This presentation contains in brief about RCH, RMNCH+A and Various maternal health programmes of India.

1. REVIEW OF
rch, RMNCH+A INCLUDING
OTHER MATERNAL
HEALTH PROGRAMMES
Harimu Bargayary
PG Resident, Community Medicine
1

2. CONTENTS
2
1) EVOLUTION OF THE PROGRAMME
2) REPRODUCTIVE AND CHILD HEALTH (RCH) PROGRAMME
3) REPRODUCTIVE, MATERNAL, NEWBORN, CHILD AND ADOLESCENT
HEALTH (RMNCH+A) PROGRAMME
4) CURRENT STATUS AND TRENDS OF RELATED HEALTH INDICATORS
5) MATERNAL HEALTH PROGRAMMES
6) SUMMARY
7) REFERENCES

3. MAJOR EVOLUTION OF THE PROGRAMME
Year Program launched
1951 (1st Five-year plan) Family Planning Programme
1977 (5th Five-year plan) Family Welfare Programme (renamed)
1992 (8th Five-year plan) Child Survival and Safe Motherhood (renamed)
1997 (9th Five-year plan) Reproductive and Chid Health Programme – Phase 1
2000 National Population Policy
2005 National Rural Health Mission (NRHM)
2005 (10th Five-year plan) Reproductive and Chid Health Programme – Phase II
2013 National Health Mission (National Urban Health Mission + NRHM)
2013 Reproductive, Maternal, Newborn, Child and Adolescent
Health (RMNCH+A)
3

4. REPRODUCTIVE
&
CHILD HEALTH
(RCH) 4

5. INTRODUCTION
 Reproductive and Child Health (RCH) programme is a comprehensive sector
wide flagship programme, under the umbrella of the Government of India's
(GoI) National Health Mission (NHM), to deliver the RCH targets for
reduction of maternal and infant mortality and total fertility rates.
 The foundation of this program was laid in the International Conference on
Population and Development (ICPD) held at Cairo in 1994.
5

6. COMPONENTS
OF
RCH 1
6
CHILD SURVIVAL SAFE MOTHERHOOD
SEXUALLY
TRANSMITTED
DISEASES
REPRODUCTIVE
TRACT
INFECTIONS
RCH
PHASE 1
 Launched throughout the country on 15th October,
1997.
RCH PHASE 1

7. • It integrated all ongoing programs on MCH and focused on child
survival and safe motherhood, along with implementation of -
otarget free approach,
otraining IEC activities,
oRTI or STI clinics,
ofacilities for safe abortions,
oenhanced community participation and
oadolescent health and reproductive hygiene.
7
Contd…

8. • The program focused on the districts on the basis of crude birth
rate and female literacy rate.
• All districts are divided into 3 categories:
 Category A having 58 districts,
 Category B having 184 districts and
 Category C having 265 districts.
• All the districts were covered in a phased manner over a period
of 3 years.
8
Contd…

9. RCH 1 MAJOR INTERVENTIONS
 Essential obstetric care
 Emergency obstetric care including strengthening of FRUs
 24 hour delivery services at PHC / CHCs
 Medical termination of pregnancy (MTP)
 Control of RTI and STD
 Immunization
 Essential newborn care
 Control of diarrhoeal diseases and acute respiratory infections of
infants
 Prevention and control of anaemia and vitamin A deficiency in
children 9

10. 10
RCH-1 RCH-11
• Launched in 1st April 2005.
• Objective: To reduce maternal and child morbidity and
mortality with emphasis on rural healthcare.

11. NEW INITIATIVES
UNDER RCH II
• Training of MBBS doctors in Life
saving anaesthetic skills for emergency
obstetric care.
• Setting up of Blood storage centres
at FRUs according to Government of
India guidelines.
11

12. RCH
II
Populatio
n
Stabilizati
on
Materna
l Health
RTIs and
STIs
Newborn
and
child
health
Adolesce
nt health
Initiatives
for
vulnerable
groups
Mainstreami
ng gender
and equity
Strengtheni
ng
system and
partnership
ESSENTIAL
COMPONEN
TS OF THE
RCH II
PROGRAM.
12

13. DIFFERENCES BETWEEN OLDER AND NEWER APPROACH
Old Approach (Family Planning) New Approach (Reproductive and Child Health)
Population-Centered People-Centered
Over-emphasis on sterilization Informed Choice of contraceptives
Quantitative targets Qualitative targets
Family Planning in a separate basket FP merged with Health: One package for Health, MCH & FP
Focus on 30(+) women with 3 or 4 children Focus on new operation, in particular, adolescents (15-25
years)
Insensitive to gender issues Focus on gender issues and concern for gender equity and
elimination of discrimination against women
No linkage with basic needs of the poor Priority for fulfilling the Minimum Needs Programme
No consultation with people at the grassroot level Decentralised programme run through panchayats & nagar-
palikas
Family Welfare Department- the sole custodian of
population matters
Abolish the Department and establish a Population and
Social Development Communion and Fund 13

14. RCH PHASE II - IMPROVEMENTS OVER RCH PHASE I
Lessons learnt from RCH I Corrective Measures in RCH II
Limited involvement and
ownership by states
States will prepare plans linked to clear outcomes after
assessing their own priorities, allowing a needs-based
state-specific plan to be developed.
Slow pace of implementation Bottlenecks to fund flows to be removed by simplifying
processes.
Low utilization of public
health facilities
Addressed through pre-service and in-service training,
with a particular focus on provider attitudes and making
services more users friendly
Infrastructure to be completed
within the project time frame
Simplified processes of managing and construction of
infrastructure.
Limited management capacity Lateral infusion of skilled personnel to improve the
management capacity structure at the national, state and
district levels, with clearly defined functional
responsibilities and roles. 14

15. Lessons learnt from RCH I Corrective Measures in RCH II
Need to incorporate the system of smooth
smooth flow of funds
Financial management systems will be built into
the program management structure.
Implemented as a project; there was a
need to incorporate well-defined outcome
indicators
Visualized as a long-term program, oriented
towards achieving ambitious, but realistic health
outcomes and improvements
“One size fits all” design Differential approach may be extended to the
district level depending upon the performance
of districts
Need to move away from “stand alone”
public health approach
Adopted a program approach, bringing in key
elements of sector management and reform and
strengthening of systems
Focused almost exclusively on the supply
side
Necessarily includes supply side strategies,
complemented by an integrated and robust
strategy to stimulate demand for services.
Centrally designed with little consultation Designed after wider consultation.
15
Contd…

16. REPRODUCTIVE, MATERNAL,
NEWBORN, CHILD AND
ADOLESCENT HEALTH
(RMNCH+A)
For Healthy Mother and Child
1
6

17. INTRODUCTION
 Following the GoI’s “Call to Action (CAT) Summit” in February, 2013,
the MoFHW launched RMNCH+A to influence the key interventions for
reducing maternal and child morbidity and mortality.
17

18. WHAT’S NEW ?
1. Built upon the continuum of care concept.
2. Holistic in design, encompassing all interventions aimed at reproductive, maternal,
newborn, child, and adolescent health under a broad umbrella.
3. Focuses on the strategic lifecycle approach.
4. It promotes links between various interventions across thematic areas to enhance
coverage throughout the lifecycle.
18

19. (1) Inclusion of adolescence as a distinct ‘life stage’ in the
overall strategy;
(2) linking of maternal and child health to reproductive
health and other components (like family planning,
adolescent health, HIV, gender and Preconception and
Prenatal Diagnostic Techniques (PC&PNDT);
(3) linking of community and facility-based care as well as
referrals between various levels of health care system to
create a continuous care pathway, and to bring an additive
/synergistic effect in terms of overall outcomes and impact.
PLUS
1
9
RMNCH+A

20. 2
0

21. CONTINUUM OF CARE
Two
dimensions to
healthcare
stages of the life cycle
places where the care is
provided
21
Adolescence
/ Pre-
pregnancy
Pregnancy
Birth
Newborn /
Postnatal
Childhood

22. NATIONAL HEALTH OUTCOME GOALS
ESTABLISHED IN THE 12TH FIVE YEAR PLAN
RELEVANT TO RMNCH+A
• Reduction of Infant Mortality Rate (IMR) to 25 per 1,000 live births by 2017
• Reduction in Maternal Mortality Ratio (MMR) to 100 per 100,000 live births by
2017
• Reduction in Total Fertility Rate(TFR) to 2.1 by 2017
22

23. 5 X 5 MATRIX
FOR HIGH-IMPACT RMNCH+A INTERVENTIONS
To be implemented with High Coverage and High Quality
Reproductive Health Maternal Health Newborn Health Child Health Adolescent Health
Health Systems
Strenthening
Cross Cutting
Interventions
2
3

24. RMNCAH+N strategy covers Reproductive, Maternal, Newborn, Child and
Adolescent Health and the “plus” within it focuses on Nutrition, as well as important
linkages between these services and other components like family planning,
adolescent health, HIV, gender, and preconception and prenatal diagnostic
techniques. It also focuses on linkages between community-based services and
facility-based services and ensures referrals, and counter-referrals between various
levels of health care system to create a continuous care pathway. 24
YEAR
2021

25. 25

26.  Under RMNCAH+N, reproductive health and nutrition interventions
are cross cutting across all life stages.
 The reproductive health forms the primary pillar of RMNCAH+N.
 RMNCAH+N aims at ensuring healthy reproductive practices,
encouraging contraceptive use while having an effective integration
of the maternal, child, adolescent health and family planning.
26

27. 27

28. PRIORITY INTERVENTIONS IN VARIOUS STAGES OF LIFE STAGES
Adolescent Pregnancy and
Childbirth
Newborn and Childcare Reproductive Years
1. Adolescent nutrition; IFA
supplementation
2. Facility-based
adolescent reproductive
and sexual health
services(ARSH)
(Adolescent health
clinics)
3. Information and
counselling on
adolescent sexual
reproductive health and
other health issues
4. Menstrual hygiene
5. Preventive health
checkups
1. Delivery of antenatal
care package and
tracking of high-risk
pregnancies
2. Skilled obstetric care
3. Immediate essential
newborn care and
resuscitation
4. Emergency obstetric
and new born care
5. Postpartum care for
mother and newborn
6. Postpartum IUCD and
sterilization
7. Implementation of
PC&PNDT Act
1. Home-based newborn
care and prompt referral
2. Facility-based care of
the sick newborn
3. Integrated management
of common childhood
illnesses (diarrhea,
pneumonia and malaria)
4. Child nutrition and
essential micronutrients
supplementation
5. Immunization
6. Early detection and
management of defects
at birth, deficiencies,
diseases and disability in
children (0–18 years)
1. Community-based
promotion and delivery
of contraceptives
2. Promotion of spacing
methods (interval IUCD)
3. Sterilisation services
(vasectomies and
tubectomies)
4. Comprehensive
abortion care (includes
MTP Act)
5. Prevention and
management of sexually
transmitted and
reproductive infections
(STI/RTI)
28

29. CURRENT STATUS OF KEY RMNCAH+N/RCH INDICATORS
Indicator Current status
(SRS 2020)
National Health
Policy targets
SDG 2030
Target
INDIA UTTAR
PRADESH
Maternal Mortality
Ratio (per lakh live
births)
97 167 100 by 2020 < 70
Neonatal Mortality
Rate (%)
20 28 16 by 2025 < 12
Infant Mortality Rate
(%)
28 38 28 by 2019 -
Under 5 Mortality Rate
(%)
32 43 23 by 2025 < 25
Total Fertility Rate 2.0 2.4(NFHS-5) Replacement -
29

30. TREND IN MATERNAL MORTALITY RATIO (MMR)
30

31. Number of states which have achieved Sustainable Development Goal (SDG) for
Maternal Mortality Ratio (MMR) target has risen from:
3
1
Six states
(SRS 2019)
Eight states
(SRS 2020)
Kerala (19) < Maharashtra (33) < Andhra Pradesh (45) < Telangana
(43) < Tamil Nadu (54) < Jharkhand (56) < Gujarat (57) <
Karnataka (69)

32. TREND IN NEONATAL MORTALITY RATE (NMR)
3
• Six (6) States/ UT have attained SDG target of NMR (<12 by 2030):
Kerala (4), Delhi (9), Tamil Nadu (9), Maharashtra (11), Jammu & Kashmir (12) and Punja
(12).

33. TREND IN INFANT MORTALITY RATE (IMR)
3
3
 At the National level, IMR is reported to be 28 and varies from 31 in rural
areas to 19 in urban areas respectively.
 At the national level, mortality for female infants is at par with male infants.

34. TREND IN UNDER 5 MORTALITY RATE (U5MR)
3
4
 U5MR for Female is higher (33) than male (31). However there has been a decline of
4 points in male U5MR and 3 points in female U5MR during the corresponding
period.
 Highest decline of U5MR is observed in the State of Uttar Pradesh (5 points) and
Karnataka (5 points).

35. TREND IN TOTAL FERTILITY RATE (TFR)
 TFR varies from 2.2 in rural areas to 1.6 in urban areas.
 States with Replacement level Fertility above 2.1:
Bihar, Meghalaya, Uttar Pradesh, Jharkhand and Manipur.
35
3.2
2.9
2.2
2.0
0
0.5
1
1.5
2
2.5
3
3.5
1999 2005 2018 2020

36. OTHER KEY RMNCAH+N INDICATORS (AT NATIONAL LEVEL)
Indicators NFHS-5 NFHS-4
Reproductiv
e Health
Health worker ever talked to female non-users
about family planning
23.9% 17.7%
mCPR 56.5% 47.8%
Male Sterilization 0.3% 0.3%
Unmet Need 9.4% 12.9 %
Maternal
Health
Mothers who had an ANC in the 1st trimester 70.0% 58.6%
PW are anaemic 52.2% 50.4%
Consumption of IFA among PW (min.
100days)
44.1% 30.3%
4 ANC 58.1% 51.2%
Registered pregnancies and received MCP
card
95.9% 89.3%
Mothers who received postnatal care from a 78.0% 62.4% 3
6

37. Indicators NFHS-5 NFHS-4
Newborn &
Child Health
Institutional delivery 88.6% 78.9%
Early Initiation of Breast Feeding (EIBF) 41.8% 41.6%
Exclusively Breastfed 63.7% 54.9%
Immunization level 76.4% 62.0%
Prevalence of diarrhoea 7.3% 9.2%
children are stunted 35.5% 38.4%
Children are anaemic 67.1% 58.6%
Adolescent
Health
Teenage Marriage (female) 23.3% 26.8%
Teenage Pregnancy 6.8% 7.9%
Adolescent are anaemic (female) 59.1% 54.1%
Adolescent are anaemic (male) 31.1% 29.2%
using hygienic methods of protection
during menstrual period
77.3% 57.6%
37
Contd…

38. OTHER KEY RMNCAH+N INDICATORS (AT UTTAR PRADESH)
Indicators NFHS-5 NFHS-4
Reproductiv
e Health
Health worker ever talked to female non-users
about family planning
25.1 % 12.8%
mCPR 44.5% 31.7%
Male Sterilization 0.1% 0.1%
Unmet Need 12.9% 18.1%
Maternal
Health
Mothers who had an ANC in the 1st trimester 62.5% 45.9%
PW are anaemic 45.9% 51.0%
Consumption of IFA among PW (min. 100days) 22.3% 12.9%
4 ANC 42.4% 26.4%
Registered pregnancies and received MCP
card
95.7% 79.8%
Mothers who received postnatal care from a
doctor/nurse/LHV/ANM/midwife/other health
72.0% 54.0%
3
8

39. Indicators NFHS-5 NFHS-4
Newborn &
Child Health
Institutional delivery 83.4% 67.8%
Early Initiation of Breast Feeding (EIBF) 23.9% 25.2%
Exclusively Breastfed 59.7% 41.6%
Immunization level 69.6% 51.1%
Prevalence of diarrhoea 5.6% 15.0%
children are stunted 39.7% 46.3%
Children are anaemic 66.4% 63.2%
Adolescent
Health
Teenage Marriage (female) 15.8% 21.1%
Teenage Pregnancy 2.9% 3.8%
Adolescent are anaemic (female) 52.9% 53.7%
Adolescent are anaemic (male) 28.2% 31.5%
using hygienic methods of protection
during menstrual period
72.6% 47.1%
39
Contd…

40. MATERNAL HEALTH
PROGRAMMES
40

41. 4
1
JANANI SURAKSHA YOJANA
(JSY)
• Earlier called NATIONAL MATERNITY BENEFIT SCHEME.
• Launched in 12th April, 2005.
• Objectives:
• To reduce maternal and neonatal deaths by promoting institutional deliveries
and focusing at institutional care among women of BPL families.
• 100% Centrally sponsored scheme.
• It integrate cash assistance with delivery and post delivery care.
• ASHA – effective link between the Government and poor pregnant women.

42. 4
2
Eligibility for Cash Assistance:
LPS States All pregnant women delivering in Government health centres like
Sub-centre, PHC/CHC/ FRU / general wards of District and state
Hospitals or accredited private institutions
HPS States BPL pregnant women, aged 19 years and above
LPS & HPS All SC and ST women delivering in a government health centre like
Sub-centre, PHC/CHC/ FRU / general ward of District and state
Hospitals or accredited private institutions
***While mother will receive her entitled cash, the scheme does not provide for ASHA
package for such pregnant women choosing to deliver in an accredited private institution.

43. 4
3
Category
Rural Area Urban Area
Mother’s
Package
ASHA’s
Package
Mother’s
Package
ASHA’s
Package
LPS Rs. 1400/- Rs. 600/- Rs. 1000/- Rs. 200/-
HPS Rs. 700/- Rs. 200/- Rs. 600/- Rs. 200/-
Scale of Cash Assistance for Institutional Delivery:
Limitations of Cash Assistance for Institutional
Delivery:
In LPS
States
All births, delivered in a health centre – Government or
Accredited Private health institutions.
In HPS
States
Upto 2 live births.

44. 44
Low-performing states (LPS) :-
 Uttar Pradesh,
 Uttarakhand,
 Bihar,
 Jharkhand,
 Madhya Pradesh,
 Chhattisgarh,
 Assam,
 Rajasthan,
 Orissa and
 Jammu and Kashmir.
***The remaining
states have been
named as High
performing States
(HPS).

45. 4
5
JANANI SHISHU SURAKSHA KARYAKRAM
(JSSK)
• Launched in 1st June, 2011.
• Objective: To eliminate out-of-pocket expenses for institutional
delivery of pregnant women and treatment of sick infants.
• The policy commits to:
• Free entitlements including cashless delivery and C-sections
for pregnant women, and
• Management of sick neonates upto 30days.

46. 46
Entitlements for Pregnant Women:
 Free & Zero expense Delivery & Caesarean section
 Free Drugs & Consumables
 Free Essential Diagnostics (Blood, Urine tests and USG, etc.)
 Free Diet during stay in the health institution ~ Normal delivery: upto 3 days
~ C-section : upto 7 days
 Free Provision of Blood
 Free Transport from Home to Health Institutions
 Free Transport between facilities in case of referral
 Drop Back from Institutions to Home after 48 hours stay
 Exemption from all kinds of User Charges

47. 47
Entitlements for Sick Newborn:
 Free & Zero expense treatment
 Free Drugs & Consumables
 Free Diagnostics
 Free Provision of Blood
 Free Transport from Home to Health Institutions
 Free Transport between facilities in case of referral
 Drop Back from Institutions to Home
 Exemption from all kinds of User Charges

48. 48
Average out-of-pocket expenditure per delivery in a
public health facility:
Rs. 3197/-
NFHS-4
Rs. 2916/-
NFHS-5
Rs. 1956/-
NFHS-4
Rs. 2300/-
NFHS-5
INDIA:
UTTAR
PRADESH:

49. 49
PRADHAN MANTRI MATRU VANDANA YOJANA
(PMMVY)
 A maternity benefit program run by the government of India.
 Centrally Sponsored DBT scheme.
 Provides cash incentives for pregnant and lactating mother.
 previously known as the Indira Gandhi Matritva Sahyog Yojana.
 originally launched in 2010 and renamed in 2017.

50. 5
0
Conditionalities and Installments
Installments Conditions Amount
First installment Early Registration of pregnancy 1,000/-
Second
installment
Received at least one ANC (can be claimed
after 6 months of pregnancy)
2,000/-
Third installment i. Child Birth is registered
ii. Child has received first cycle of BCG, OPV,
DPT and Hepatitis-B or its equivalent /
substitute
2,000/-
 The eligible beneficiaries receive an average of Rs.6000/- including the
incentive given under the Janani Suraksha Yojana (JSY).
Pregnant women & Lactating Mother receives a cash benefit of Rs.5000/- in 3
installments at the following stages:

51. PRADHAN MANTRI SURAKSHIT MATRITVA ABHIYAAN
(PMSMA)
• Launched on 9th June, 2016.
• Aim: To provide fixed day assured, comprehensive, quality
antenatal care services, free of cost, universally to all pregnant
women on 9th of every month .
• Guarantees a minimum package of antenatal care services to
women in their 2nd / 3rd trimesters of pregnancy at designated
government health facilities.
• Involves private sector’s health care providers as volunteers to
provide specialist care in government facilities. 5
1

52. 52
Achievements under PMSMA:
Since inception -
 More than 2.88 crore Ante-natal check-ups conducted.
 More than 23.60 lakh high risk pregnancy cases have been
identified across the country.
 More than 6000 volunteers registered under PMSMA.

53. 53

54. 54

55. SURAKSHIT MATRITVA AASHWASAN (SUMAN)
• Launched in 10th October, 2019.
• An Initiative for Zero Preventable Maternal and Newborn Deaths.
5
5
• To create a responsive healthcare system which strives to achieve zero
maternal and infant deaths through quality care provided with dignity
and respect.
VISION
• To end all preventable maternal and newborn deaths.
GOAL
• All pregnant women
• All mothers upto 6 months post delivery
• All sick infants
BENEFICIARIES

56. Progress so far and way forward:
• Standard Operational Guidelines disseminated in 2020-21
• Orientation on SUMAN held from Sept’20-Nov’20 during State MH reviews
• IEC collaterals developed and disseminated
• SUMAN Identified facilities:
• SUMAN notified facilities:
5
6
CEmONC BEmONC BASIC TOTAL
1109 2619 4140 7868
CEmONC BEmONC BASIC TOTAL
763 1271 3473 5507
Challenges:
1. Many high case load facilities converted into dedicated Covid centres.
2. Non-functionalisation of 104 call-centre across many State/UTs , which is
necessary for validation of primary respondents of MDs.
3. Assam, J&K , Kerala, MP, Maharashtra , Karnataka , Punjab (bigger states) yet to
notify SUMAN facilities.

57. LAQSHYA
Labour Room Quality Improvement Initiative
5
7
Launched on 11th December,
2017.

58. Target: 2805 LR and 1905 OTs: Government Medical Colleges,
District Hospitals, Sub Divisional Hospitals, FRU, High Case Load
CHC
Front runner states: Maharashtra,
Gujarat, Madhya Pradesh and Tamil
Nadu
Challenges:
 Zero LaQshya Certification of
Medical Colleges in 27 State/UT.
 High case load district level
facilities converted into dedicated
Covid health centres.
 Nil Certification: A&N and
Lakshadweep.
58
LaQshya Certification Status

59. MIDWIFERY SERVICES INITIATIVES IN INDIA
A Paradigm Shift from Traditional care to Collaborative
care
59
Goal: To create a cadre of Nurse Practitioners in Midwifery who are skilled in
accordance to competencies prescribed by the International Confederation of
Midwives (ICM) and are knowledgeable and capable of providing compassionate
women-centered, reproductive, maternal and newborn health care services”
Achievement :
• As of now 14 National Midwifery Training Institutes have been identified.
• Scope of Practice for Midwifery Educators and Nursing Practitioner Midwife has
been launched.
• Curriculum for Nurse Practitioner Midwife has been published as the gazette
notification.

60. COMPREHENSIVE ABORTION CARE (CAC)
60
 More than 14,500 MOs have been trained in CAC trainings upto June,

61. 1. CHIRANJEEVI YOJANA - GUJARAT
2. SAUBHAGYAWATI SCHEME – UTTARAKHAND
3. JANANI SAHAYOGI YOJANA – MADHYA PRADESH
4. AYUSHMATI SCHEME – WEST BENGAL
5. MAMTA FRIENDLY HOSPITAL SCHEME – NEW DELHI
6. JANANI SUVIDHA YOJANA - HARYANA
61
Other Maternal health programmes:

62. SUMMARY
• The Maternal Health Division under NHM strives to provide quality
services to pregnant women and their newborns through various
interventions and programmes, building capacity of health
personnel and routine health systems strengthening activities.
• NFHS-5 shows an overall improvement in Sustainable Development
Goals indicators in all States/Union Territories (UTs).
6
2

63. • India’s efforts in successfully lowering the MMR ratio provides
an optimistic outlook on attaining SDG target of MMR less
than 70 much before the stipulated time of 2030.
• The country has been witnessing a progressive reduction in
IMR, U5MR and NMR since 2014 towards achieving the
Sustainable Development Goals (SDG) targets by 2030.
• Although India has achieved replacement level fertility, there is
still a significant population in the reproductive age group who
must remain at the centre of our intervention efforts.
6
3
Contd…

64. REFERENCES
6
4
 Park’s Textbook of PREVENTIVE AND SOCIAL MEDICINE; 26th edition by K.
Park
 IAPSM’s Textbook of Community Medicine; 2nd edition by AM Kadri
 Textbook of Community medicine; 4th edition by Rajvir Bhalwar
 https://rch.nhm.gov.in/
 https://www.nhp.gov.in/
 https://censusindia.gov.in/
 https://pib.gov.in/
 https://www.google.com/

65. 65