Reproductive

and child health

programme
Introduction
One of the primary missions of the National health
mission is to reduce infant mortality rate, maternal
mortality rate and provide quality services to
pregnant women and children across India. The
reproductive child health program was launched in
the year 1997 to enable women to regulate fertility
and to ensure safe pregnancy and childbirth.
Reproductive and child health
programme
In India women of the child wearing age (15 to 44) years
constitute nearly 19.1 percentage and children less than 15
years of age about 40% every aspect of community health
program in India has marked effects on vulnerable age groups
especially,
● Pregnant mothers
● lactating mothers
● infants
● Children under 5 years of age.
● 1983 : National health policy - MCH and family
welfare services were integrated during this policy
● 1992:- child survival and safe motherhood
programme (CSSM) was launched in 20th August to
meet the total help needs of both the mother and
child
● 1994 cssm was replaced by the RCH program
Objectives
● Reduction of maternal morbidity and mortality.
● Reduction of infant morbidity and mortality
● Reduction of under 5 morbidity and mortality
● Promotion of adolescent health
● control of reproductive infections and sexually transmitted
infections
● improve efficiency quality and coverage of the family
wellness services
● Population stabilization through responsible reproductive
behaviour.
● Ensure safe motherhood and child survival
Concept of reproductive child
health programme
● Management and prevention of unwanted
pregnancy.
● Child survival
● HIV or AIDS prevention
● Management and prevention of RTI or STD
Reproductive child health components

● Child survival and safe motherhood program

● Management and prevention of RTI or STD and AIDS
● Family planning
● Providing information
● Counselling services on gender difference sexuality
and health
● Nutrition, education, growth monitoring
● Reproductive health services for adolescents.
Elements related to reproductive
health
● Responsible and healthy sexual behaviour.
● Intervention to promote safe motherhood
● Prevention of unwanted pregnancy
● Increase accessibility of contraceptives
● Safe abortions
● Pregnancy and delivery services
● Management of RTI or STD
● Referral facility by government or private sectors
for pregnant women at risk
● Reproductive health services for adolescence
● Screening and treatment of infertility cancer and
other gynecological disorders.
Child survival
elements
 Reproductive and child
health programme -phase
1
Goals
● To bring down the birth rate below 21 for 1000
population
● To reduce the infant mortality rate below 60 per
thousand live birth
● To bring down the maternal mortality rate below
400 per one lakh
● 80% institutional delivery
● 100% immunization of children
Programmes

● Camp oriented
● Quality oriented
● Target oriented
● Vertical program
Components/ package of RCH
Elements of reproductive and
child health program6.immunization
phase 1
1. Essential obstetric care 7. Dragon equipment
supplies
2. Emergency obstetric
8. Essential newborn care
care
9.Oral rehydration therapy
3. 24 hour delivery
10. Acute respiratory tract
services infection
4. Medical termination of 11. control prevention and
control of vitamin A
pregnancy
deficiency
5. Control of reproductive
12. prevention and control of
1. Essential obstetric care
● Antenatal care
○ Early registration of pregnancy (12 to 16 weeks)
○ Minimum 3 antenatal visits
○ Anemia prophylaxis
○ Two doses of TT
○ Minimum investigations
○ Treatment of worm infestation
○ Health education on diet, breast feeding,care of
breast, personal hygiene during pregnancy and
family planning.
● Intranatal care
○ Delivery by trained personnel
○ Institutional delivery
○ Care at birth
● Postnatal care
○ 3 postnatal checkups of mother after
delivery
○ Early and exclusive breastfeeding
○ Minimum 3 years between 2 pregnancy
○ Kangaroo mother care to take care of low
2.Emergency obstetric care
● Management of complicated delivery cases
● Availability of gynecologist,anesthetists and lab
technician.
3. 24 hour delivery services

● Round the clock facilities at health care centre

4. Medical termination of pregnancy
● Provision of MTP equipments to district
hospitals,CHCs,PHCs
5. Control of RTIs/STIs
Collaboration with National AIDS control organisation
for planning and implementation of services on RTI
SDA clinics training counselling social marketing of
condoms supply of RTA drugs

6. Immunization
Universal immunization program became the part
of cssm in 1992 and RCH in 1997 it provides
vaccines for polio tetanus DPT and tuberculosis
D rugs and equipments
Types of kit for FRUs ● Kit L uterine
● Kit E laparotomy set evacuation set
● Kit F mini laprotomy ● Kit M equipment for
set anesthesia
● Kit G IUD insertion ● Kit N neonatal
set resuscitation set
● Kit H vasectomy set ● Kit O equipment and
● Kit I normal delivery reagent for blood
set test
● Kit J vaccum ● Kit P donor blood
Essential newborn care
8.Oral rehydration therapy

● Goal - to decrease diarrheal death on

under five by 70%
● Strategy - promote breastfeeding, supply
of ORS, encourage home management
of diarrhoea
10. Acute respiratory tract infection control

Cotrimoxazole tablets supplied to health

workers.

I11. Prevention and control of vitamin

A deficiency
6 doses of vitamin A solution to alla
12. Prevention and control of anemia in children

● For children - tablet containing 20 mg

elemental iron and 0.1 mg of folic acid
● For adult - 100 mg iron and 20 mg
folic acid
 Reproductive and child
health programme phase
ll
It began from April 1 2005 with a vision to
bring about outcomes as envisioned in the
● Millennium development goals
● The national population policy 2000 goals
● The tenth five year plan
● The national health policy 2002
● Vision 2020 India
 ● Improve access to
skilled care and
emergency obstetric
care.
Objectives ● Increase the coverage
and quality of antenatal
care.
● Improve coverage of
post partum care.
Elements
● Maternal health
● Infant and child health
● Adolescent health
● Family welfare
● RTIs/STIs
● Infrastructure strengthening for service
● Behavioral change communication
● Helath management information system
● Strengthening of teaching institution
● Establishing urban health posts
Community mobilization
strategies
Jananisuraksha Yojana
● To reduce maternal and infant mortality
through promotion of institutional delivery.
● To protect female foetus and child
● Women belonging to BPL
● Recieve financial assistance of Rs 1500/-
● Transport assistance of Rs 150/- for rural
women.
Provide deliveries by skilled birth
attendants at subcentre in
community
Extended role of ANMs to
administer obstetric first aid
Strengthen post partum care in
community
Vande mataram scheme
Gynecologist will provide free op care to
pregnant women on fixed day each month
● Each vande mataram physician will provide
akit of IFA tablet, condoms,IUDs free to
patients
Integrated management of
neonatal and childhood illness
(IMNCI)
Newborn stabilization units
Special newborn care unit
First referral units (FRUs)
The main focus of FRU is to provide comprehensive
essential obstetric care. The services provide are;
● 24 hours delivery service
● emergency obstetric care
● newborn care
● emergency care of sick children
● treatment of sexually transmitted infection
● Blood storage facility
● essential laboratory services
● Referral services
Facilities required are
● Minimum bed strength
● Fully functional OT
● Fully functional labour room
● Functional laboratory
● Blood storage facility
● 24 hour water supply and electricity
● Waste disposal and ambulance services
Packages of services at FRUs
● Vacuum extraction
● Anesthesia administration
● Blood transfusion
● C section
● Manual removal of placenta
● Suction curettage for incomplete abortion
● Sterilization and insertion of IUDs