Healthy foetus- A Global Healthy foetus- A Global commitmentcommitment

Role of Role of Governmental Governmental and and

Non Non Governmental Governmental

Organization in Organization in

foetal well beingfoetal well being

Reproductive rights of womenReproductive rights of women

Right to have information about Right to have information about sexuality and reproductionsexuality and reproduction

Right have good quality and Right have good quality and comprehensive reproductive health comprehensive reproductive health servicesservices

Right have safe pregnancy and Right have safe pregnancy and childbirthchildbirth

Right to marry at legally correct ageRight to marry at legally correct age

Right conceive at medically approved ageRight conceive at medically approved age

Right to obtain medical consultation Right to obtain medical consultation during pregnancyduring pregnancy

Right to protect against prenatal sax Right to protect against prenatal sax determination determination

Right to say “no” to female feticideRight to say “no” to female feticide

Right to refuse to get pregnant when Right to refuse to get pregnant when medically advised against itmedically advised against it

Right to obtain safe delivery servicesRight to obtain safe delivery services

% Girls married before age 18 % Girls married before age 18 years India- years India- RCH-I SurveyRCH-I Survey

%Households with %Households with Low Standard of Living-Low Standard of Living-RCH I SurveyRCH I Survey

% Women received 3 or more % Women received 3 or more Antenatal Checkups-Antenatal Checkups-RCH I surveyRCH I survey

Percentage of deliveries attended by Doctor Nurse or other Percentage of deliveries attended by Doctor Nurse or other health care provider-health care provider-RCH-I survey RCH-I survey

Health servicesHealth services

Public health care services (Governmental Public health care services (Governmental organization)organization)

Public private partnership (PPP)Public private partnership (PPP)

Private :Private : profit -profit - non profit- NGO,MNGO,SNGO,FNGOnon profit- NGO,MNGO,SNGO,FNGO private service provider private service provider Private sectorPrivate sector

Governmental organizationGovernmental organization

National health programmesNational health programmes National Rural Health Mission National Rural Health Mission National Urban Health MissionNational Urban Health Mission Rashtriya Swatha Bima YojanaRashtriya Swatha Bima Yojana Varumun Kappom Thittam

National health Policy :National health Policy :

Inter sectoral coordination Inter sectoral coordination NGOs, NGOs, Civil Societies, Civil Societies, Panchayati Raj Institutions andPanchayati Raj Institutions and Women’s GroupWomen’s Group

Non Governmental organizationNon Governmental organization WHOWHO United nations development programme (UNDP)United nations development programme (UNDP) United nations children’s emergency fund (UNICEF)United nations children’s emergency fund (UNICEF) South Asian regional cooperation (SAARC)South Asian regional cooperation (SAARC) Department for international development (DFID)Department for international development (DFID) USA-Agency for international development (USAID)USA-Agency for international development (USAID) Cooperative assistance and Relief everywhereCooperative assistance and Relief everywhere

(CARE)(CARE) Indian Red cross societyIndian Red cross society

Voluntary health association of India (VHAI)Voluntary health association of India (VHAI)

Professional bodies:Professional bodies: IMA,IMA, IAP,IAP, FOGSI,FOGSI, IPHA, IPHA, Indian association of Indian association of

preventive social medicinepreventive social medicine

Reproductive and Child Health Reproductive and Child Health Programme (Programme (RCH) II :

Maternal, newborn, child, and adolescent health and Family planning services

Community participation and Empowering people. IMNCI strategy, Immunization, Skilled care at birth, Infant and young child feeding.

Anemia control programme: 50- 80% pregnant women

Improve dietary intake to meet RDA for all macro and micronutrients

Iron and folic acid prophylaxisprophylaxis

Dietary diversification-inclusion of iron folate rich foods as well as food items that promote iron absorption

Food fortification- including introduction of iron and iodine-fortified salt and other iron-fortified items (e.g. atta)

Health and nutrition education

Prevention and control of Vitamin A deficiency:

40- 50 % Antenatal mothers Vit-A >30 mcg/dl

Vit –A supplementation not more than 10000 IU/day

Health education - intake of Vitamin A rich food , Early detection and prompt treatment of infections

Immunization programme :Immunization programme :

2 doses of T.T – Neonatal tetanus2 doses of T.T – Neonatal tetanus

Goiter control programme:Goiter control programme: Prevalence rate 10%Prevalence rate 10% Req 100- 150 mcgReq 100- 150 mcg Iodine fortified salt Iodine fortified salt IECIEC

HIV/AIDS control programme:HIV/AIDS control programme: PPTCT PPTCT providing voluntary, confidential testing providing voluntary, confidential testing Universal precautionUniversal precaution Drug prophylaxisDrug prophylaxis Blood safetyBlood safety Infant feeding counseling for pregnant Infant feeding counseling for pregnant

women, women, Control and management of STDsControl and management of STDs

Nutritional programme:Nutritional programme:

Integrated Child Development Integrated Child Development Services:Services:

Adolescent ,Adolescent ,

Pregnant andPregnant and

Nursing women Nursing women

Applied nutrition programmeApplied nutrition programme

500 cal&

20-25 gmsprotein

Adolescent health initiative:Adolescent health initiative:

Adolescent friendly health Adolescent friendly health servicesservices

Adolescent health counseling Adolescent health counseling servicesservices

National Oral health program:National Oral health program:

18% preterm low birth weight babies 18% preterm low birth weight babies due to peridontal diseases in due to peridontal diseases in pregnant womenpregnant women

Pilot project- 5 states Pilot project- 5 states Oral health educationOral health education Formulation of basic package on oral Formulation of basic package on oral

healthhealth Strengthening of manpower and Strengthening of manpower and

infrastructureinfrastructure

National Rural Health Mission(2004National Rural Health Mission(2004))

2001 -72.22% of the people live in rural2001 -72.22% of the people live in rural Goals:Goals:

Reduction of MMR & IMR ratio 50%Reduction of MMR & IMR ratio 50%

Integrated comprehensive primary health careIntegrated comprehensive primary health care

universalize access to public health service –universalize access to public health service –MCHMCH

Assuring population stabilization & healthy life Assuring population stabilization & healthy life stylestyle

Accredited Social Health Activist (ASHA )Accredited Social Health Activist (ASHA )

Vande Matram SchemeVande Matram Scheme

Janani Suraksha YojanaJanani Suraksha Yojana

          Assistance to mother increased to Rs. Assistance to mother increased to Rs. 700 in rural areas of Low Performing 700 in rural areas of Low Performing States (>25%) and Rs. 600 to Urban areas States (>25%) and Rs. 600 to Urban areas of LPS & Rural areas of HPS (<25%). of LPS & Rural areas of HPS (<25%).

              Assistance package of Rs. 600 in Rural Assistance package of Rs. 600 in Rural Area for Institutional Delivery in low Area for Institutional Delivery in low Performing States to meet Dai/ASHA fee, Performing States to meet Dai/ASHA fee, transport cost and food and incidental transport cost and food and incidental charges during delivery.charges during delivery.

Dr.Muthulakshmi Reddy Maternity Benefit Scheme :

Women from families listed under Women from families listed under the Below Poverty Line and aged the Below Poverty Line and aged above 19 are eligible for assistance. above 19 are eligible for assistance.

The annual income of the The annual income of the beneficiary's family seeking beneficiary's family seeking assistance should not exceed Rs. assistance should not exceed Rs. 12,000. 12,000.

Control the anaemia and malnutrition among the women and children,

Rs.6000/- i.e. Rs.3000/- 7th month of pregnancy and Rs.3000/- at the time of delivery.

Millennium Development Goals:

Millennium Declaration was adopted by 189 nations during the UN Millennium Summit in September 2000.

Goal 4: Reduce child mortalityTarget: Reduce by two thirds the mortality rate among

children under fiveGoal 5: Improve Maternal HealthTarget: Reduce by three quarters the maternal

mortality ratio.Goal 6: Combat HIV/AIDS, malaria and other diseasesTarget: Halt and begin to reverse the spread of

HIV/AIDS.Target: Halt and begin to reverse the incidence of

malaria and other major diseases

Preconception and pre- natal Preconception and pre- natal diagnostic techniques( prohibition diagnostic techniques( prohibition

of sex selection) act ,1994of sex selection) act ,1994

No prenatal diagnostic testing except for No prenatal diagnostic testing except for the detection:the detection:

Chromosomal abnormalitiesChromosomal abnormalities Genetic metabolic diseasesGenetic metabolic diseases HemoglobinopathiesHemoglobinopathies Sex linked genetic disorderSex linked genetic disorder Congenital anomaliesCongenital anomalies Any other abnormalities specified by Any other abnormalities specified by

central boardcentral board

No person including husband or No person including husband or relative encourage to seek prenatal relative encourage to seek prenatal diagnostic testing diagnostic testing

No person shall communicate the sex No person shall communicate the sex of the babyof the baby

no person shall conduct prenatal no person shall conduct prenatal diagnostic testing for the purpose of diagnostic testing for the purpose of the determine sex of the babythe determine sex of the baby

Indian Penal Code (IPC, 1860)Indian Penal Code (IPC, 1860)

Section 312Section 312 Any one voluntarily causing miscarriage to a Any one voluntarily causing miscarriage to a

woman with child, other than in good faith for woman with child, other than in good faith for the purpose of saving her life is punishable by the purpose of saving her life is punishable by imprisonment (simple or rigorous) &/or a fineimprisonment (simple or rigorous) &/or a fine

Sections 313 - 316Sections 313 - 316 for death due to procedure for death due to procedure

Up to 10 years imprisonment and fine, Up to 10 years imprisonment and fine, extending up to life imprisonment where the extending up to life imprisonment where the abortion was conducted without consentabortion was conducted without consent

The MTP Act (Act No. 34 of 1971The MTP Act (Act No. 34 of 1971

‘ ‘An Act to provide for the termination An Act to provide for the termination of of certain pregnanciescertain pregnancies by registered by registered medical practitioners & for matters medical practitioners & for matters connected therewith & incidental connected therewith & incidental thereto.’thereto.’

Maternity benefit act:Maternity benefit act:

To safe guard mother and foetus :To safe guard mother and foetus :

12 weeks of maternity leave12 weeks of maternity leave 6 weeks leave for miscarriage6 weeks leave for miscarriage Pregnant woman must be Pregnant woman must be

exempted from any work which exempted from any work which involves long working hours, break involves long working hours, break after 5 hrs,after 5 hrs,

Free prenatal and post natal health Free prenatal and post natal health service or Payment of Rs250 as bonusservice or Payment of Rs250 as bonus

Two breaks for nursing the childTwo breaks for nursing the child

If employer contravenes this act If employer contravenes this act punishable with imprisonment 3- 12 punishable with imprisonment 3- 12 month or and with fine Rs2000- 5000.month or and with fine Rs2000- 5000.

Child marriage restraint act (1929)Child marriage restraint act (1929)

Child marriage shall be punishable Child marriage shall be punishable with simple imprisonment or with with simple imprisonment or with finefine