PLANNING &ORGANISATION OF
RCH SERVICES FOR 1 LAKH
POPULATION IN A RURAL AREA
Dr. I.Selvaraj
I am very grateful to The Super course, as my view is
disseminated to global audience through my Power point
presentations in different topics. I hope you might have
enjoyed.
This power point presentation is prepared based on RCH
PHASE-II Programme. Those who have gone through my
earlier presentations on RCH-PHASE-I , RCH-PHASE-II
&Modified RCH-PHASE-II will be benefited. My aim of this
presentation is to help the developing countries to strengthen
their activities in their areas so that our ultimate goal of
population stabilization will be achieved.
My vision is always to disseminate the knowledge of
community medicine to all my public health colleagues
without any monetary gain. I hope you will all enjoy & gain a
lot. Please send me the feedback.
Thanking you
Dr.I.selvaraj, I.R.M.S
B.Sc., M.B.B.S., D.I.H.,PGCH&FW(NIHFW)
(M.D Community Medicine, Sree Ramachandra Medical college &RI)
D.P.H., (MADRAS MEDICAL COLLEGE, Recognized by MCI)
Senior Divisional Medical officer (Selection Grade Officer)
On Study Leave
INDIAN RAILWAYS
Reproductive health can be defined as a state in
which people have the ability to reproduce and
regulate their fertility, women are able to go through
pregnancy and child birth safely, the outcome of
pregnancy is successful in terms of maternal and
infant survival and well being, and couples are able
to
have
sexual
relations
free
of
pregnancy and of contracting diseases.
the
fear
of
• Right of the men & women to be informed
• To have access to safe, effective, affordable, &
acceptable methods of fertility regulation of their
choice
• Right of access to appropriate health care
services
• To enable women to go safely through pregnancy
and childbirth
• To provide couples with best chance of having a
healthy infant
The first phase of the programme was started on
1997 with an aim to bring down the birth rate
below 21 per 1000 population, to reduce the
infant mortality rate below 60 per 1000 live birth
and to bring down the maternal mortality rate
<400/1,00,000lakh. 80% institutional delivery,
100% antenatal care and 100% immunization of
children were other targeted aims of the RCH
programme.
The 5 year RCH phase II is launched in TamilNadu on 2005
with a vision to bring about outcomes as envisioned in the
Millennium Development Goals, the National Population
Policy 2000 (NPP 2000), the Tenth Plan, the National
Health Policy 2002 and Vision 2020 India, minimizing the
regional variations in the areas of RCH and population
stabilization through an integrated, focused, participatory
programme meeting the unmet needs of the target
population,
and
provision
responsive quality services.
of
assured,
equitable,
VISION
To bring about outcomes as envisioned in the
1. Millennium Development Goals
2. The National Population Policy 2000 Goals
3. The Tenth Plan Goals
4. The National Health Policy 2002
5. and Vision 2020 India
National
Population
Policy 2000
(by 2010)
Millennium
Developme
nt
Goals
(
By 2015)
Tenth Plan
Goals (20022007)
RCH II Goals
(2005-2010)
Population
Growth
16.2%
(2001-2011)
16.2%
(2001-2011)
-
-
Infant
Mortality Rate
45/1000
35/1000
30/1000
-
Under 5
Mortality Rate
-
-
-
Reduce by
2/3rds
from 1990
levels
Maternal
Mortality Ratio
200/100,000 150/100,000
100/100,000
Reduce by
3/4th from
1990 levels
Total Fertility
Rate
2.3
2.2
2.1
-
Couple
Protection Rate
65%
65%
Meet 100%
needs
-
Indicator
•
Immediate objective:
1.To Improve routine immunization coverage
2.To reduce the unmet need for contraception
•
Medium term objective:
To bring the Total fertility Rate to replacement level
by 2010
•
The long term objective:
Population stabilization
by 2045
Target:
• Total fertility rate to the replacement level by 2010
• To achieve the indicators of Health for All,
MilleniumDevelopmentGoal,NationalHealthpolicy2002, &10th
Five year plan Goal
Program:
Plan
Comprehensive R.C.H services
: High quality, integrated, decentralized,
Need based and holistic approach, CNAMA
Monitoring &
Evaluation:
R.C.H indicators/Feedback data
Strategy
1. Reduction of Maternal Morbidity And Mortality
2.Reduction of Infant Morbidity And Mortality
3.Reduction of Under 5 Morbidity And Mortality
4.Promotion of Adolescent Health
5.Control of Reproductive Tract Infections and Sexually
Transmitted Infections.
Programme strategy
•
•
•
•
•
•
•
•
•
•
•
•
Decentralized participatory planning
CNAMA
Good quality care
Upgraded facilities
Improved training
Target free approach
Absence of incentives
Making services gender sensitive
Male participation in family planning
Involvement of Panchayat raj
Multi sectoral approach
Client satisfiaction
CNAA APPROACH
• It refers to need assessment and planning for services with the
involvement of community.
• It is based on the felt need of the community and relevant to
the community.
• Enable the clients to meet their Goals
• Client centered, Demand driven, Bottom-up, Decentralized
• Full range of integrated high quality RCH services
• Participatory planning
• Target free approach
• performance monitoring by Quality of care, Client satisfaction,
coverage measures
• Accountable to the client, community
There are about 50 comprehensive R.C.H services to
be effectively carried out for the entire population:
•
M.C.H Services
•
Nutritional Services
•
Management of childhood diseases
•
Referral Services
•
Fertility Services
•
Population control and sexuality educational
Services
•
R.T.I / S.T.I Control Services
•
Health education regarding gender issues
•
Formal and Non-formal education about
public health
•
Forty Plus Care etc.,
RCH PACKAGE OF SERVICES
For Mothers
1. All pregnancies to be registered by health workers.
2. Pregnant women must be given two doses of tetanus toxoid
immunizations.
3. Pregnant women must be given iron folic acid tablets for prevention
and treatment of anemia.
4. Pregnant women must be given three antenatal checkups, which
include checking their blood pressure and ruling out complications.
5. Deliveries by trained personnel in safe and hygienic surroundings
should be encouraged.
6. Institutional deliveries should be encouraged for women having
complications.
7. Referrals should be made to first referral units for management of
obstetric emergencies.
8. Three postnatal checkups should be given to mothers after the
delivery.
9. Spacing of at least three years between children must be encouraged
For New born & Children
1.Essential newborn care like keeping the baby warm, checking the baby's
weight and giving the baby mother's first milk is important. The
premature babies or low birth weight babies need special care. Babies
with any complications should be refereed to the nearest health center.
2. Exclusive breast-feeding must be encouraged for the first three months.
Weaning or starting the baby on semisolid food should start in the
fourth month.
3. BCG, DPT, Polio and Measles immunizations should be administered to
every child meticulously to prevent death and disabilities.
4. Vitamin A prophylactic for children is necessary to prevent blindness.
5. Parents must be informed about oral rehydration therapy and correct
management of diarrhea. The availability of ORS packets in the villages
should be ensured.
6. Acute respiratory infection in children should be detected early. They can
be treated by cotrimoxazole tablets. Acute cases should be refereed to
health center.
7. Treatment of Anemia.
ELIGIBLE COUPLES
1. Promoting use of contraceptive methods among
eligible couples is important to prevent unwanted
pregnancies. Couples should be able to choose from
various contraceptive methods including condoms,
Oral pills, IUDs, male and female sterilization.
2. Safe services for medical termination of pregnancies
should be encouraged for women desiring abortions.
OTHER NEW SERVICES
1. A large number of people suffer in silence due to reproductive
tract infections (RTIs) and sexually transmitted diseases (STDs).
RTIs and STDs can make people infertile. If a pregnant woman
has RTIs or STDs, it can affect the health of her child. People
suffering from such infections should be referred to the health
center.
2. Adolescents are parents of tomorrow. It is important to prepare
them for the future by counseling them on family life and
reproductive health. This can be a sensitive topic, as it has not
been addressed before. Therefore, the involvement of parents,
Anganwadi workers, and Mahila Swasthya Sanghs should be
ensured
NEW STRATEGY OF RCH PHASE 
1.To constitute empowered action group
2. Training of dais
3. To conduct RCH camps & organize RCH out reach scheme
4. Training of MBBS doctors in Life saving anesthetic skills for
emergency obstetric care at FRUs.
5. Strengthening of core strategy of the existing PHCs and CHCs,
and provision of 30-50 bedded CHC (community health centre)
per lakh population for improved curative care to a normative
standard (Indian Public Health Standards defining personnel,
equipment and management standards)
6.All Community health centers & 50% of the Primary health
centers are to be made functional for providing 24 Hrs. delivery
services
7.Primary Health Centers are proposed to be taken up for
improving access to Essential Obstetric and New Born Care
services round the clock. Cont……
8.Improving quality of antenatal, neonatal and postnatal care by
providing increased number of antenatal checkups, fixed day
antenatal clinics, linking visits of neonates with postnatal care,
empowering the VHNs in performing obstetric first aid and
newborn care.
9.Improvement of the referral networking systems by
establishing emergency helpline
10.Regular conduct of blood donation camps for the continued
availability of blood in the blood banks.
11.Universalizing the concept of birth companionship during the
process of labor in all health facilities conducting deliveries.
12.Operationalisation of maternal death audit to address the
issues that have led to maternal deaths
• Janani Suraksha Yojna (National Maternity Benefit Scheme) is
envisaged as a package of services, geared at reducing
maternal mortality, neonatal mortality, and female feticide and
gender disparity.
•
“Vandematram” scheme -launched on 9th Feb. 2004 in all
the districts of the country with the active collaboration of the
professional bodies. The aim of the scheme is to reduce the
maternal mortality and morbidity of the pregnant and
expectant mothers by involving and utilizing the vast
resources of specialists/trained workforce available in the
private sector.
•
A new initiative in National Rural Health Mission (20052012) is accountability. Every village/large habitat will have a
female Accredited Social Health Activist (ASHA),
accountable to the Panchayat. She will act as the interface
between the community and the public healthcare system.
INFANT AND CHILD HEALTH
1. Reduction of Neo-natal deaths, infant deaths and child deaths
by providing continuous health care and strengthening of newborn care infrastructure facilities.
2. Organizing counseling sessions for the mothers.
3.Implementing integrated management of neonatal and
childhood illness
4. Operational sing infant death/stillbirth verbal autopsy.
5. Addressing the issue of female infanticide and foeticide
6Gadchiroli model to take care of home based neonatal care
7.Kangaroo mother care to take care of low birth weight infants
FAMILY WELFARE
Higher order births will be targeted for intensified intervention
2. Social marketing programme has to be developed for condom
and other health commodities, promotion of IUD insertions,
familiarizing the concept of one-stop Family Welfare Centre.
3. Increasing access to safe abortion services by popularizing
manual vacuum aspiration (MVA) technique.
4. Establishment of one-stop family welfare services at
Comprehensive Emergency Obstetric and New Born Care
(CEMONC) Centres.
5. Popularizing No Scalpel Vasectomy.
6. Availability of a wide range of contraceptive methods MCH and
other services
1.
7. Availability of a wide range of contraceptive methods MCH
and other services
8. Accessibility, complete and accurate information about
contraceptive methods, including their health risks and
benefits
9. Safe and affordable services, along with high quality
supplies
10. Well-trained service providers with skills in inter-personal
communication and counseling
11.Appropriate follow-up care
12. Regular monitoring and evaluation of performance
13.A paradigm shift from individualized vertical interventions
to a more holistic and integrated life cycle approach giving
more focused attention to the reproductive health care.
OTHER INNOVATIVE REFORMS:
1. Improved drug procurement & supply systems to tackle the
problem of inadequate and irregular supplies
2. Improved supply of cross-matched blood in first referral units
thereby decreasing the inter-institutional transfers for transfusion
3. Regular conduct of blood donation camps for the continued
availability of blood in the blood banks.
4. Systematic reporting and auditing of maternal & infant deaths
5. For monitoring purposes, standardized systematic reporting of
services rendered at primary care level, using simple, manually
completed, computer readable forms
6. Ensuring block and district level inter-sectoral coordination
for ICDS
7. Improvement of the referral networking systems by
establishing emergency help line
8. Each community health center should have one additional post
of public health manager and public health nurse
Strengthening of IEC activities.
These activities should cover the following messages:
•
Ideal age at marriage, Ideal age to produce a child, small
family norm, Avoidance of higher order births, spacing,
contraceptive acceptance, importance of female literacy,
anemia control, monitoring the weight gain of mothers and
growth monitoring of babies, breast feeding and importance
of colostrums, diarrhea management, oral rehydration
therapy, eradication of female infanticide and foeticide,
upholding the image of girl child and women, safe delivery,
institutional delivery, immunizations and nutrition.
Propagation of messages through films, video spots, dramas,
street plays and booklets have to be undertaken. Electronic
media such as T.V. and radio have to be utilized. Audio-visual
aids will be provided in medical institutions and publication of
booklet on IEC activities.
Quality care
Factors determining good quality care
• Service delivery
•
Promoting informed choice
•
Need based service delivery
•
Providing follow up care
• Interpersonal communication
•
Friendly and cooperative attitude of health
worker
Spending time with clients
Caring of clients privacy and dignity
• Social aspects
•
Gender sensitive service provision
•
Male participation
•
Increase Women role in the programme
ADOLESCENT HEALTH.
a) Focusing adolescents as receivers and providers of
knowledge and function as link volunteers in the community.
b) Utilising the services of trained adolescents for propagating
Indian System of Medicines.
c) Broadcasting and Telecasting of programme by AIR/TV
focusing adolescent, gender and health related subjects.
d) Formation of co-ordination committee at the district level
and monitoring committee at the State level for overseeing
the AIR/TV programme.
Reproductive tract infections / Sexually
transmitted infections / Cancer control.
a) Establishment of Reproductive Tract Infection /
Sexually Transmitted Infection, early Cancer detection
clinics .
b) Strengthening RCH outreach services.
c) RTI/STD clinic in selected primary health centers
Infrastructure strengthening for service
delivery
a) Construction of HSC buildings where HSCs are currently
functioning in rented premises
b) Rebuilding HSCs which are unfit for occupation.
c) Taking up of repairs/renovation and provision of water
supply/electrical works to PHCs/HSCs.
d) Need-based supply of equipment/furniture to the HSCs and
PHCs as per the standard list including gas connections.
e) Provision of Cell phones to HSCs where large number of
deliveries take place.
f) Provision of telephones to PHCs
BEHAVIOURAL CHANGE COMMUNICATION
(BCC)
a) Social mobilization activity against female infanticide and
foeticide by preventive counselling.
b) Formation of HSC, Block, District level committees for saving
female babies.
c) Conducting of Kalaipayanam (traveling street theatre) to
promote social mobilization and to improve health care among
the target population
d) Telecasting of TV serials, Radio broadcasts, wall paintings,
hoardings and glow signs for popularizing health and
reproductive health messages in important places.
Packages of services at sub-centre
Immunization, Antenatal, Natal and Postnatal care,
prevention of malnutrition and common childhood
diseases, family planning services and counselling.
They also provide elementary drugs for minor ailments
such as ARI, diarrhea, fever, worm infestation etc. and
carryout community needs assessment.
PACKAGES OF SERVICES AT FRU
•Vacuum Extractions
•Administration of Anesthesia
•Blood Transfusion
•Caesarean Section
•Manual Removal of Placenta
•Carry out Suction Curettage for Incomplete
Abortion
•Insert Intrauterine Devices
•Sterilization Operation
KIT-A –SUB-CENTRE
KIT-B-SUB-CENTRE
KIT-C-SUB-CENTRE
KIT-D-PHC (PRIMARY HEALTH CENTR)
TYPES OF KIT FOR FIRST REFERAL UNIT
•Kit-E – Laparotomy set
•Kit-F - Mini– Laparotomy set
•Kit-G – IUD insertion set
•Kit-H – Vasectomy set
•Kit- I – Normal delivery set
•Kit- J – Vacuum extraction set
•Kit- k – Embryotomy set
•Kit- L – Uterine evacuation set
•Kit-M – Equipment for anesthesia
•Kit-N- Neonatal resuscitation set
•Kit-O- Equipment and reagent for blood test
•Kit-P – Donor blood transfusion set
Evaluation
GOALS&OBJECTIVES
Yes
No
Assessment
of health need
Monitoring
PLANNING CYCLE
Implementation
of programme
Assessment
of resources
Time
frame
Action
plan
Establish
goals
&objectives
Select the
best
alternative
Design
alternative
programme
Establishment
of priorities
BLOCK PRIMARY HEALTH CENTRE/COMMUNITY HEALTH
CENTRE
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Medical officers (Surgeon, Gen. Physician, Gynecologist, Anesthetist,
Public Health Managers)
Pharmacist
Lab-technician
Lab-Assistant
Ophthalmic Assistant
Dark Room Assistant
Sector Nurses
ANM
Hospital worker
Cook-water carrier
Sanitary worker
BHE
BEE
CHN(COMMUNITY HEALTH NURSE0
BHS
PHC HI (CHIEF HEALTH INSPECTOR)
VHN (VILLAGE HEALTH NURSE)
HI
Siddha M.O
Siddha-Pharmacist
Siddha – Assistant
• Primary Health centre (upgraded PHC, Additional PHC,
Mini PHC)
M.O, Staff Nurse, Health assistants (Male, Female), Health
Inspectors, Pharmacist, Lab technician, Ambulance driver,&
Sanitary cleaners, Block extension educator, UDC,LDC (15-17)
• Sub centre (5-6 )
Multi purpose Health worker (Male, Female)
• Village level (25-30)
Supporting Health workers (Village Health Guide, Traditional
birth attendant, Anganwadi workers, ASHA(NRHM)
INDICATORS OF MONITORING &EVALUATION
RCH-II PROGRAMME
1.The public health managers have to monitor the
programme.
2.They have to evaluate the effectiveness of the
programme with the following indicators.
ACCESSIBILITY INDICATOR
•No. of Eligible couples registered/ANM
•No. of Antenatal Care sessions held as planned
•% of Sub Centers with no ANM
•% of Sub Centers with working equipment of ANC
•% ANM/TBA without requisite skill
•% Sub centers with DDKs
•% of Sub centers with infant weighing machine
•% Sub centers with vaccine supplies
•% Sub centers with ORS packets
•% Sub centers with FP supplies
QUALITY INDICATOR
•% Pregnancy registered before 12 weeks
•% ANC with 5 visits
•% ANC receiving all RCH services
•% High-risk cases referred
•% High-risk cases followed up
•% Deliveries by ANM/TBA
•%PNC with 3 PNC visits
•% PNC receiving all counselling
•% PNC complications referred
•% Eligible couple offered FP choices
•% Women screened for RTI/STDs
•% Eligible couple counselled for prevention of
RTI/STDs
•% ADD given ORS
•% ARI treated
•% Children fully immunized
IMPACT INDICATOR
•%Deaths from maternal causes
•Maternal mortality ratio
•Prevalence of maternal morbidity
•% Low birth weight
•Neo-natal mortality ratio
•Prevalence of postnatal maternal morbidity
•% Baby breast-feeds within 6 hrs of delivery
•Couple protection rate
•Prevalence of terminal method of sterilization
•Prevalence of spacing method
•% Abortion related morbidity
•Prevalence of ADD
•Prevalence of ARI
•Prevalence of RTI/ST
HEALTH MANAGEMENT INFORMATION SYSTEMS
Introduction of IT-enabled HMIS for planning and
monitoring health services at the State/District
/Block levels
TRAINING
a) Skill upgradation training with focus on
improving/upgrading the skills of health care providers.
b) Integrated skill training for peripheral health
functionaries such as VHNs, SHNs, medical officers and
health inspectors.
c) Improving managerial and communication skills of
health staff.
SUB CENTRE ACTION PLAN
•
•
•
•
•
•
•
•
•
•
•
To collect the C.B.R from C.D.M.O’S office
Survey the population of the area
Estimate the No of eligible beneficiaries
Estimate the no of Infants
Estimate the no of Live births
Estimate the no of <5 years children
Estimate the no of Antenatal registration
Estimate the no of High risk pregnancies
Estimate the no of anemic pregnant women
Estimate the no of high risk newborns
Estimate the no of <3 years children
CALCULATION OF VACCINE REQUIREMENT
• Population of the area
• Birth rate
• Infant mortality rate
•
•
•
•
No of beneficiaries
No of doses of each vaccine
Wastage & Multiplication factor
Number of sessions
•
Probable number of pregnancies =Population of area ×Birth rate of
the area
= 1,00,000 ×16.7 =1670
1000
Antenatal registration = Probable number of pregnancies + 10% (for
pregnancy wastage)
= 1670 + 167 = 1837
15% of the antenatal registration are high risk
= 1837 × 15 = 276
100
•
50% of the registered antenatal mothers are anemic
•
Total No of Live Births to be expected = 1670
10% of the live birth babies are sick or high risk and need referral
•
•
•
•
•
= 1837 = 978.5 =919
2
= 167
Infants alive at one year in the area =number of live birth-infant
mortality rate of the area = 1670 – 53 = 1617
8% of the total population is children below 3 years of age
= 8000
15% of the total population is children below 5 years of age
= 15000
22% of the total population is women in the age group of 15-45 years
= 22000
• The number of pregnant women = Population × Birth rate
• The number of infants
= Population × Birth rate ×(1-IMR)
Annual Vaccine Requirement
= No of eligible ×No of doses × Proposed coverage
×Multiplication factor based on VAR
(DPT,DT, TT, OPV ) Multiplication factor=1.33
( BCG,Measles) Multiplication factor
=2
•
T.T
= 1837 × 1.33 × 2= 4886 Doses
= 245 vials ( Each Vial = 20 doses)
• D.P.T
= 1620 × 1.33 × 3 = 6464 Doses
= 646 vials ( Each vial = 10 Doses)
• B.C.G
= 1620 ×2 ×1
= 3240 Doses
= 324 Vials+ Diluents ( Each vial = 10 doses)
• Measles
= 1620 ×2 ×1
= 3240 Doses
= 324 Vials + Diluents
• OPV
= 1620 ×1.33 ×4
= 8618 Doses
= 862 vials
Estimation of syringes & Needles
= No of registered pregnant women ×Session planned +No of infants ×
session planned
= 3674+ 8100 = 11774 AD Syringes &Needles
ESTIMATION OF Iron & Folic acid tablets
• Antenatal registration : 1837
• Prophylaxis = 100 large tablets × No of pregnant women (5025-25)
•
= 100 × 1837 =1,83,700
• 50% pregnant mothers expected to be anaemic = 918.5
• Therapeutic dose = 200 tablets×50% No of pregnant women
(100-50-50)
•
= 200 tablets× 919 =1,83,800
• 10% children <5 years expected to be anaemic
= 15000 × 10 =1500
100
• 100 small tablets/child after de- worming
= 100 × 1500 = 1,50,000
Total = 1,83,700+1,83,800 =367500 (Large tablets)
= 1,50,000 (small tablets)
• Large tablets (Elemental Iron =100 mgm,Folic acid =0.5 mgm)
• Small tablets ( Elemental iron = 20 mgm, Folic acid = 0.1 mgm)
ESTIMATION OF Vit-A concentrated solution
• All children below 1 year of age will require = 1 lakh unit
• All children 1-3 years of age will require
= 2 doses of 2
lakhs units/year
• 20% wastage
• The number of infants = Population × Birth rate ×(1IMR)
= 1,00,000 × 16.7 × 0.97 = 1620
1000
Total doses for infants = 1620
= 1620 × 1,00,000 I.U
Each bottle = 100 ml
= 1 ml = 1,00,000I.U
= 17 Bottles
Total doses for children < 3 years =8000-1620=6380
= 6380 × 4 =25520 doses
= 2ml = 1dose = 510 bottles + 17
Total Vit-A Solutions = 100ml × 527
Estimation of ORS PACKET
• Estimate the number of children < 5 years in a
sub- centre area (15% of total population)
=15,000
• Each child/ 3 episodes of diarrhea/year
• 10% episodes with signs of dehydration – 3 ORS
packets
• children
• 15,000×3 =45,000 episodes
• 4500×3 =13,500 ORS PACKETS
ESTIMATION OF MEBENDAZOLE TABLETS
• Estimate the number of pregnant women
• 50% pregnant women would require deworming in the 2nd
3rd Trimester
• 40% under 5 children would require deworming
• Probable Number of pregnancies:
= Population of the area ×Birth Rate
= 1,00,000 × 16.7 = 1670
1000
= 1670 = 835
2
= 15000 ×40 =6000
100
= 835+ 6000 =6835 ×6 =41010
Estimation Co-trimoxazole
• Estimate the number of <5 years children (15%
of total population)
• 3 episodes/year
• 15000×3 =45000
• 15% episodes of ARI Pneumonia
• 6750× 20 Pediatric dose of Co-trimoxazole tablets
= 1,35,000
COLD BOXES
• 5 Litres – One month supply of PHC
• 20 Litres – One month supply of Health centre for 1 lakh
population
• 5 days
• VACCINE CARRIER
• 16-20 VIALS (20 NUMBERS)
• 2 days
• Day carrier
• 6-8 vials
• 8 hrs
Sphygmomanometer & stethoscope
One for each sub center
One weighing scale for adult & on spring balance for babies in
each sub centre
CONCLUSION:
Public health experts should be an essential part of the executive management
team and will have to play a key role in our country by identifying the major
problems in the RCH programme such as the absence of links between communities,
subcentres and referral facilities; shortages of equipment and trained staff at
referral facility; and a lack of emergency transport to adequately meet the needs of
pregnant women particularly for obstetrical emergencies. Allocation of resources
should be linked to states performance as well as to population size. They have to
identify the new indicators for performance, and allocation of resources based on
the felt need of the on priority.
Active participation of Community with involvement and support of women’s
self help groups, village health nurse, anganwadi workers, asha activist etc., will be
very effective in improving women accessibility to different components of RCH
services and increasing sensitivity to women’s needs. The private sectors role in
improving women’s health is very helpful. We have to find out a mechanism to
involve them through appropriate rules &regulations to provide the RCH Phase-II
programme to the community.
World Health Day slogan 2005 “Make Every Mother and Child Count”
reflects that health of women and children should be given higher priority at all
levels of health care system. Every one is accountable for health of mothers &
children. The World Health Day slogan 2006 “Working together for health” reflects
the involvement of health care workers to provide quality health care services to the
community. The fulfillment objective of Phase-II RCH programme is the joint effort
of community and service providers.
REFERENCES:
•
National Health programs of India by J.KISHORE
•
Text book of Preventive & Social Medicine 19th edition
•
ISSN 0019-557X, VOL.XXXXIX No.3 JULY-SEPTEMBER,
2005
•
Country fact file on Maternal, Newborn and Child Health
situation in India Centre for Community Medicine*All
India Institute of Medical Sciences New Delhi – 110029
•
www.tn.gov.in/spc/tenthplan/CH_5.PDF
•
Public Health in South-East Asia in the 21st Century
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