Strategies To Improve Access To & RCH Services

Maternal health services, particularly antenatal care and postnatal care services, require special attention to reduce both maternal and infant mortality. A large proportion of women in both urban and rural areas are anaemic and are not protected against tetanus. The proportion availing of postnatal care services are also very low. Prophylaxis against nutritional deficiency would be able to save many lives.

Deliveries conducted by trained personnel are extremely low in UP. Most of the deliveries take place at home and are attended by untrained personnel. This has led to high infant mortality, particularly neonatal mortality and also maternal mortality. To reduce infant and maternal mortality, added emphasis will be placed on increasing institutional deliveries and the proportion of deliveries attended by trained personnel.

The reach of child health services and their acceptability have to be considerably increased in order to reduce infant mortality. Immunization of children against vaccine-preventable diseases, proper management of diarrhoea, treatment of acute respiratory infection and improved nutrition are the important measures that need to be strengthened further. There has been considerable improvement in the recent past in immunization coverage and in the use of ORS packets or home-made solutions in the case of diarrhoea.

Sterilization services have a major role to play in the reduction of fertility. Demand for sterilization services is extremely high and has increased over time. The sterilization performance in the state has declined in the recent past, particularly after the introduction of the target-free approach. Health workers' visits to villages and their contacts with women to promote informed choice have also declined. There is an urgent need to streamline the service delivery systems to provide services to voluntary acceptors of sterilization methods.

Integrated RCH camps conducted in select districts of UP have helped to improve access to and quality of services. RCH camps planned in advance and publicised through various media have substantially improved access to services. The camp approach may not be the best approach to provide high-quality services on a regular and continuous basis but, given the current service delivery situation in the state, is the best suited to reach those in need of services. The RCH camp approach will be further strengthened and expanded to cover the entire state.

Involvement of men in family planning has sharply declined in the past two decades. Vasectomy, once the most accepted method, has hardly any users now. Male participation is essential not only to increase the use of contraceptives but also to reduce the enormous burden the non-participation of men imposes on women. UP has already trained several medical officers to conduct no-scalpel vasectomy operations.