RCH PROGRAMME

Introduction:
• People have the ability to reproduce and
regulate their fertility, women are able to go
through pregnancy and child birth safely, the
outcome of pregnancies is successful in terms
of maternal and infant survival and well being,
and couples are able to have sexual relations,
free of fear of pregnancy and of contracting
diseases.
• RCH PHASE - I
• The programme was formally launched on
15th October 1997.
RCH phase – I interventions in all districts
• Child survival interventions i.e immunization, vit-A,
ORT and prevention of pneumonia.
• Safe motherhood interventions e.g. antenatal check
up, immunization for tetanus, safe delivery, anaemia
control programme.
• Implementation of target free approach
• High quality training at all levels
• IEC activities
• Specially designed RCH package for urban slums and
tribal areas
• District sub-projects under local capacity enhancement
• RTI/STD clinics at district hospitals
• Facility for safe abortions at PHC by providing
equipments and contractual doctors.
• Enhanced community participation through
panchayats, women’s groups and NGOs
• Adolescent health and reproductive hygiene
RCH phase – I interventions in selected states
• Screening and treatment of RTI/STD at sub-
divisional level
• Emergency obstetric care at selected FRUs
• Essential obstetric care
• Additional ANM at sub-centres
• Improved delivery services and emergency care
by providing drug and equipments, ANM kits at
sub-centres
• Facility of referral transport for pregnant
women during emergency (through panchayats)
RCH – I services and major interventions
1.Essential obstetric care
2.Emergency obstetrical care
3.24 -hour delivery services at PHCsCHCs
4.Medical termination of pregnancy MTP act
1971
5. Control of reproductive tract infections and
sexually transited diseases h
6.Immunization
7.Drug and equipment kits : equipment kits
supplied at various levels as follows:
• At sub-centre level : United Nations Office for
Project Services
• Drug kit A
• Drug kit B
• Mid- wifery kit
• Sub- centre equipment kit
• At PHC level- PHC equipment kit
• At CHC level- equipment kits from kit E to kit P
• 8.Essential newborn care
• 9.Oral rehydration therapy
• 10.Prevention and control of vitamin A deficiency
in children
• Under the program , doses of vitamin A are given
to all children under 5 years of age.
• The first dose( 1 lakh units) is given at nine
months of age along with measles vaccination
• The second dose is given along with DPT OPV
booster doses
• Subsequent doses ( 2 lakh units each) six months
intervals
• 11. Acute respiratory disease control
cotrimoxazole is being supplied to the health
worker through the CSSM drug kit
• 12. Prevention and control of anemia in children
under this program of control and prevention of
anemia ,tablets containing 20 mg of elemental
iron and 100 mcg for of folic acid for 5 years, 30
mg iron and 250 mcg 6-10 years for 100 days are
provided at sub-centre level .
The health workers to provide 100 tablets to
children clinically found to be anemic.
• 13. Training of Dais
• RCH –PHASE II
• RCH –PHASE II began from 1st April 2005,the focus
is to reduce maternal and child mortality and
morbidity with emphasis on rural health care.
• The major strategies are
• 1) Essential obstetric care a. Institutional delivery b.
Skilled attendance at delivery c. Policy decisions
• 2) Emergency obstetric care a. operationalizing first
referral units b. operationalizing PHCs and CHCs for
round clock delivery services
• 3) Strengthening referral system
1) Essential obstetric care
A) INSTITUTIONAL DELIVERY: to promote
institutional delivery 50% of PHC and CHC would
be made operational as 24 hours delivery centre.
B) SKILLED ATTENDANCE AT DELIVERY: for MOs/
ANMs/LHVs – guidelines for conducting normal
delivery and management of obstetric
complications.
C) POLICY DECISIONS: ANMs/LHVs/SNs –
Permitted to use drugs in specific emergency
situations to reduce maternal mortality.
2) Emergency obstetric care (EmOC)
• The FRUs be made operational for providing emergency
obstetric care
• The minimum services provided by a fully functional
FRUs
• 1. 24 hrs delivery services including normal and assisted
deliveries
• 2. EmOC including surgical interventions like caesarean
section.
• 3. New-born care
• 4. Emergency care of sick children.
• 5. Full range of family planning services including
laproscopic services.
• 6. Safe abortion services
• 7. Treatment of RTIs/STIs.
• 8. Blood storage facility
• 9. Essential lab services
• 10. Referral (transport ) services
3) Strengthening referral system
• Funds were given to panchayat for providing
assistance to poor people in case of obstetric
emergencies.
• Involvement of local self-help groups, NGOs
and women groups.
NEW INTIATIVES
1. Training of MBBS doctors in life saving
anesthetic skills for emergency obstetric care.
Govt .of India is also introducing training of
MBBS doctors of obstetric management skills,
prepared training plan for 16 weeks in all
obstetric management skills,inculding caesarean
section operation.
2.Setting up of blood storage centres at FRUs
according to government of India guidelines.
3.JANANI SURAKSHA YOJANA
• The national maternity benefit scheme has been
modified into a (JSY) JANANI SURAKSHA YOJANA.
• It was launched on 12th April 2005.
• It is a 100% centrally sponsored scheme
• Under national rural health mission ,it integrates
the cash assistance with institutional care during
antenatal, delivery and immediate post-partum
care
• ASHA would work as a link worker
• LPS=Low Performing State
• HPS= High performing State
4.VANDEMATARAM SCHEME
• It is a voluntary scheme wherein any obstetric
and gynaec specialist, maternity home, nursing
home, MBBS DOCTORS can volunteer
themselves for providing safe motherhood
services.
• 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.
5.Safe abortion services
Under RCH – II the following services are provided: –
• Medical method of abortion:
Under preview of MTP act-1971; Mifepristone (RU
486) followed by Misoprostol. It is recommended
upto 7 weeks(49 days) of amenorrhoea.
• Manual vacuum aspiration:
MVA technique has been piloted in coordination
with FOGSI (FEDERATION OF OBSTETRIC AND
GYNECOLOGICAL SOCIETIES OF INDIA), WHO and
respective state Govts.
6.Village health and nutrition day
• Once in a month at AWCs
• To provide antenatal/post-partum care to PW,
promote institutional delivery, health
education, immunization, family planning and
nutrition services.
7.Maternal death review
• Both facility and community maternal death
review
• To improve the quality of obstetric care and
reduce the maternal morbidity and mortality.
8.JANANI-SHISHU SURAKSHA KARYAKRAM (JSSK)
• Launched on 1st June 2011
• To make available better health facilities for women and
child.
• The facilities to pregnant women: –
 all PW delivering in PH institutions to have absolutely free
and no expense including C-Section.
 The entitlements include free drugs & consumables, free diet
upto 3 days during normal delivery and upto 7 days for C-
section, free diagnostics and free blood, free transport from
home to institution & between facilities an case of referral.
 Similar entitlements for all sick newborns.
 The scheme has now been extended to cover the
complications during ANC, PNC & sick newborn.
• Summary
•
• REFERENCES
• Thank you