Historical Background/Periodical Development
Govt. of Maharashtra started Family Welfare Programme during 1957. It is implemented as per guidelines given by Govt. of India. It is 100% Centrally sponsored programme. It was target oriented programme till 1995–96. From the year 1996–97, the Target Free Approach was implemented as per guidelines given by Govt. of India.

The State is implementing Reproductive & Child Health Programme– Phase II. The period of RCH Phase II is 2005–06 to 2009–10. The programme has set the following goals to be achieved by 2007 & 2010.

Important goals identified ro RCH II by the state are as below

Govt. of India has approved the State Programme Implementation Plan (PIP) of RCH–II for Rs.660 crores (for next 5 years) and sanctioned Rs.115 crores per year for next two years. The activity wise budget allocation is shown as below:

(a) Technical strategies & activities – 46%.
(b) Urban RCH – 16%.
(c) Institutional strengthening – 14%.
(d) Trainings – 7%.
(e) Behavioural change communication – 8%.
(f) Programme Management – 9%.

Main outcomes

• Improved quality and outreach RCH services.
• Improved organizational culture, structure and management of department.

Priority key areas

• Safe abortion services including MVA technique and medical abortion by RU 486.
• BCC including IEC, counseling, family & community participation.
• Male participation.
• Development of strong referral system for EmOC and EmPC.
• 40 plus care including screening code for CaCx.
• Strengthening of infrastructure.
• Ensuring availability of skill mix at CHC/FRU.
• Sensitizing health staff on humane approach and orienting on gender and equity issues.
• Improving skill based trainings by hand holding and providing competency based trainings.
• Refining the management systems especially for drugs and equipment procurement and distribution and financial monitoring.
• Broad basing the monitoring and evaluation.
• Building community participation.

Strategy of Reproductive & Child Health II
Planning at District Level
Considering the need of decentralization, districts have been directed to identify health needs based on available information of health indicators and plan for activities for the next 5 years. Districts have to prepare the plan of action for RCH – II

RCH Phase II in the format prescribed by GOI and indicate need of yearly grants. Districts have been communicated tentative annual grants for RCH– II activities (Statement enclosed ).

Availability of Component wise budget for next 2 years (Rs. In Lakhs)

Special Plan for Urban Areas
Considering availability of RCH outreach services in very few municipal corporations, review of situation is being taken in 22 municipal corporation, 222 municipal councils and 7 cantonments areas. Provision of contractual ANMS and urban health post/mobile health clinic as per need is being planed and allocation has been made.

Activities for Tribal Areas
Out of 15 tribal districts 5 districts are sensitive where following important activities will be under taken

• Competency based training – Medical Officer and Nurses working at first referral unit will be trained for medication of high risks obstetric cases.
• IMNCI training – As the Infant death and child death rate is high in these districts Integrated training medication of children up to 5 year. Health staff from Rural hospital/PHC and at village level will be given training of 1 week.

Operationlising a Primary Health Centre for providing 24 Hour Delivery and Newborn care under RCH – II
The following guidelines are given to assist the districts in operationalising their PHCs for 24 X 7:

Essentital Service Package

• 24 – hour delivery services (normal and assisted).
• Essential newborn care.
• Referral for emergencies.
• Antenatal care and routine immunization (fixed day services).
• Postnatal care.
• Early and safe abortion sevices (including MVA).
• Family planning services.
• Prevention and management of RTIs/STIs.
• Essential laboratory services.

The Services mentioned above are in additon to all services that the PHC is normally required to provide. The first 3 services are critical for labeling a PHC as one providing round the clock delivery & new born care services.
List of 24 X 7 PHC’s