Overview of Key Child Health Initiative Programs in India

Important Child Health Initiative Programmes 

1. Navjat Shishu Suraksha Karyakram

2. Rashtriya Swasthya Bal Karyakram

3. Home-Based Newborn Care

4. Home-Based Young Child Care

5. Facility-Based Newborn Care

6. IMNCI

7. Indian Newborn Action Plan

8. ICDS (Integrated Child Development Services) Scheme

9. Anemia Mukt Bharat

Navjat Shishu Suraksha Karyakram (NSSK)

Two days of training are provided to healthcare workers and medical officers in newborn care and resuscitation services.

Purpose

• To provide basic knowledge about newborn care.
• To bring awareness about the resuscitation services since childbirth can also be carried out at PHCs (Primary Healthcare Centers) by medical officers.

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Rashtriya Bal Swasthya Karyakram (RBSK)

Features

• Launched in 2013
• Relies on early childhood screening and interventional services.

Target age group

• 0-6 years: Rural areas + Urban slums
• 6-18 years: Enrolled in government schools

Screened for

Secondary level of prevention. Screening done for 4Ds:

Diseases

• Skin conditions (scabies, fungal and eczema)
• Otitis media
• Rheumatic heart disease
• Reactive airway disease
• Dental conditions
• Convulsive disorders

Defects

• Neural tube defects
• Down's syndrome
• Talipes (club foot)
• Developmental dysplasia of the hip
• Congenital cataract
• Congenital deafness
• Congenital heart diseases
• Retinopathy of prematurity

Deficiencies

• Anaemia, especially severe anaemia
• Vitamin A deficiency (Bitot spot)
• Vitamin D deficiency (rickets)
• Severe Acute malnutrition
• Goitre

Developmental delays

• Vision impairment
• Hearing Impairment
• Neuromotor impairment
• Motor delay
• Cognitive delay
• Language delay
• Behavior disorder
• Deficit hyperactivity disorder
• Sickle cell anemia, b thalassemia, congenital hypothyroidism

Screened via

Mobile teams and this includes:

• Medical officers
• Ayush officers
• Pharmacists
• Lab technicians

Home-Based Newborn Care

Purpose

• Counsel the women about newborn care.
• Provided by ASHA workers.
• Home visits are made by ASHA workers.
• Essential visits – 4 ANC or 4 PNC
• If it is a home delivery, additional visits have to be made.

Objectives

• To ensure that vaccination is given to infants.
• To ask about the diet of the mother.
• To counsel and educate the mother about
  • Breast-feeding
  • Keeping baby warm
  • Newborn care

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Home-Based Young Child Care

• Additional visits are being made by both ANM and ASHA workers.
• For children with low birth weight (LBW) and children released from SNCU (Special Newborn Care Unit).
• Visits performed after the 42nd day.
• Starts from 60 days onwards with a 3-month gap.
• Usually 3, 6, 9, 12, and 15 months.
• Incentive: Rs 50/- per visit.

Facility Based Newborn Care

• Done differently at different health facilities.
• Different units have been set up.

Services Provided at NBCC, NBSU, and SNCU

Newborn Care Corner

• Care of normal newborn, Breastfeeding support, Care of sick newborn
• Identification and prompt referral of at-risk and sick newborn

Newborn Stabilization Unit

• Care of normal newborn
• Breastfeeding support
• Care of sick newborn
• Phototherapy for newborns with hyperbilirubinemia
• Management of newborn sepsis
• Stabilization and referral of sick newborns and those with very low birth weight (1800–2500 gms)
• Referral services

Special Newborn Care Unit

• Care of normal newborn
• Breastfeeding support
• Care of sick newborn
• Managing all sick newborns (except those requiring mechanical ventilations)
• Low birth weight <1800 gms are managed
• Follow-up of all babies discharged from SNCUs
• Immunization services
• Referral services

Health facility

• MCH level I - PHC, Sub-centre (Deliveries happens here)
  • Labour room newborn care corner (Basic care of newborn happens here)
  • Urgent referral
• MCH level II - CHC, First referral unit
  • Labour room and operation theater.
  • Newborn care corner
  • Newborn stabilization unit

• MCH level III - District hospital
  • Labour room and operation theater
  • Newborn care corner
  • Special newborn care unit

Also read: Understanding Health Indicators: Importance & Types 

IMNCI - Integrated Management of Neonatal and Childhood Illnesses

• Launched by Government of India
• Target: 0-5 years

Illness included

• Acute respiratory infections (ARI) like Pneumonia is a major concern
• Diarrhea
• 3Ms: Measles, Malaria, Malnutrition
• Otitis media (most common complication of measles)

Indian Newborn Action Plan (INAP)

Launched on 18th September 2014 to fulfill country commitments in response to the global Every Newborn Action Plan (ENAP).

Included

• Preconception and antenatal care 
• Care during labor and childbirth
• Immediate newborn care 
• Care of healthy newborn
• Care of small and sick newborn
• Care beyond survival 

Integrated Child Development Services (ICDS) 

• Target: 0-6 years.
• Provides
  • Supplementary nutrition
  • Non formal education
  • Immunization services
  • Health checkups
  • Referral services
• Pregnant women and adolescent girls also benefit.

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Anemia Mukt Bharat

• Previous name: Intensifying Natural Iron Plus Initiative
• Prophylactic iron and folic acid tablets are given.
• Also include deworming:
  • <2 years: ½ tab Albendazole
  • >2 years: Full tab Albendazole

Initiatives of Adolescents

Rashtriya Kishor Swasthya Karyakram (RKSK)

• Kishore is a male adolescent, and Kishori is a female adolescent.
• India's first comprehensive adolescent health

Strategy: RMNCH + A (reproductive, maternal, newborn, child health + adolescent)

Targets

• Girls and boys
• Married and unmarried
• Poor and affluent
• School and out of school

Objectives

• Improve nutrition
• Enable sexual and reproductive health.
• Enhance mental health.
• Prevent injuries and violence
• Prevent substance abuse or misuse
• Address conditions for non-communicable diseases

Critical components

• Coverage
• Content
• Communities
• Clinics
• Counseling
• Communication
• Convergence

AFHC Adolescent Friendly Healthcare clinics

Provides clinical and counseling services

• Sexual and reproductive health is setting up friendly health clinics
• Nutrition
• Substance abuse
• Injuries and violence
• Non communicable diseases
• Mental health

Trained service providers

• Medical officers
• ANM
• Counselors

Location

• PHCs
• CHCs
• District hospitals
• Medical colleges
• Not located at Sub-centers

Menstrual Hygiene Scheme (MHS)

Introduced by Ministry of Health and Family Welfare

Aim: Promote menstrual hygiene among adolescent girls (10-19 years) in rural areas.

Objectives: 

• Increase awareness about menstrual hygiene in adolescent girls.
• Increase access to use of high-quality sanitary napkins in adolescent girls in rural areas.
• To ensure safe disposal of sanitary napkins.

FREEDAYS

• Sanitary packs are provided at Rs 6 for 6 napkins to adolescent girls in rural areas.
• ASHA workers get Rs 1 for a pack sold and a free pack of napkins every month for personal use.

Kishori Shakti Yojana (KSY)

• Comes under ICDS for adolescent girls.
• Ministry of Health and Family Welfare (MOHFW): All programs from child initiatives. All programmes from adolescent initiatives (except ICDS)
• Ministry of Women and Child Development (MOWCD): ICDS-Kishori Shakti Yojna

Ujjawala Scheme

• To protect from child and woman trafficking.
• Ministry: Ministry of Women and Child Development (MOWCD)
• Ujwala Scheme
  • All below poverty line women are provided with LPG cylinders.
  • Ministry: Ministry of Petroleum
• Ujala Scheme: Scheme for LED bulbs.

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Important Points to Remember

• The Ministry of Human Resource Development launched the Mid-Day Meal, but later shifted to the Ministry of Education.
• Ministry of Women and Child Development
  • Maternal health initiative (Pradhan Mantri Mathur Vandana Yojana)
  • ICDS
  • Poshan Abhiyan
  • Ujjawala
  • Integrated Child Health Protection Services

• Congenital glaucoma is not screened while screening for birth defects.
• Vitamin C and B are not screened for while screening for deficiencies.
• In adolescents, the same program is termed Rashtriya Kishor Swasthya Karyakram (Kishore-AAdolescent).
• Janani Shishu Suraksha Karyakram can also be included in child health initiatives (0–1-year age).

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