REPRODUCTIVE & CHILD HEALTH PROGRAMMES (RCH), MIZORAM

A. Introduction: Health & Family Welfare Programme started in India in 1951, with the National Family Planning Programme. The Family Planning Programme focused mainly on terminal methods with a view to control over population growth. As a result, it received set back owing to rigid implementation of target-based approach. The experiences gained throughout the country revealed that improvement of the health of women in the reproductive age group and children (up to 5 years) is of crucial importance to reduce the problem of population growth. This realization led to change in the approach from Family Planning to Family Welfare. Since the 7th Plan implemented during 1984 – 89, the Family Welfare programme have evolved on the health needs of mothers and children, as well as on providing contraceptives and spacing services to the targeted group. The main objective of Family Welfare programme has been to stabilize the population at level of the need of the country’s development.


In 1997, the Government of India followed up the International recommendation on Reproductive and Child Health (RCH) as a National Programme. RCH programme integrates all the related programmes of the eight plan and it aims to bring all RCH services easily available for the community.
Accordingly, RCH Programme has been started in Mizoram since mid 1998. Various Maternal and Child Health Schemes have been implemented. In addition to these, Mizoram was included among the selected 24 districts of 17 states for the implementation of RCH Sub-Project (Area Project). The Sub-Project covered the entire state of Mizoram and it was mainly concerned with Infrastructure development of rural health care. The RCH Sub-project had come to an end on 31st March 2004.

Since the Schemes which had been implemented during RCH I were mostly concerned with rural health, the GoI has approved Urban Health Project for Aizawl and Lunglei towns since January 2004. Consequently, Other District capitals are also to take up under Urban health project for which proposals have already been submitted to Government of India.

RCH I has technically ended on 31st March 2004. The Government of India has however extended one year Interim period for preparation of project implementation plan (PIP) for RCH II. Since there have been improvements in the areas of services provided to some extent during RCH I, the Government of India decided to continue RCH phase II so that the targeted group may get better health at maximum level.

B. Objectives of the programme

The vision of RCH programme is to bring about outcomes as envisages in the National Population policy 2000 (NPP-2000), the National population policy 2002, minimizing the regional variations in the areas of Reproductive and Child Health and population stabilization through integrated, focused, participatory programme, meeting the unmet demands of the target population and provision of assured, equitable, responsive quality services. RCH programme focuses on reduction of Maternal Mortality Ratio, Infant Mortality Rate and Total Fertility Rate. It also aims to increase the couple protection rate and coverage of child immunization. The goals are -

  1. To reduce Maternal Mortality Ratio from 60 (State Report) to 55
  2. To reduce Infant Mortality Rate from 34 (NFHS-3) to 25
  3. To reduce Total Fertility Rate from 2.9 (NFHS-3) to 2.5

Achievement during 2018-19       

 

ACHIEVEMENTS OF VARIOUS ACTIVITIES UNDER RCH

Sl. No

Indicator

Year 2017-18

MATERNAL HEALTH

1

Total ANC registered

21,582

2

Total ANC registered within 1st trimester

16,265

3

No. Of Pregnant women who had at least 4 ANCs

9,547

4

No. Of High-Risk pregnant women referred

14

5

No. Of Pregnant women who had 2 doses of TT Injection

13,642

6

No. Of Pregnant women under Prophylaxis & Treatment of Anaemia

5,193

7

No. Of Home Deliveries by trained & untrained birth attendants

2,169

8

No. of deliveries last health institutions both Public & Private

17,403

9

No. of RTI/STI cases detected, treated & referred

1,968 treated/ 2,527 detected

10

No. of children fully immunized

16,155

11

No. of MBBS Doctors trained in EmOC

7

12

No. Of MBBS Doctors trained in LSAS

11

13

No. of Maternal Death Reviews conducted

3

14

Janani Suraksha Yojana (JSY)

No. Of beneficiaries - Mother

6,945

No. Of beneficiaries - ASHA

6,526

15

Janani Shishu Suraksha Karyakram (JSSK)

Drugs & Consumables

6,955

Diagnostic

3,792

Diet

2,701

Referral transport

7,196

16

Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA)

Total ANC

8,535

Severe Anaemia

83

Pregnancy Induced Hypertension (PIH)

9

Others

5

CHILD HEALTH

1

No. of Live Births

19,393

2

No. of Newborns with Low Birth Weight

872

3

No. Of Newborns with birth weight recorded

18,468

4

No. of Newborns breastfed within 1 hour of birth

17,994

5

No. Of Institutions having Sick Newborn Care Unit (SNCU)

4

6

No. of Sick Newborns admitted at SNCU

1,332

7

Janani Shishu Suraksha Karyakram (JSSK)

Drugs & Consumables

1,058

Diagnostic

98

Referral transport

1,045

8

Intensified Diarrhoea Control Fortnight (IDCF)

No. Of Children given ORS

1,07,636 (92%)

No. of Children with diarrhoea given ORS

1,330

No. of Zinc-ORS corners established

1,256

No. of Schools having Handwashing demonstration

1,430

9

National Deworming Day (NDD)

No. of children administered Albendazole

August 2017 - 3,46,816 (91%)

February 2018 - 3,74,743 (92.6%)

10

Special Newborn Care Unit (SNCU)

Total deliveries

6,213

Admission - Male

720

Admission - Female

612

LBW

322

Preterm

194

Successfully discharged

1220 (91.2%)

Death

104 (7.8%)

FAMILY PLANNING

1

Female Sterilization

1,336

2

IUCD Insertion

1,965

3

PPIUCD

268

4

Family Planning Indemnity Scheme

8

5

Injectable Contraceptives - DMPA & Oral Contraceptive Pills training of Medical Officers/Staff Nurses & Health workers conducted

202 personnel trained

 

                Challenges faced in achieving our targets:

Human Resources gap for delivery of primary health care - especially in the Western belt of Mizoram - there are 4 High Priority Districts (HPDs) - Mamit, Lunglei, Lawngtlai & Saiha districts.

Inter-sectoral convergence to address social determinants of health (SDH)

Community Participation is often poor especially in HPDs

Irregularity in fund flow results in failure to complete and carry out activities on time.


Achievement during 2017-18

Maternal Health

Sl.no

Data

Mizoram Status

1.

Total Number of Pregnant women registered for ANC

20041

2.

Of which Number registered within first trimester (within 12 weeks)

14703 (73.36%)

3.

Number of pregnant women received 4 or more ANC check up

during pregnancy

7972 (39.77%)

4.

Number of pregnant women having Hb level <7 detected

454 (2.26%)

5.

Number of pregnant women tested positive for GDM

223 (1.11%)

6.

Number of new cases of Hypertension (BP>140/90) detected in Pregnant women at the institution

333 (1.66%)

7.

Number of Institutional Deliveries conducted (Including C-Sections)

12576

8.

Total Number of Caesarean (C-Section) deliveries performed

1971

9.

Total numbers of deliveries conducted at Home and attended by trained and non-trained SBA

1978

10.

Number of newborns received 7 Home Based Newborn Care (HBNC) visits in case of Home delivery

570

11.

Number of newborns received 6 HBNC visits after Institutional Delivery

1437

12.

Number of Complicated pregnancies treated with Blood Transfusion

71

PMSMA (Pradhan Mantri Surakshit Matritva Abhiyan)

Free special Antenatal checkup for 2nd and 3rd trimester pregnancy (i.e.4 – 9 months) on 9th of every month by Doctor at PHCs, CHCs, SDH and DH.

Observed on

9th of every month (working days and on 10th if it falls on holidays)

No of Pregnant Women receiving ANC (Jan – Oct 2017)

6956

Received Antenatal care under PMSMA on 2nd or 3rd trimester for the first time

4207 (60.48%)

No. of ultrasound conducted

1794 (25.79%)

No. of other High Risk Pregnancy detected

117 (1.68%)

Volunteer Doctors who give free Antenatal checkup during PMSMA

1.Dr. Lalhmingliana

2.Dr. Abirami B

3.Dr. R. Lianzama

4.Dr. RL Dangvela

5.Dr. Eileen Lalrinpuii

6.Dr. Mohanapriyas

Child Health

Sl.no

Data

Mizoram Status

1.

Total number of live births

14815

2.

Number of Pre term newborns ( < 37 weeks of pregnancy)

141

3.

Number of still births

131

4.

Live birth + still birth

14946

5.

Number of Abortions (spontaneous or induced)

911

6.

Number of newborns having weight less than 2.5 kg

643

7.

Number of Newborns breast fed within 1 hour of birth

13820

8.

Number of children who were administered Albendazole (1-19 yrs) at National Deworming day 10th August round

346816 (91%)

9.

Number of children who were administered Albendazole (1-19 yrs) at National Deworming day 10th February round

374743 (92.7%)

IDCF(Intensified Diarrhoea Control Fortnight)

Launched & Observed

12th June 2017- 24thJune2017

Free ORS given

107865 out of 111083 children i.e 97%

No. of schools where hand-washing demonstration was carried out

2167

Family Planning

Sl.no

Data

Mizoram Status

1.

Total Fertility Rate

2.3 (NFHS 4)

2.

Total sterilizations

1043

3.

Total IUCD insertion

1441

4.

Total PPIUCD inserted

192

5.

Total PAIUCD inserted

45

6.

Total Number of Condom distributed

140746

7.

Total Number of Oral pills distributed

78742

8.

Total Number of Emergency pills distributed

2227

9.

Total Number of PTK used

11919

10.

Number of FPIS claim paid

10/10

11.

Number of districts where Antara is rolled out

7/9

World Population Fortnight

WPD 2017 was launched on 11th July, 2017 at Vanapa Hall Gate, Aizawl. The programme was launched by Shri _, Hon’ble Minister, H&FW Dept. at 6:30 a.m. under the chairmanship of Dr. Lalrozama, IAS, Mission Director, Mizoram.

Total female sterilization performed

137

Total IUCD inserted

254

PPIUCD inserted

2

Deaths

Sl.no

Data

Mizoram Status

1.

NeoNatal death

Number-148

2.

Infantdeath (Lesser than last year)

Number-319

3.

U5MR(Under 5 Mortality Rate) death

Number-387

4.

Maternal death

Number-14

SNCU (SpecialNewborn Care Unit)

Special Newborn Care Unit at 4 Districts namely Aizawl East, Lunglei , Saiha and Lawngtlai District where intensive treatment is provided for newborn who requires it.

Sl.no

Data

Mizoram Status

1.

Total SNCU admitted

1066

2.

Percentage of Male admitted

573 (53.8%)

3.

Percentage of Female admitted

493 (46.2%)

4.

Number of Low Birth Weight admitted

259 (24.3%)

5.

Percentage of Baby successfully discharged

960 (90%)

Institutions

Sl.no

Data

Mizoram Status

1.

Number of Institutions having Operational Sick New Born and Child Care Units (SNCU)

4(Aizawl East, Lunglei, Saiha & Lawngtlai)

2.

Number of Institutions having designated New Born Stabilisation Units (NBSU)

11

3.

Number of Institutions having New Born Care Corner (NBCC)

110

4.

Number of CHC or SDH or DH functioning as First Referral units (FRUs

14(8 DHs,1SDH,5CHCs)

5.

Number of Delivery Points

45 (9 DHs, 7 CHCs, 1 SDH, 18 PHCs & 11 Sub-centres )