Community Medicine
Reproductive, Maternal and Child Health
Community medicine reproductive, maternal and child health for MBBS: antenatal care, immunisation schedule, IMNCI, family planning and adolescent health, mapped to NMC codes CM10.1 to CM10.9.
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Reproductive, Maternal and Child Health
Community medicine reproductive, maternal and child health for MBBS: antenatal care, immunisation schedule, IMNCI, family planning and adolescent health, mapped to NMC codes CM10.1 to CM10.9.
This chapter covers the continuum of reproductive, maternal, newborn, child and adolescent health, from antenatal care and safe delivery to immunisation and child survival interventions. It details the Universal Immunization Programme schedule, family planning methods and the national programmes that support women's and children's health in India.
High-yield: Reproductive, Maternal and Child Health
- The maternal mortality ratio is maternal deaths per hundred thousand live births and reflects the quality of maternal care.
- The infant mortality rate and under-five mortality rate are key indicators of child health and survival.
- Antenatal care under the current guidelines recommends at least four visits, now expanded, with early registration in the first trimester.
- The Janani Suraksha Yojana promotes institutional delivery through cash incentives to reduce maternal and neonatal deaths.
- The Universal Immunization Programme protects against tuberculosis, diphtheria, pertussis, tetanus, polio, hepatitis B, Haemophilus influenzae type b, measles, rubella and other diseases.
- BCG, oral polio and hepatitis B vaccines are given at birth in the national immunisation schedule.
- The pentavalent vaccine given at six, ten and fourteen weeks combines diphtheria, pertussis, tetanus, hepatitis B and Haemophilus influenzae type b.
- Measles and rubella vaccine is given at nine to twelve months and again at sixteen to twenty-four months.
- Integrated Management of Neonatal and Childhood Illness provides a standardised approach to common childhood illnesses at the primary level.
- Exclusive breastfeeding is recommended for the first six months, with complementary feeding started at six months.
- Spacing methods of contraception include condoms, oral pills, injectables and the intrauterine device.
- Permanent methods of contraception are tubal ligation for women and vasectomy for men.
- Adolescent health is addressed through the Rashtriya Kishor Swasthya Karyakram covering nutrition, mental health and reproductive health.
- The high-risk approach in maternal care identifies pregnancies with danger signs for closer monitoring and referral.
National immunisation schedule highlights
- **At birth:** BCG, oral polio vaccine zero dose and hepatitis B birth dose.
- **6, 10 and 14 weeks:** Pentavalent (DPT, hepatitis B and Hib), oral polio and other injectable polio and rotavirus doses.
- **9 to 12 months:** First dose of measles and rubella vaccine, with vitamin A.
- **Family planning:** Spacing methods (condom, pills, injectables, IUD) and permanent methods (tubal ligation, vasectomy).
NMC competencies in this chapter
- **CM10.1:** Current status of reproductive, maternal, newborn and child health
- **CM10.2:** Screening of high-risk groups and common health problems
- **CM10.4:** Child survival and safe motherhood interventions
- **CM10.5:** Universal Immunization Programme and IMNCI
- **CM10.6:** Family planning methods, their advantages and shortcomings
- **CM10.7:** Basis and organisation of the Family Welfare Programme
- **CM10.8:** Adolescent health including ARSH
Frequently Asked Questions
What does the Universal Immunization Programme protect against?
It provides free vaccines against tuberculosis, diphtheria, pertussis, tetanus, polio, hepatitis B, Haemophilus influenzae type b, measles, rubella and, in a phased manner, rotavirus, pneumococcal disease and Japanese encephalitis in endemic areas.
Which vaccines are given at birth?
In the national schedule a newborn receives BCG against tuberculosis, the zero dose of oral polio vaccine and the birth dose of hepatitis B vaccine, ideally within the first day of life.
What is the Janani Suraksha Yojana?
It is a safe motherhood scheme that provides cash incentives to encourage institutional delivery among poor pregnant women, aiming to reduce maternal and neonatal mortality by ensuring skilled birth attendance.
How long is exclusive breastfeeding recommended?
Exclusive breastfeeding, meaning only breast milk with no other food or water, is recommended for the first six months of life, after which appropriate complementary feeding is started while breastfeeding continues.
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