It’s in Lockdown 4.0 that the Union Health Ministry has finally focussed its attention on the health services related to reproductive, maternal, newborn, child and adolescents, or RMNCAH+N, saying that these should be continued in a restricted manner in areas defined as containment and buffer zones and that coronavirus testing is not mandatory in such cases.
There have been several reports of people facing problems in availing such services at their doorsteps. The Guidelines have come amidst UNICEF report that an estimated 20 million mothers and newborns will receive pregnancy and newborn care in India in the nine-month-period following declaration of the COVID-19 pandemic. It advocated high priority to maternal and child health services as countries respond to the disease.
The Ministry guidelines said that home delivery of folic acid, calcium and zinc tablets, oral rehydration solution sachets and contraceptives can also be arranged in the containment zones.
Areas where multiple coronavirus cases are reported have been classified as containment zones and its surrounding areas are called buffer zones.
“In India, with the second-largest global population, the growing epidemic of coronavirus requires that special efforts have to be made to continue the essential routine RMNCAH+N services,” the Ministry said in its guidelines. “Covid testing is not mandatory for RMNCAH+N service. ICMR testing guidelines need to be followed.”
The Ministry added that it is important to ensure that essential health services for vulnerable population are continued during the pandemic. “Critical services for women, children and adolescent should be provided irrespective of their Covid status,” it said. “Under no circumstances should there be a denial of essential services.”
In its guidelines, the Ministry said that a mother and her newborn should be nursed together as far as possible and breastfeeding must be initiated within one hour of delivery, irrespective of the coronavirus status. However, the mother must wear a face mask and practice hand hygiene before feeding the child, it added.
The advisory noted that services such as antenatal and newborn care, immunisation, family planning and adolescent health, among others, are to be provided at different levels in accordance with the zonal categorisation of containment zones, buffer zones and beyond these zones. “Any area exiting a “containment/ buffer zone” can start RMNCAH+N activities as listed in “areas beyond buffer zone” after a minimum gap of 14 days following delisting,” it added.
The health ministry also said private sector hospitals can be involved in non-coronavirus essential services if the public sector needs to be supported. “Practices of physical distancing, handwashing, and respiratory hygiene need to be maintained at all service areas by all beneficiaries and service providers.”
As per the UNICEF, India will see 20.1 million child births in the nine months since the pandemic declaration, followed by China at 13.5 million, Nigeria at 6.4 million, Pakistan (5 million) and Indonesia (4 million)
