Reproductive and Child Health Services

1. REPRODUCTIVE & CHILD
HEALTH PROGRAM
Presented by:
Mr. Veeresh R Demashetti
MSc(N)
Dept. of Community Health Nursing

2. Background
 Maternal and child health
- Madras state was the first to establish a
separate Maternal Welfare section in
office of District of Health Services in
1931
- In 1946 the Bhore Committee
recommended the integration of MCH
within General Health Services
- But implimenatation occurred after 1955

3. Introduction
 The reproductive and child health
program was formally launched by Gov.
of India on 15th Oct 1997.
 As per recommendation of International
Conference on Population and
development held in Cario in 1994.

4. Definition
 In ICPD at Cairo, Fathallah defined RCH
as “A state of complete, physical, mental,
and social well-being and merely the
absence of disease or infirmity in all
matters relating to reproductive system
and its function and process.”

5. Cont…
 “States in which people have the ability to
reproduce and regulate their fertility are
able to go through pregnancy and child
birth, the outcome of pregnancy is
successful in terms of maternal and infant
survival and well-being, and couples are
able to have sexual relation free of the
fear of pregnancy and of contracting
diseases.”

6. Objective
 To promote the health of the mothers and
children to ensure safe motherhood and
child survival.
 The intermediate objective is to reduce
IMR & MMR.
 The ultimate objective is population
stabilization, through responsible
reproductive behavior.

7. Intervention & concept to RCH
 Prevention and management of unwanted
pregnancies.
 Maternal care (safe motherhood)
 Child survival
 Prevention and management of RTIS /STD
 Prevention of HIV/AIDS

8. Components of RCH
 Following services are included in the
reproductive health area as proposed by
Government of India.
 MAIN COMPONENTS:-
◦ Family planning
◦ Child survival and safe motherhood program
◦ Prevention /management of RTI/STD and
AIDS
◦ Client approach to health care.

9. Other activities
 Providing counseling, information and
communication services on health,
sexuality and gender difference.
 Referral services for all above
intervention.
 Growth monitoring, nutrition education,
reproductive health services for
adolescents etc.

10. RCH package for various
services
 For maternal services (safe-motherhood):-
The service components are obstetric care,
infection control and nutrition promotion.

11. Cont…
 For child services (child survival):-The
essential care of the newborn, including care
of the at risk newborn by prompt referral
service.
◦ Infection control measures.
◦ Nutritional Promotions.

12. Cont…
 Reproductive Health:-
◦ Fertility control
◦ MTP services (for prevention and
management of unwanted Pregnancies.
◦ Adolescent
◦ HIV/ AIDS

13. RCH Program Phase 1
 Under the RCH Programme Phase 1,
various provision were made to improve
the status of maternal and child health.
These include:-
 Provision of essential & emergency care.
 Provision of equipment and drug kits to
selected PHCs and selected FRUs in all
districts.

14. Cont…
 Provision for additional ANM, Staff
nurse, and Laboratory technicians for
selected districts.
 Provision for 24 hours delivery services at
PHCs and CHCs.
 Referral transport in case of obstetric
complication.
 Immunization and oral rehydration
therapy.

15. Cont…
 Prevention and control of Vitamin-A
deficiency in children.
 Integrated management of childhood illness
(IMCI).
 District surveys for focused intervention to
reduce IMR and MMR.
 New initiatives undertaken during phase 1 of
RCH are:
◦ Setting up of blood storage units at FRUs
◦ Training of MBBS doctors in anesthetic skills for
emergency obstetric care at FRU.

16. Lacunae of RCH Phase 1
They were as follows:-
 The outreach services were not available
to the vulnerable and needy population.
 The management of financial resources
was inadequate.
 The human resources such as doctors,
nurse, health worker, etc were deficient.

17. Cont…
 The management information and evaluation
system was lacking.
 The effective network of first referral units
was lacking.
 Quality of services in PHCs and CHCs was
poor.
 Lack of community participation.

18. RCH Program Phase 2
 It was started from April 1st 2005
 The RCH 2 vision articulates, “Improving
access, use and quality of RCH services,
especially for the poor and underserved
population.”

19. Aims of RCH 2
 To reduce infant mortality rate, maternal
mortality rate, total fertility rate, and to
increase couple protection rate and
immunization coverage especially in rural
areas.

20. Objectives of RCH 2
 To improve the management performance.
 To develop human resources intensively.
 To expand RCH services to tribal areas
also.

21. Cont…
 To monitor and evaluate the services.
 To improve the quality, coverage and
effectiveness of the existing family
welfare services and essential RCH
services with a special focus on the
above mentioned EAG states.

22. Components of RCH 2
 Population stabilization
 Maternal health
 Newborn care
 Child health
 Adolescent health
 Control of RTI/STI’s
 Urban health
 Tribal health
 Monitoring and evaluation
 Other priority areas

23. Bibliography
 Basavanthappa BT, Community Health Nursing 1st
Edition, 1998, Jaypee Brothers, Delhi, Page no. 319-321.
 Chalkey A. M., A Textbook for the Health Worker, 1st
Edition, 1985, N.A.I. Limited, Publisher, New Delhi, Page
no. 330-340.
 Kumari Neelam, Essentials of Community Health Nursing,
1st Edition 2011, PV books Jalandhar, Page no. 225-226.
 Park K., Essentials of Community Health Nursing, 4th
Edition 2004, Banarasidas Bhanot Publisher, Jabalpur,
Page no. 225-226.
 Swarnkar K., Community Health Nursing, 2nd Edition
2008, N.R. Brother, Indore, Page no.639-642.

24. Thank You