RMNCH+A

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

The main objective of the RMNCAH+N 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 ,Vision 2020 India and Sustainable Development Goals. 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

HWCs

X

X

X

X

STRATEGIES UNDERTAKEN TO ACHIEVE THE TARGETS AND GOALS

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 RCH Portal  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.
  • 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 , CH Sector 22 and CH 45 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

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 (FY 2019-20)

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

21382

21388

107604

2950

4503

Total no. of sick infant who availed the free entitlements

7246

NA

7376

307

988

  • Sunboards /Banners/flexes on JSSK have been displayed at various health facilities of Chandigarh
  • 6 BLS though 112 Help-Line number
  • Orientation of the field

JANANI SURAKSHA YOJNA (JSY)

  • The 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
  • Roll out of DBT through PFMS under JSY w.e.f. July 2015-16 covering all the delivery points of U.T. Chandigarh

Beneficiaries of JSY services ( F.Y 2019-20)

SNo.

Rural

Urban

Total

1.

0

572

572

 

 

 

 

Pradhan Mantri Surakshit Matritva Abhiyan” ( PMSMA) , chain of campaign  being carried out on 9th of every month by the Health department U.T Chandigarh  .It has been expanded to the eleven health centres i.e Civil Hospital Manimajra, Civil Hospital 45, CD Sarangpur, CD Ramdarbar, CD Citco, CD Kajheri, PHD 25, CD Dadumajra, EWS Dhanas, CD Moulijagran to provide comprehensive  and quality services  to pregnant female (2nd and 3rd trimester) under one roof.

                       A Fixed day strategy for 9th of every month.

Objectives:-

  • Ensure care provision by a physician/specialist in at least one ante-natal visit in the second or third trimester.
  • Provision of all services under one roof
  • Opportunity to track the pregnant women who have missed their antenatal visit
  • Identification of high risk pregnancies
  • Special emphasis on Malnutrition

Under “I PLEDGE FOR 9” an appeal has been made for inclusion of the private practitioners to volunteer for generating awareness and to participate in the Abhiyan at government health facilities. At present 1 Radiologist at CH 22 is providing the  ultrasonography services free of cost only on 9th of every month

Service Indicator

Total

Total number of pregnant women Received Antenatal care under PMSMA

8252

Received Antenatal care under PMSMA in 2nd or 3rd trimester for 1st time

7374

No of pregnant women whose Ultrasound was conducted

7355

Total Number of high risk pregnancies identified

1404

 

 

 

 

 

 

 

 

.Benchmarks under Maternal Health: Shared with all the health centres of U.T. Chandigarh for improving the service delivery  

 

Service Indicator

2017-18

2018-19

2019-20

Total number of pregnant women registered for ANC

41894

40023

35144

Percentage of pregnant women received 3/ 4 or more ANC check ups

71.72%

92.47%

109.04%

Percentage of pregnant women given 100 IFA tablets

72.31%

90.89%

98.49%

Percentage of pregnant women given 360 Calcium Tablets

68.87%

100.98%

103.36%

Percentage of pregnant women tested for Hemoglobin 4 or more than 4 times for respective ANCs

71.72%

93.55%

98.40%

RTI/STI Programme

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

LaQshya :Labour Room Quality Improvement Initiative:

LaQshya initiative for the quality improvement of Labour room and Maternity OT was launched in U.T. with the following objectives:

  • To reduce the maternal and newborn mortality and morbidity
  • To improve Quality of care during the delivery and immediate post partum care, stabilization of the complications and ensure timely referrals and to enable two way follow up system
  • To enhance satisfaction of the beneficiaries and to provide Respectful Maternity care to all the pregnant women attending the public health institutions

The mentoring visits were conducted on frequent basis to handhold the staff of the Labour room and Maternity OT of the delivery points under Chandigarh Administration  regarding LaQshya implementation

The National Assessment was done by the External Assessors appointed by NHSRC, New Delhi as per NQAS in the month of September 2019 per NQAS .

S.no

Name of the Delivery point

LaQshya Certified

LaQshya Certified with Conditionality

LaQshya certified through reassessment  done on 8.2.2020

1.

 District Hospital GMSH-16

 ✔

(Maternity OT & Labour Room)

         ✔

-

2

Sub Divisional Hospital Manimajra

-

         ✔

(Maternity OT & Labour Room)

-

3

Civil Hospital- 22

        ✔

(Maternity OT )

-

       ✔

(Labour Room)

4

Civil Hospital- 45

-

         ✔

(Maternity OT & Labour Room)

-

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Further, an appreciation letter was also received from GOI to the Director Health Services cum MD NHM  U.T.  Chandigarh stating that “ it’s a matter of pride that within a period of one  year , Chandigarh successfully achieved National Certification for 3 Labour Rooms and 4 Operation Theatres and they acknowledge and congratulate for the success” 

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

  • The Infant Mortality Rate of UT Chandigarh is now 13 for reference year 2018 and has decreased by 1 point (earlier was 14) as per SRS published in May 2020.
  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.

  • Provision for essential new Born Care(at Every delivery point) - Training in essential New Born Care(NSSK) - Home based New Born Care, pre-natal care training.
  • Special New Born Care Units have been established at PGIMER, GMSH-16, GMCH-32 to cater to sick new born being delivered there and to handle any new born referred from fields. PGIMER and GMCH 32 being tertiary care hospitals cater to very sick newborns referred from the neighboring states.
  • NBSU (New Born Stabilization Unit) are established at Civil Hospital Sector-22, Civil Hospital Manimajra and Civil Hospital Sector-45. The new born requiring phototherapy/conservative care are being managed there so to avoid hustle at tertiary care hospital.
  • NBCC (New born care corner) are established in each labour room any newborn delivery with mild complication like birth asphyxia,  and those requiring routine as well as observational care are managed there.
  • NRC (Nutritional Rehabilitation Centre). 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. The play area has been established at NRC GMSH 16 and inaugurated by DH&FW cum MD NHM on 19th November 2018.
  • 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).
  • Implementation of Child Death Review CDR has been rolled out since September 2015 as per guidelines of MoHFW, GOI
  • All the child deaths are analyzed at facility as well as community level.
  • The CDR committees have been formulated at facility level. 
  • Regular meeting under the chairpersonship of Mission Director, NHM, U.T, Chandigarh are conducted and corrective actions are being undertaken.
  • As an intervention of Child Death Review it was viewed that the areas of Manimajra, Indira colony and Kishangarh accounted for maximum deaths. Therefore, to reduce area specific deaths Tender care Clinic is functional at Civil Hospital Manimajra as an area specific action plan for areas of Manimajra, Indira colony and Kishangarh wherein newborns at 6 weeks of age are checked up by a pediatrician.
  • Implementation of Mother’s Absolute Affection (MAA) Programme an initiative for promotion of breastfeeding as per GOI Instructions has been initiated at UT Chandigarh. Facility nodal person has been designated for implementation of the same.
  • As an initiative, breastfeeding certificates have been distributed to all delivery points of U.T. Chandigarh for onward transmission to the proud mother for early initiation of breastfeeding within one hour of birth under MAA initiative.
  • 5. Celebration of Intensified Diarrhoea control Fortnight:-

    Intensified Diarrhoea control Fortnight (IDCF 2019) was celebrated in UT Chandigarh from 28th May to 9th June 2019 wherein following activities have been carried out:-

  • The ORS-Zinc Corners were made functional at all the health facilities of UT Chandigarh.
  • The sensitization of mothers and children upto 5 years of age was done regarding handwashing and sanitation.
  • IYCF

  • Breast feeding week is celebrated from 1st August to 8th August every year for early initiation of breast feeding, exclusive breast feeding and complimentary breast feeding. The queries of beneficiaries in regard to breast feeding are also answered
  • World Breastfeeding week was celebrated from 1st - 7th August 2019 at all the delivery points of UT Chandigarh.
  • Health Talks were held at antenatal and post natal wards highlighting early initiation of breast feeding, right technique of breast feeding, advantages of breast feeding and discouraging pre lacteals and top feeds.
  • Sensitization of pregnant and lactating women at Aaganwadi centers conducted by health workers of U.T. Chandigarh.
  • Nukkad natak was organized at Sabzi Mandi, Sector 38 West Chandigarh during the week.
  • As an initiative, the Breastfeeding certificates are being distributed to all delivery points of U.T. Chandigarh for onward transmission to the proud mother for early initiation of breastfeeding within one hour of birth.
  • Skits by the students from Dietetics Department, GMSH 16 performed at Civil Hospital Manimajra and Civil Hospital 22.
  • Counseling for promotion of early initiation of Breastfeeding, exclusive Breastfeeding and complementary feeding after six months of age is being done by Health Staff across all facility of U.T. Chandigarh
  • Videos regarding Breastfeeding were shared with all stakeholders.
  • Event at Police Hospital 26:- A lecture/counseling session regarding nutritional diet and importance of breastfeeding to pregnant and lactating women was conducted at PH 26 on 3rd August 2019. The same was taken by Dr. Bhavneet Bharti, Professor, Division of Social Paediatrics, PGIMER. The camp was attended by Medical Officers, Paramedical staff and 76 police personnel and families of nearby areas. The hemoglobin testing of the beneficiaries was also undertaken. 
  • Gidda Programme was held at UPHC Daddumajra.Nukkad natak was organized at Sabzi Mandi, Sector 38 West Chandigarh during the week.
  • . Celebration of POSHAN MAAH POSHAN MAAH was celebrated in month of September 2019 wherein following activities were carried out

  • All health facilities actively participated during the month and special counseling session on complete POSHAN were conducted and reported on daily basis.
  • Special counseling sessions at Nutrition Rehabilitation center (NRC) established at GMSH 16.
  • Drawing Competition was held among admitted children on health diet at Play Area of NRC, GMSH-16.
  • Counselling done by Medical Officer NRC regarding benefits of green leafy vegetables, herbal plantation and benefits of breastfeeding in Paediatric OPD of GMSH-16
  • Orientation of 32 ANMs and 13 Staff Nurses from Delivery points for one day Mother's Absolute Affection (MAA) programme was done on 26th September 2019
  • NEWER INITIATIVES:-

  • Rolling out of Home Based Care for Young Child (HBYC) across all health facilities of UT Chandigarh wherein additional home visits by ANM between 3 and 15 months i.e. 2nd year of life are done at 3rd, 6th, 9th, 12th and 15th months.
  • Implementation of SAANS (Social Awareness and Action to Neutralise Pneumonia Successfully) initiative has been done.
  • Celebration of National Newborn week 2019 was done during 15th November to 21st November 2019 to “raise nationwide awareness about the community care of newborn through the Home Based Care for newborn and children”. The key themes of the week were:-
  • Nurse mother and baby together
  • Keeping the newborn baby warm at all times
  • Keeping the cord dry.
  • Hand-washing is a must before feeding and after visiting toilet.
  • Early recognition of danger signs and timely referral.
  • Early initiation of Breastfeeding and ensuring support for breastfeeding.

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/ RCH Portal

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 
  • The MCTS is presently upgraded to the new version of RCH portal, which is the cloud based solution having complete traking of eligile couples, pregnent women, children services.

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: 07/24/2020 - 11:15
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