Integrated approach to maternal and child health and family planning
Bhargava, I.
Indian Pediatrics 20(6): 395-400
1983
ISSN/ISBN: 0019-6061 PMID: 6642610 Document Number: 402118
India has been emphasizing the interrelationship between primary health care, maternal and child health, and family planning as the major problem for family welfare. Family welfare has been adopted at the national level by the government. Integration of these 2 components of family welfare maternal and child health (MCH) and family planning has been recognized as a feasible proposition for improving the effectiveness and efficiency of the related services. An integration of these 2 services can lead to an improved acceptance of the family planning, give it credibility, and improve cost effectiveness. India follows a policy of simultaneous and concurrent focus on MCH and family planning which are being treated as the 2 arms of family welfare department. The integration of family planning and MCH can be effected in 2 ways: the structural integration, where a common administrative agency runs the program but the services are delivered through different category of workers; and the process integration where the administration and the lower formations take care of both the components of the family welfare services. The integrated approach raises 2 fundamental issues: how to achieve the integration; and the stage at which a particular component should be emphasized. To analyze the problem, a conceptual model was developed. It consists of 4 elements arranged in a sequential manner, indicating the process, the objectives leading to activities which produce certain results, and these results are reflected by the indicators. A newly married couple wants to have children. The pattern of the family in accordance with the small family norm can be developed by the following objectives: to bring about wanted conceptions; the wanted conceptions to develop into healthy newborns; the wanted newborns to be reared to healthy children; to avoid unwanted births; to regulate the interval between the pregnancies; and to adopt a small family norm. Each of the objectives lead to a series of respective activities which produce specific results. The health outcomes of such an integrated program of family planning and MCH can be considered in 3 categories, namely, effects on: mother's health as illustrated by low maternal mortality and morbidity, an improved nutritional status, and a low incidence of preventible complications of pregnancy; fetal health, a low fetal mortality and stillbirth rate, proper care of the newborn, prevention, and early detection of abnormalities of development; and child health, as shown by reduction in perinatal, neonatal, infant and child mortality, a better health of the infant at birth, and a decreased vulnerability to disease by the children.