CHN-SPECIALIZED COMMUNITY HEALTH SERVICES-SYNPS-14-PHC

πŸ₯🌐 SPECIALIZED COMMUNITY HEALTH SERVICES

🧠 Important for NORCET, NHM, AIIMS, RRB, GPSC, ESIC & BSc/GNM Nursing Exams


πŸ”° What Are Specialized Community Health Services?

🧠 Specialized Community Health Services refer to focused healthcare programs designed to serve specific populations or health needs at the community level beyond general outpatient care.

They address targeted health issues like maternal health, occupational hazards, elderly care, mental health, school health, etc., and often work alongside primary health care and public health programs.


🧬 Key Specialized Health Services in India

🧩 Type🎯 Focus Area
1. MCH ServicesπŸ‘©β€πŸΌ Maternal & Child Health – Antenatal, postnatal, immunization
2. Family Planning ServicesπŸ‘¨β€πŸ‘©β€πŸ‘§ Spacing, permanent methods, contraceptive supply
3. School Health Services🏫 Screening, health education, immunization, mid-day meals
4. Occupational Health Services🏭 Worker safety, factory inspections, prevention of occupational diseases
5. Geriatric Health ServicesπŸ‘΅πŸ‘΄ Health & wellness of elderly, chronic disease management
6. Adolescent Health ServicesπŸ§‘β€βš•οΈ Anemia, menstruation, mental health, substance abuse
7. Mental Health Services🧠 Counseling, psychiatric care, suicide prevention
8. Rehabilitation Servicesβ™Ώ Physio, social & vocational rehab for disabled persons
9. HIV/AIDS Services (ART/NACO)πŸ§ͺ Testing, treatment, PMTCT, stigma reduction
10. Nutrition Services🍲 Supplementation, Poshan Abhiyaan, ICDS
11. Emergency/Disaster Services🚨 First aid, triage, referral during floods, epidemics, accidents
12. Mobile Medical Units (MMUs)🚐 Outreach in tribal, hilly, or remote areas
13. Tribal Health ServicesπŸ•οΈ Culture-sensitive care to indigenous populations
14. Health & Wellness Centres (HWCs)πŸ₯ NCD screening, physiotherapy, mental health, oral care
15. Adolescent Friendly Health Clinics (AFHCs)πŸ’¬ Counseling, menstrual hygiene, SRH
16. AYUSH Services🌿 Ayurveda, Yoga, Unani, Siddha, Homeopathy at PHC/CHC levels

🧠 Why Are Specialized Services Important?

βœ… Focus on vulnerable populations
βœ… Provide preventive and promotive care
βœ… Reduce hospital burden
βœ… Promote early diagnosis and community-based management
βœ… Support universal health coverage (UHC)


πŸ‘©β€βš•οΈ Nurse’s Role in Specialized Health Services

πŸ”Ή Screening and early identification
πŸ”Ή Community outreach and home visits
πŸ”Ή Health education and behavior change communication
πŸ”Ή Follow-up and referrals
πŸ”Ή Record keeping and reporting
πŸ”Ή Support to ASHA and Anganwadi workers


🧠 Golden MCQs for Quick Revision

βœ… Q1. Which program provides health services to workers exposed to occupational hazards?
πŸ…°οΈ Occupational Health Services

βœ… Q2. School Health Services include all EXCEPT β€”
πŸ…°οΈ Surgery (Correct Answer)

βœ… Q3. Services for disabled people include β€”
πŸ…°οΈ Rehabilitation services

βœ… Q4. Adolescent-friendly clinics primarily deal with β€”
πŸ…°οΈ Sexual & reproductive health, mental health

βœ… Q5. Which AYUSH systems are included in India’s specialized health services?
πŸ…°οΈ Ayurveda, Yoga, Unani, Siddha, Homeopathy

πŸ€°πŸ‘Ά MATERNAL AND CHILD HEALTH (MCH)

🧠 Essential for NHM, NORCET, RRB, AIIMS, GPSC, ESIC & Community Health Nursing Exams


πŸ”° Definition:

🧠 Maternal and Child Health (MCH) refers to the health services and care provided to women during pregnancy, childbirth, postpartum, and to infants and children up to adolescence β€” aimed at reducing mortality, morbidity, and malnutrition.


🎯 Objectives of MCH

βœ”οΈ Reduce Maternal Mortality Rate (MMR)
βœ”οΈ Reduce Infant Mortality Rate (IMR)
βœ”οΈ Improve nutritional and health status of women and children
βœ”οΈ Promote safe motherhood and child survival
βœ”οΈ Provide essential immunizations and health education


πŸ‘©β€πŸΌ MCH Services Include:

🀰 1. Maternal Health Services:

πŸ“Œ Stageβœ… Key Services
Antenatal (ANC)Early registration, 4 ANC check-ups, iron/folic acid, TT vaccine, dietary advice
IntranatalSkilled birth attendance, clean delivery, management of complications
Postnatal (PNC)Observation for 6 weeks, breastfeeding support, postnatal visits

πŸ‘Ά 2. Child Health Services:

πŸ‘Ά Age GroupπŸ“‹ Services
Neonates (0–28 days)Essential newborn care, thermal protection, early breastfeeding
Infants (0–1 year)Immunization (BCG, DPT, Polio, Hepatitis B), growth monitoring
Children (1–5 years)Vitamin A, deworming, nutrition counseling
School-going ChildrenSchool health check-ups, health education, mid-day meals

πŸ“Š Key MCH Indicators in India (2023)

πŸ“Œ IndicatorπŸ“ˆ Current Data (NFHS-5)
MMR~97 per 1,00,000 live births
IMR~28 per 1,000 live births
Institutional Deliveries~89%
Full ANC Coverage~58%
Exclusive Breastfeeding~64%
Child Immunization~76% fully immunized

πŸ›οΈ Major MCH Government Programs in India

πŸ“… Program🎯 Focus
RMNCH+AReproductive, Maternal, Newborn, Child & Adolescent Health
Janani Suraksha Yojana (JSY)Cash incentive for institutional delivery
Janani Shishu Suraksha Karyakram (JSSK)Free delivery, drugs, transport for pregnant women & sick newborns
Mission IndradhanushImmunization strengthening
POSHAN AbhiyaanMalnutrition reduction
RBSK (Rashtriya Bal Swasthya Karyakram)Screening for 4 Ds – Defects, Diseases, Deficiencies, Developmental delay
ICDS SchemeNutrition, preschool education for children <6 yrs

🧠 Nurse’s Role in MCH Services

πŸ‘©β€βš•οΈ Antenatal and postnatal care
πŸ‘Ά Immunization and growth monitoring
πŸ‘©β€πŸ« Health education to mothers
πŸ“‹ Record-keeping (MCP cards, immunization cards)
🩺 Early identification of danger signs in mother & child
🀝 Referral and follow-up services
πŸ§ƒ Promoting nutrition and breastfeeding


🧠 Golden MCQs for Practice

βœ… Q1. What is the full form of RMNCH+A?
πŸ…°οΈ Reproductive, Maternal, Newborn, Child, and Adolescent Health

βœ… Q2. Janani Suraksha Yojana offers cash incentives for β€”
πŸ…°οΈ Institutional delivery

βœ… Q3. At what age should a child receive the first dose of Vitamin A?
πŸ…°οΈ 9 months (with measles vaccine)

βœ… Q4. What is the normal period for exclusive breastfeeding?
πŸ…°οΈ First 6 months

βœ… Q5. Rashtriya Bal Swasthya Karyakram (RBSK) focuses on β€”
πŸ…°οΈ Early detection of 4 Ds in children

🀰🍼 RCH PROGRAMME – PHASE I & II (Reproductive and Child Health)

🧠 Important for NORCET, NHM, AIIMS, RRB, GPSC, ESIC & Community Health Nursing Exams


πŸ”° What is RCH?

🧠 RCH – Reproductive and Child Health Programme is a comprehensive health initiative launched by the Government of India under the National Health Mission (NHM) to improve the health status of women, newborns, and children through a life cycle approach.


πŸ“… RCH Phase I (Launched: 1997)

🎯 Objectives:

  • Ensure universal access to reproductive and child health services
  • Reduce Maternal Mortality Rate (MMR) and Infant Mortality Rate (IMR)
  • Improve access to contraception, safe delivery, and essential newborn care

🧰 Key Components of RCH Phase I:

πŸ”Ή Service Areaβœ… Activities
Maternal HealthAntenatal care, safe delivery, emergency obstetric care
Child HealthImmunization, control of ARI & diarrhea
Family PlanningAccess to spacing & permanent contraceptive methods
RTI/STI ManagementSyndromic management of reproductive tract infections
Adolescent Health (pilot)Health education & counseling
TrainingTraining of ANMs, LHVs, and medical officers

πŸ“… RCH Phase II (Launched: 2005)

πŸ‘‰ Merged with National Rural Health Mission (NRHM)

🎯 Objectives:

  • Reduce MMR to <100 per lakh live births
  • Reduce IMR to <30 per 1000 live births
  • Strengthen health infrastructure and service delivery
  • Promote client-centered, demand-driven services

🧰 Key Strategies of RCH Phase II:

πŸ› οΈ Component🎯 Focus Areas
Essential Obstetric & Newborn CareSkilled birth attendance, 48-hour stay post-delivery
Emergency Obstetric Care (EmOC)Availability of C-sections and blood transfusions
JSY (Janani Suraksha Yojana)Cash incentives for institutional delivery
JSSK (2011)Free delivery, medicines, diagnostics, transport
Home-based Newborn Care (HBNC)Postnatal care visits by ASHAs
Adolescent Reproductive & Sexual Health (ARSH)Education, menstrual hygiene, anemia control
RTI/STI ServicesDedicated clinics and syndromic management
RBSK (2013)Screening of 0–18 years for 4Ds
Logistics ManagementEnsuring supply of IFA, vaccines, contraceptives

πŸ“Š Targets Achieved Under RCH

πŸ“Œ IndicatorπŸ“ˆ Progress (NFHS-5)
MMRReduced to ~97/100,000 live births
IMRReduced to ~28/1000 live births
Institutional DeliveryIncreased to ~89%
Contraceptive Use~56% modern method usage
Immunization Coverage~76% full immunization

πŸ‘©β€βš•οΈ Nurse’s Role in RCH Program

βœ… ANC and PNC care
βœ… Immunization & HBNC visits
βœ… Growth monitoring & counseling
βœ… RTI/STI education and screening
βœ… Maintain records (MCP card, JSY reports)
βœ… Refer high-risk cases promptly
βœ… Support ASHA & Anganwadi workers


🧠 Top MCQs for Practice

βœ… Q1. When was RCH Phase I launched?
πŸ…°οΈ 1997

βœ… Q2. Which program offers cash incentive to promote institutional delivery?
πŸ…°οΈ Janani Suraksha Yojana (JSY)

βœ… Q3. RCH Phase II merged with which national initiative?
πŸ…°οΈ National Rural Health Mission (NRHM)

βœ… Q4. Which RCH component promotes postnatal home care by ASHAs?
πŸ…°οΈ Home-based Newborn Care (HBNC)

βœ… Q5. What does RBSK under RCH screen for?
πŸ…°οΈ 4Ds – Defects, Diseases, Deficiencies, Developmental delay

πŸ€°πŸΌπŸ‘§ RMNCH+A Strategy

(Reproductive, Maternal, Newborn, Child + Adolescent Health)
🧠 Vital for NORCET, NHM, RRB, GPSC, ESIC, BSc/GNM Nursing & CHN Exams


πŸ”° Introduction:

🧠 RMNCH+A is a comprehensive and integrated health strategy launched by the Ministry of Health & Family Welfare, Government of India in 2013 to improve the survival and health of mothers, newborns, children, and adolescents using a “continuum of care” approach.


🧩 Meaning of RMNCH+A:

πŸ”  LetterπŸ‘ΆπŸ‘© Represents
RReproductive health (family planning, RTI/STI)
MMaternal health (ANC, delivery, PNC)
NNewborn health (immediate care, HBNC)
CChild health (immunization, nutrition, illnesses)
AAdolescent health (anemia, menstrual hygiene, counseling)

🎯 Objectives of RMNCH+A:

βœ”οΈ Reduce Maternal Mortality Rate (MMR)
βœ”οΈ Reduce Infant Mortality Rate (IMR)
βœ”οΈ Reduce Under-5 Mortality Rate (U5MR)
βœ”οΈ Improve contraceptive usage & spacing
βœ”οΈ Enhance adolescent health awareness & services
βœ”οΈ Strengthen service delivery at all levels – from home to facility


πŸ“Š Key Indicators (NFHS-5 & MoHFW 2023)

πŸ“Œ IndicatorπŸ“ˆ Latest Status
MMR~97/100,000 live births
IMR~28/1000 live births
Institutional Deliveries~89%
Child Immunization~76%
Adolescent Anemia~40–50% prevalence

πŸ› οΈ Key Components & Interventions Under RMNCH+A

1️⃣ Reproductive Health

  • Family planning (IUCDs, OCPs, injectables)
  • RTI/STI clinics (Designated STI/RTI Clinics – Suraksha Clinics)
  • Pre-marital & pre-conception counseling

2️⃣ Maternal Health

  • Janani Suraksha Yojana (JSY) – cash for institutional delivery
  • Janani Shishu Suraksha Karyakram (JSSK) – free transport & care
  • Skilled Birth Attendance (SBA)
  • Management of obstetric emergencies (BEmOC & CEmOC)

3️⃣ Newborn Health

  • Essential Newborn Care (ENBC)
  • Home-Based Newborn Care (HBNC)
  • Facility-Based Newborn Care (FBNC), SNCUs, NBSUs
  • Immediate breastfeeding, thermal protection, cord care

4️⃣ Child Health

  • Immunization (UIP & Mission Indradhanush)
  • Diarrhea, ARI, malnutrition management
  • Vitamin A, deworming, ORS + Zinc

5️⃣ Adolescent Health

  • Rashtriya Kishor Swasthya Karyakram (RKSK)
  • Weekly Iron & Folic Acid Supplementation (WIFS)
  • Menstrual Hygiene Scheme (MHS)
  • Adolescent Friendly Health Clinics (AFHCs)

πŸ₯ Continuum of Care – 3 Dimensions of RMNCH+A

πŸ”— ContinuumπŸ“ Focus
1. Life StageFrom adolescence β†’ pregnancy β†’ childbirth β†’ child
2. Place of CareHome β†’ Community β†’ Health Facility
3. Level of CarePrimary β†’ Secondary β†’ Tertiary

πŸ‘©β€βš•οΈ Role of Nurse in RMNCH+A

βœ… ANC and PNC services
βœ… Conducting deliveries and newborn care
βœ… Immunization and growth monitoring
βœ… Health education to mothers and adolescents
βœ… Counseling on contraception
βœ… Home visits (HBNC, HBCC)
βœ… Record-keeping (MCP cards, RCH registers)


🧠 Top 5 MCQs for Quick Revision

βœ… Q1. When was RMNCH+A strategy launched?
πŸ…°οΈ 2013

βœ… Q2. What does β€˜A’ in RMNCH+A stand for?
πŸ…°οΈ Adolescent Health

βœ… Q3. Which program offers Weekly IFA tablets to adolescents?
πŸ…°οΈ WIFS (Weekly Iron and Folic Acid Supplementation)

βœ… Q4. What type of care does HBNC offer?
πŸ…°οΈ Home-based newborn care through ASHAs

βœ… Q5. Which scheme ensures free care for mother and child up to 1 year?
πŸ…°οΈ JSSK – Janani Shishu Suraksha Karyakram

πŸ‘©β€πŸΌπŸ’° Janani Suraksha Yojana (JSY)

🧠 Important for NORCET, NHM, AIIMS, GPSC, RRB, BSc/GNM Nursing & CHN Exams


πŸ”° Introduction:

Janani Suraksha Yojana (JSY) is a safe motherhood intervention under the National Health Mission (NHM), launched on 12th April 2005 by the Ministry of Health & Family Welfare, Government of India.

🎯 Goal:

To reduce maternal and neonatal mortality by promoting institutional delivery among poor pregnant women, especially in rural and underserved areas.


πŸ‘©β€πŸ‘§β€πŸ‘¦ Key Objectives of JSY:

βœ”οΈ Promote institutional deliveries
βœ”οΈ Ensure skilled birth attendance
βœ”οΈ Reduce Maternal Mortality Rate (MMR)
βœ”οΈ Reduce Infant Mortality Rate (IMR)
βœ”οΈ Enhance access to maternal care services for Below Poverty Line (BPL) women


πŸ“ Target Beneficiaries:

πŸ‘©β€βš•οΈ Eligible women include:

  • BPL and Scheduled Caste/Scheduled Tribe (SC/ST) women
  • Pregnant women aged 19 years and above
  • Up to 2 live births only
  • Institutional deliveries in Government or Accredited Private Facilities

πŸ›οΈ Classification of States:

JSY provides different incentive amounts based on state performance.

πŸ—ΊοΈ State TypeπŸ“ Examples
Low-Performing States (LPS)Bihar, UP, MP, Rajasthan, Jharkhand, Odisha, Chhattisgarh, Assam, J&K
High-Performing States (HPS)Kerala, Tamil Nadu, Maharashtra, Gujarat, etc.

πŸ’° Cash Assistance Details:

πŸ‘©β€βš•οΈ BeneficiaryπŸ₯ LPS – RuralπŸ™οΈ LPS – UrbanπŸ₯ HPS – RuralπŸ™οΈ HPS – Urban
Motherβ‚Ή1400β‚Ή1000β‚Ή700β‚Ή600
ASHA Workerβ‚Ή600β‚Ή200β‚Ή600*β‚Ή400*

πŸ“ *ASHA incentives are subject to performance and delivery of services.


🩺 Essential Services Covered Under JSY:

  • Free institutional delivery
  • Free drugs and consumables
  • Free diagnostics
  • Free blood transfusion (if required)
  • Free transport to and from health facility
  • Diet during hospital stay

πŸ”— Linkages with Other Programs:

πŸ”Ή JSSK (2011) – Janani Shishu Suraksha Karyakram provides completely free care to mother and child
πŸ”Ή RMNCH+A – JSY is a core part of maternal health strategy
πŸ”Ή Home-Based Newborn Care (HBNC) – Postnatal follow-ups by ASHA


πŸ‘©β€βš•οΈ Role of Nurses and ASHA Workers:

βœ… Motivate for early registration and ANC checkups
βœ… Identify and track high-risk pregnancies
βœ… Encourage institutional delivery
βœ… Accompany mother to facility
βœ… Postnatal visits and newborn care
βœ… Maintain JSY records and reporting


🧠 Top 5 MCQs for Revision

βœ… Q1. In which year was JSY launched?
πŸ…°οΈ 2005

βœ… Q2. Who is the key link worker in JSY implementation?
πŸ…°οΈ ASHA

βœ… Q3. What is the cash benefit for a rural woman in LPS under JSY?
πŸ…°οΈ β‚Ή1400

βœ… Q4. JSY is part of which larger health mission?
πŸ…°οΈ National Health Mission (NHM)

βœ… Q5. How many live births are eligible under JSY benefits?
πŸ…°οΈ Up to 2 live births

πŸΌπŸš‘ Janani Shishu Suraksha Karyakram (JSSK)

🧠 Essential for NORCET, NHM, AIIMS, GPSC, RRB, ESIC & Community Health Nursing Exams


πŸ”° Introduction:

JSSK stands for Janani Shishu Suraksha Karyakram, a scheme launched on 1st June 2011 under the National Health Mission (NHM) by the Ministry of Health & Family Welfare, Govt. of India.

🎯 Goal:
To eliminate out-of-pocket expenses for pregnant women and sick newborns by providing free and cashless services in public health facilities.


🎯 Objectives of JSSK

βœ”οΈ Reduce maternal and infant mortality
βœ”οΈ Promote institutional deliveries
βœ”οΈ Improve access to quality healthcare
βœ”οΈ Provide completely free care for both mother and child


πŸ‘©β€πŸΌπŸ‘Ά Eligible Beneficiaries

βœ… All pregnant women delivering in public health facilities
βœ… All sick newborns (0–30 days) including home-delivered ones
βœ… Sick infants (up to 1 year) – expanded later
βœ… No conditions on age, number of children, or income


🧰 Key Entitlements Under JSSK

🚺 For Pregnant Women:

βœ… ServiceπŸ’― Free & Cashless
πŸ‘©β€βš•οΈ Normal & C-section deliveryYes
πŸ’Š Drugs & ConsumablesYes
πŸ§ͺ Diagnostics (blood, urine, USG)Yes
πŸ’‰ Blood transfusionYes
πŸ›οΈ Diet during stayYes (3 days for normal, 7 for C-section)
πŸš‘ TransportHome β†’ Facility β†’ Home + Referrals

πŸ‘Ά For Sick Newborns (0–30 days) & Infants:

βœ… ServiceπŸ’― Free & Cashless
πŸ₯ Treatment & AdmissionYes
πŸ’Š Drugs & ConsumablesYes
πŸ§ͺ Lab investigationsYes
πŸ’‰ Blood transfusion (if needed)Yes
πŸš‘ Free transportFacility-to-facility + discharge to home

πŸ“ Implementation Level:

πŸ₯ Services are available at PHC, CHC, District Hospitals, and Medical Colleges.

🧾 Monitoring via JSY–JSSK registers, ANM reports, and tracking through Mother-Child Protection (MCP) card.


πŸ‘©β€βš•οΈ Role of Nurse/ANM/ASHA:

βœ… Identify and motivate eligible mothers
βœ… Assist in transport arrangement
βœ… Provide delivery & postnatal care
βœ… Counsel about newborn danger signs
βœ… Educate about availability of JSSK entitlements
βœ… Maintain records and refer complicated cases


πŸ“ˆ Impact of JSSK (as per NHM data):

πŸ”Ή Increased institutional deliveries
πŸ”Ή Reduced financial burden on poor families
πŸ”Ή Improved neonatal and maternal outcomes
πŸ”Ή Strengthened public trust in govt. facilities


🧠 Top 5 MCQs for Practice

βœ… Q1. In which year was JSSK launched?
πŸ…°οΈ 2011

βœ… Q2. Which group gets completely free transport under JSSK?
πŸ…°οΈ Pregnant women & sick newborns

βœ… Q3. How long is the hospital stay covered under JSSK for a C-section?
πŸ…°οΈ 7 days

βœ… Q4. What age group of children are eligible under JSSK?
πŸ…°οΈ 0 to 1 year (initially 0–30 days)

βœ… Q5. Does JSSK cover diagnostics like blood tests and USG?
πŸ…°οΈ Yes – fully free

πŸŒŸπŸ§’ Mission Indradhanush

🧠 Important for NHM, NORCET, AIIMS, GPSC, RRB, ESIC & BSc/GNM Nursing Exams


πŸ”° Introduction:

🧠 Mission Indradhanush (MI) is a flagship immunization initiative launched by the Ministry of Health & Family Welfare, Government of India on 25th December 2014 under the National Health Mission (NHM).

🎯 Goal:

To achieve >90% full immunization coverage among children and pregnant women in India by targeting left-out and dropout populations.


🧩 Why the Name β€œIndradhanush”?

🌈 β€œIndradhanush” means Rainbow, symbolizing the 7 essential vaccines included in India’s Universal Immunization Programme (UIP).


🧬 Key Objectives:

βœ”οΈ Immunize all children under 2 years & pregnant women
βœ”οΈ Focus on underserved, high-risk, and low-coverage areas
βœ”οΈ Reduce morbidity and mortality from vaccine-preventable diseases
βœ”οΈ Strengthen routine immunization systems


πŸ“‹ Vaccines Under UIP (7 Traditional Vaccines):

πŸ’‰ Disease PreventedπŸ’Š Vaccine
TuberculosisBCG
Diphtheria, Pertussis, TetanusDPT
PolioOPV/IPV
MeaslesMeasles/MR
Hepatitis BHepatitis B vaccine
Haemophilus influenzae type BHib (as Pentavalent)
Tetanus (for mothers)TT/TD

πŸ†• Also includes:
– Rotavirus
– Pneumococcal Conjugate Vaccine (PCV)
– Japanese Encephalitis (JE) in endemic areas
– COVID-19 (for special campaigns)


πŸ“… Phases of Mission Indradhanush:

πŸ—“οΈ PhaseπŸ”Ž Key Features
Phase I (2015)201 districts with <50% coverage
Phase II (2015)352 more districts added
Phase III & IV (2016–17)Urban slums, tribal areas
Intensified MI (2017)Focus on 173 districts & 17 urban areas
IMI 2.0 (2019)Focused micro-planning in 272 districts
IMI 3.0 (2021)Integration with COVID-19 vaccination
IMI 5.0 (2023)Tech-based tracking, real-time monitoring

πŸ“ Special Focus Areas:

πŸ”Ή Urban slums
πŸ”Ή Remote/tribal areas
πŸ”Ή Conflict zones
πŸ”Ή Migratory population
πŸ”Ή Left-out/dropout children


πŸ‘©β€βš•οΈ Role of Nurses & ASHAs in Mission Indradhanush:

βœ… House-to-house surveys
βœ… Tracking due and missed children
βœ… Counseling parents
βœ… Immunization session planning
βœ… Record-keeping (MCP card, eVIN)
βœ… AEFI monitoring and follow-up


🧠 Top MCQs for Practice

βœ… Q1. When was Mission Indradhanush launched?
πŸ…°οΈ 25th December 2014

βœ… Q2. What is the target immunization coverage under MI?
πŸ…°οΈ More than 90%

βœ… Q3. What does “Indradhanush” represent?
πŸ…°οΈ 7 vaccines of the UIP

βœ… Q4. Which mobile app/digital tool supports vaccine tracking in MI?
πŸ…°οΈ eVIN (Electronic Vaccine Intelligence Network)

βœ… Q5. Who are the main field workers for MI success?
πŸ…°οΈ ASHAs, ANMs, and AWWs

🌾🍽️ POSHAN Abhiyaan

(Prime Minister’s Overarching Scheme for Holistic Nutrition)
🧠 Important for NORCET, NHM, GPSC, RRB, AIIMS, ESIC & Community Health Nursing Exams


πŸ”° Introduction:

POSHAN Abhiyaan was launched on 8th March 2018 by the Ministry of Women & Child Development (MWCD).

🎯 Main Goal:

To reduce malnutrition among children, pregnant women, and lactating mothers through a convergent, technology-driven, and community-based approach.


🌟 Key Objectives of POSHAN Abhiyaan:

βœ”οΈ Reduce stunting among children (0–6 years)
βœ”οΈ Reduce underweight children
βœ”οΈ Reduce anemia among children, women & adolescent girls
βœ”οΈ Improve nutritional status through behavioral change and community participation


πŸ“Š Targets to be Achieved by 2022 (Phase I):

🎯 IndicatorπŸ“‰ Annual Reduction Target
Stunting (under-5)↓ 2% per year
Underweight (under-5)↓ 2% per year
Low birth weight↓ 2% per year
Anemia (adolescent girls, women, children)↓ 3% per year

🧩 Key Features of POSHAN Abhiyaan:

🧠 Featureβœ… Explanation
πŸ“² Use of TechnologyICDS-CAS mobile app for real-time monitoring
🀝 ConvergenceIntegration of MWCD, MoHFW, MoRD, MHRD, MoW
πŸ‘©β€πŸ« Behavior Change CommunicationPoshan Maah, rallies, competitions, IEC material
🎯 Focus on First 1000 DaysPregnancy to age 2 – critical for development
πŸ—ƒοΈ Growth MonitoringUse of MCP cards, MUAC tapes, and digitized records
πŸ‘₯ Jan Andolan (People’s Movement)Community participation and awareness campaigns

πŸ“ Priority Beneficiaries:

πŸ‘Ά Children (0–6 years)
🀰 Pregnant Women
🀱 Lactating Mothers
πŸ‘§ Adolescent Girls


πŸ“… Special Campaigns Under POSHAN:

1️⃣ Rashtriya Poshan Maah (September)

  • Month-long national campaign for nutrition awareness

2️⃣ Rashtriya Poshan Pakhwada (March)

  • 15-day focused drive on nutrition-related activities

πŸ‘©β€βš•οΈ Role of Nurses, ANMs, AWWs & ASHAs:

βœ… Growth monitoring & nutritional counseling
βœ… Track high-risk pregnancies and undernourished children
βœ… Provide Iron-Folic Acid (IFA), deworming tablets
βœ… Conduct home visits and Poshan sessions
βœ… Record & report via ICDS-CAS
βœ… Mobilize community during Poshan Maah events


🧠 Top 5 MCQs for Practice

βœ… Q1. When was POSHAN Abhiyaan launched?
πŸ…°οΈ 8th March 2018

βœ… Q2. What does POSHAN stand for?
πŸ…°οΈ Prime Minister’s Overarching Scheme for Holistic Nutrition

βœ… Q3. What is the annual reduction target for stunting under POSHAN?
πŸ…°οΈ 2% per year

βœ… Q4. Which digital app supports real-time data in POSHAN Abhiyaan?
πŸ…°οΈ ICDS-CAS

βœ… Q5. POSHAN Abhiyaan focuses mainly on which β€œwindow of opportunity”?
πŸ…°οΈ First 1000 days (pregnancy to 2 years)

πŸ§’πŸ©Ί RBSK – Rashtriya Bal Swasthya Karyakram

🧠 Important for NHM, NORCET, RRB, AIIMS, GPSC, ESIC & Community Health Nursing Exams


πŸ”° Introduction:

RBSK was launched in 2013 under the National Health Mission (NHM) by the Ministry of Health & Family Welfare (MoHFW).

🎯 Goal:

Early identification and free management of 4Ds in children:
πŸ”Ή Defects at birth
πŸ”Ή Diseases
πŸ”Ή Deficiencies
πŸ”Ή Developmental delays (including disabilities)


πŸ‘Ά Target Population & Age Groups:

🎯 GroupπŸ§’ Age Range
Children in anganwadis0 – 6 years
School children (Govt./Govt-aided)6 – 18 years
Special schools & institutionsAll age groups under 18 years

πŸ”Ή Estimated to cover ~27 crore (270 million) children across India


🧬 Conditions Covered Under 4Ds:

βœ… 1. Defects at Birth (10 conditions)

Examples:

  • Neural tube defects
  • Cleft lip/palate
  • Clubfoot
  • Congenital cataract
  • Down syndrome

βœ… 2. Diseases (4 common diseases)

  • Skin conditions
  • Otitis media
  • Rheumatic heart disease
  • Reactive airway disease (asthma)

βœ… 3. Deficiencies (5 key deficiencies)

  • Iron Deficiency Anemia
  • Vitamin A deficiency
  • Malnutrition
  • Iodine deficiency disorders
  • Dental caries

βœ… 4. Developmental Delays & Disabilities (12 categories)

  • Hearing loss
  • Vision problems
  • Autism
  • Cerebral palsy
  • Learning disability
  • Behavioral disorders

🧰 Service Delivery Under RBSK:

πŸ”Ή TypeπŸ”§ Details
Mobile Health Teams2 per block (doctor + ANM + pharmacist + ASHA)
Screening LocationsAnganwadi centers, government schools, residential schools
Facility-based careDistrict Early Intervention Centres (DEICs)

πŸ₯ District Early Intervention Centre (DEIC):

  • Located at District Hospital
  • Manages children referred from screening
  • Provides early diagnosis, interventions, rehabilitation & referrals
  • Includes: pediatrician, physiotherapist, psychologist, speech therapist, optometrist

πŸ‘©β€βš•οΈ Role of Nurses/ANMs/ASHAs in RBSK:

βœ… Assist in school/anganwadi screening
βœ… Mobilize children and parents
βœ… Refer children to DEIC
βœ… Maintain health records and reports
βœ… Educate families on growth & development
βœ… Monitor children with special needs


🧠 Top 5 MCQs for Practice

βœ… Q1. When was RBSK launched?
πŸ…°οΈ 2013

βœ… Q2. What do the 4Ds in RBSK stand for?
πŸ…°οΈ Defects at birth, Diseases, Deficiencies, Developmental delays

βœ… Q3. What is the age group covered under RBSK?
πŸ…°οΈ 0–18 years

βœ… Q4. Which center provides advanced care under RBSK?
πŸ…°οΈ District Early Intervention Centre (DEIC)

βœ… Q5. Who are members of the RBSK Mobile Health Team?
πŸ…°οΈ Doctor, ANM, Pharmacist, ASHA

🧺🍲 ICDS Scheme – Integrated Child Development Services

🧠 Essential for NHM, NORCET, RRB, GPSC, BSc/GNM Nursing & Community Health Exams


πŸ”° Introduction:

Integrated Child Development Services (ICDS) is one of the world’s largest early childhood care programs, launched by the Government of India on October 2, 1975 under the Ministry of Women and Child Development (MoWCD).

🎯 Goal:

To provide holistic development of children (0–6 years) and pregnant/lactating mothers through health, nutrition, and pre-school education.


πŸ‘ΆπŸ‘©β€πŸΌ Target Beneficiaries:

βœ… Children: 0–6 years
βœ… Pregnant women 🀰
βœ… Lactating mothers 🀱
βœ… Adolescent girls (under SABLA scheme)
βœ… Women (especially from low-income and rural areas)


🧩 Key Services Under ICDS:

🧺 Serviceβœ… Details
🍚 Supplementary NutritionFree food (hot cooked meals or take-home ration)
πŸ“š Non-formal Preschool EducationFor children 3–6 years at anganwadi centers
🩺 ImmunizationWith MoHFW support (BCG, DPT, OPV, Measles)
βš•οΈ Health Check-upsGrowth monitoring, screening, ANC/PNC check-ups
🩹 Referral ServicesFor severely malnourished, sick or special-needs children
🧠 Nutrition & Health EducationFor mothers on breastfeeding, weaning, hygiene, family planning

🏠 Anganwadi Centers (AWC):

βœ”οΈ Backbone of ICDS
βœ”οΈ 1 AWC per 1000 population (700 in tribal areas)
βœ”οΈ Staffed by:

  • Anganwadi Worker (AWW) – Key service provider
  • Anganwadi Helper (AWH) – Assists in cooking & cleaning
  • Support from ASHA, ANM, and community workers

πŸ“ˆ ICDS Special Initiatives:

πŸ“Œ Scheme🎯 Focus
POSHAN AbhiyaanConvergence platform for nutrition improvement
SABLA SchemeFor adolescent girls – nutrition, life skills
VHSNDsVillage Health Sanitation and Nutrition Days
THR ProgramTake-Home Ration distribution to children & mothers

🧠 Role of ANM/Nurse in ICDS:

βœ… Support immunization and health check-ups
βœ… Refer high-risk children and pregnant women
βœ… Participate in nutrition counseling
βœ… Maintain records with AWW
βœ… Assist during VHSNDs and Poshan Maah activities


🧠 Top 5 MCQs for Practice

βœ… Q1. When was the ICDS scheme launched?
πŸ…°οΈ October 2, 1975

βœ… Q2. Who is the key worker in an Anganwadi center?
πŸ…°οΈ Anganwadi Worker (AWW)

βœ… Q3. What is the age group for non-formal preschool education under ICDS?
πŸ…°οΈ 3 to 6 years

βœ… Q4. What does THR stand for in ICDS?
πŸ…°οΈ Take-Home Ration

βœ… Q5. What is the main aim of POSHAN Abhiyaan under ICDS?
πŸ…°οΈ Holistic nutrition improvement of women and children

🌸🍽️ SABLA Scheme, VHSNDs, and THR Program

🧠 Important for NHM, NORCET, RRB, GPSC, BSc/GNM Nursing & CHN Exams


🌸 1️⃣ SABLA Scheme – Rajiv Gandhi Scheme for Empowerment of Adolescent Girls

πŸ”° Launched: 2010

πŸ›οΈ By: Ministry of Women and Child Development (MWCD)

🎯 Objectives:

βœ”οΈ Improve nutrition and health status of adolescent girls (11–18 yrs)
βœ”οΈ Provide life skills, health education, and vocational training
βœ”οΈ Promote awareness about family welfare, menstrual hygiene, and reproductive health


πŸ‘§ Target Group:

  • Out-of-school adolescent girls aged 11 to 18 years
  • In-school girls receive services through school health programs

🧺 Key Services Provided:

πŸ”Ή CategoryπŸ“Œ Details
πŸ› Nutrition SupportTake-Home Ration (THR) or hot cooked meals
πŸ“˜ Non-NutritionLife skills education, IFA tablets, health check-ups
πŸ‘©β€πŸ« Vocational SkillsTraining for older girls (16–18 years)
🩸 Menstrual HygieneDistribution of sanitary napkins + awareness

πŸ‘©β€βš•οΈ Role of AWW & Health Workers in SABLA:

  • Distribute THR, IFA, sanitary napkins
  • Conduct life skills and health sessions
  • Maintain weight/height records
  • Refer malnourished or anemic girls to PHC/CHC

🌿 2️⃣ VHSND – Village Health, Sanitation & Nutrition Day

πŸ”° Purpose: Monthly community outreach session to deliver MCH + Nutrition + WASH services at the village level

πŸ—“οΈ When? Once every month, usually on Wednesdays


πŸ‘¨β€πŸ‘©β€πŸ‘§ Key Services During VHSND:

βœ… Provided By🧰 Services
ANM, ASHA, AWW
🍼 ImmunizationBCG, OPV, DPT, MR, Hep B, PCV
πŸ“ Growth MonitoringHeight, weight, MUAC
πŸ’Š IFA & DewormingFor children, adolescents, pregnant women
πŸ“š Health EducationHandwashing, breastfeeding, family planning
πŸ“ Pregnancy TrackingANC/PNC follow-up, MCP card updates

🎯 Objective:

β€œConvergence of health and nutrition at grassroots level” through community mobilization.


🍱 3️⃣ THR – Take Home Ration Program

πŸ”° What is THR?

THR is part of the ICDS Scheme, where nutritious food supplements are provided in pre-packed or raw form to beneficiaries at home.


πŸ§’ Beneficiaries of THR:

πŸ‘₯ GroupπŸ₯£ THR Provided
Children (6–36 months)Energy-dense food
Pregnant WomenProtein-rich supplements
Lactating MothersMicronutrient-enriched food
Adolescent Girls (SABLA)Fortified cereals, IFA

πŸ“Œ Advantages of THR:

βœ… Convenient for families
βœ… Improves regularity of intake
βœ… Reduces undernutrition
βœ… Encourages household-level nutrition awareness


🧠 Top 5 MCQs for Quick Revision

βœ… Q1. What is the age group targeted under SABLA scheme?
πŸ…°οΈ 11–18 years (adolescent girls)

βœ… Q2. What does VHSND stand for?
πŸ…°οΈ Village Health, Sanitation & Nutrition Day

βœ… Q3. Which program distributes sanitary pads to adolescent girls?
πŸ…°οΈ SABLA Scheme

βœ… Q4. THR is provided under which major program?
πŸ…°οΈ ICDS (Integrated Child Development Services)

βœ… Q5. How often is VHSND organized?
πŸ…°οΈ Once a month (usually Wednesday)

🍼🍽️ IYCF – Infant and Young Child Feeding

🧠 Important for NHM, NORCET, AIIMS, GPSC, RRB, BSc/GNM Nursing & Community Health Nursing Exams


πŸ”° What is IYCF?

IYCF refers to the optimal feeding practices for infants (0–12 months) and young children (up to 2 years) to ensure survival, growth, and development.

🧠 It is a global strategy endorsed by WHO & UNICEF and implemented in India under NHM.


🎯 Objectives of IYCF:

βœ”οΈ Promote exclusive breastfeeding for the first 6 months
βœ”οΈ Ensure timely, adequate complementary feeding
βœ”οΈ Reduce infant mortality, malnutrition, and infections
βœ”οΈ Educate mothers & caregivers on proper feeding habits


πŸ“… IYCF Core Practices

πŸ‘Ά Age Group🍽️ Recommended Feeding Practice
Birth to 1 hourInitiate breastfeeding within 1 hour of birth
0 to 6 monthsExclusive breastfeeding – NO water, formula, food
6 to 24 monthsContinue breastfeeding + start complementary feeding
After 24 monthsGradual weaning; continue healthy family diet

🍼 Exclusive Breastfeeding (EBF)

πŸ”Ή Only mother’s milk – no water, honey, sugar, or formula
πŸ”Ή Supplies all nutrients, hydration & immune protection
πŸ”Ή Reduces risks of diarrhea, pneumonia, and neonatal death


🍲 Complementary Feeding (6–24 months)

πŸ”Ή Start at 6 months with semi-solid, mashed food
πŸ”Ή Give small, frequent meals (2–3 times/day β†’ 5–6 times/day)
πŸ”Ή Continue breastfeeding up to 2 years
πŸ”Ή Include energy-dense, diverse foods (grains, pulses, vegetables, fruits, eggs)
πŸ”Ή Ensure responsive feeding (feed actively, encourage child)


πŸ§ƒ Micronutrient Support Under IYCF

  • Iron–Folic Acid syrup
  • Vitamin A supplementation
  • Deworming after 12 months
  • Zinc with ORS for diarrhea

πŸ‘©β€βš•οΈ Role of Nurse/ANM/AWW in IYCF:

βœ… Counsel mothers during ANC & PNC visits
βœ… Support early initiation of breastfeeding
βœ… Educate about correct complementary feeding
βœ… Identify feeding problems/malnutrition
βœ… Demonstrate hygiene in food preparation
βœ… Monitor weight gain and growth


πŸ“Œ Related Initiatives in India:

πŸ›οΈ Program🎯 Purpose
MAA ProgrammeMothers’ Absolute Affection – promote breastfeeding
POSHAN AbhiyaanImprove nutrition & support IYCF practices
VHSNDsNutrition & IYCF counseling at village level
ICDS ProgramGrowth monitoring & THR distribution

🧠 Top MCQs for Quick Revision

βœ… Q1. What does IYCF stand for?
πŸ…°οΈ Infant and Young Child Feeding

βœ… Q2. At what age should complementary feeding begin?
πŸ…°οΈ 6 months

βœ… Q3. Up to what age is exclusive breastfeeding recommended?
πŸ…°οΈ 6 months

βœ… Q4. Which program promotes breastfeeding through MAA campaign?
πŸ…°οΈ NHM (National Health Mission)

βœ… Q5. Which vitamin is supplemented every 6 months from 9 months?
πŸ…°οΈ Vitamin A

πŸŒΈπŸ‘©β€πŸΌ MAA Campaign – Mothers’ Absolute Affection

🧠 Essential for NHM, NORCET, GPSC, RRB, AIIMS, ESIC & Community Health Nursing Exams


πŸ”° Introduction:

MAA – Mothers’ Absolute Affection is a nationwide breastfeeding promotion initiative launched in August 2016 by the Ministry of Health & Family Welfare (MoHFW), Government of India.

🎯 Goal:
To enhance breastfeeding practices through mass awareness, counseling, and community involvement under National Health Mission (NHM).


🎯 Objectives of MAA:

βœ”οΈ Promote early initiation of breastfeeding within 1 hour of birth
βœ”οΈ Ensure exclusive breastfeeding for 6 months
βœ”οΈ Promote continued breastfeeding up to 2 years or beyond
βœ”οΈ Educate mothers, caregivers, and health staff
βœ”οΈ Establish lactation support systems at community and facility levels


πŸ“Œ Key Features of the MAA Programme:

🧩 ComponentπŸ“‹ Description
πŸ—£οΈ IEC/BCC ActivitiesPosters, media, street plays, audio-visual content
πŸ‘©β€βš•οΈ Capacity BuildingTraining of ANMs, ASHAs, nurses, and medical officers
πŸ›οΈ Lactation Support ServicesEstablish Breastfeeding Corners, Lactation Management Centres
πŸ₯ Facility-based CounselingIYCF counseling during ANC/PNC visits and delivery
πŸ‘₯ Community EngagementMother support groups, SHGs, community meetings

🍼 Core Breastfeeding Messages by MAA:

πŸ”Ή Start breastfeeding within 1 hour of birth
πŸ”Ή Feed only breast milk for 6 months (no water, honey, etc.)
πŸ”Ή Continue breastfeeding up to 2 years or more
πŸ”Ή Feed on demand, day and night
πŸ”Ή No use of bottles, formula, or pacifiers


🧠 Benefits of Breastfeeding (Promoted via MAA):

πŸ‘Ά For Baby🀱 For Mother
Protects from infections (e.g., diarrhea, pneumonia)Reduces risk of breast & ovarian cancer
Enhances brain developmentHelps in uterine involution
Ensures proper growth & nutritionDelays return of menstruation
Reduces risk of obesity & diabetesEmotional bonding with baby

πŸ‘©β€βš•οΈ Role of Nurses, ANMs & ASHAs:

βœ… Counsel mothers during ANC, delivery & PNC
βœ… Monitor and support early initiation of breastfeeding
βœ… Identify and manage breastfeeding problems
βœ… Demonstrate proper positioning and latching techniques
βœ… Encourage skin-to-skin contact (Kangaroo Care)
βœ… Refer to Lactation Management Centres if needed


🧠 Top 5 MCQs for Quick Revision

βœ… Q1. What does MAA stand for?
πŸ…°οΈ Mothers’ Absolute Affection

βœ… Q2. When was the MAA campaign launched?
πŸ…°οΈ August 2016

βœ… Q3. Under which mission is MAA implemented?
πŸ…°οΈ National Health Mission (NHM)

βœ… Q4. How long should exclusive breastfeeding be continued?
πŸ…°οΈ First 6 months

βœ… Q5. Who are key frontline workers under MAA?
πŸ…°οΈ ANMs, ASHAs, and nurses

πŸ‘©β€βš•οΈπŸš‘ Mamta Sakhi & Mamta Doli Initiatives

🧠 Highly important for NHM, GPSC, RRB, Community Health Nursing & NORCET Exams (especially Odisha & tribal areas)


🌸 1️⃣ Mamta Sakhi – Community Birth Companion Program

πŸ”° Launched by:

National Health Mission (NHM), Odisha

🎯 Objective:

To ensure safe, respectful, and hygienic delivery in public health facilities by supporting pregnant women through emotional, physical, and psychological care during labor.


πŸ‘©β€πŸΌ Who is a Mamta Sakhi?

  • A trained female community volunteer (often ASHA-like)
  • Chosen from the local village community
  • Supports the pregnant woman during delivery at health facility

🧺 Roles and Responsibilities:

βœ… Key RoleπŸ“ Details
πŸ‘£ Assist during laborProvides moral support, holds hands, encourages pushing
🧼 Ensures clean environmentSupports hygienic practices, helps nurse
🍡 Postnatal helpSupports mother with food, rest, comfort
πŸ‘Ά Neonatal care supportAssists in early breastfeeding, mother-infant bonding
🀝 Acts as a link with familyBridges communication between hospital staff and family

πŸ’° Incentive:

Usually a small honorarium/performance-based payment by NHM


πŸš‘ 2️⃣ Mamta Doli – Tribal Ambulance Support Service

πŸ”° Launched by:

Government of Odisha (under NHM) – in remote tribal districts

🎯 Objective:

To provide last-mile transport to pregnant women in hilly or inaccessible tribal areas where ambulances cannot reach directly.


🚩 How It Works:

  • Doli (palanquin) or hand-held stretcher used to carry the pregnant woman
  • Used to reach the nearest motorable point where a 108 ambulance can take over
  • Helps reduce home deliveries and maternal deaths

🩺 Special Features:

πŸ”§ FeatureπŸ“Œ Details
🧭 Manual or bamboo stretcherTraditional but effective in rough terrain
πŸš‘ Linked with 108 ambulanceProvides full transport chain
🀝 Community participationCarried by trained volunteers from village
πŸ₯ Access to institutional careIncreases facility-based deliveries in remote belts

🧠 Top 5 MCQs for Quick Revision

βœ… Q1. In which Indian state is the Mamta Sakhi initiative active?
πŸ…°οΈ Odisha

βœ… Q2. What is the role of a Mamta Sakhi?
πŸ…°οΈ Provides emotional and physical support to women during labor

βœ… Q3. What is Mamta Doli?
πŸ…°οΈ A tribal transport support service using stretchers/palanquins

βœ… Q4. Why was Mamta Doli introduced?
πŸ…°οΈ To transport pregnant women from inaccessible areas to health centers

βœ… Q5. Who carries the Mamta Doli?
πŸ…°οΈ Community volunteers or trained helpers

πŸΌπŸ’— NSSK – Navjaat Shishu Suraksha Karyakram

🧠 Important for NHM, NORCET, AIIMS, RRB, GPSC, BSc/GNM Nursing & Community Health Nursing Exams


πŸ”° Introduction:

NSSK stands for Navjaat Shishu Suraksha Karyakram, a nationwide initiative launched in 2009 by the Ministry of Health and Family Welfare (MoHFW) under the National Health Mission (NHM).

🎯 Objective:

To reduce neonatal mortality rate (NMR) by training healthcare providers in basic newborn care and resuscitation.


🧠 Why NSSK?

πŸ‘Ά Nearly 2 out of every 10 newborn deaths occur due to birth asphyxia and lack of skilled neonatal care.
πŸ§‘β€βš•οΈ NSSK trains doctors, nurses, ANMs & paramedics in “First Golden Minute” response and essential newborn care.


πŸ“¦ Key Components of NSSK Training:

βœ… Skill AreaπŸ“Œ Focus
πŸ• Golden Minute ConceptImmediate resuscitation within 1st minute after birth
πŸ› Thermal ProtectionDrying, skin-to-skin contact, delayed bathing
🫁 Airway, Breathing, Circulation (ABC)Clear airway, stimulate breathing, ventilation
🍼 Early BreastfeedingWithin 1 hour of birth
πŸ›οΈ Infection PreventionHandwashing, sterile cord care
🧼 Clean Delivery PracticesUse of sterile gloves, instruments, etc.
🩺 Monitoring & ReferralIdentifying danger signs and timely referrals

πŸ‘₯ Who Is Trained Under NSSK?

  • Medical Officers (MO)
  • Staff Nurses (GNM/BSc)
  • ANMs & LHV
  • Lab Technicians and Paramedics
  • AYUSH doctors at delivery points

πŸ“ Training Centers:

District Hospitals, CHCs, FRUs (First Referral Units), training sites accredited by MoHFW


🧰 Equipment Used in NSSK Training:

  • NeoNatalie manikin (for simulation-based training)
  • Bag and mask for resuscitation
  • Suction devices
  • Radiant warmers
  • Cord clamp, clean towels, sterile gloves

🧠 NSSK Golden Rules:

🟒 Keep baby warm
🟒 Start breathing quickly
🟒 Start breastfeeding early
🟒 Avoid infections
🟒 Refer promptly if danger signs appear


πŸ‘©β€βš•οΈ Role of Nurses/ANMs in NSSK:

βœ… Provide thermal protection & clean delivery
βœ… Conduct basic resuscitation if baby not breathing
βœ… Promote early breastfeeding
βœ… Counsel mother on newborn care
βœ… Record APGAR scores
βœ… Refer neonates to SNCU if needed


🧠 Top 5 MCQs for Quick Revision

βœ… Q1. What does NSSK stand for?
πŸ…°οΈ Navjaat Shishu Suraksha Karyakram

βœ… Q2. What is the critical period focused on in NSSK?
πŸ…°οΈ First Golden Minute after birth

βœ… Q3. Which condition is mainly addressed by NSSK?
πŸ…°οΈ Birth asphyxia

βœ… Q4. When should breastfeeding be initiated as per NSSK?
πŸ…°οΈ Within 1 hour of birth

βœ… Q5. Who is trained under NSSK?
πŸ…°οΈ MOs, Nurses, ANMs, Paramedics

πŸ‘©β€βš•οΈπŸ“¦ IMNCI – Integrated Management of Neonatal and Childhood Illnesses

πŸ”° Introduction:

IMNCI is the Indian adaptation of WHO-UNICEF’s IMCI (Integrated Management of Childhood Illnesses).
Launched in India in 2003 by MoHFW, it integrates neonatal care into the global IMCI framework.


🎯 Main Objectives:

βœ”οΈ Reduce neonatal and child mortality
βœ”οΈ Promote early identification and treatment of childhood illnesses
βœ”οΈ Improve quality of care at community and facility levels
βœ”οΈ Educate caregivers and health workers in holistic child care


πŸ§’ Age Groups Covered:

πŸ‘Ά Age Group🎯 Focus of Care
0 to 7 days (Neonate)Thermal care, feeding, sepsis, danger signs
7 days to 2 monthsFever, sepsis, jaundice, feeding problems
2 months to 5 yearsPneumonia, diarrhea, malnutrition, malaria, ear problems, measles

πŸ” Key Illnesses Addressed in IMNCI:

  1. Pneumonia / Cough / Cold
  2. Diarrhea
  3. Malaria (in endemic areas)
  4. Measles
  5. Malnutrition
  6. Ear infections
  7. Severe infections (sepsis) in neonates

🧰 Key Components of IMNCI Approach:

🧩 ComponentπŸ“‹ Details
βœ… AssessmentCheck for danger signs, symptoms, nutrition, immunization
πŸ”· ClassificationBased on color-coded signs (Pink, Yellow, Green)
πŸ’Š TreatmentOn-spot or referral as per classification
πŸ“£ Counseling of CaregiverHome care, feeding, danger signs, follow-up
πŸ“„ Follow-Up & Record KeepingScheduled based on condition severity

🎨 Color Code System in IMNCI:

πŸŸͺ ColorπŸ” ClassificationπŸ“Œ Action
πŸ”΄ PinkSevere illnessUrgent referral / hospital
🟑 YellowModerate illnessSpecific treatment at PHC
🟒 GreenMinor illness or no illnessHome care and follow-up

πŸ‘©β€βš•οΈ Role of Nurse/ANM in IMNCI:

βœ… Assess sick children using IMNCI chart booklet
βœ… Identify danger signs in neonates and children
βœ… Provide oral rehydration therapy, antibiotics if needed
βœ… Counsel mothers on feeding, immunization, and home care
βœ… Refer severe cases to FRUs or District Hospitals
βœ… Maintain records and follow-up


πŸ“¦ Training Tools & Materials:

  • IMNCI Chart Booklet
  • Home-based Newborn Care (HBNC) kit
  • Sick child recording form
  • Drug kit – ORS, zinc, amoxicillin, paracetamol
  • Growth charts, MUAC tape, respiratory timer

🧠 Top 5 MCQs for Quick Revision

βœ… Q1. What does IMNCI stand for?
πŸ…°οΈ Integrated Management of Neonatal and Childhood Illness

βœ… Q2. IMNCI covers children of which age group?
πŸ…°οΈ 0 days to 5 years

βœ… Q3. What are the three color classifications in IMNCI?
πŸ…°οΈ Pink (urgent), Yellow (specific care), Green (home care)

βœ… Q4. When was IMNCI launched in India?
πŸ…°οΈ 2003

βœ… Q5. Name one key illness targeted under IMNCI.
πŸ…°οΈ Pneumonia / Diarrhea / Malnutrition / Sepsis

πŸ“ŠπŸ‘Ά The Growth Chart (Road to Health Chart)


πŸ”° What is a Growth Chart?

A growth chart is a visual tool used to monitor a child’s growth over time, especially weight-for-age, to detect malnutrition, failure to thrive, or obesity early.

πŸ“˜ Also called β€œRoad to Health Chart” or Mother-Child Protection Card (MCP Card) in India.

πŸ“… Target Age Group:

πŸ‘Ά Children from 0 to 5 years

🎯 Objectives of Using Growth Charts:

βœ”οΈ Detect early growth faltering
βœ”οΈ Identify malnutrition or overweight
βœ”οΈ Monitor effect of nutrition and illness
βœ”οΈ Guide feeding advice and counseling
βœ”οΈ Record immunization & developmental milestones


πŸ“ Types of Growth Charts:

πŸ“˜ TypeπŸ” Used For
Weight-for-age (WFA)Most common; early detection of undernutrition
Height-for-age (HFA)Detect stunting (chronic malnutrition)
Weight-for-height (WFH)Detect wasting (acute malnutrition)
BMI-for-ageDetect overweight/obesity in children

🎨 Color Zones in MCP Growth Chart (India):

🎨 Color BandπŸ“Œ InterpretationπŸ› οΈ Action Needed
🟒 GreenNormal growthContinue good feeding, growth monitoring
🟑 YellowModerate undernutritionNutrition counseling, close follow-up
πŸ”΄ RedSevere undernutrition (SAM)Immediate referral & nutritional rehab

πŸ“ˆ How to Plot Growth:

  1. Weigh the child accurately (preferably monthly)
  2. Mark the age (X-axis) and weight (Y-axis)
  3. Plot the point on the chart
  4. Join the dots over months to see the growth trend
  5. Flat or falling line = danger sign

🧠 Key Terms:

  • Normal Growth Line: Gently upward curve along green band
  • Growth Faltering: Flat or declining curve
  • Catch-up Growth: Rapid gain after illness/malnutrition

πŸ‘©β€βš•οΈ Role of Nurse/ANM/ASHA:

βœ… Regular weighing & plotting
βœ… Identify growth faltering or severe wasting
βœ… Educate mother on age-appropriate feeding
βœ… Refer child to NRC (Nutritional Rehabilitation Centre) if needed
βœ… Keep records in MCP card / ICDS register
βœ… Coordinate during VHSNDs & Poshan Maah


🧠 Top 5 MCQs for Practice

βœ… Q1. Growth chart monitors which age group?
πŸ…°οΈ 0–5 years

βœ… Q2. In which color zone is a child considered normal?
πŸ…°οΈ Green

βœ… Q3. What does a falling growth curve indicate?
πŸ…°οΈ Growth faltering / illness / undernutrition

βœ… Q4. What is the most commonly used parameter in growth charts?
πŸ…°οΈ Weight-for-age

βœ… Q5. What action is taken if the growth line enters the red zone?
πŸ…°οΈ Refer to NRC for immediate care

Published
Categorized as CHN-SYNOPSIS-PHC, Uncategorised