RMNCH+A

Reproductive, Maternal, Newborn ,Child Health and Adolescents( RMNCH+A)

The main objective of the RMNCH+A program is to bring about a change in three critical health indicators i.e. reducing total fertility rate, infant mortality rate and maternal mortality ratio with a view to realize the outcome envisioned in the Millennium Development Goals, the National Population Policy 2000, and the Tenth Plan Document, the National Health Policy 2002 and Vision 2020 India. Monitorable indicators i.e. MMR, IMR, TFR are an endeavour to improve the goals and objectives of RMNCH+A among the vulnerable population by ensuring accessibility and availability of quality primary health care and family welfare services to them. However still there is lot of scope for improvement so that indicators are comparable with that of developed nations.

VISION : A city with no deaths occurring due to the preventable causes in mother and child, where every pregnancy is wanted, every birth celebrated, and women, babies and children survive, thrive and fulfill their dreams.

GOALS

  •  To reduce maternal deaths to less than 70 per 1,00,000 live births by 2030 ( SDGs)
  •  To reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births by 2030, along with end of preventable deaths of newborns and children under 5 years of age ( SDGs)

Name, Addresses of Centers where Health Facilities are provided to the Public

Health facility

Facilities available

Maternal Health

Child Health

Family Planning facility

Blood bank/ storage facility

Transport Facility

ANC 

Deliveries

Postnatal care

Essential newborn care

Immunization facility

PGIMER

GMCH-32

GMSH-16

ESI-Hospital Ramdarbar

X

CH-Manimajra

CH Sector 22

CH Sector 45

X

X

X

X

CDs

X

X

X

X

Sub centers

X

X

X

X

STRATEGIES UNDERTAKEN TO ACHIEVE THE TARGETS AND GOALS

MATERNAL HEALTH (REDUCTION  IN MATERNAL MORTALITY RATIO(MMR)

  • Extensive Health talks to adolescents regarding the right age for marriage and delay of first pregnancy.

  • Timely detection of high risk pregnancy and early initiation of the treatment

  • Use of MCTS to ensure early registration of pregnancy and provide full ANC and regular follow up on that basis

  • Implementation of JSSK, JSY& MCP Card.

  • Micro birth planning- Improved perinatal care by ANMs

  • Improved Postnatal Care- Assured 48hrs. stay in the hospital after delivery, strengthening of home visits by ANMs between 48hrs. to 14 days of hospital delivery and within 24 hours of home delivery.

  • Collaboration with SWD, NGOs, VHSCs.

  • Health Talks / Counseling with beneficiaries at the Community level and decision makers in the family.

  • A model has been set up for the effective involvement of the Panchayat members for reducing home deliveries and also for tackling the problems of the migratory population

  • Focus on regular Supervisory visits to remain in regular contact with the health providers with a motive to identify gaps in service delivery and suggesting corrective measures during supportive supervision

  • MCH Wings are being strengthened in GMSH 16,CH Manimajra and CH Sector 22 to overcome the constraints of increasing case loads and institutional deliveries at these facilities.

  • All severely anemic pregnant women are being tracked and line listed for providing timely treatment of anemia along with the focus on reverse tracking.

  • CH-45 has been made functional as the delivery point on dated 5.1.2016

     

IMPLEMENTATION OF MATERNAL DEATH REVIEW (MDR)

  • MDR has been implemented since April 2011 with the formulation of the MDR Committee and all the deaths are analyzed at facility and community level.

  • Regular meeting under the chairmanship of Mission Director, NHM, U.T, Chandigarh.

  • Data regarding causes of death especially 3 delays is being shared with the respective stake holders for corrective measures.

  • Meeting the unmet need of contraception to reduce deaths due to indirect causes.

  • Collaboration with the other programmes like RNTCP for tackling the indirect cause of maternal deaths

  • Referral transport mechanism has been implemented in the FY 2014 for reducing the overcrowding at the delivery points by sending the right patient to the right centre thereby reducing the time lost in transportation and also helping the higher centres like PGIMER, GMCH-32 to focus on Education, Research and care of the critically ill patients

  • Social networking programme has been started in which decision makers in the family and neighbours are mandatorily sensitized to the needs of a women in labour and for all support to her to ensure hospital delivery. An innovation to reduce the MMR

SAFE ABORTION 

  • Strict implementation of MTP ACT has been done with an enumeration of all MTP Centers (less than and more than two weeks)
  • Linkage has been done with PC & PNDT Act The report are analyzed on monthly basis for planning future strategies. However, with over the counter sale of abortifacients, more and more no of patients report with excessive bleeding at various Health centres.
  • Trainings and meetings with the Gynaecologists and regular inspection of the centres are being conducted for the gap analysis and for the adoption of any corrective measures
  • Counseling of the beneficiaries for post abortion adoption of any contraceptive method

JANANI SHISHU SURAKSHA KARYAKRAM ( JSSK)

 

Provision of Free services under Janani Shishu Suraksha Karyakaram (JSSK)

Facility

CH-22

CH-Mani Majra

GMSH-16

GMCH-32

CH-45

Provision of cashless deliveries

Y

Y

Y

Y

Y

Provision of free treatment of sick new born up to 1 year

Y

Y

Y

Y

Y

Provision of free drugs

Y

Y

Y

Y

Y

Provision of free blood during complications

Y

Y

Y

Y

Y

Provision of free diet

Y

Y

Y

Y

Y

Provision of free diagnostics

Y

Y

Y

Y

Y

Transportation from home to institute

Y

Y

Y

Y

Y

Provision of free transport between facilities in case of referrals (strengthening of referral transport has been proposed)

Y

Y

Y

Y

Y

Beneficiaries of JSSK services ( Till July 2016 for F.Y. 2016-17)

JSSK services delivery

Free drugs and consumables

Free Diet

Free Diagnostic

Free blood

Free referral transport service

Total no. of pregnant women who have availed the free entitlements

6727

6757

31347

979

1165

Total no. of sick neonates who availed the free entitlements

1556

NA

1600

110

153

  • Wall Paintings on JSSK entitlements at Sub Centres
  • Sunboards /Banners/flexes on JSSK have been displayed at various health facilities of Chandigarh.
  • 10 referral vehicle that can be  availed through Centralized Control Room /Hospital Enquiry Number/Help Line number 102 and 6 BLS though 108 Help-Line number
  • Orientation of the field

JANANI SURAKSHA YOJNA (JSY)

  • ch beneficiary registered under this Yojana should have a JSY card along with MCPcard . The ANM under the overall supervision of  MO incharge  prepare a micro-birth plan which effectively helps in monitoring Antenatal Check-up and the post delivery care.
  • Apart from the GOI guidelines, Chandigarh Administration is also giving the cash assistance to the poor pregnant women delivering in the public health institution (as per norms) once certified as poor‘ by the Medical Officer/ ANM/ LHV of the area only for JSY purpose.
  • Review meetings are carried out on monthly basis
  • Roll out of DBT through PFMS under JSY in phase wise manner w.e.f. July 2015-16 covering all the delivery points of U.T. Chandigarh
  • Beneficiaries of JSY services ( Till July 2016 for F.Y. 2016-17)

 

S.No.

Number of beneficiaries

 

Financial Achievement

 

Rural

Urban

Total

1

91

184

275

₹ 174100/-

Pradhan Mantri Surakshit Matritva Abhiyan ( PMSMA)- an initiative of Government of India

Campaign was started in U.T. Chandigarh on the 9th of June 2016 from EWS Dhanas and was rolled out at four centres centres i.e. EWS Dhanas, Civil Dispensary Moulijagran, Civil Dispensary Ramdarbar and  PHD-25in the subsequent months

This is a fixed day strategy for the antenatal mothers  on the 9th of every month across the country wherein the objective is to provide quality maternal health services to the women in the later part of their pregnancy .Under the campaign a minimum package of antenatal services which includes examination by a doctor, lab investigations, ultrasound examinations, immunizations etc are ensured for timely detection and treatment  of the high risk cases in order to reduce the maternal mortality and the associated morbidity as well as to achieve the Sustainable Development Goal of having a maternal mortality ratio of less than 70 per 1 lakh live births.

Till date total number of 736 pregnant women have been examined and  investigated . The essential medicines like Calcium, Iron Folic Acid, Folic acid, Albendazole etc have been distributed to all . Out of the registered pregnant women, 194 high risk pregnancies have been identified at the different centres and are being managed /referred to the higher institutes for further care.

RTI/STI PROGRAMME

  • Collaboration has been done with NACO/SCAS UT Chandigarh.
  • Regular meetings are being held.
  • Treatment is provided at all the civil dispensaries of U.T. Chandigarh
  • Data is being shared with State AIDS Control Society, Chandigarh

CHILD HEALTH (PRIORITY INTERVENTIONS (REDUCTION IN INFANT MORTALITY RATE)

1. Facility-based care of the sick newborn

Neonatal mortality is one of the major contributors (2/3) to the Infant Mortality. To address the issues of higher neonatal and early neonatal mortality, facility based newborn care services at health facilities have been emphasized. Setting up of facilities for care of Sick Newborn such as Special New Born Care Units (SNCUs), New Born Stabilization Units (NBSUs) and New Born Baby Corners (NBCCs) at different levels is a thrust area under NHM.

  • Sick New Born Care Unit are functional at PGIMER, GMSH-16, GMCH-32 to cater to sick new born being delivered there and to handle any new born referred from field.

  • NBSU (New Born Stabilization Unit) are functional at Civil Hospital 22, Civil Hospital Manimajra and Civil Hospital 45. The new born requiring phototherapy/conservative care are being managed there so as to avoid hustle at tertiary care hospital.

  • NBCC (New born care corner) are established in each labour room. Any newborn delivered with mild complications like birth asphyxia, and those requiring routine as well as observational care are managed there.

2. To address to Malnutrition:-

  • Nutritional rehabilitation Centre is established at GMSH 16 since October 2012 wherein all the children having malnourishment are admitted and treated. Free Diet has been started at NRC (Nutritional rehabilitation Centre) since 15th September 2015.

3. Facility Based Integrated Management of Neonatal and Childhood Illness (F- IMNCI)

  • Management of Diarrheal diseases with ORS and zinc and Management of Acute Respiratory Infection.

  • Intensified Diarrhea Control Fortnight 2017 (celebrated from12th to 24th June 2017). The coverage distribution of ORS Packets to under five children as a part of prophylaxis has * increased to 93% from last year figure of 57%.

4. Child death review

  • As the reduction in Infant mortality is the key goal of NHM hence Child Death review (CDR) has been rolled out since 14th September 2015.

  • Formulation of the CDR Committee at all the delivery points is accomplished and all the deaths reported are being analyzed at facility and community level.

  • Regular meeting under the chairmanship of Mission Director, NHM, U.T, Chandigarh are held.

  • Each child death occurring at community level is being reported on monthly basis and the causes of deaths are reviewed and accordingly action is taken.

5. Home-based newborn care and prompt referral

  • Each newborn is paid home visits by the health workers posted at various health facilities to detect any danger sign in newborn and assuring prompt referral to higher facility if required. Six visits are paid to newborn in the case of institutional delivery (Days 3, 7, 14, 21, 28 and 42), and Seven visits in the case of home delivery (Day 1, 3, 7, 14, 21, 28, and 42).

6. Infant Young Child Feeding Practices (IYCF)

  • Provision of services related to IYCF through Home Based Care is also planned • Breast feeding along with Intensified Diarrhoea Fortnight week is celebrated every year for early initiation of breast feeding, exclusive breast feeding and complimentary breast feeding. The queries of beneficiaries in respect to breast feeding are also answered

7. Tracking of Low Birth Weight babies

  • Each Low Birth Weight baby born is being tracked and paid 6 home visits as per schedule.

  • Regular monitoring is being done by health workers and constant supervision by head quarter is assured.

8. Newer Initiative by Government of India - MAA (Mothers’ Absolute Affection)

  • UT Chandigarh has implemented the nationwide programme named - ‘MAA’ (Mothers’ Absolute Affection), which will provide an opportunity to improve rates of breastfeeding and appropriate child feeding practices. • Capacity building of nurses and supportive supervision of the health workers under the ‘MAA’ Programme is being done, thereby reaching to pregnant and lactating mothers of all under two age children for advocating ideal IYCF practices in the community. Counseling of mother on 9th of every month where ANC clinics are being held under Pradhan Mantri Surakshit Matritva Abhiyaan (PMSMA).

Infant and young child feeding practices, hand hygiene and management of diseases such as diarrhea, acute respiratory infection etc immunization etc

 9. JSSK

  • JSSK has been implemented in UT Chandigarh & the provision for both pregnant women and sick infant till one year after birth are (1) Free and zero expense treatment, (2) Free drugs and consumables, (3) Free diagnostics & Diet, (4) Free provision of blood, (5) Free transport from home to health institutions, (6) Free transport between facilities in case of referral, (7) Drop back from institutions to home, (8) Exemption from all kinds of user charges. 

Rolling out of Child death review to find out the cause of death and assessment of gaps and delays if any to be rolled out in current financial year.

 

IMPLEMENTATION OF PC& PNDT

The PC&PNDT Act (Pre conception pre natal diagnostic techniques) is to provide for the prohibition of sex selection, before or after conception, and for regulation of pre-natal diagnostic techniques for the purposes of detecting genetic abnormalities or metabolic disorders or chromosomal abnormalities or certain congenital malformations of sex-linked disorders and for the prevention of their misuse for sex determination leading to female foeticide and for matters connected therewith or incidental thereto..Read more about implementation of PC & PNDT Act in Chandigarh

  • In compliance of the directions passed by Hon’ble Supreme Court in the Writ Petition (c) No. 341 of 2008- Sabu George Vs. UoI & Ors: Section 22 of the PC-PNDT Act 1994 prohibits any advertisement in any form including internet relating to preconception and prenatal determination of the sex or sex selection (Download detailed order click here..)

IMPLEMENTATION OF FAMILY PLANNING PROGRAMME

India is the first country that launched a National Family Planning Programme in 1952, emphasizing fertility regulation for reducing birth rates to the extent necessary to stabilize the population at a level consistent with the socio-economic development and environment protection. The NRHM provides a policy framework for advancing goals and prioritizing strategies during the next decade, to meet the reproductive and child health needs of the people of India, and to achieve replacement level of total fertility rate (TFR) of 2.1 by 2017 (12th plan goal)..Read more about implementation of Family Planning Programme in Chandigarh

 STRATEGIES ADOPTED TO IMPROVE CHILD SEX RATIO 

  • Formation of Committees as per norms
  • Medical audit of all the cases undergoing Ultra sound /genetic test and MTPs.
  • Extensive health talks under ARSH Programme.
  • Health talks with beneficiaries at the Community level and decision makers in the family
  • Establishment of Gender equity cell/PCPNDT cell.
  • Implementation of WIFS programme .
  • Collaboration has been done with School health programme, SWDs, Education department.
  • Extensive IEC in the colleges .
  • Health Talks with beneficiaries at the Community level and decision maker in the family .

IMPLEMENTATION OF MOTHER & CHILD TRACKING SYSTEM

Tracking of Pregnant Mothers and Children has been recognized as a priority area for providing effective healthcare services to Mothers during ANCs and PNC services and immuniation in Children.

  • Mother and Child Tracking System has been implemented in UT Chandigarh since June 2011. The quality offline documentation is being done by the ANMs which is regularly monitored by the supervisory teams on regular basis during the field visits and are also monitored by DFWO in monthly and other review meetings. 
  • Online Date Transmission of MCTS software through webportal http://nrhm-mcts.nic.in initiated w.e.f June,2011. 
  • State Project e-Mission Team constituted under the leadership of Worthy Secretary health for Effective monitoring of MCTS. As per guidelines of GOI a State Project e-Mission Team for monitoring the Mother & Child Tracking System is constituted in UT Chandigarh 

IMPLEMETATION OF ARSH PROGRAMME

Objective :

  • Reduce  teenage pregnancies
  • Meeting unmet contraception needs,
  • Reducing number of teenage maternal deaths
  • Reducing incidence of STIs and RTIs 
  • Reducing proportion of HIV infections among this age group, Nutritional anemia, Implementation of WIFS Programme 

STRATEGIES ADOPTEDARSH PROGRAMME Mapping for School going, out of school married/unmarried adolescents  has been completed, peer group leaders has been completed. 10 ARSH Clinics are functional

  • TOT, training of all Health Providers, AWWs has been completed.
  •  Peer group leaders shall be trained by the end of first quarter
  • ARSH shall be an agenda  in all VHNDS meetings.
  •  AFHC are functional at 10 health centres and data being generated in transmitted to MOHFW, GOI on monthly basis.Health Talks with beneficiaries at the Community level and decision maker in the family

Information Education Communication Activities under the programme(Click here to download)

Contact detail of Programme Officer:

    Dr. Manju Behl

    Programme Officer-RCH

    UT-Chandigarh

    Contact no. 0172-2700928

    Email Address:  porchchd[at]gmail[dot]com

    District  Family Welfare Officer, 4th Floor, New Administrative Block, GMSH, Sector 16, Chandigarh

    Contact no. 0172-2700928

    Email Address:   dfwochd[at]yahoo[dot]co[dot]in

 

Updated On: 05/22/2018 - 14:16
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