reproductive child health .pptx

rch
reproductive child health
definition new intiative reproductive care



role of nurse
role of community nurse
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1. Reproductive and Child Health Ms. Bhoomika P 4 th yr Bsc nursing

2. Table of Contents 01 02 04 05 03 06 INTRODUCTION DEFINITION OBJECTIVES STRATEGIES AND INTERVENTION COMPONENT RCH PHASE 1 RCH PHASE 2 NEW INITIATIVES 07 08

3. Introduction The reproductive and child health program was formally launched by government of India on 15th oct 1997. As per recommendation of international conference on population and development held in Cario in 1994.

4. DEFINITION In ICPD at Cairo, Fathallah defined RCH as “A state of complete physical, mental and social well being and merely the absence of disease or infirmity in all matters relating to reproductive system and its function and process”

5. DEFINITION “States in which people have the ability to reproduce and regulate their fertility are able to go through pregnancy and child birth, the outcome of pregnancy is successful in terms of maternal and infant survival and well being, and couples are able to have sexual relation free of the fear of pregnancy and of contracting diseases.”

6. OBJECTIVES To promote the health of the mothers and child to ensure safe motherhood and child survival. The intermediate objective is to reduce infant mortality rate and maternal mortality rate. The ultimate objective is population stabilization, through responsible reproductive behavior.

7. COMPONENT AND INTERVENTION Prevention and management of sexually transmitted disease Prevention and management of unwanted pregnancies Maternal care (safe motherhood) Child survival Prevention of HIV/AIDS

8. STRATEGY OF RCH Bottom up planning Decentralized participatory planning and implementation Integrated training package Strengthening infrastructure Improved management

9. For maternal services (safe motherhood): the service components are obstetric care, infection control and nutrition . For children services (child survival): the essential care of the new born, including care of the at risk newborn by prompt referral services, infection control measures, nutrition promotion Reproductive health: fertility control, MTP services (for prevention and management of unwanted pregnancies.), adolescent, HIV/AIDS RCH PACKAGE FOR VARIOUS SERVICES

10. RCH PHASE -1 Under the RCH programe phase 1, various provision were made to improve the status of maternal and child health. These include:- Provision of essential and emergency care. Provision of equipment and drug kits to selected PHCs and selected FRUs in all districts. Provision for additional ANM, staff nurse and laboratory technicians for selected districts. Provision for 24 hrs delivery services at PHCs and CHCs. Referral transport in case of obstetric complication

11. Immunization and oral rehydration therapy.
Prevention and control of Vitamin-A deficiency in children.
Integrated management of childhood illness(IMNCI)
District surveys for focused intervention to reduce IMR and MMR.
New initiatives undertaken during phase 1 of RCH are a. Setting up of blood storage units at FRUs b. Training of MBBS doctors in anesthetic skills for emergency obstetric care at FRUs

12. 1.The outreach services were not available to vulnerable and needy population. 2.The management of financial resources was inadequate . 3.The human resources such as doctor, nurse, health worker etc were deficient. 4.The management information and evaluation system was lacking 5.The effective network of first referral unit was lacking 6.Quality of services in PHCs and CHCs was poor. 7.Lack of community participation LACUNAE/ FAILURE OF RCH 1

13. RCH PHASE -2

14. It was started from April 1st 2005 up to 2009. The RCH 2 vision articulates, “improving access, use and quality of RCH services, especially for the poor and underserved population.” Aims of RCH 2: To reduce infant mortality rate, maternal mortality rate, total fertility rate, and to increase couple protection rate and immunization coverage especially in rural areas.

15. OBJECTIVES OF RCH 2 To improve the management performance.
To develop human resources intensively.
To expand RCH areas also
To monitor and evaluate the services.
To improve the quality, coverage and effectiveness of the existing family welfare services and essential RCH services with a special focus on the above mentioned EAG states.

16. ESSENTIAL OBSTETRIC CARE a. institutional delivery b. skilled attendance at delivery c. policy decision EMERGENCY OBSTETRIC CARE a. operationalizing first referral units b. operationalizing PHCs and CHCs for round clock delivery services STRENGTHENING REFERRAL SYSTEM THE MAJOR STRATEGIES :

17. COMPONENT OF RCH 2 Monitoring and evaluation Population stabilization. Maternal health Newborn care Child health Adolescent health Control of RTI/STIs Urban health Tribal health Other priorities

18. NEW INITIATIVES

19. JANANI SURAKSHA YOJANA The national maternity benefit scheme has been modified into 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.

20. VANDEMATRAM SCHEME It is a voluntary scheme wherein any obsetric and gynaec speciality , maternity home,nursing home , MBBS doctor can volunteer themselves for providing safe motherhood services. Enrolled doctor will display vandematram logo at their clinics. Iron and follic acid tablets, oral pills , tt injection, etc will be provided for free distribution.

21. JANANI SHISHU SURAKSHA KARYAKRAM Launced on 1st June 2011. To make better health facility for women and child All pregnant women in primary health institute to have absolutely free and no expense including C-sections . The entitlement include free drugs and consumables, free diet upto 3 days during normal delivery and upto 7 days of c-section, free diagnostics and free blood , free transport from home to institution and between facilities on any case of referral. Similar entitlement for all sick newborns . The scheme has now been extended to cover the complication during ANC PNC and sick newborn

22. SAFE ABORTION SERVICES Medical method of abortion-under MTP act. MIFIPRISTONE followed by MISOPROSTOL. Manual vacuum aspiration

23. VILLAGE HEALTH AND NUTRITION DAY To provide antenatal / postnatal care to pregnant women promote institutional delivery, health education, immunization, family planning and nutrition services

24. The strategy for child health care aims to reduce underfive child mortality through improved child care practices and child nutrition: Nutrition rehabilitation centre IMNCI Facility based newborn care Home based new born care Navjot shishu suraksha karyakram Rashtriya bal swasth karyakram CHILD HEALTH COMPONENT

25. DURING PREGNANCY DURING DELIVERY OF THE BABY DURING POSTNATAL PERIOD ROLE OF COMMUNITY HEALTH NURSE

26. 1.Registration 2. Taking history 3. blood, urine testing 4. vital sign 5. recording height and weight 6. diet and nutrition status 7.immunization and follic acid tablets 8.Educating mother and family member 9. Supervision & guidance to ANM and healthworker 10.Referral of mother to FRU 11. Records and registers DURING PREGNANCY

27. 1.Preparation of place 2. Preparation of equipments and supplies 3. physical and psychological preparation 4.examination of mothers condition 5. Conducting delivery 6.Referral of mother during emergency 7.immediate care to baby 8. record and reporting DURING DELIVERY OF THE BABY

28. DURING POSTNATAL PERIOD Regular visit Observation of general condition of mother and child Examine breast and nipple, fundus height, lochia Examination of baby’s skin Inquiry about diet, sleep, pain Educating about breastfeed

29. BIBLIOGRAPHY K. Park, textbook of prvention and social medicine K.K. Gulani , Community health nursing www.slideshare.com http://main.mohfw.gov.in http://rch.nhm.gov.in