National Rural Health Mission

NATIONAL PROGRAMMES

Reproductive and Child Health Services (RCHS) – (RMNCAH+N)

Family Welfare Programme, also known as Reproductive, Maternal, New Born, Child,  Adolescent Health and Nutrition Programme focuses on the total well-being of the woman as well as offspring and Adolescents.  This programme is designed so that people have the ability to reproduce and regulate their fertility; women are able to go through pregnancy and childbirth safely, the outcome of pregnancy is successful in terms of maternal and infant survival and well being; and couples are able to have sexual relations free of the fear of pregnancy and contacting disease. Taking care of newborns ,child health and Adolescent health will ensure continuum of care leading to healthy adults and healthy society.  Thus RMNCHA+N programme is a need-based, client-centered, demand-driven, high quality and integrated services.

The RMNCH+A strategy is holistic in design, encompassing all interventions aimed at reproductive, maternal, newborn, child, and adolescent health under a broad umbrella, and focusing on the strategic lifecycle approach.

• Introduction: State Family Welfare Bureau caters to various components under the RMNCHA+N  strategy which are as follows :  Family Planning (Reproductive Health), Maternal health, Gender Issues including PC-PNDT Act, LaQshya Child health & Neonatal Health, Immunisation, Adolescents  Health, Information Education and Communication (I.E.C.),
• Organisational Chart Of The Department :

LaQshya : For the State of Goa, 5 facilities (Goa Medical College, 2 District Hospitals and 2 Sub-District Hospitals) have been taken up under LaQshya which is an initiative to provide quality health care to all delivering patients.
Currently, the Labor Room & Maternity Operation Theatre of North Goa District Hospital, Mapusa and Sub-District Hospital, Ponda is LaQshya Certified alongwith the Labor Room of Goa Medical College.

• Family Planning Indemnity Scheme of Government of India, is implemented wherein cases of failed sterilizations conducted in Government Hospitals are paid compensation of Rs.60,000/-. 
• Janani Suraksha Yojana (JSY): Janani Suraksha Yojana is a scheme wherein women can avail of monetary benefit i.e. Rs.700/- for rural and Rs.600/- for urban area, if they belong to the BPL family or any women of the SC/ST community irrespective of their income. Ideally, the objective of the scheme is to promote Institutional deliveries which will contribute towards reduction of maternal and neonatal deaths.  

• Data DHS website

 1)  Family Planning: 

Promotion of various spacing and permanent methods of contraception are undertaken. 

The Total Fertility Rate for the State of Goa stands at 1.7 (NFHS-4).  

Source : HMIS

2)  Maternal Health: 

• Screening of antenatal cases by doctors at all the Health Centres/Hospitals, wherein all the cases are screened for HIV, Syphilis, Hb & urine tests as well as Ultra Sonography.  

• Maternal Mortality (MM): The Institutional Deliveries in Goa are to the tune of  99.9% (HMIS). For the year 2019-20, deliveries reported (on HMIS) are 18,419 against 8 Maternal Deaths. 

• Medical Termination of Pregnancy (MTP Act) – Comprehensive Abortion Care Services are provided at both District Hospitals, Sub-District Hospitals & CHCs/PHCs wherever Gynaecologists are posted.
• Status of MTPs in Goa (HMIS Data):

3)  Child Health:

• Infant mortality rate for Goa is 7 (SRS 2020 reference year 2018) per 1000 Live Birth. Preterm / prematurity, Low birth weight, Congenital anomalies, Birth asphyxia ,pneumonia ,neonatal infections are a few important causes of infant deaths in Goa

• New born screening for inborn errors of metabolism and congenital defects has been initiated in GMC, both District Hospitals, Sub District Hospitals and other delivery points in CHCs/PHCs from August 2018. Since inception till June 2020, 20230 babies are screened out of which 83 are confirmed positive and managed. 

• Pulse Polio Immunization Programme: For the year 2020, Pulse Polio Immunization  Programme was conducted in the State on 19th January 2020 and 1,19,013 children were administered oral polio vaccine dose for children less than five years of age in addition to the routine immunization.

• Rotavirus Vaccine  is introduced in the Universal Immunization Programme on 25th July 2019.  From July 2019 to March 2020,   9,879 children are immunized.

• Observance of National Deworming Day : Every year, bi-annual rounds of National De-worming Day are conducted through the platform of Schools & Anganwadi Centres, wherein all the pre-school & school age children (1-19 years) are administered with a single dose of Albendazole. For the year 2019-20. 

De-worming Day was conducted in targeted 1488 Govt./Govt. Aided schools, 302 private schools and 1447 anganwadi centres. 

• Rashtriya Bal Swasthya Karyakram (RBSK): For the year 2019-20, 5,16,221 children have been screened out of which 11,644 children have been identified with one of the 4Ds. of which 11,477  have been referred to the facilities for the treatment, and 6,977 children have received secondary/tertiary care. 

• District Early Intervention Centres (DEIC): For the year 2019-20,   8,255 children in the age group 0-18 years reached DEIC, all children have been confirmed with 4 D’s,  of which 7,987 received secondary or tertiary care and 268 referred out to higher centres for further management.

                          Universal Immunization Programme:

Achievements for the year 2019-2020

Source : HMIS

Note : * New Vaccine

Under this programme routine Immunization activities are carried out at all the sub centres, PHCs, CHCs, DHs, SDH on fixed days. In addition to this, outreach sessions are conducted once monthly to cover the high risk areas.

4)   Adolescent Health (AH) : 

 Rashtriya  Kishor  Swasthya Karyakram (RKSK)

 Yuva clinics are set up at the CHC/PHC/UHC/District Hospitals & Goa Medical College to address the issues relating to Reproductive Tract Infections, Sexually Transmitted Infections, Nutrition, Gender, Sexuality, Substance abuse, non communicable diseases Mental Health etc. among Adolescent. There are 33 Yuva clinics and Counsellors are posted to offer counselling services.  For the year 2019-20,     36,511 adolescents accessed clinical services and 23,990 accessed counselling services.

Acts and Rules Implemented By The Department: 

PC PNDT 

A law was enacted in the year 1994 called the Pre Natal Diagnostic techniques (Regulation & Prevention of Misuse ) Act No 57 of 1984. This law was amended in 2013 (amended wide Act 14 of 2003, effective 14. 02. 2013), now called the Pre conception and Pre natal diagnostic techniques (Prohibition of Sex Selection) Act. 

The Act prohibits sex Selection and regulates the use of Pre conception and Pre natal diagnostic techniques so that these techniques are not misused for the purpose of detecting sex of the Foetus. 

IMPLEMENTATION OF THE ACT

The implementing machinery for the state of Goa under this Act comprises of 

• State Supervisory Board (20 members)

• State Appropriate Authority (3 Members)

1. 1. North Goa District Appropriate Authority :- The District Magistrate, North Goa has been notified as the District Appropriate Authority for North District .
   2. South Goa District Appropriate Authority :- The District Magistrate, North Goa has been notified as the District Appropriate Authority for North District.

• District Advisory Committee for North Goa – (8 Member )

• District Advisory Committee for South Goa – (8 Member )

The District Appropriate Authorities perform the following function:-

• An application for registration is made to the District Appropriate Authority along with the prescribed fees. He would hold an inquiry as per the rules under the act and grant a certificate of registration on fulfillment of all the criteria. 
• It can grant, suspend or cancel registration of Genetic Clinics, Counselling Centres or Laboratories.
• In the case of breach of provisions of the Act, it is meant to investigate complaints and take immediate action.
• It has the power to search premises, examine any records, register, document, etc.
• It also has the power to seize any of the above that may furnish as evidence of the commission of the offence.

The advisory committee of respective district is responsible for providing advice and guidance on matters of implementation and to aid the respective Appropriate Authority to discharge its functions.

 REGISTRATION OF THE PREMISES

Genetic clinics, Genetic Laboratories, Ultrasound Clinics or imaging Centres having ultrasound machines or imaging machines capable of sex determination have to be registered. 

Registered clinics must display their certificate of registration as well as the message that sex selection is illegal.

The number of registered clinics under PCPNDT till June 2014

NORTH GOA       SOUTH GOA

• Government  –  11 Government  – 11

• Private –   76 Private – 78

TOTAL – 176

PUNISHMENT 

A medical practitioner may get an imprisonment for a term that may extend to 3 years and with a fine that may extend upto Rs. 10, 000/- and on any subsequent condition, he/ she may get an imprisonment that may extend to 5 years and with a fine that may extend to Rs 50, 000/-

The name of the medical practitioner would be reported to the State Medical Council by the Appropriate Authority for taking necessary action.

Any person who seeks the aid of any establishment and professionals for the purpose of sex selection would be punished with imprisonment for a term that may extend to 3 years and with a fine that may extend to Rs. 50, 000/- and on any subsequent condition, with imprisonment that may extend to 5 years and with a fine that may extend to Rs 1, 00, 000/-

No person, organisation, Genetic clinic or Genetic laboratory shall issue, publish or distribute an advertisement in any manner regarding sex selection.

An offence under this law is cognizable, non- bailable and non – compoundable.

Every Genetic clinic is required to maintain Form F (form for maintenance of records in respect of pregnant women). For better reporting, monitoring and analysis, online filling of F-form by all registered ultrasound clinics and submission to Appropriate Authority has been initiated  under NIC Software.  

Medical Termination of Pregnancy (MTP Act) – Comprehensive Abortion Care Services are provided at both District Hospitals, Sub-District Hospitals & CHCs/PHCs wherever Gynaecologists are posted.

PCPNDT

PCPNDT Rules

PC-PNDT ACT-1994