Under National Rural Health Mission, the following interventions are being implemented to improve child health situation in the country:
1. Promotion of Institutional Delivery through JananiSurakshaYojana (JSY) and JananiShishuSurakshaKaryakram (JSSK): Promoting Institutional delivery to ensure skilled birth attendance is a key to reducing both maternal and neo-natal mortality. JSY incentivizes pregnant women to opt for institutional delivery and provides for cash assistance. JSSK entitles all pregnant women to absolutely free and zero expense delivery including caesarean section operation in Government health facilities and provides for free to and fro transport, food, drugs and diagnostics. Similar entitlements have also been put in place for sick neonates. This scheme has now been extended to cover all infants in the country.
2. Strengthening Facility based newborn care: Newborn care corners (NBCC) are being set up at all health facilities where deliveries take place to provide essential newborn care at birth to all new born babies; Special New Born Care Units (SNCUs) at District Hospitals and New Born Stabilization Units (NBSUs) at FRUs are being set up for the care of sick newborn. As on date 401 SNCUs, 1542 NBSUs and 11508 NBCCs are functional across the country.
3. Home Based Newborn Care (HBNC): Home based newborn care through ASHA has recently been initiated to improve new born care practices at the community level and for early detection and referral of sick new born babies. The schedule of home visits by ASHA consists of at least 6 visits in case of institutional deliveries, on days 3, 7, 14, 21, 28 & 42nd days and one additional visit within 24 hours of delivery in case of home deliveries. Additional visits will be made for babies who are pre-term, low birth weight or ill.
4. Capacity building of health care providers: Various trainings are being conducted under National Rural Health Mission (NRHM) to build and upgrade the skills of doctors, nurses and ANM for early diagnosis and case management of common ailments of children and care of newborn at time of birth. These trainings include Integrated Management of Neo-natal and Childhood Illness (IMNCI) and NavjaatShishuSurakshaKaryakram (NSSK). A total of 5.8 lakh health care workers have been trained in IMNCI in 505 districts and 89,962 health workers trained in NSSK so far.
5. Management of Malnutrition: Emphasis is being laid on reduction of malnutrition which is an important underlying cause of child mortality. 605 Nutritional Rehabilitation Centres have been established for management of Severe Acute Malnutrition (SAM). Iron and Folic Acid is also provided to children for prevention of anaemia. Recently, weekly Iron and Folic Acid is proposed to be initiated for adolescent population. As breastfeeding reduces infant mortality, exclusive breastfeeding for first six months and appropriate infant and young child feeding practices are being promoted in convergence with Ministry of Woman and Child Development.
6. Village Health and Nutrition Days (VHNDs) are also being organized for imparting nutritional counseling to mothers and to improve child care practices.
7. Universal Immunization Program (UIP): Vaccination against seven diseases is provided to all children under UIP. Government of India supports the vaccine program by supply of vaccines and syringes, cold chain equipments and provision of operational costs. UIP targets to immunize 2.7 crore infants against seven vaccine preventable diseases every year. 21 states with more than 80% coverage have incorporated second dose of Measles in their immunization program.Pentavalent vaccine has been introduced in two states of Kerala and Tamil Nadu and now expanded to six more states. Year 2012-13 has been declared as ˜Year of intensification of Routine Immunization™. India has achieved a historic milestone by remaining polio free for two full years now. WHO has taken India off the list of polio endemic countries.
8. Mother and Child Tracking System: A name based Mother and Child Tracking System has been put in place which is web based to enable tracking of all pregnant women and newborns so as to monitor and ensure that complete services are provided to them. States are encouraged to send SMS alerts to beneficiaries reminding them of the dates on which services are due and generate beneficiary-wise due list of services with due dates for ANMs on a weekly basis.
9. Recently, a new national programme RashtriyaBalSwasthyaKaryakram has been launched under National Rural Health Mission. The details of this initiative are as below:
(a) The purpose of RBSK is to improve survival, development and quality of life of children in the age group of 0 to 18 years through early detection of Defects at birth, Diseases, Deficiencies, Development Delays including Disability and follow-up for appropriate management and treatment, if required (medical or surgical). RBSK envisages covering 30 common health conditions prevalent in children for early detection and free intervention and treatment.
(b) The child health screening services builds on the existing school health services and will be provided through dedicated mobile health teams placed in every block. The block level dedicated mobile medical health teams would comprise of trained doctors and paramedics.
(c) Existing services offered by Ministry of Women and Child Development, Social Justice and Empowerment and Education will also be optimally utilized.
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