The Reproductive and Child Health (RCH) program was launched in India in 1997 with the goal of reducing infant and maternal mortality rates and achieving population stabilization. RCH Phase I focused on promoting maternal and child health through interventions like family planning, maternal care, child survival, and prevention of diseases. RCH Phase II, launched in 2005, expanded the goals and components of the program. It aimed to further reduce infant and maternal mortality as well as increase immunization coverage, especially in rural areas through strategies like strengthening health infrastructure and focusing on high-priority states. The components of RCH Phase II included population stabilization, maternal health, newborn and child health, adolescent health, and control of diseases. Monitoring and evaluation was emphasized
2. Historical Background 1952- National Family Planning Programme 1977- National Family Welfare Programme 1985- Universal Immunization Programme 1992- Child Survival And Safe Motherhood Programme 1997- RCH (Phase-1) 2005- RCH (Phase-11)
3. RCH Programme- I Definition “People have the ability to reproduce and regulate their fertility, women are able to go through pregnancy and child birth safety, the outcome of pregnancies is successful in terms of maternal and infant survival and wellbeing and couples are able to have sexual relations free of fear of pregnancies and of contracting diseases”. (Fathalla,1989)
4. RCH Programme- I Immediate Objective- To promote health of mother and children. Intermediate Objective- To reduce IMR and MMR. Ultimate Objective- Population Stabilization
5. RCH Programme- I Intervention / Strategies:- Prevention $ Management of unwanted pregnancies Maternal Care Child Survival Prevention $ Management of RTIs $ STIs Prevention of HIV / AIDs
6. RCH Programme- I Management Strategies :- Bottom- up Planning Decentralized Training Management information and Evaluation System (MIES) $ IEC and Community Participation
7. RCH Programme- II AIM To reduce Infant Mortality Rate (IMR), Maternal Mortality Rate (MMR), Total Fertility Rate (TFR), To increase Couple Protection Rate (CPR), and Immunization coverage, specially in rural areas.
9. Lacunae of RCH-I Poor out reach service Inadequate financial resources Inadequate human resources MIES was lacking Effective network of FRU was lacking Poor infrastructure Quality of PHC’s $CHC’s service was poor Poor Neonatal and Adolescent health care Minimum community participation Regional variation
10. RCH Programme- II, Objectives To improve the management performance To develop human resources intensively To expand RCH services to tribal areas also To improve the quality, coverage and effectiveness of the existing services and more focused on empowered action group (EAG) states To monitor and evaluate services
11. Components of RCH-II Population Stabilization Maternal Health Newborn Care and Child Health Adolescent Health Control of RTIs / STIs Urban and Tribal Health Monitoring and Evaluation Other Priority areas
12. Components of RCH-II Population Stabilization- Strategies By incorporating the newer choices of contraception methods e.g:-Centchroman By increasing trained personals By converging the service at grass root level By public private partnership Social marketing of contraceptives to be strengthened Involving Panchayat Raj Institutions, Urban Local Bodies $ NGO’s By increasing incentives
13. Components of RCH-IIMaternal Health- Strategies Essential Obstetrical Care Three or More Checkups Two doses of TT IFA Tablet Counseling Emergency Obstetrical Care First Referral Unit
14. Components of RCH-II New Born Care and Child Health Effective Newborn Health Intervention During Antenatal Period Labor, Birth, $ the first 1- 2 hours Early Newborn Care Late Newborn Care
15. Components of RCH-II New Born Care and Child Health OBJECTIVES Skilled care at birth Package of preventive, promotive and curative intervention Strengthen IMNCI services
16. Components of RCH-II New Born Care and Child Health Strategies IMNCI plus Strengthening of health infrastructure and FRUs Ensuring referral service of sick neonates and utilization of referral funds Permitting ANMs to administer selected antibiotics like Gentamycin and co-trimoxazole by AWW
17. Cont….. Availability of drugs and supplies Good supervision and monitoring Efficiency of the administrative/ financial system Community based intervention Promoting breast feeding practices Vit A, Iron and Folic Acid Supplimentation Strengthening the quality of UIP
18. Components of RCH-IIAdolescent Health Subcentre Enroll newly married couple Provision of spacing methods Routine antenatal care and institutional delivery Referral service HIV/ AIDS /STIs preventive education Nutritional Counselling
19. Cont….. PHC $ CHC Contraceptive Management of menstrual disorder HIV/ AIDS /STIs preventive education and management Counseling
21. Components of RCH-II Urban Health Urban Health Centers- 1:50,000 Population Medical Officer- 1 ANMs- 3-4 Lab Assistant- 1 Public Health Nurse- 1 Clerk- 1 Chowkidar- 1 Peon- 1
22. Components of RCH-II Tribal Health Community Level Sub centre PHC Block PHC / CHC
23. Components of RCH-IIMonitoring and Evaluation MIES Planning Monitoring / Information Quality Assessment Evaluation Validation
24. Newer Schemes and Services Training of MOs Training of traditional birth attendents Prasoothiaraike JananiSurakshaYojana Scheme Vandemataram Scheme Safe abortion service Medical Method-Mifepristone $ Misoprostol Manual Vaccum Aspiration
26. Evaluation 1.RCH Programme was launched in the year……….. (1972, 1996, 1997, 1994) 2. In PHC,…….. $.............. arethe two drugs used for medical abortion. (Mifepristone and Misoprostone, Mifepristone and Oxytocin’ Meperidine and Misoprostone)
27. Cont…. RCH –II was started from 1st April………. Up to……… (2005-2009, 2005-2025, 2005-2050)
28. ASSIGNMENT Write an assignment on JananiSurakshaYojana and the role of ASHA in this scheme.