launched in 2013 MNCH+A approach was and it essentially looks to address the major causes of mortality among women and children as well as the delays in accessing and utilizing health care and services. The RMNCH+A strategic approach has been developed to provide an understanding of the continuum of care and 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.
Key Features of RMNCH+A Strategy:
- Health systems strengthening (HSS) focusing on infrastructure, human resources, supply chain management, and referral transport measures.
- Prioritization of high-impact interventions for various lifecycle stages.
- Increasing effectiveness of investments by prioritizing geographical areas based on evidence.
- Integrated monitoring and accountability through good governance, use of available data sets, community involvement, and steps to address grievance.
- Broad-based collaboration and partnerships with ministries, departments, development partners, civil society, and other stakeholders.
The “Plus” Within the Strategy Focuses On:
- Inclusion of adolescence as a distinct life stage within the overall strategy.
- Linking maternal and child health to reproductive health and other components like family planning, adolescent health, HIV, gender, and preconception and prenatal diagnostic techniques.
- Linking home and community-based services to facility-based services.
- Ensuring linkages, referrals, and counter-referrals between and among various levels of the health care system to create a continuous care pathway, and to bring an additive/ synergistic effect in terms of overall outcomes and impact.
Objectives of RMNCH+A
- Increase facilities equipped for perinatal care (designated as ‘delivery points’) by 100%
- Increase proportion of all births in government and accredited private institutions at annual rate of 5.6 % from the baseline of 61%
- Increase proportion of pregnant women receiving antenatal care at annual rate of 6% from the baseline of 53%
- Increase proportion of mothers and newborns receiving postnatal care at annual rate of 7.5% from the baseline of 45%
- Increase proportion of deliveries conducted by skilled birth attendants at annual rate of 2% from the baseline of 76%
- Increase exclusive breastfeeding rates at annual rate of 9.6% from the baseline of 36%
- Reduce prevalence of under-five children who are underweight at annual rate of 5.5% from the baseline of 45%
- Reduce anaemia in adolescent girls and boys (15–19 years) at annual rate of 6% from the baseline of 56% and 30%, respectively
- Decrease the proportion of total fertility contributed by adolescents (15–19 years) at annual rate of 3.8% per year from the baseline of 16%
- Raise child sex ratio in the 0–6 years age group at annual rate of 0.6% per year from the baseline of 914
- While the number of staff and their placement in the organisation structure will primarily be determined by the organisational set-up in each state, certain guiding principles have been set out with the aim of ensuring that RMNCH+ approach receives the necessary organisational emphasis.
- At the national level, the reproductive and child health (RCH) division currently has the provision for deputy commissioners, assistant commissioners, and a team of technical consultants.
- At the state level, a dedicated full-time Director for RCH (including maternal health, child health, family planning and adolescent health) will take charge at the state level. Director RCH will be supported by separate dedicated full-time directorate officials for maternal health, child health, family planning and adolescent health as well as for key cross cutting functions.