NEEDS ASSESSMENT REPRODUCTIVE CHILD HEALTH RCH CARE PRASANTA

NEEDS ASSESSMENT : REPRODUCTIVE & CHILD HEALTH [RCH] CARE PRASANTA KUMAR SAHA, M. Sc. (Stat), CStat(UK), Fellow of the Royal Statistical Society, UK, Chartered Statistician, UK. E-Mail 1

NEEDS ASSESSMENT OF RCH CARE : INTRODUCTION ----. • • IN GENERAL NECESSITY FELT BY PEOPLE FOR CERTAIN BASIC & ESSENTIAL SERVICES THOSE SERVICES TO BE PROVIDED BY THE GOVT OR PUBLIC SECTOR 2

NEEDS ASSESSMENT OF RCH CARE: INTRODUCTION -Contd. ANY RESEMBLANCE WITH u ESTIMATION OF DEMANDS OR NEEDS FOR GOODS? u ESTIMATION OF DEMANDS OR NEEDS FOR SERVICES? NO. 3

NEEDS ASSESSMENT OF RCH CARE: INTRODUCTION -Contd. u SUCH DEMAND OR NEEDS ESTIMATION RELATES TO u A MATHEMATICAL RELATIONSHIP SHOWING u DEMAND AS A DEPENDENT VARIABLE u PRICE OR SUPPLY AS INDEPENDENT VARIABLES 4

NEEDS ASSESSMENT OF RCH CARE: INTRODUCTION -Contd. u THE PROCESS OF NEEDS ASSESSMENT FOR RCH CARE IS A MECHANISM FOR IMPLEMENTING THE COMMUNITY PARTICIPATION APPROACH FOR REPRODUCTTIVE RIGHTS & REPRODUCTIVE HEALTH RECOMMENDED BY CAIRO CONFERRENCE OF ICPD IN SEPT. , 1994. 5

NEEDS ASSESSMENT OF RCH CARE: CONCEPT & DEFINITION § IN THIS TOPIC DEFINITION OF NEEDS ASSESSMENT RELATES TO ASSESSING OR WORKING OUT THE NEEDS FOR REPRODUCTIVE HEALTH CARE OF WOMEN IN REPRODUCTIVE AGE GROUP & CHILD HEALTH CARE COVERING INFANTS AND CHILDREN. 6

NEEDS ASSESSMENT OF RCH CARE: CONCEPT & DEFINITION -Contd. u NEEDS ASSESSMENT FOR RCH CARE: u A SPECIFIC SOCIAL CONCEPT u AN INNOVATIVE CONCEPT WITH WIDE SIGNIFICANCE u A NOBLE CONCEPT WITH WIDE IMPLICATIONS u EFFECTIVE APPROACH IN DEVELOPING SOCIETY 7

NEEDS ASSESSMENT OF RCH CARE: ITS SIGNIFICANCE u QUESTION OF AVAILIBILITY OF RCH SERVICE FACILITIES u DEVELOPING SOCIETY VIS-A-VIS RICH SOCIETY u RICH SOCIETY: SERVICES ARE OPTMUM u DEVELOPING SOCIETY: SERVICES ARE SUB-OPTIMUM 8

NEEDS ASSESSMENT OF RCH CARE: ITS SIGNIFICANE -Contd. u DEVELOPING SOCIETY: u ENTIRE RESPONSIBILITY WITH GOVT u ECONOMIC CAPACITY OF PEOPLE VERY WEAK u MAGNITUDE OF PROBLEMS-MORE COMPLEX & VAST. 9

NEEDS ASSESSMENT OF RCH CARE: ITS SIGNIFICANE -Contd. DEVELOPING SOCIETY : COMMON PEOPLE u CAN’T AFFORD COSTLY HEALTH CARE SERVICES u CAN’T AFFORD THOSE SERVICES FROM PRIVATE SECTOR u PRIVATE SECTOR SERVICES VERY COSTLY u PRIVATE SECTOR SERVICES INADEQUATE. u 10

NEEDS ASSESSMENT OF RCH CARE: STATUS IN INDIA: u THIS CONCEPT IS ABSOLUTELY NEW u TILL 1996 -97 NO SUCH CONCEPT IN ANY SECTOR u VERY CHALLENGING FOR THE GOVT u INNOVATIVE & REVOLUTIONARY APPROACH 11

NEEDS ASSESSMENT OF RCH CARE : OBJECTIVE u OBJECTIVE OF NA: u PROVIDING QUALITY RCH SERVICES u MEETING DEMAND-DRIVEN CLIENT’ S SATISFACTION u THUS FULFILLING OBJECTIVES OF RCH CONCEPT AS RECOMMENDED BY ICPD’ 94. 12

NEEDS ASSESSMENT OF RCH CARE : OBJECTIVE-CONTD u TO PREPARE ANNUAL ACTION PLANS FOR ALL ITEMS OF RCH & FAMILY WELFARE SERVICES AT VARIOUS LEVELS 13

NEEDS ASSESSMENT OF RCH CARE: FULFILLING THE OBJECTIVES u MECHANISM OF FULFILLING THE OBJECTIVES: u THROUGH COMMUNITY PARTICIPATION u THROUGH PLANNING AT THE GRASS-ROOT LEVEL 14

NEEDS ASSESSMENT [NA] OF RCH CARE: COMMUNITY PARTICIPATION ROLE OF COMMUNITY PARTCIPATION [CP] FOR NA FOR RCH SERVICES: u PROCESS OF NA TO BE PERFORMED THROUGH CP u CP IS PRINCIPAL FORCE FOR NA u WITHOUT PEOPLE’S PARTICIPATION VALIDITY OF NA NOT ACCEPTABLE. u 15

NEEDS ASSESSMENT OF RCH CARE : INFRASTRUCTURES FUNCTIONARIES TO WORK OUT NA: AT SUB-CENTER: u ANM u MPHW AT PHC: u MO u SUPERVISORY HEALTH STAFF 16

NEEDS ASSESSMENT OF RCH CARE: INFRASTRUCTURES -CONTD. FUNCTIONARIES -CONTD. : AT CHC/FRU: u SR. SUPERVISORY IN –CHARGE AT DISTRIC HOSPITALS: u CMO/DY. CMO AT STATE HEALTH DEPT. : u COMMISIONER/DIRECTOR OF HEALTH & FW. 17

NEEDS ASSESSMENT OF RCH CARE : PROCEDURE VILLAGE LEVEL: u TO BE PERFORMED IN THE START OF A FINANCIAL YEAR t u IN VILLGES BY ANM& MALE h MPW OF SC e u HOUSE-TO-HOUSE INTERACTIONS WITH t h CLIENTS u CONSULTATIONS WITH PANCHAYAT, HEALTH COMMITTEE, ANGANWADI WORKERS, WOMEN GROUPS IN THE u VILLAGES. 18

NEEDS ASSESSMENT OF RCH CARE: PROCEDURE -CONTD. u TO HOLD DISCUSSION WITH THE CONCERNED PEOPLE IF NEEDED u TO PREPARE ACTION PLAN u TO FILL UP PRESCRIBED FORM TO NOTE DOWN THE INFORMATION ON REQUIREMENT OF RCH CARE FOR ACTION PLAN 19

NEEDS ASSESSMENT OF RCH CARE: PROCEDURE -CONTD. u ACTION PLANS PREPARED AT THE LEVELS OF u SUB-CENTER [SC] u PRIMARY HEALTH CENTER [PHC] u COMMUNITY HEALTH CENTER[CHC]/FIRST REFERRAL UNIT[FRU] u DISTRICT HEALTH AUTHORITY u STATE HEALTH AUTHORITY 20

NEEDS ASSESSMENT OF RCH CARE: TYPES OF RCH CARE TO BE COVERED u ANTE-NATAL u NATAL CARE [ANC] CARE u NEO-NATAL CARE u MTP u RTI/STI 21

NEEDS ASSESSMENT OF RCH CARE: TYPES OF RCH CARE TO BE COVERED - CONTD. u NEED OF IFA TABLETS u TO PREVENT & CURE ARI u TO PREVENT & CURE ACUTE DIARRHOEAL DISEASE u NEED OF FAMILY PLANNING METHODS 22

NEEDS ASSESSMENT OF RCH CARE: CONCLUSION u AS HAS BEEN MENTIONED IN THE BEGINNING OF THIS LECTURE, NEEDS ASSESSMENT IS AN INNOVATIVE AND ABSOLUTELY NEW SYSTEM IN A DEVELOPING COUNTRY LIKE INDIA. AS IT IS WELL KNOWN, A MOST MODERN TECHNOLOGY MAY NOT GENERATE DESIRED EFFECT IN SOCIAL OR ECONOMIC LIFE UNLESS MINDSET OF THE PEOPLE IS CHANGED. THIS SITUATION IS ALSO APPLICABLE TO NEEDS ASSESSMENT PROCESS IN INDIA. 23

NEEDS ASSESSMENT OF RCH CARE: CONCLUSION -CONTD. u THE MINDSET OF THE HEALTH SERVICE PROVIDERS IS YET TO CHANGE TO EMBRACE THIS NOBLE SYSTEM. THE CONVENTIONAL SYSTEM OF IMPOSING TARGET FROM THE HIGHER LEVEL AMONG THE STATE AUTHORITIES IS STILL PREVALENT IN MAJORITY OF THE HEALTH PERSONNEL IN THE STATES. HOWEVER, ABOUT 40% OF THE DISTRICT AUTHORITIES OF HEALTH & FW IN INDIA ARE GETTING ENGAGED IN THEIS SYSTEM. IN RESPECT OF COMMUNITY PARTICIPATION, ASSOCIATION OF PANCHAYAT IN THE VILLAGES IS NOT IMPRESSIVE. HOWEVER, ANM’S VISIT TO HOUSE AND THE COUPLES IN THE VILALGES IS BEING DONE IN AN IMPRESSIVE MANNER. 24

NEEDS ASSESSMENT OF RCH CARE: CONCLUSION -CONTD. u HOWEVER, A GOOD NUMBER [OUT OF ABOUT 530 DISTRICTS] OF THE DISTRICT AUTHORITIES OF HEALTH & FW IN INDIA ARE GETTING ENGAGED IN THIS SYSTEM. IN RESPECT OF COMMUNITY PARTICIPATION, ASSOCIATION OF PANCHAYAT[ A LOCAL ELECTED BODY IN THE VILLAGE] IN THE VILLAGES IS NOT IMPRESSIVE. HOWEVER, ANM’S VISIT TO HOUSES AND THE COUPLES IN THE VILLAGES IS BEING DONE IN AN IMPRESSIVE MANNER. THANKS 25