Improving the maternal and child health and their survival are central to the achievement of national health goals under the National Health Mission (NHM) as well as the Millennium Development Goals (MDG) 4 and 5. SDG Goal 3 also includes the focus on reducing maternal, newborn and child mortality. In the past seven years, innovative strategies evolved under the national programme to deliver evidence-based interventions to various population groups.
A substantial increase in the availability of financial resources for Reproductive and Child Health (RCH), healthcare infrastructure and workforce as also the expansion of programme management capacity since the launch of NRHM in 2005 provides an important opportunity to consolidate all our efforts. As we had crossed the 2015 year where we have to reach the MDG goals but we are far away from the goals. There is an opportunity to further accelerate progress towards MDG and SDG goals, redefine the national agenda to come up with a coordinated approach to maternal and child health in the upcoming years.
In order to bring greater impact through the RCH programme, it is important to recognize that reproductive, maternal and child health cannot be addressed in isolation as these are closely linked to the health status of the population in various stages of life cycle. The health of an adolescent girl impacts pregnancy while the health of a pregnant woman impacts the health of the newborn and the child. As such, interventions may be required at various stages of life cycle, which should be mutually linked. And hence, on the basis of available data and the close inter-linkages between different stages of life cycle RMNCH+A strategy is introduced. It constitutes to the 'Continuum of Care' approach of defining and implementing evidence-based packages of services for diﬀerent stages of the lifecycle, at various levels in the health system, has been adopted under the national health programme. This strategic approach includes Reproductive, Maternal, Newborn, Child Plus Adolescent Health (RMNCH+A). The 'Plus' in the strategic approach denotes the (1) inclusion of adolescence as a distinct 'life stage' in the overall strategy; (2) linking of maternal and child health to reproductive health and other components (like family planning, adolescent health, HIV, gender and Preconception and Prenatal Diagnostic Techniques (PC&PNDT); and (3) linking of community and facility-based care as well as referrals between various levels of health care system to create a continuous care pathway, and to bring an additive /synergistic eﬀect in terms of overall outcomes and impact.
Programmes under RMNCH+A