|
In 1996, the existing family welfare programme was
transformed into the new RCH programme. This new programme integrates all
family welfare and women & child health services with the explicit
objective of providing beneficiaries with ‘need based, client centred,
demand driven, high quality integrated RCH services’.
The “essential package” of reproductive health
services identified includes the following.
-
Services to promote safe motherhood, Services
to promote child survival, Prevention and management of unwanted pregnancies,
Establishment of an effective referral system, Health, sexuality and gender
related counseling, Reproductive health services for adolescents, Prevention
and treatment of Reproductive Tract Infections (RTIs) and Sexually
Transmitted Diseases (STDs), & Nutritional services to the vulnerable
groups.
However, Only the first three services are presently
available under the ‘Primary Health Care services’ in selected Primary
Health Centres (PHCs) and that too on a limited scale. Most of the supposedly
targeted beneficiaries are not aware of the ‘safe motherhood’ package,
which includes “ante-natal care (ANC), safe delivery and post-natal care”.
Routine services like Ante-Natal Care are reduced to “registering mothers’
names and giving them Tetanus Toxoid (TT) and 100 tablets of Iron Folic Acids
(IFA)”. Further services like ‘emergency obstetric care (EOC) and
treatment of RTIs’ are not effectively available through the PHCs and
Community Health Centres (CHCs).
Back to Top
Over the fast five years there has been virtually no or
negligible increase in numbers of hospitals and dispensaries, whereas the
number of ‘Mother & Child Welfare Centre and Aid Posts’ has remained
static. The only changes have been in case of Primary Health Centres (PHCs)
and Sub-Centres (SCs,) 23% and 10% respectively. But this change too has been
disproportionate vis-a-vis manpower deployment. Additionally the increase has
significantly reduced over the years. Tables indicating this have not been
given in this newsletter due to lack of space.
Back to Top
(i) Per medical
institution service area (in Sq. Kms.) - 28
(ii) Per medical institution
population (in Nos.) - 4360
(iii) Per Bed population (in Nos.)
- 1403
(iv) Per Doctor population (in
Nos.) - 8628
The above figures indicates a deficiency in the
qualitative as well as quantitative aspects of the accessibility and
availability of public healthcare services.
Back to Top
In Rajasthan, 10% of rural women live in a village with
a PHC, 47% live in a village with a sub-centre, and 50% live in a village with
either a PHC or a sub-centre. The proportions who live in a village with other
health facilities are 7% for hospitals and 20% for dispensaries or clinics.
About 53% of rural women live in a village that has some kind of health
facility.
Median distances from particular health facilities are
8.9 Kms. for a PHC, 12.1 Kms. for a hospital, and 6.6 Kms. for a dispensary or
a clinic.
Back to Top
78% of the rural residents live in villages that have a
primary school and 64% of the rural residents live in villages that have an anganwadi
centre. Only one-fifth of rural residents live in villages that have a private
doctor and 58% live in villages with a traditional birth attendant. 86% of
rural residents live in villages that are at least partly electrified and only
11% of rural residents live in villages with an STD booth (for long-distance
telephoning within India). Only 14% of rural residents live in villages with a
pharmaceutical shop and 17% live in villages with a Mahila Mandal, a
women’s community group. Other facilities that are available in villages
where about half or more of rural residents live are post offices and kirana
shops (small grocery stores).
Back to Top
Results indicate that messages disseminated through the
mass media have reached only 36% of ever-married women in Rajasthan. But the
fact that overall exposure among rural women is about one-third of that among
the urban women shows the lop-sided scenario.
Exposure to family planning messages varies
substantially by education. 92% of women who have completed at least high
school have heard or seen a family planning message from at least one media
source, as compared with 22% of illiterate women.
Back to Top
The vaccination of children against six serious but
preventable diseases (tuberculosis, diphtheria, pertussis, poliomyelitis, and
measles) has been corner stone of child healthcare system in India. As part of
National Health Policy, the National Immunisation Programme is being
implemented on a priority basis.
Children who received
BCG, measles, and three doses
each of DPT as well as Polio vaccines are considered to be fully vaccinated.
Based on the information obtained from a card or reported by the mother, only
17% of children age 12-23 months are fully vaccinated, and 23% have not
received any vaccinations.
Back to Top
Promotion of maternal and child health has been one of
the most important components of the Family Welfare programme of the
Government of India. One of the goal is for each pregnant woman to receive at
least three antenatal check-ups plus two tetanus toxoid injections and a full
course of iron & folic acid (IFA) supplements. Coverage by all three
interventions is lower for women living in rural areas and for women in
disadvantaged socio-economic groups than for other women.
Mothers received antenatal checkups from doctors for
27% of births and from other health professionals (such as ANMs, nurses,
midwives, or LHVs) for 12% of births. Mothers received antenatal checkups
exclusively at home from a health worker for 9% of births.
CUTS has actively taken up advocacy at various levels
to address some of these areas of concern and to ensure faster development of
this crucial sector.
|
