Family Health Program

Subject: Community Health Nursing II

Overview

Family Health Program

Family Planning

Modern contraceptive techniques are made accessible by the National Health Service through medical facilities at fixed clinics and through mobile outreach services. The primary metric for tracking the success of the National Family Planning Program is the contraceptive prevalence rate (CPR). The CPR for the use of contemporary family planning techniques nationwide stayed at 43% in 2072–73, the same as the year before.

Objectives

General Objectives:

Regardless of a person's gender, caste, or financial standing, GoN works to improve their health situation. Therefore, the ultimate goal of the FP program is to enhance everyone's health status through an equitable and responsible health service delivery system by empowering individuals to access and use voluntary FP in an educated manner (through increased and equitable access to quality FP information and services).

Specific Objectives:

  • to improve access to and use of high-quality FP services that are suitable for both singles and couples, safe, and efficient. Increasing access to services in areas where the rural poor, Dalits, other marginalized persons, and those with high unmet need reside is a particular priority.
  • to foster an atmosphere that will increase both men's and women's access to high-quality family planning services.
  • by putting in place a variety of behavior change communication strategies, to raise demand for family planning services.

Activities in Health-Post

  • Counseling to clients about family planning.
  • Provide all family planning services.
  • Counseling about emergency contraceptives.
  • Counseling and referral for sterilization.

Safe Motherhood: 

The safe motherhood programme is one of the priority programmes of Nepal. Safe pregnancy, safe delivery and safe birth of new born are the major components of safe motherhood. This can be accomplished through increased access to effective antenatal, delivery and postnatal care and a massive health awareness activity in local communities as well as by addressing avoidable factors that cause death during pregnancy, childbirth and postpartum period. Evidence suggests that three delays are important factors for maternal and newborn morbidity and mortality in Nepal (delays in seeking care, reaching care and receiving care),

Goal

  • Its primary goal is to reduce maternal and neonatal mortality
  • To improve maternal and neonatal health through preventive and promotive activities and by addressing avoidable factors that cause death during pregnancy, childbirth and the postpartum period

Activities in Health-Post for Mother

  • Encourage for 4 ANC visit,
  • Monitor BP, FHS, Weight,
  • Provide ANC services,
  • Counseling about the dangers signs,
  • Encourage for birth preparedness,
  • Treatment of worm infestation,
  • Provide TD Vaccine,
  • Facilitate referral,
  • Provide safe delivery system Provide postnatal services.
  • Detection of postnatal complication.
  • Provide VIT A for postnatal mother.

Newborn and Under 5 Child

  • Counseling about exclusive breast feeding, hypothermia, immunization
  • Detection of danger signs and referral system
  • Resuscitation and stabilization of new-born with asphyxia
  • Stabilize and manage premature baby with kangaroo mother care
  • Identifications of danger signs
  • Provide immunization
  • Growth monitoring
  • Educate about new born and child care
  • Treatment of minor infection
  • Refer for the treatment of major infection.

Adolescent Sexual and Reproductive Health: Between childhood and adulthood, the adolescent years are a time of physical, psychological, and social maturation. It is the stage between childhood and adulthood. Due to pubertal changes, it is important to provide teenagers with the knowledge and resources they need to understand their sexuality and avoid unintended pregnancies, STDs, and the associated risk of infertility. In order to reach the NHSP-2 goal of having 1,000 public health facilities adolescent-friendly by 2015, the National ASRH program is being steadily ramped up.

National Adolescent's Reproductive Health Strategies Goal:

The objectives of National adolescent's reproductive health strategies is

  • To improve the health and nation.
  • To increase the availability and access the information about the adolescent development and provide opportunities to build skill of adolescent services. 
  • To improve the health and socioeconomic status of adolescent
  • To increase accessibility and utilization of adolescent health and counseling services adolescents.
  • To create safe and supportive environment for adolescent in order to improve their leg social and economic status.
  • To create awareness on adolescence issues through BCC campaigns and at national, districts and community levels through FCHVS and mothers groups.

Targets

To make 1,000 health facilities adolescent-friendly by 2015 in line with NHSP-2 (2010-2015) The National Health Policy (2014) and NHSS (2016-2021) envision all health facilities adolescent friendly health services. The programme aims to reduce the adolescent fertility rate (AFR) by improving access to family planning information and devices. 

Activities

  • Free availability of oral pills and condom
  • Provide ANC, PNC, New born care services as per national protocol
  • Conduct school health programs related to family planning ARSH program

FCHV Programme

Female community health volunteer program was initiated in 1988 in 27 districts and to all 75 districts thereafter. It mainly focuses on family planning, maternal and child health. 

Goal and Objectives of the FCHV Programme Goal

  • Mobilize a pool of motivated volunteers to connect health programmes with communities and to provide community-based health services.
  • Activate women to tackle common health problems by imparting relevant knowledge and skills.
  • Increase community participation in improving health.
  • Develop FCHVs as health motivators and.
  • Increase the use of health care services.

The major role of FCHVS is

  • Advocate healthy behavior by mothers and community people to promote safe motherhood. child health, and family planning and other community based health issues and service delivery.
  • FCHVS distribute condoms and pills, ORS packets and vitamin A capsules,
  • To identify the sign and symptoms of pneumonia treat pneumonia cases, refer serious cases to health institution
  • Motivate and educate local people on healthy behavior.
  • They also distribute iron tablets to pregnant women.
  • Act as community-based, voluntary health educators, promoters, community mobilizers. referral agents and service providers in areas of health, as per trainings received.
  • Promote utilization of health services and adoption of preventive health practices.
  • Linkage the community with available PHC services and play key roles in services for family planning, maternal/neonatal health, child health and selected infectious diseases

Primary Health Care Outreach Health: Health facilities were extended to the village level under the National Health Policy. However, the use of services provided by these facilities, especially preventive and promotive services, was limited due to accessibility factors. Primary health care outreach clinics (PHC-ORC) were therefore initiated in 1994 (2051 BS) to bring health services closer to communities.

Aim of PHC Outreach

The aim of these clinics is to improve access to basic health services including family planning, child health and safe motherhood. These clinics are service extension sites of PHCCs and health posts.

Targets: Access the basic health care services to the disadvantages, marginalized and backward people.

Services to be Provided by PHC-ORCS according to PHC-ORC strategy

Safe Motherhood and Newborn Care:

  • Antenatal, postnatal, and newborn care
  • Iron supplement distribution
  • Referral if danger signs identified.

Family Planning:

  • DMPA (Depo-Provera) pills and condoms
  • Monitoring of continuous use
  • Education and counseling on family planning methods and emergency contraception
  • Counseling and referral for IUCDs, implants and VSC services
  • Tracing defaulters.

Child Health:

  • Growth monitoring of under 3 years children
  • Treatment of pneumonia and diarrhea.

Health Education and Counseling:

  • Family planning
  • Maternal and newborn care
  • Child health
  • STI, HIV/AIDS
  • • Adolescent sexual and reproductive health.

First aid:

  • Minor treatment and referral of complicated cases.

Demography and Reproductive Health Research

Demography and Reproductive Health Research includes the planning, monitoring and evaluation of reproductive health activities as key functions of the Programme. This section conducts studies and coordinates reproductive health related research and studies carried out by other organizations in Nepal.

Objective

  • Estimate annual national targets for family planning, safe motherhood and adolesc reproductive health services including family planning acceptors and reproductive he commodities.
  • Conduct periodic and ad-hoc research and studies on family planning, maternal and health, safe abortion services, adolescent sexual and reproductive health and FCHV necta services
  • Provide supportive supervision to DHOS, DPHOS and all levels of health facilities o reproductive health services.
  • Conduct and support the piloting of maternal and newborn health initiatives.
  • Regularly monitor reproductive health and essential obstetric care (EOC) activities.
Things to remember

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