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Chapter: 12th Nursing : Chapter 5 : Child Health Nursing

Maternal and Child Health services

Maternal and Child Health services include the curative, preventive and social aspects of maternity services, paediatrics, family welfare, nutrition, child development and health education.

Maternal and Child Health services

Maternal and Child Health services include the curative, preventive and social aspects of maternity services, paediatrics, family welfare, nutrition, child development and health education. The specific objectives of MCH are:

·  Reduction of morbidity and mortality rate for mothers and children

·  Promotion of reproductive health and

·  Promotion of the physical and psychological development of the child within the family.

 

Components of MCH

·  Family planning and reproductive health service

·  Maternal, newborn and child health service

·  Health Communication

·  Health Commodities and supplies

·  Health systems strengthening

The Ministry of Health and Family Welfare has launched National Health Mission in May 2013. Many different health and welfare programmes have been brought together under the umbrella of National Health Mission (NHM) with National Rural Health Mission (NRHM) and National Urban Health Mission (NUHM) as its two sub missions. The programme components include Reproductive-Maternal-Newborn-Child and Adolescent Health (RMNCH+A); and control of communicable and non communicable diseases.

 

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

his programme has been launched in 2013. It aimed to reduce the maternal mortality and child mortality and addressed the delays in accessing and utilizing health care and services. Under this programme, the areas of care include

·  Reproductive care

·  Maternal care

·  Neonatal care

·  Child care and

·  Adolescent health care

The three goals that are relevant to RMNCH+A strategic approach in 12th Five Year Plan which has to be achieved by 2017 is as follows:

·  Reduction of Infant Mortality Rate (IMR) to 25 per 1,000 live births

·  Reduction in Maternal Mortality Ratio (MMR) to 100 per 100,000 live births

·  Reduction in Total Fertility Rate (TFR) to 2.1

Priority interventions in RMNCH+A

The following are the intervention for children. They are

·  Home-based newborn care and prompt referral

·  Facility-based care of the sick newborn

·  Integrated management of common childhood illnesses (diarrhoea, pneumonia and malaria)

Child nutrition and essential micronutrients supplementation

·  Immunization

·  Early detection and management of defects at birth, deficiencies, diseases and disability in children (0–18 years)

 

Janani SurakshaYojana (JSY)

It is a safe motherhood intervention under the National Rural Health Mission (NRHM). It was launched in 12th April 2005. The objective of JSY is reducing maternal and neo-natal mortality by promoting institutional delivery among the poor pregnant women. A monetary benefit is given to the mother under this programme for institutional delivery.

 

Janani Shishu Suraksha Karyakaram (JSSK)

Government of India has launched Janani Shishu Suraksha Karyakaram (JSSK) on 1st June, 2011. This programme aimed to motivate the mother for institutional delivery.

The following are the free entitlements for pregnant women:

·  Free delivery

·  Free Caesarean Section

·  Free drugs and consumables

·  Free diagnostics

·  Free diet in the hospital

·  Free provision of blood

·  Exemption from user charges

·  Free transport from home to hospital

·  Free transport during referral services

·  Free drop back from hospital to home

The following are the free services for sick newborns till 30 days after birth.This has now been expanded to cover sick infants:

·  Free treatment

·  Free drugs and consumables

·  Free diagnostics

·  Free provision of blood

·  Exemption from user charges

·  Free Transport from Home to hospital

·  Free transport during referral services

·  Free drop back from hospital to home

 

Rashtriya Bal Swasthya Karyakram (RBSK)

It is a new initiative launched in February 2013. It includes provision for child health screening and early intervention services through early detection and management of 4 Ds, prevalent in children. These are

·  Defects at Birth

·  Deficiencies

·  Diseases of Childhood

·  Developmental delays and disabilities

 

Integrated Management of Neonatal and Childhood Illnesses (IMNCI)

It is one of the main interventions under the Reproductive and Child Health programme as well as under NRHM. It has two components.

Care of Newborns and Young Infants (infants under 2 months)

It includes

·  Keeping the child warm

·  Initiation of breastfeeding immediately after birth

·  Counseling for exclusive breastfeeding and non-use of pre lacteal feeds

·  Cord, skin and eye care.

·  Recognition of illness in newborn and management and/or referral

·  Immunization

·  Home visits in the postnatal period.

Home visits are an essential part of this intervention. Home visits done by health workers help mothers and families to understand and provide essential newborn care at home and detect and manage newborns with special needs due to low birth weight or sickness.

Care of Infants (2 months to 5 years)

It includes

·  Management of diarrhoea, acute respiratory infections (pneumonia) malaria, measles, acute ear infection, malnutrition and anemia

·  Recognition of illness in children and management/referral

·  Prevention and management of Iron and Vitamin A deficiency

·  Counseling on feeding for all children below 2 years

·  Counseling on feeding for malnourished children between 2 to 5 years

·  Immunization

 

Dr.Muthulakshmi Reddy Maternity Benefit Scheme

This scheme is being implemented in Tamil Nadu with a noble objective of providing financial assistance to poor pregnant mothers to meet expenses on nutritious diet, to compensate for the loss of income during motherhood and to avoid low birth weight of new born babies. In this scheme, Rs. 12,000 per beneficiary is given from 20 Feb 2017, it is increased to Rs. 18000 for the improvement of healthy motherhood.

 

Amma Baby care kit

This is launched in Tamil Nadu in the year 2015. Under this scheme, all the babies born in Government institutions are given Amma Baby Care Kit worth of Rs.1,000/-. It is distributed with the objective of improving the hygiene of the postnatal mothers and the newborn baby and inculcating hygienic practices among the mothers for self and baby care. The Amma Baby Care kit contains 16 items viz. baby towel, baby dress, baby bed, baby protective net, baby napkin, baby oil, baby shampoo, baby soap, baby soap box, baby nail clipper, baby rattle, baby toy, liquid hand wash, bathing soap, sowbagyasundilehiyam and a kit bag to securely keep all the items.

 

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12th Nursing : Chapter 5 : Child Health Nursing : Maternal and Child Health services |


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