ROLE OF THE NURSE IN FAMILY WELFARE PROGRAMME Communication is a key factor in family planning programme.

The nurse has to convey the correct ideas & meaning to persons. For this she needs to be well informed herself, & needs to use various aids in explanation. Her approach should be according to individual needs. t certainly re!uires skill to convey the right message. "he needs t be very patient while explaining. The level of understanding of a common man or women is limited. Hence a clear & appropriate explanation would help to overcome one#s fears. The nurses responsibilities may be summari$ed as follows %& 'nderstanding 'nderstanding the problem herself is first & foremost. (e as nurses need to understand our own feelings & attitudes about sex & family planning. )& *nowledge about family planning a& +opulation problem b& ,ature of family planning c& -ethods of family planning d& .esources available in the community e& /overnment policies 0& *nowledge about the person a& ndividuals needs & awareness b& Culture, beliefs, attitudes c& Customs, practices 1& Communication & health education a& 2e a good listener b& ndirect counselling needs to be offered c& Health education through various media "he could involve community leaders to participate in the programme & through them she could carry out family planning work. 3& Clinics a& 4ssist doctor in conducting clinics b& 4ssist in 'C5 insertions c& 4ssist in postnatal clinics 6& Follow up a& Through home visits b& Through clinic visits c& -aintaining careful record of follow up, findings, date of supplying device etc. 7& .eferral -ake referrals to various agencies as per need. 8& .ecords .ecords of the people using birth control methods individually, their attitudes, date of acceptance, 7 any problems 9& .esearch +articipates in research pro:ects carried out

CHILD SURVIVAL AND SAFE MOTHERHOOD PROGRAMME n %987 a world wide safe motherhood campaign ;"- safe motherhood initiative& was launched by (orld 2ank. The child survival & safe motherhood ;C""-& programme was launched on )<, 4ugust %99). This programme gets high priority by the central & state governments for improving the health status of women & children. The programme is directed at achieving 9 of the %7 gooals of ,ational Health +olicy ;%980& which are related to maternal & child health. Package of serv ces For !"e c" #$re% a. =ssential new born care b. mmuni$ation c. 4ppropriate management of diarrhea d. 4ppropriate management of 4. e. >itamin 4 prophylaxis For !"e &o!"ers a. mmuni$ation b. +revention & treatment of anaemia c. 4ntenatal care & early identification of maternal complications d. 5eliveries by trained personnel e. +romotion of institutional deliveries f. -anagement of obstetric emergencies g. 2irth spacing Esse%! a# Ne'(or% care t aims to reduce the +erinatal & neonatal mortalities both in domiciliary & institutional deliveries Co&)o%e%!s %. .esuscitation of newborn with asphyxia ). +revention of hypothermia 0. +revention of infections 1. =xclusive breast feeding 3. .eferral of sick newborn S!ra!eg es %. Train medical & other health personnel in essential newborn care ). +rovide basic facilities for care for low birth weight & sick newborns in the first referral units & district hospitals 0. Create awareness about essential newborn care among health care providers, pregnant women & mother of the newborns.

1. 'se of low?cost effective & locally available e!uipment for newborn care 3. mprove maternal care and promote birth spacing Goa#s of CSSM %. -., --. & under five mortality rates as mentioned in -CH goals ). +olio eradication by )<< 45 0. ,eonatal tetanus elimination by %993 1. -easles prevention 3. 5iarrhea?prevention of 7<@ deaths & )3@ cases by )<<< 45 6. 4cute .espiratory nfections ;4. &, prevention of 1<@ deaths by )<<< 45 CSSM Goa#s for C" #$re% %. ,ewborn care at home A warmth & feeding ). +rimary immuni$ation by %) months?%<<@ coverage 0. >itamin 4 prophylaxis ;9months to 0 years& A %<<@ coverage 1. +neumonia A correct case management at homeBhealth facilitiesB C." in every village CSSM Goa#s for Preg%a%! Wo&e% %. mmuni$ation against TT?%<<@ coverage ). 4nemia prophylaxis & oral therapy A %<<@ coverage 0. 4,C checkup A at least 0 checkups is %<<@ 1. .eferral of complicated cases 3. Care at birth A promotion of clean delivery 6. 2irth timing & spacing Fulfillment of these goals will go a long way in reducing maternal deaths. -aternal death is defined as the death of a woman while pregnant or within 1) days of termination of pregnancy from any cause reated to or aggravated by pregnancy or its management but not form accidental causes like plane crash. "- ;"afe -otherhood nitiative& plans to set up first referral units at taluks & towns to achieve the -CH & C""- goals. The C""- has 0 e#s for its ma:or components, these are %. = A =ssential -aternal care ). = A =arly identification of complications 0. = A =mergency obstetric care P*r)ose of !ra % %g %. To provide essential maternal care in the antenatal, intranatal, postnatal & neonatal period ). To promote safe delivery practices 0. To promote early identification, referral & appropriate treatment of maternal complications 1. +rompt identification of severe complications re!uiring immediate reference to First referral 'nits ;F.'#s& for treatment by a gynecologist for the pregnant woman or the neonatologist for the neonate at risk 3. 5ata collection & record keeping of all pregnancies, & deliveries, maternal, +erinatal, neonatal, infant, under five children mortality & morbidities. 6. "upervision of midwives, ancillary personnel training of dais REPRODUCTIVE AND CHILD HEALTH This recent concept of mother and child care is provided through reproductive and child health programme ;.CH& The reproductive and child health programme addresses the needs that have emerged over years of implementing the family welfare programme. 'nification of many women &

child health areas will now enable health workers to more easily & completely understand service needs & deliver services accordingly. 4s opposed to the family welfare programme, the .CH programme aims to be more in true with the ground relatives concerning the %. Cverall health needs of women & children ). mplementation needs of health workers 0. Docal demographic needs & conditions Progra&&e co&)o%e%!s The .Ch programme will build on the success of the ' + & the C""- programmed. n addition, it will cover all aspects of women#s reproductive health across their reproductive cycle, from pubery to menopause. n a nutshell .CH will cover the services offered under the C""- & Family (elfare +rograme as well as two new interventions, namely management of reproductive tract infections & adolescent reproductive health. RCH Packages of Serv ces For &o!"ers 4ll pregnancies have to be registered by health workers Two doses of Tetanus Toxiod ron & folic acid supplementation for prevention & treatment of anemia Three antenatal checkups which include checking their blood pressure & ruling out complications 5eliveries by trained personnel in safe & hygienic surroundings nstitutional deliveries for complicated cases .eferral to first level referrals units for management of obstetric emergencies Three postnatal checkups "pacing of atleast three years between children For c" #$re% =ssential newborn care like keeping the baby warm, checking the baby#s weight & giving the baby mother#s first milk ;colostrum& "pecial care to babies that are premature or low birth weight babies .eferral of babies with any complications to health centre or first referral units =xclusive breast feeding for the first three months & staring additional foodsBweaning in the fourth month mmuni$ation ;2C/, C+>, +olio & -easles& to prevent death & disability >itamin E4# prophylaxis to prevent nutritional blindness Cral rehydration & correct management of diarrhea. =nsure C." packets are available in the villages 4cute respiratory infections in children should be detected early & treated with cotrimoxa$ole if needed. .eferral to health centre as necessary Treatment of anemia For E# g (#e Co*)#es +romoting use of contraceptive methods among eligible couples to prevent unwanted pregnancies "afe services for medical termination of pregnancy O!"er serv ces

dentify & refer people suffering silently from reproductive tract infections ;.T & & sexually transmitted infections ;"T s& +reparing the adolescents for future by counselling them on family life & reproductive health through the involvement of parents, anganwadi workers & mahila swasthya sanghs ;women#s club&

RCH )rogra&&e s!ra!eg es The .CH programme will address those problems by using the following strategies Community participation in planning for services & prioriti$ing Client centered approach to service provision =mphasis on good !uality care 'pgraded facilities & improved training 4bsence of contraceptive targets & incentives -aking services gender sensitive -ulti sectoral approach in implementing & monitoring services. ICDS PROGRAMME I%!egra!e$ c" #$ $eve#o)&e%! serv ces C5" was designed as an early childhood development programme to lay the foundation of proper psychological, physical & social development of the child as one of its key ob:ectives Daunched in %973 with 00 pro:ects, the programmes has been universali$ed to extent to about 6lakh villages, hamlets & slums covering all children in the gae group <? 6 years, expectant & nursing mothers. Cb:ectives %. mprovement in the health & nutrition status of children below 6 years ). Daying the foundation of proper psychological, physical & social development of children 0. Coordination of policy for convergence of sectoral services 1. .eduction in school dropout rates 3. =nhancement of mothers capability to look after the health & nutritional needs of their children. NATIONAL POPULATION POLICY +opulation policy refers to policies which intend to decrease the birth rate. n ndia the first population policy was framed in %976 emphasi$ing the increase in the legal minimum age at marriage from %3 to %8 years & %8 to )% years for males. The new national +opulation +olicy )<<< deals not only with fertility & mortality rates but also with women#s educationF empowering women for improved health & nutritionF child survival & healthF needs for family welfare services, that are yet to be coveredF health care for neglected population, adolescent healthF participation of men in planned parenthood & collaboration with ,/Cs. De&ogra)" c goa#s (+ ,-.%. 4ddress unmet needs of basic .CH services ). Compulsory free education up to %1 years of age 0. .educe nfant mortality rate to below 0< per %<<< live births 1. .educe maternal mortality rate to below %<< per %<<<<< live births 3. %<<@ protection against vaccine preventable disease for children 6. +referable age at marriage for girls is )< years & not earlier than %8 years

7. 8<@ of deliveries in institutions, %<<@ deliveries by trained personnel 8. %<<@ registration of births, deaths, marriage & pregnancy. 9. Contain the spread of 4 5" %<. ntegrate ndian system of medicine POPULATION PRO/LEM ndia is noted for its large population, ranking second, next to china in the world. 4t present ndia#s population is e!ual to that of '.".4., the then '"". & Gapan put together. t is found that 33,<<< babies are born everyday in ndia. There arenearly )% million births & 8 million deaths occurring annually which results in an addition of %0 million population each year. 4t this rate it was estimated that by %98%, the population of ndia would exceed 7<< million. The %98% census as of march %st revealed that the population of ndia was 680 million ;according to the central 2ureau of Health ntelligence, Health "tatistics of ndia, new delhi, %98%&, where as the (orld +opulation .eference 2ureau at (ashington in '"4 mentions that the %98% population of ndia of ndia was 689 million. However as mentioned earlier the population by now ;%98)& would have reached nearly 7<< million. ndia#s population is rapidly growing. The following table will explain how fast the growth rate has been during the past 8< years.