Healthy foetus- A Global commitment Role

Healthy foetus- A Global commitment

Role of Governmental and Non Governmental Organization in foetal well being

Reproductive rights of women n n Right to have information about sexuality and reproduction Right have good quality and comprehensive reproductive health services n Right have safe pregnancy and childbirth n Right to marry at legally correct age

n n n Right conceive at medically approved age Right to obtain medical consultation during pregnancy Right to protect against prenatal sax determination Right to say “no” to female feticide Right to refuse to get pregnant when medically advised against it Right to obtain safe delivery services

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

%Households with Low Standard of Living-RCH I Survey

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

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

Health services n n Public health care services (Governmental organization) Public private partnership (PPP) Private : n profit n non profit- NGO, MNGO, SNGO, FNGO n private service provider n Private sector

n n n Governmental organization National health programmes National Rural Health Mission National Urban Health Mission Rashtriya Swatha Bima Yojana Varumun Kappom Thittam

National health Policy : n Inter sectoral coordination n NGOs, n Civil Societies, n Panchayati Raj Institutions and n Women’s Group

Non Governmental organization WHO n United nations development programme (UNDP) n United nations children’s emergency fund (UNICEF) n South Asian regional cooperation (SAARC) n Department for international development (DFID) n USA-Agency for international development (USAID) n Cooperative assistance and Relief everywhere (CARE) n Indian Red cross society n

n Voluntary health association of India (VHAI) Professional bodies: ü IMA, ü IAP, ü FOGSI, ü IPHA, ü Indian association of preventive social medicine n

Reproductive and Child Health Programme (RCH) II : Maternal, newborn, child, and adolescent health and Family planning services ü Community participation and ü Empowering people. ü IMNCI strategy, ü Immunization, ü Skilled care at birth, ü Infant and young child feeding.

Anemia control programme: 50 - 80% pregnant women n n Improve dietary intake to meet RDA for all macro and micronutrients Iron and folic acid prophylaxis 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 n Vit –A supplementation not more than 10000 IU/day n n Health education - intake of Vitamin A rich food , Early detection and prompt treatment of infections

Immunization programme : 2 doses of T. T – Neonatal tetanus Goiter control programme: n Prevalence rate 10% n Req 100 - 150 mcg n Iodine fortified salt n IEC

HIV/AIDS control programme: n PPTCT n providing voluntary, confidential testing n Universal precaution n Drug prophylaxis n Blood safety n Infant feeding counseling for pregnant women, n Control and management of STDs

Nutritional programme: Integrated Child Development Services: 500 cal Adolescent , & 20 -25 gms Pregnant and protein Nursing women n n Applied nutrition programme

Adolescent health initiative: n n Adolescent friendly health services Adolescent health counseling services

National Oral health program: n n n 18% preterm low birth weight babies due to peridontal diseases in pregnant women Pilot project- 5 states Oral health education Formulation of basic package on oral health Strengthening of manpower and infrastructure

National Rural Health Mission(2004) 2001 -72. 22% of the people live in rural n Goals: Reduction of MMR & IMR ratio 50% Integrated comprehensive primary health care universalize access to public health service –MCH Assuring population stabilization & healthy life style n n Accredited Social Health Activist (ASHA ) Vande Matram Scheme

Janani Suraksha Yojana n n Assistance to mother increased to Rs. 700 in rural areas of Low Performing States (>25%) and Rs. 600 to Urban areas of LPS & Rural areas of HPS (<25%). Assistance package of Rs. 600 in Rural Area for Institutional Delivery in low Performing States to meet Dai/ASHA fee, transport cost and food and incidental charges during delivery.

Dr. Muthulakshmi Reddy Maternity Benefit Scheme : n n Women from families listed under the Below Poverty Line and aged above 19 are eligible for assistance. The annual income of the beneficiary's family seeking assistance should not exceed Rs. 12, 000.

n n Control the anaemia and malnutrition among the women and children, Rs. 6000/- i. e. Rs. 3000/- 7 th 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 mortality Target: Reduce by two thirds the mortality rate among children under five Goal 5: Improve Maternal Health Target: Reduce by three quarters the maternal mortality ratio. Goal 6: Combat HIV/AIDS, malaria and other diseases Target: 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 diagnostic techniques( prohibition of sex selection) act , 1994 n Ø Ø Ø No prenatal diagnostic testing except for the detection: Chromosomal abnormalities Genetic metabolic diseases Hemoglobinopathies Sex linked genetic disorder Congenital anomalies Any other abnormalities specified by central board

n n n No person including husband or relative encourage to seek prenatal diagnostic testing No person shall communicate the sex of the baby no person shall conduct prenatal diagnostic testing for the purpose of the determine sex of the baby

Indian Penal Code (IPC, 1860) n Section 312 Any one voluntarily causing miscarriage to a woman with child, other than in good faith for the purpose of saving her life is punishable by imprisonment (simple or rigorous) &/or a fine n Sections 313 - 316 for death due to procedure Up to 10 years imprisonment and fine, extending up to life imprisonment where the abortion was conducted without consent

The MTP Act (Act No. 34 of 1971 ‘An Act to provide for the termination of certain pregnancies by registered medical practitioners & for matters connected therewith & incidental thereto. ’

Maternity benefit act: To safe guard mother and foetus : n n n 12 weeks of maternity leave 6 weeks leave for miscarriage Pregnant woman must be exempted from any work which involves long working hours, break after 5 hrs,

n n n Free prenatal and post natal health service or Payment of Rs 250 as bonus Two breaks for nursing the child If employer contravenes this act punishable with imprisonment 3 - 12 month or and with fine Rs 2000 - 5000.

Child marriage restraint act (1929) n Child marriage shall be punishable with simple imprisonment or with fine