REPRODUCTIVE & CHILD HEALTH PROGRAMME

1. INTRODUCTION:

Preamble:

RCH – II programme is being implemented in the State under the umbrella of NHM with a decentralized approach. The programme aims at reducing MMR, IMR and TFR leading to enhanced Reproductive and Child health status and population stabilization.

 

Aims & Objectives:

• Improving quality and outreach of RCH services.
• Improving organizational structure and management of State Health Department.

 

Indicator	Current status
	India	Maharashtra
MMR**	97	33
U 5 MR*	32	18
IMR*	28	16
NMR*	20	11
TFR*	2.0	1.5
Source : * SRS Report 2020 **MMR Bulletin & RGI Report 2018-2020

Implementation Strategies:

To achieve the targets, State is implementing various Schemes under RCH PIP. These schemes involve activities mainly related to Maternal Health, Child Health, Family Planning, Adolescent Health, implementation of PCPNDT Act, Tribal RCH. Overall strategies are as follows.

• Enhancing Quality and access of services by poorer.
• Streamlining Management System at Various levels.
• Streamlining of existing inbuilt, monitoring and evaluation system.
• Systematic provision of training inputs.
• Facilitating convergence with other Govt. Dept.
• Outsourcing of services where permanent functionaries are not available.
• Collaborating with NGO and external services Viz. Unicef, UNFPA
• Linking with private medical practitioners for specialized services.
• Women and community empowerment initiatives.
• Adolescent reproductive health initiative.

 

Facilities providing Services:

Services under all these Schemes are being provided through the network of Primary Health Centers, Sub Centers, Rural Hospital, Sub-District Hospitals, Women Hospitals, District Hospitals, Hospitals under Municipal Corporations, Accredited Private Health Institutes.

 

Manpower :-

Medical and Paramedical Personnel working in these institutes provide these Health Services.

To maintain quality, training programmes are conducted for these personnel regularly.

 

Major Activity In RCH:

1.   Maternal Health :

Maternal Health is an essential component of Reproductive & Child Health Programme. Following programmes are being implemented in the State in the year 2024-2025 under RCH PIP Maternal Health Head.

• Janani Shishu Suraksha Karyakram – In this programme following free entitlements are provided to pregnant mothers and sick infants.

Ø  Free transport services from home to institute, institute to other institute & institute to home.

Ø  Free diet services to mothers (3 days for normal deliveries and 7 days for C section)

Ø  Zero user fees.

Ø  Free deliveries and C section.

Ø  Free diagnostics, medicines, Blood Transfusion.

• Janani Suraksha Yojana
• FRU
• Maternal Death Review
• Pradhan Mantri Surakshit Matrutva Abhiyan.
• Surakshit Matritva Aashwasan(SUMAN)
• Pradhan Mantri Matru Vandana Yojan
• Laqshya (Labour Room Quality Improvement Initiative implementation)

2.   Child Health:

Ø  Special NewBorn Care Unit. (SNCU)

Ø  New Born Stabilization Unit (NBSU)

Ø  New Born Care Corner Unit. (NBCC)

Ø  Child Treatment Centre (CTC)

Ø  Nutritional Rehabilitation Centre.(NRC)

Ø  Child Death Review (CDR)

Ø  Organization of Bi Annual Rounds of De-worming and Vitamin A supplementation.

Ø  Infant and Young Child Feeding

Ø  Home Based Newborn Care Scheme

Ø  Management of Spesis Pneumonia and Diarrheo & LBW babies by ASHA by giving Anitbiotics.

Ø  Mother Aboslute Affection MAA

Ø  Anemia Mukt Bharat (AMB)

 

3.   Rashtriya Baal Swasthya Karyakram (RBSK) :

• RBSK aims at early detection and management of the ‘4Ds’ (Defects at birth, Diseases in children, Deficiency conditions and Developmental delays including disabilities) prevalent in children.
• Mobility Support
• Stationary
• Operation cost of DEIC
• Communication Cost for MO/DPS/DEIC
• Referral Support for Secondary/ Tertiary care
• Surgeries

4.   Tribal RCH (Navsanjivani Yojana):

The activities under this Head are being implemented in 16 Navsanjivani tribal Districts, namely Thane, Palghar, Raigad, Nashik, Dhule, Nandurbar, Jalgaon, Ahmadnagar, Pune, Nanded, Amravati, Yeotmal, Nagpur, Gondia, Chandrapur, Gadchiroli. This includes following activities:-

Ø  Since year 2016-17 Medical Officers are being provided Rs. 18000/- per month through RCH PIP (NHM) funds and  additon TSP Fund to Rs. 22000/- honorarium. Total Rs.40000/- honorarium.

Ø Monitoring of RCH Activities in Melghat area of Amravati District.

Ø Hardship Allowance to ADHO & THO working in Melghat Area of Amravati District.

Ø Special Residency CME for MO’s in very remote tribal areas.

 

5.   Routine Immunization Programme:

This programme is for reducing Morbidity and Mortality in children due to diseases preventable by vaccination with Polio, BCG, Hepatitis B, Measles and Rubella, Pentavalent, DPT, Td vaccines. This programme aims at Immunization of children & Pregnant mothers against communicable diseases like Diphtheria, Pertusis, Tetanus, Hepatitis B, Polio, childhood Tuberculosis, Measles and Rubella, Hemo influenza B.

Pentavalent vaccine is launched in routine immunization programme on 22nd Nov 2015 in Maharashtra.

Pentavalent vaccine protects against five potential killers – Diptheria, Tetanus, Pertusis, Hib, and Hepatitis B. The immunization against these diseases produces immunity in infants, children &Pregnant mothers.

The budget for this programme received from Government of India through NHM under Routine Immunization Head. Vaccine and AD syringes are also supplied by Govt. of India. Vaccine is given to the beneficiaries in Immunization sessions which are held at Health Institutes. Cold Chain is maintained during transport of vaccine to maintain potency of vaccine.

Injection IPV is introduced from 25th April 2016 in Routine Immunization Programme as per GOI instructions. This vaccination is given along with 1^st& 3^rd dose of OPV for the beneficiaries under 1 year of age. Switch from  tOPV use to bOPV use is done on 25^th April 2016 in Maharashtra.

Japanese Encephalitis / (J.E.) vaccine is included in Routine Immunization. This vaccine is given in districts namely Amravati (including MC), Yavatmal, Nagpur, Bhandara, Gondia, Washim, Gadchiroli, Latur and Beed districts. Govt. of India has set a Goal to eliminate Measles and control Rubella/Congenital Rubella Syndrome by the year 2020.

Public Health Department Government of Maharashtra had conducted Measles Rubella Vaccination Campaign across Maharashtra on 27th November 2018 onwards, targeting nearly 2.90 crore children from 9 months to less than 15 years of age regardless of previous vaccination status.

Rota Virus Vaccine:

Rotavirus vaccine is already introduced in State of Maharshtra on 20 July 2019.

This vaccine is given through oral syringes in 3 doses (2.0ml) at the age of 6th, 10th and 14th week in regular vaccine schedules.

Td Vaccine:

As per GOI instructions Td vaccine is given instead of TT vaccine to all pregnant women, 10 years and 16 years children. Now TT vaccine is replaced by Td vaccine.

Pneumococcal Conjugate Vaccine (PCV):-

The pneumococcal conjugate vaccine (PCV) has been introduced in the UIP to Protect children against pneumococcal diseases .PCV has been introduced in the State of Maharashtra from July 2021. PCV is given in three doses ( 2 primary doses and one booster) at 6 week, 14 weeks and 9 months of age.

Pulse Polio Programme:

Pulse Polio Immunization program was launched in 1995-96 to cover all children below the age group of 3 years. In order to accelerate the pace of polio eradication, the targeted group was increased up to 5 years of age group.

Ø  2010 – Five virological positive case were detected in Maharashtra (Malegaon-4, Beed-1).

Ø  2011 – There is no polio case detected in Maharashtra.

Ø  2011 – Only one polio case has been detected in India from West Bengal

Ø  2012 – There is no polio case detected in Maharashtra

Ø  2013 – VDPV (Vaccine Derived Polio Virus) case detected in Beed on 27/04/2013 and in Navi Mumbai VDPV case detected on 11 July 2013

Polio Cases

Year	2010	2011	2012	2013	2014	2015	2016	2017	2018	2019	2020	2021	2022	2023	2024 (Up to Oct. 24)
World	1349	650	223	414	359	74	37	22	33	176	140	6	30	12	72
India	42	1	0	0	0	0	0	0	0	0	0	0	0	0	0
MH	5	0	0	0	0	0	0	0	0	0	0	0	0	0	0

 

6. Family Planning:

This includes following activities:-

Ø  Organising NSV Camps

Ø  Compensation grants for acceptors of Female Sterilization and Vasectomy.

Ø  Workshop   for   owners    of   Accredited Private         Hospitals        to    orient them            regarding implementation of Family Welfare Programme & Family planning Insurance Scheme.

Ø  Transport support for sterilization cases and Operating Surgeons.

Ø  Repairs of Laparoscopes.

Ø  Celebration of World Population Day on 11th July.

Ø  Family Planning Indemnity Scheme.

Ø  Implimentation of newer contraceptive (DMPA) & weekly Centchroman Pill (Chhaya)

7.   Adolescent Health / RKSK (Rashtriya Kishore Swasthya Karyakram):

Adolescents (age 10-19) constitute over 23% of the population in Maharashtra. Adolescence is a phase of rapid physical growth, Psychosocial development and sexual transformation. Adolescents are not a homogenous group but, depending upon the region, culture, socio-political and economic background, have diverse educational career, social, behavioural, developmental and health needs. Activities for this group are as follows,

• ARSH Clinics along with support for outreach activities at 958 health Institutes.
• Appointment of counselors at DH.
• Weekly Iron Folic Acid supplementation Scheme
• Establishment of new clinics
• Promotion of Menstrual Hygiene in Adolescents Girls. Under this Programme sanitary napkins are provided at Low cost.
• Mobility Support for AH/ICTC counselors
• Non financial Incentives for each Peer Educator, IEC
• Adolescent Friendly Club at sub-centre level
• Organizing Adolescent Health day
• Writing slogans on walls, Printing WIFS Registers, Reporting Formats.

8.   PCPNDT:

Ø  Operationalise PCPNDT Cell at State Level.

Ø  Orientation of Appropriate Authorities on PCPNDT ACT.

Ø  Support for Sting operations in district and corporation area.

Ø  Provision of Transport Expenses for witness support participated in PCPNDT Court Cases.

Ø  Support for district level inspection team.

Ø  District level Orientation Workshops for Appropriate Authorities

Ø  Award to informers about Sonography Center practicing illegal sex determinations.

Ø  Support of State and Regional Vigilance Squad.

Ø  Complaint registration on helpline and website www.amchimulgi.gov.in

9.   Training:

Various types of trainings for Medical and Para Medical workers being organized. They cover trainings under Maternal Health, Child Health, Family Planning. ARSH and other RCH activities.These training include Skilled attendance at Birth, BEmOC, CEmOC, ARSH training for ANMs/LHVs/AWWs/ASHA, Laproscopic Sterilization Training, Minilap Training, IUD Training, IMNCI Training, RTI/STI Training.

10.  Programme Management :

This includes payment of contractual staff both at State and district level. Provision of equipments, furniture, mobility support for DPMU Staff, Audit program.

11.  Vulnerable Group:

Vulnerable Group means vulnerable communities such as SC/ST and BPL populations living in targeted Rural areas and not covered by Urban RCH programmes and Tribal RCH Programmes. Mainly these are Migratory populations of Labours, not living in slums.This includes following activities

Ø RCH outreach camps for migratory sugarcane cutters in 25 districts having Co-Operative Sugar Factories.

Ø Health Check up of Migrant brick workers.

Beneficiary:

Citizens

Benefits:

As above