Reproductive and Child Health Program

(RCH)
Reproductive health refers to reproductive organs that are healthy and
function normally.
According to the World Health Organisation (WHO), reproductive health
is defined as comprehensive well-being in all areas of reproduction, including
physical, mental, behavioural, and social well-being.
India was one of the first countries to implement reproductive health
initiatives. In 1951, family planning measures were created to attain overall
reproductive health, and these tactics were examined regularly.
RCH (reproductive and child health care) programmes are designed to
raise public knowledge about various reproductive issues and assist in
developing a reproductively healthy society by offering resources and support.

Reproductive and Child Health- Phase I Program

The abbreviation RCH stands for Reproductive and Child Health. It is a
programme initiated in October 1997 to reduce maternal, newborn, and child
mortality rates.

Objectives -
Objectives that were aimed at achieving during the first stage of the programme
 To improve policy administration by implementing a participatory design
that empowers organisations to make the best use of project resources.
 To improve the current family wellness services’ quality, coverage, and
effectiveness.
 To gradually broaden the scope and coverage of services related to family
welfare to provide a comprehensive package of RCH help.
 Increase the range of the existing family welfare (FW) wellness
programmes to accommodate new components.
 To improve the quality and infrastructure of FW services, preference
should be given to rural parts of cities or districts.

Components -
The four components included in the RCH phase I program are:
1. Family planning.
 2. Reducing child mortality and safe motherhood.
3. Health-care delivery with a client-centred approach.
4. RTI, STD, and AIDS prevention and management.

RCH Phase I Interventions in all Districts-

1) Immunisation, Vitamin A, and pneumonia prophylaxis are examples of
child survival interventions.
2) Vitamin A is provided to all children under the age of five. The first
dosage (1 lakh units) is given along with measles vaccination at nine
months. The second dose is administered along with DPT OPV booster
doses. There is a six-month interval between subsequent dosages (2 lakh
units each).
3) Antenatal checkups, tetanus immunisation, safe delivery, and anaemia
management programmes are examples of safe motherhood interventions.
4) Implementation of the target-free strategy.
5) At all levels, high-quality training is provided.
6) Slums and tribal communities have their RCH package.
7) District hospitals have RTI/STD clinics.
8) PHC provides a safe abortion facility by providing equipment and
contract doctors.
9) Panchayats, women’s groups, and non-governmental organisations
(NGOs) have increased community participation.
10) Adolescent reproductive health and hygiene

Reproductive and Child Health- Phase II Program

Beginning on April 1, 2005, RCH –Phase II focused on lowering mother
and child mortality and morbidity, concentrating on rural health care.
Institutional delivery: To promote institutional delivery, the primary initiatives
are:
 Essential Obstetric Care
 Institutional Delivery: Half of the PHC and CHC would be
converted into 24-hour delivery centres.
 Skilled attendance at delivery: Guidelines for conducting
regular deliveries and managing obstetric difficulties for
Auxiliary Nurse Midwife (ANM) and Lady Health Assistant
(LHV) in attendance at delivery.
  Policy decisions: ANMs and LHVs can use medications in
certain emergency cases to reduce maternal mortality

 Emergency Obstetric Care

 The minimum services provided by fully functional first
referral units (FRUs):
 Normal and assisted deliveries are available 24 hours a day.
 Surgical operations, including caesarean sections, are
included in Emergency Obstetric Care (EmOC).
 Care for newborns
 Emergency care of sick children.
 Laparoscopic services are available as part of the full range of
family planning options.
 Safe abortion services
 RTIs and STIs are treated.
 Storage facility for blood
 Essential lab services
 Transportation (referral) services

New Initiatives under RCH Phase II Program-

1) Life-saving anaesthetic skills training for MBBS doctors in emergency
obstetric care. The Government of India is also implementing obstetric
management skills training for MBBS doctors, with a 16-week training
schedule in all obstetric management abilities, including caesarean
section surgery.
2) Establishment of blood storage centres at FRUs in accordance with Indian
government norms
3) Safe abortion services
4) Village health and nutrition day should be conducted once a month to
give prenatal and postpartum care and promote institutional delivery,
health education, immunisation, family planning, and nutrition
programmes.
5) Maternal death reviews are conducted to improve the quality of obstetric
treatment and reduce maternal morbidity and mortality.
Other Initiatives Taken by the Government For Reproductive Health
Awareness-
1) Introducing sex education in schools is a helpful step in providing
accurate information to teenagers and discouraging them from believing
in sex-related myths and misconceptions. Adolescents should be educated
on reproductive organs, adolescence and its changes, safe and sanitary
sexual behaviours, Sexually Transmitted Diseases (STDs), AIDS, and
other topics.
2) Married couples or those of marriageable age should be taught about birth
control methods, prenatal care, postnatal care of the mother and child, the
value of breastfeeding, and equal opportunity for male and female
children, among other topics. As a result, healthy families of the desired
size will be formed.
3) Strong support and infrastructure are required to implement action plans
such as providing medical help and care for reproduction-related
disorders, pregnancy, delivery, STDs, abortions, contraception,
menstruation problems, infertility, and so on.
4) Statutory ban on amniocentesis: Amniocentesis is useful for detecting
chromosomal abnormalities and developmental issues in the foetus.
However, it is being abused to determine the gender of a foetus, resulting
in female foeticides. As a result, the statutory ban on amniocentesis for
sex determination keeps female foeticides in check.

Birth Control Strategies-

Some methods of contraception are:
1) Natural or Traditional
2) Barrier Methods
3) Intrauterine devices (IUDs)
4) Oral contraceptives
5) Injectable and implants
6) Surgical Methods
References-
1. Park K. Park's textbook of preventive and social medicine. 25th ed. Bhanot
Publishers; 2019.
2. Dash B. A Comprehensive Textbook Of Community Health Nursing. 1st ed. New
Delhi: Jaypee Brothers Medical Publishers (P) Ltd; 2017.
3. https://rch.nhm.gov.in/RCH/about-rch.aspx
4. CodeHunk. Reproductive and Child Health Programme [Internet]. [cited 2023 May
21]. Available from:
http://www.nihfw.org/NationalHealthProgramme/REPRODUCTIVEANDCHILDHE
ALTH.html