Capacity building
Improving referral system
Strengthening MIS
Innovative schemes
22. Dr. Mahendra kumar verma 22
Essential obstetric care
Promotion of institutional deliveries
50% of the PHCs and CHCs made operational as 24
hours delivery centers.
Skilled attendance at birth
Policy descions to permit Health workers to use
drugs in emergency situations to reduce maternal
mortality
23. Dr. Mahendra kumar verma 23
Emergency obstetric care
Operationalisation of FRUs to provide:
24 hours delivery services
Emergency obstetric care
New born care and emergency care of the sick child
Full range of family planning services
Safe abortion services
Treatment of RTI and STI
Blood storage facility
Essential laboratory services
Referral ( transport ) services
24. Dr. Mahendra kumar verma 24
New initiatives
Training of PHC doctors in life saving anesthetic
skills for emergency obstetric care a FRUs
Setting up of blood storage centres at FRUs
Janani suraksha yojana
Vandemataram scheme
Safe abortion services
Integrated Management of Childhood illnesses.
25. Dr. Mahendra kumar verma 25
24 hrs. Functioning of PHCs
• It is planned to establish 2000 FRUs in phases in
RCH-II 50% PHCs and all CHCs to be
operationalised in phases
• Availability of Services such as
- 24 Hrs. Delivery services
- New Born care
- Family Planning, Counselling and services
- Availability of RTI, STI services
- Safe abortion services (MVA etc.)
26. Dr. Mahendra kumar verma 26
Training in Anaesthesia
• Training of MBBS Doctors in Life Saving
Anaesthetic Skills for Emergency Obstetric Care.
• 18 weeks training course
• The First Training Programme
Conducted at AIIMS for Chhattisgarh
• Training to be conducted in phases
and limited to the requirement at
FRUs.
27. Dr. Mahendra kumar verma 27
Training in Obstetric Management
• Training of MBBS doctors in obstetric
management and skills including C.S. in
RCH-II
• Training to be conducted in collaboration
with FOGSI
• Duration of training to be 16 weeks
• Expert Group is considering other details
28. Dr. Mahendra kumar verma 28
Blood Storage Facility
Management of obstetric emergencies is sometimes
not possible due to non-availability of blood.
The Drugs and Cosmetics Act was therefore
modified to facilitate establishment of blood
storage centres at FRU’s.
29. Dr. Mahendra kumar verma 29
Janani Surkasha Yojna
To promote Institutional Deliveries
To reduce overall
Maternal Mortality Ratio
Infant Mortality Rate
A safe motherhood intervention, replacing the
“NationalMaternity Benefit Scheme”, under NRHM
100 % centrally sponsored
Integrates cash assistance with delivery
& post-delivery care.
30. Dr. Mahendra kumar verma 30
Vandematram Scheme
It is a voluntary scheme wherein any obstetric and
gynaec specialist, maternity home can volunteer
Enrolled doctors will display ‘vandemataram logo’
at their clinics.
Iron and folic acid tablets, oral pills, TT injections,
etc will be provided for free distribution.
31. 31
Referral Transport
Key issues: Roads, transportation, RCH I funds
poorly Utilized, Community participation lacking
Under Consideration
– Place funds with AWW /ANM; [ JSY]
– Develop community mechanisms
– Provide out source ambulances at PHCs
CHCs, and FRUs
Easy access to ambulance & assistance from AWW
32. Dr. Mahendra kumar verma 32
Role of ASHA
• A village level link worker attached to
AWW/ANM
• Motivator for ANC, PNC, Institutional
Delivery, Immunization and
Family Planning Services
• Provide Escort to beneficiary for above
services.
• Adolescents Health Counsellor.
33. DrDr. Mahendra kumar verma 33
Strategy for addressing Adolescent
Reproductive and Sexual Health (ARSH)
A two-pronged strategy will be supported:
Incorporation of adolescent issues in all the
RCH training programs and all RCH materials
developed for communication and behaviour
change.
Dedicated days and dedicated timings for
adolescents at PHC’s.
34. Dr. Mahendra kumar verma 34
Infection Management and Environment
Plan
IMEP which is being extended to health care
facilities includes:
a) Treatment and disposal of
biomedical wastes
b) Disposal of syringe waste
c) Provision of water sanitation and
good hygiene conditions
35. Dr. Mahendra kumar verma 35
Safe Abortion Practices
MEDICAL METHOD
Termination of early pregnancy (49days) using 2 drugs
- mifeprestone followed by mesoprostol
MANUAL VACCUM ASPIRATION
Safe and simple technique for termination of pregnancy.
Can be used at PHC or comparable facility
FOGSI, WHO & state govt. are coordinating the project
36. Dr. Mahendra kumar verma 36
Some Innovative State Initiatives
Gujarat
Increase access to safe delivery services. It is in partnership
with private providers (Chiranjivi Yojana)
A Dai Sangathan has been formed by 10 leading NGOs of
the state to facilitate interface between the health system and
the community
Punjab
Proposed to pay an incentive of Rs. 500/- to BPL SCs
belonging to urban areas
Purchase and supply of nutrients like iron, calcium, D-
worming tablets for pregnant mothers belonging to SC
classes.
37. Dr. Mahendra kumar verma 37
Contd….
Screening code for Ca Cervix – Tamil Nadu
Subsidized Medical Practitioner (SMP) scheme-
Assam, Bihar
Nurse Practitioners Scheme
Laproscopic Training – Maharashtra
Implementation of Health Insurance scheme on
pilot basis.
38. Dr. Mahendra kumar verma 38
Monitoring :
Accessibility Indicators
No. of eligible couples registered/ANM
No. of Antenatal Care sessions held as planned
% of sub Centers with no ANM
% of sub Centers with working equipment of ANC
% ANM/TBA without requisite skill
% sub centers with DDKs
% of sub centers with infant weighing machine
% subcenters with vaccine supplies
% sub centers with ORS packets
% sub centers with FP supplies
39. Dr. Mahendra kumar verma 39
Quality Indicators
Following are the quality indicators used to monitor and evaluate
RCH programme through monthly reports:
1. Number of antenatal cases registered
2. Number of pregnant women who had 3 antenatal checkups
3. Number of high risk pregnant women referred
4. Number of pregnant women who had 2 doses of TT
5. Number of pregnant women under prophylaxis and treatment of
anaemia
6. Number of deliveries by trained and untrained attendants
7. Number of cases with complications referred to
PHC/FRU
8. Number of newborn with birth weight recorded
40. Dr. Mahendra kumar verma 40
Contd..
9. No. of women given 3 post natal check-ups
10. No. of RTI/STD cases detected, treated and referred
11. No. of children fully immunized
12. No. of adverse reactions reported after immunization
13. No. of cases of ARI and diarrhea under 5yrs
14. No. of cases motivated and followed for contraception.
41. Dr. Mahendra kumar verma 41
Impact Indicators
% DEATHS FROM MATERNAL CAUSES
MATERNAL MORTALITY RATIO
PREVALENCE OF MATERNAL MORBIDITY
% LOW BIRTH WEIGHT
NEO-NATAL MORTALITY RATIO
PREVALENCE OF POST NATAL MATERNAL MORBIDITY
% BABY BREAST FEED WITHIN 6 HRS OF DELIVERY
COUPLE PROTECTION RATE
PREVALENCE OF TERMINAL METHOD OF STERILIZATION
PREVALENCE OF SPACING METHOD
% ABORTION RELATED MORBIDITY
PREVALENCE OF ADD
PREVALENCE OF ARI
PREVALENCE OF RTI/STDs