The Reproductive and Child Health programme (RCH) II under the National Rural Health Mission (NRHM) comprehensively integrates interventions that improve child health and addresses factors contribution to infant and under-five mortality. Reduction of infant and child moratlity has been an important tenet of the health policy of the Government and it has tried to address the issue right from the early stages of planned development. The major components of Child Health Programmes are: i) Establishment of New Born Care facilities and Facility Based Integrated Management of Neonatal and Childhood Illness (F-IMNCI), ii) Navjaat Shishu Suraksha Karyakram, iii) Integrated Management of Neonatal and Childhood Illnesses (IMNCI) and Pre- service IMNCI iv) Home Based Care of Newborns, v)Universal Immunization vi) Early detection and appropriate management of Acute Respiratory Infections, Diarrhoea and other infection, vii)Infant and young child feeding including promotion of breast feeding,viii) Management of children with malnutrition, xi) Vitamin A supplementation and Iron and Folic Acid supplementation.
The National Population Policy (NPP) 2000, the National Health Policy 2002, Eleventh Five Year Plan (2007-12) and National Rural Health Mission (NRHM-2005-2012) have laid down the goals for child health.
TRENDS OF CHILD HEATH INDICATORS
1. Infant Mortality Rate
Infant mortality is defined as the probability of dying before the first birthday. As per the Sample Registration System 2011, the Infant Mortality Rate (IMR) for the country is 44 per 1000 live births.
2. Under-five Mortality Rate (U5MR)
Under five mortality is defined as the probability of dying before the fifth birthday. As per the Sample Registration System 2010, the under five-mortality rate is 59 per thousand live births.
3. Causes of under 5 Mortality
As per WHO estimates, the causes of Child Morality in the age group 0-5 years in India are Neonatal causes (52%), Pneumonia (15%), Diarrhoeal disease (11%), Measles (3%), Injuries (4%) and Others (15%)
CHILD HEALTH INTERVENTIONS
1. Facility Based New born and Child Care
Neonatal mortality is one of the major contributors (2/3) to the Infant Mortality. To address the issue 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 (NBBCs) at different levels is being done under NRHM.
2. Integrated Management of Neonatal & Childhood Illnesses (IMNCI) which includes Pre-service and In-service training of providers, improving health systems (e.g facility up-gradation, availability of logistics and referral systems), Community and Family level care.
NAVJAT SHISU SURAKHSA KARYAKRAM (NSSK)
This programme aims to train health personnel in basic newborn care resuscitation and look into Prevention of Hypothermia, Prevention of Infection, Early initiation of Breast feeding and Basic Newborn Resuscitation . The objective of this new initiative is to have a trained health personnel in Basic new born care and resuscitation at every delivery point.
INFANT AND YOUND CHILD FEEDING
Promotion of early initiation of breast feeding (within one hour of delivery) and exclusive breast feeding till 6 months and timely complementary feeding with continued breast feeding is emphasized under the infant and young child feeding programme.
NUTRIONAL REHABILITATION CENTRES (NRC)
These centres aim at preventing acute malnutrition. Severe Acute Malnutrition (SAM) is an important contributing factor for most deaths amongst children suffering from common childhood illnesses, such as diarrhea and pneumonia.
SCHOOL HEALTH PROGRAMME (SHP)
Keeping children free from physical and mental health concerns is the focus of the School Health Programme. The programme targets school going children and adolescents in 6-18 years are group in the Government and Government aided schools. The programme entails biennial health screening and early management of disease, disability and common deficiency and linkages with secondary and tertiary health facilities as required.
UNIVERSAL IMMUNIZATION PROGRAMME
Immunization Programme is one of the key interventions for protection of children from life threatening conditions, which are preventable. Immunization Programme in India was introduced in 1978 as Expanded Programme of Immunization. This gained momentum is 1985 as universal immunization programme (UIP). Since 1997, immunization activities have been an important component of National Reproductive and Child Health Programme. Immunization is one of the key areas under National Rural Health Mission (NRHM) launched in 2005. Under the Universal Immunization Programme, Government of India is providing vaccination to prevent seven vaccine preventable disease i.e. Diphtheria, Pertussis, Tetanus, Polio, Measles, severe form of Childhood Tuberculosis and Hepatitis B.
Pulse Polio immunization
With the global initiative of eradication of polio in 1988. Pulse Polio Immunization programme was launched in India in 1995. Children in the age group of 0-5 years are administered polio drops during National and Sub-national immunization rounds (in high risk areas) every year. About 172 million children are immunized during each National Immunization Day (NID).