NEEDS ASSESSMENT OF RCH CARE : INTRODUCTION ----- .

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NEEDS ASSESSMENT :NEEDS ASSESSMENT : REPRODUCTIVE & CHILD HEALTH REPRODUCTIVE & CHILD HEALTH

[RCH] CARE[RCH] CARE

PRASANTAPRASANTA KUMAR SAHA, M.Sc. KUMAR SAHA, M.Sc.(Stat),CStat(UK),(Stat),CStat(UK),

Fellow of the Royal Statistical Society, UK,Fellow of the Royal Statistical Society, UK,Chartered Statistician, UK. Chartered Statistician, UK.

E-MailE-Mail

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NEEDS ASSESSMENT OF RCH NEEDS ASSESSMENT OF RCH CARE : INTRODUCTIONCARE : INTRODUCTION

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IN GENERAL NECESSITY FELT BY IN GENERAL NECESSITY FELT BY PEOPLE FORPEOPLE FOR

• CERTAIN BASIC & ESSENTIAL CERTAIN BASIC & ESSENTIAL SERVICES SERVICES

• THOSE SERVICES TO BE PROVIDED THOSE SERVICES TO BE PROVIDED BY THE GOVT OR PUBLIC SECTORBY THE GOVT OR PUBLIC SECTOR

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NEEDS ASSESSMENT OF RCH NEEDS ASSESSMENT OF RCH CARE: CARE: INTRODUCTIONINTRODUCTION -Contd.-Contd.

ANY RESEMBLANCE WITH ANY RESEMBLANCE WITH ESTIMATION OF DEMANDS OR ESTIMATION OF DEMANDS OR

NEEDS FOR GOODS?NEEDS FOR GOODS? ESTIMATION OF DEMANDS OR ESTIMATION OF DEMANDS OR

NEEDS FOR SERVICES?NEEDS FOR SERVICES?

NONO..

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NEEDS ASSESSMENT OF RCH NEEDS ASSESSMENT OF RCH CARE: CARE: INTRODUCTIONINTRODUCTION -Contd.-Contd.

SUCH DEMAND OR NEEDS SUCH DEMAND OR NEEDS ESTIMATION RELATES TOESTIMATION RELATES TO

A MATHEMATICAL RELATIONSHIP A MATHEMATICAL RELATIONSHIP SHOWINGSHOWING

DEMAND AS A DEPENDENT DEMAND AS A DEPENDENT VARIABLEVARIABLE

PRICE OR SUPPLY AS PRICE OR SUPPLY AS INDEPENDENT VARIABLESINDEPENDENT VARIABLES

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NEEDS ASSESSMENT OF RCH NEEDS ASSESSMENT OF RCH CARE: CARE: INTRODUCTIONINTRODUCTION -Contd.-Contd. THE PROCESS OF NEEDS THE PROCESS OF NEEDS

ASSESSMENT FOR RCH CARE IS A ASSESSMENT FOR RCH CARE IS A MECHANISM FOR IMPLEMENTING THE MECHANISM FOR IMPLEMENTING THE COMMUNITY PARTICIPATION COMMUNITY PARTICIPATION APPROACH FOR REPRODUCTTIVE APPROACH FOR REPRODUCTTIVE RIGHTS & REPRODUCTIVE HEALTH RIGHTS & REPRODUCTIVE HEALTH RECOMMENDED BY CAIRO RECOMMENDED BY CAIRO CONFERRENCE OF ICPD IN CONFERRENCE OF ICPD IN SEPT.,1994.SEPT.,1994.

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NEEDS ASSESSMENT OF RCH NEEDS ASSESSMENT OF RCH CARE: CARE: CONCEPT & DEFINITIONCONCEPT & DEFINITION

IN THIS TOPIC DEFINITION OF NEEDS IN THIS TOPIC DEFINITION OF NEEDS ASSESSMENT RELATES TO ASSESSING ASSESSMENT RELATES TO ASSESSING OR WORKING OUT THE NEEDS FOR OR WORKING OUT THE NEEDS FOR REPRODUCTIVE HEALTH CARE OF REPRODUCTIVE HEALTH CARE OF WOMEN IN REPRODUCTIVE AGE WOMEN IN REPRODUCTIVE AGE GROUP & CHILD HEALTH CARE GROUP & CHILD HEALTH CARE COVERING INFANTS AND CHILDREN .COVERING INFANTS AND CHILDREN .

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NEEDS ASSESSMENT OF RCH NEEDS ASSESSMENT OF RCH CARE: CARE: CONCEPT & DEFINITION CONCEPT & DEFINITION

-Contd.-Contd. NEEDS ASSESSMENT FOR RCH CARE:NEEDS ASSESSMENT FOR RCH CARE:

A SPECIFIC SOCIAL CONCEPTA SPECIFIC SOCIAL CONCEPT

AN INNOVATIVE CONCEPT WITH WIDE AN INNOVATIVE CONCEPT WITH WIDE SIGNIFICANCE SIGNIFICANCE

A NOBLE CONCEPT WITH WIDE IMPLICATIONSA NOBLE CONCEPT WITH WIDE IMPLICATIONS

EFFECTIVE APPROACH IN DEVELOPING EFFECTIVE APPROACH IN DEVELOPING SOCIETYSOCIETY

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NEEDS ASSESSMENT OF RCH NEEDS ASSESSMENT OF RCH CARE: CARE: ITS SIGNIFICANCEITS SIGNIFICANCE

QUESTION OF AVAILIBILITY OF RCH QUESTION OF AVAILIBILITY OF RCH SERVICE FACILITIESSERVICE FACILITIES

DEVELOPING SOCIETY VIS-A-VIS RICH DEVELOPING SOCIETY VIS-A-VIS RICH SOCIETYSOCIETY

RICH SOCIETY: SERVICES ARE RICH SOCIETY: SERVICES ARE OPTMUMOPTMUM

DEVELOPING SOCIETY: SERVICES ARE DEVELOPING SOCIETY: SERVICES ARE SUB-OPTIMUMSUB-OPTIMUM

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NEEDS ASSESSMENT OF RCH NEEDS ASSESSMENT OF RCH CARE: CARE: ITS SIGNIFICANE -Contd.ITS SIGNIFICANE -Contd.

DEVELOPING SOCIETY: DEVELOPING SOCIETY: ENTIRE RESPONSIBILITY WITH ENTIRE RESPONSIBILITY WITH

GOVT GOVT ECONOMIC CAPACITY OF PEOPLE ECONOMIC CAPACITY OF PEOPLE

VERY WEAKVERY WEAK MAGNITUDE OF PROBLEMS-MORE MAGNITUDE OF PROBLEMS-MORE

COMPLEX & VAST.COMPLEX & VAST.

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NEEDS ASSESSMENT OF RCH NEEDS ASSESSMENT OF RCH CARE: CARE: ITS SIGNIFICANE -Contd.ITS SIGNIFICANE -Contd.

DEVELOPING SOCIETY : COMMON DEVELOPING SOCIETY : COMMON PEOPLE PEOPLE

CAN’T AFFORD COSTLY HEALTH CARE CAN’T AFFORD COSTLY HEALTH CARE SERVICESSERVICES

CAN’T AFFORD THOSE SERVICES FROM CAN’T AFFORD THOSE SERVICES FROM PRIVATE SECTORPRIVATE SECTOR

PRIVATE SECTOR SERVICES VERY PRIVATE SECTOR SERVICES VERY COSTLYCOSTLY

PRIVATE SECTOR SERVICES PRIVATE SECTOR SERVICES INADEQUATE.INADEQUATE.

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NEEDS ASSESSMENT OF RCH NEEDS ASSESSMENT OF RCH CARE: CARE: STATUS IN INDIASTATUS IN INDIA

INDIA:INDIA: THIS CONCEPT IS ABSOLUTELY THIS CONCEPT IS ABSOLUTELY

NEWNEW TILL 1996-97 NO SUCH CONCEPT IN TILL 1996-97 NO SUCH CONCEPT IN

ANY SECTOR ANY SECTOR VERY CHALLENGING FOR THE GOVTVERY CHALLENGING FOR THE GOVT INNOVATIVE & REVOLUTIONARY INNOVATIVE & REVOLUTIONARY

APPROACH APPROACH

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NEEDS ASSESSMENT OF RCH NEEDS ASSESSMENT OF RCH CARE : CARE : OBJECTIVEOBJECTIVE

OBJECTIVE OF NA:OBJECTIVE OF NA: PROVIDING QUALITY RCH PROVIDING QUALITY RCH

SERVICESSERVICES MEETING DEMAND-DRIVEN MEETING DEMAND-DRIVEN

CLIENT’ S SATISFACTIONCLIENT’ S SATISFACTION THUS FULFILLING OBJECTIVES OF THUS FULFILLING OBJECTIVES OF

RCH CONCEPT AS RCH CONCEPT AS RECOMMENDED BY ICPD’94.RECOMMENDED BY ICPD’94.

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NEEDS ASSESSMENT OF RCH NEEDS ASSESSMENT OF RCH CARE : CARE : OBJECTIVE-CONTDOBJECTIVE-CONTD

TO PREPARE ANNUAL ACTION TO PREPARE ANNUAL ACTION PLANS FOR ALL ITEMS OF RCH & PLANS FOR ALL ITEMS OF RCH & FAMILY WELFARE SERVICES AT FAMILY WELFARE SERVICES AT VARIOUS LEVELSVARIOUS LEVELS

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NEEDS ASSESSMENT OF RCH NEEDS ASSESSMENT OF RCH CARE: CARE: FULFILLING THE FULFILLING THE

OBJECTIVESOBJECTIVES MECHANISM OF FULFILLING MECHANISM OF FULFILLING

THE OBJECTIVES:THE OBJECTIVES: THROUGH COMMUNITY THROUGH COMMUNITY

PARTICIPATIONPARTICIPATION THROUGH PLANNING AT THE THROUGH PLANNING AT THE

GRASS-ROOT LEVELGRASS-ROOT LEVEL

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NEEDS ASSESSMENT [NA] OF RCH NEEDS ASSESSMENT [NA] OF RCH CARE: CARE: COMMUNITY PARTICIPATIONCOMMUNITY PARTICIPATION

ROLE OF COMMUNITY PARTCIPATION ROLE OF COMMUNITY PARTCIPATION [CP] FOR NA FOR RCH SERVICES:[CP] FOR NA FOR RCH SERVICES:

PROCESS OF NA TO BE PERFORMED PROCESS OF NA TO BE PERFORMED THROUGH CPTHROUGH CP

CP IS PRINCIPAL FORCE FOR NACP IS PRINCIPAL FORCE FOR NA WITHOUT PEOPLE’S PARTICIPATION WITHOUT PEOPLE’S PARTICIPATION

VALIDITY OF NA NOT ACCEPTABLE.VALIDITY OF NA NOT ACCEPTABLE.

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NEEDS ASSESSMENT OF RCH NEEDS ASSESSMENT OF RCH CARE : CARE : INFRASTRUCTURESINFRASTRUCTURES

FUNCTIONARIES TO WORK OUT NA:FUNCTIONARIES TO WORK OUT NA:AT SUB-CENTER:AT SUB-CENTER: ANMANM MPHWMPHWAT PHC:AT PHC: MOMO SUPERVISORY HEALTH STAFFSUPERVISORY HEALTH STAFF

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NEEDS ASSESSMENT OF RCH NEEDS ASSESSMENT OF RCH CARE: CARE: INFRASTRUCTURES -INFRASTRUCTURES -

CONTD.CONTD.FUNCTIONARIES -CONTD.:FUNCTIONARIES -CONTD.:AT CHC/FRU:AT CHC/FRU: SR. SUPERVISORY IN –CHARGESR. SUPERVISORY IN –CHARGEAT DISTRIC HOSPITALS:AT DISTRIC HOSPITALS: CMO/DY.CMOCMO/DY.CMOAT STATE HEALTH DEPT.:AT STATE HEALTH DEPT.: COMMISIONER/DIRECTOR OF HEALTH & COMMISIONER/DIRECTOR OF HEALTH &

FWFW..

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NEEDS ASSESSMENT OF RCH NEEDS ASSESSMENT OF RCH CARE : CARE : PROCEDUREPROCEDURE

VILLAGE LEVEL:VILLAGE LEVEL: TO BE PERFORMED IN THE START OF A TO BE PERFORMED IN THE START OF A

FINANCIAL YEARFINANCIAL YEAR IN VILLGES BY ANM& MALE MPW OF SCIN VILLGES BY ANM& MALE MPW OF SC HOUSE-TO-HOUSE INTERACTIONS WITH HOUSE-TO-HOUSE INTERACTIONS WITH

CLIENTSCLIENTS CONSULTATIONS WITH PANCHAYAT, CONSULTATIONS WITH PANCHAYAT,

HEALTH COMMITTEE, ANGANWADI HEALTH COMMITTEE, ANGANWADI WORKERS, WOMEN GROUPS IN THEWORKERS, WOMEN GROUPS IN THE VILLAGES.VILLAGES.

theth

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NEEDS ASSESSMENT OF RCH NEEDS ASSESSMENT OF RCH CARE: CARE: PROCEDURE -CONTD.PROCEDURE -CONTD.

TO HOLD DISCUSSION WITH THE TO HOLD DISCUSSION WITH THE CONCERNED PEOPLE IF NEEDEDCONCERNED PEOPLE IF NEEDED

TO PREPARE ACTION PLANTO PREPARE ACTION PLAN TO FILL UP PRESCRIBED FORM TO TO FILL UP PRESCRIBED FORM TO

NOTE DOWN THE INFORMATION ON NOTE DOWN THE INFORMATION ON REQUIREMENT OF RCH CARE FOR REQUIREMENT OF RCH CARE FOR ACTION PLANACTION PLAN

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NEEDS ASSESSMENT OF RCH NEEDS ASSESSMENT OF RCH CARE: CARE: PROCEDURE -CONTD.PROCEDURE -CONTD.

ACTION PLANS PREPARED AT THE LEVELS OF:ACTION PLANS PREPARED AT THE LEVELS OF: SUB-CENTER [SC] SUB-CENTER [SC] PRIMARY HEALTH CENTER [PHC] PRIMARY HEALTH CENTER [PHC] COMMUNITY HEALTH CENTER[CHC]/FIRST COMMUNITY HEALTH CENTER[CHC]/FIRST

REFERRAL UNIT[FRU]REFERRAL UNIT[FRU] DISTRICT HEALTH AUTHORITY DISTRICT HEALTH AUTHORITY STATE HEALTH AUTHORITYSTATE HEALTH AUTHORITY

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NEEDS ASSESSMENT OF RCH NEEDS ASSESSMENT OF RCH CARE: CARE: TYPES OF RCH CARE TO BE TYPES OF RCH CARE TO BE

COVEREDCOVERED ANTE-NATAL CARE [ANC]ANTE-NATAL CARE [ANC] NATAL CARENATAL CARE NEO-NATAL CARENEO-NATAL CARE MTPMTP RTI/STIRTI/STI

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NEEDS ASSESSMENT OF RCH NEEDS ASSESSMENT OF RCH CARE: CARE: TYPES OF RCH CARE TO BE TYPES OF RCH CARE TO BE COVEREDCOVERED - - CONTD.CONTD.

NEED OF IFA TABLETSNEED OF IFA TABLETS TO PREVENT & CURE ARITO PREVENT & CURE ARI TO PREVENT & CURE ACUTE TO PREVENT & CURE ACUTE

DIARRHOEAL DISEASEDIARRHOEAL DISEASE NEED OF FAMILY PLANNING NEED OF FAMILY PLANNING

METHODSMETHODS

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NEEDS ASSESSMENT OF RCH NEEDS ASSESSMENT OF RCH CARE: CARE: CONCLUSIONCONCLUSION

AS HAS BEEN MENTIONED IN THE AS HAS BEEN MENTIONED IN THE BEGINNING OF THIS LECTURE, NEEDS BEGINNING OF THIS LECTURE, NEEDS ASSESSMENT IS AN INNOVATIVE AND ASSESSMENT IS AN INNOVATIVE AND ABSOLUTELY NEW SYSTEM IN A ABSOLUTELY NEW SYSTEM IN A DEVELOPING COUNTRY LIKE INDIA. AS IT DEVELOPING COUNTRY LIKE INDIA. AS IT IS WELL KNOWN, A MOST MODERN IS WELL KNOWN, A MOST MODERN TECHNOLOGY MAY NOT GENERATE TECHNOLOGY MAY NOT GENERATE DESIRED EFFECT IN SOCIAL OR DESIRED EFFECT IN SOCIAL OR ECONOMIC LIFE UNLESS MINDSET OF THE ECONOMIC LIFE UNLESS MINDSET OF THE PEOPLE IS CHANGED. THIS SITUATION IS PEOPLE IS CHANGED. THIS SITUATION IS ALSO APPLICABLE TO NEEDS ALSO APPLICABLE TO NEEDS ASSESSMENT PROCESS IN INDIA.ASSESSMENT PROCESS IN INDIA.

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NEEDS ASSESSMENT OF RCH NEEDS ASSESSMENT OF RCH CARE: CARE: CONCLUSION -CONTD.CONCLUSION -CONTD.

THE MINDSET OF THE HEALTH SERVICE PROVIDERS IS THE MINDSET OF THE HEALTH SERVICE PROVIDERS IS YET TO CHANGE TO EMBRACE THIS NOBLE SYSTEM. YET TO CHANGE TO EMBRACE THIS NOBLE SYSTEM. THE CONVENTIONAL SYSTEM OF IMPOSING TARGET THE CONVENTIONAL SYSTEM OF IMPOSING TARGET FROM THE HIGHER LEVEL AMONG THE STATE FROM THE HIGHER LEVEL AMONG THE STATE AUTHORITIES IS STILL PREVALENT IN MAJORITY OF AUTHORITIES IS STILL PREVALENT IN MAJORITY OF THE HEALTH PERSONNEL IN THE STATES. HOWEVER, THE HEALTH PERSONNEL IN THE STATES. HOWEVER, ABOUT 40% OF THE DISTRICT AUTHORITIES OF ABOUT 40% OF THE DISTRICT AUTHORITIES OF HEALTH & FW IN INDIA ARE GETTING ENGAGED IN HEALTH & FW IN INDIA ARE GETTING ENGAGED IN THEIS SYSTEM. IN RESPECT OF COMMUNITY THEIS SYSTEM. IN RESPECT OF COMMUNITY PARTICIPATION, ASSOCIATION OF PANCHAYAT IN THE PARTICIPATION, ASSOCIATION OF PANCHAYAT IN THE VILLAGES IS NOT IMPRESSIVE. HOWEVER, ANM’S VILLAGES IS NOT IMPRESSIVE. HOWEVER, ANM’S VISIT TO HOUSE AND THE COUPLES IN THE VILALGES VISIT TO HOUSE AND THE COUPLES IN THE VILALGES IS BEING DONE IN AN IMPRESSIVE MANNER.IS BEING DONE IN AN IMPRESSIVE MANNER.

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NEEDS ASSESSMENT OF RCH NEEDS ASSESSMENT OF RCH CARE: CARE: CONCLUSION -CONTD.CONCLUSION -CONTD.

HOWEVER, A GOOD NUMBER [OUT OF ABOUT HOWEVER, A GOOD NUMBER [OUT OF ABOUT 530 DISTRICTS] OF THE DISTRICT AUTHORITIES 530 DISTRICTS] OF THE DISTRICT AUTHORITIES OF HEALTH & FW IN INDIA ARE GETTING OF HEALTH & FW IN INDIA ARE GETTING ENGAGED IN THIS SYSTEM. IN RESPECT OF ENGAGED IN THIS SYSTEM. IN RESPECT OF COMMUNITY PARTICIPATION, ASSOCIATION OF COMMUNITY PARTICIPATION, ASSOCIATION OF PANCHAYAT[ A LOCAL ELECTED BODY IN THE PANCHAYAT[ A LOCAL ELECTED BODY IN THE VILLAGE] IN THE VILLAGES IS NOT IMPRESSIVE. VILLAGE] IN THE VILLAGES IS NOT IMPRESSIVE. HOWEVER, ANM’S VISIT TO HOUSES AND THE HOWEVER, ANM’S VISIT TO HOUSES AND THE COUPLES IN THE VILLAGES IS BEING DONE IN COUPLES IN THE VILLAGES IS BEING DONE IN AN IMPRESSIVE MANNER. AN IMPRESSIVE MANNER.

THANKSTHANKS