Issues that led to the policy

Health and safety are essential for a nation to achieve the set macroeconomic goals of production. In India, National Health Mission is implemented to ensure that there are improved health services to the people in the area. Healthcare facilities are required to follow the set NHM for a continuous improvement of health care services. NHM has made it possible for the healthcare facilities in the region to offer quality services to the patients following the guidelines in the NHM. The program focuses on improving the infrastructure and public health to the vulnerable groups of the society. National Rural Health Mission (NRHM) was founded in 2005 to focus on the rural populations of India by providing affordable and accessible healthcare services (NHM, National Rural Health Mission (NRHM), 2016).  The program has made it possible for the rural population to access quality healthcare services in the regions.

Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH+A) launched in 2013 aimed at utilizing healthcare services in the area (NHM, 2014). The focus of children, mothers, and adolescents has increased the economic performance of the nation. RMNCH+A policy was implemented by the government of India through the Ministry of Health to ensure that there is an equal focus on all stages of life by handling issues facing newborns, mothers, children, and adolescents. The plan provided care to the children, mothers, and adolescents at every step in life depending on their healthcare needs. Different stages in life require different health care and services requiring the stakeholders to develop the policy to deal with various issues to the public. The disadvantaged population was aimed at considering the use of NRHM in India to deal with multiple problems facing the community (Marten et al., 2014). The continuous flow of the society is based on the quality of healthcare services provided to the public. People can engage in productive activities that will improve the economic status of the nation considering that there are health and safety to the society. The focus on every stage of life made it possible for the government to come up RMNCH+A policy to deal with issues facing the community. The strategy focused on defects at birth, amount children and adolescents in the disadvantaged areas of the country.

Mother health is essential in ensuring that there is a healthy society for a continuous improvement of economic activities. In case a mother dies the newborn loses the primary caregiver making it hard for the child to grow healthy. Therefore it was essential to come up with RMNCH+A policy to reduce preventable deaths. The plan is critical in reducing the cost incurred by a nation, community and the family in handling the newborn that the mother has died during delivery (Patel et al., 2015). Developing affordable measures to deal with health risk is essential for the community as it provides a healthy environment for the pregnant woman. The contextual assessment performed aimed at improving the women and children health by handling the health risks involving them in the community. Health systems are required to be sustainable to focus on the development of a healthy environment to the women and children in the society. The focus is vital in achieving the set health standards of a nation through affordable and accessible healthcare to the people.

Contextual assessment

The primary stakeholders for the RMNCH+A policy are the Indian government and global organizations such as United Nations and USAID. Stakeholders have interest in the performance of the plan for a continuous social and economic progress of the nation. The government of India focus to the mothers and children is vital to achieving the set millennium goals of quality health care to all people in the country. RMNCH+A policy provided the healthcare services with guidelines to ensure that there is a continuous flow of activities by a focus on health and safety to the public. The U.N. has a goal which aims at reducing child mortality rate ration through quality health care to mothers and children. The Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCH+A) made it possible to monitor the progress of the nation in providing quality healthcare (Kaistha, Tarun, Vikram, & Urmil, 2017). The government of India has developed quality indicators which access the healthcare services to the community. Quality staff and health systems are required to be implemented in healthcare centers to ensure that there is a high intervention of issues facing the community.

The issue of mother and child death was identified by the United Nations requiring countries to develop policies to reduce the mortality rates. In India, the focus was on mothers, newborns, children and adolescents for stable healthcare services to the people. The Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCH+A) policy focused on reaching the most vulnerable individuals in the rural areas (Mason et al., 2014). Focusing on the disadvantaged individuals is vital in increasing the quality health care to the society for the achievement of set macroeconomic goals. Health and safety to the organization are necessary for the nation to handle issues while increasing productions from the community. Performance and quality indicators in the RMNCH+A policy were prioritized to improve the standard of services offered to the public. The government identified that there was an increased number of mother, newborn, children and adolescent deaths requiring quality healthcare to the vulnerable individuals

The policy was formulated to focus on the most vulnerable group of the community in disadvantaged areas. It is essential for the nation to focus on the well-being of the mothers and their children for improved health care in the community. The implementation of the policy started as a national population policy that focused on the vulnerable individuals in the society. The healthcare officers were required to perform a country site visit to come up with a list of prior districts in India based on data acquired from the community (USAID, 2014)The data was used to come up with the National health mission (NHM) for the people of India. The rural areas were identified as the most vulnerable areas in India which required improved health attention leading to the implementation of National Rural Health Mission (NRHM, 2016). Lastly, the RMNCH+A policy was implemented after the health officials discovered that mothers, newborn, children and adolescent required improved health care and service. The policy was performed by the most vulnerable districts in India for a stable health sector in the nation. The focus makes it possible for an individual to achieve their potentials in life due to the quality healthcare provider in the nation. Women and children health campaigns are vital in reducing the mortality which is avoidable through quality healthcare.

Policy stakeholders and their interests

The RMNCH+A policy also focused on adolescent health care for the achievement of long-term goals of production. The adolescent makes a large segment of the community requiring the focus on their health and safety for a nation to achieve its potential (Elgar, Timo-Kolja, Irene, Bart, Gonneke, & Candace, 2015). The policy was developed after the assessment of increased mortality rate for mothers, newborns, children and young individuals in the country. To handle the issue the Indian government came up with RMNCH+A policy that focused on quality health care for a smooth flow of the economy. The plan is essential in achieving the millennium development goals where quality healthcare is vital to the achievement of the set goals. The health policy provides proper guidelines to the healthcare services to handle the increased cases of health in the community. RMNCH+A policy identifies the targets to achieve in the medium and long term of its operation in maximizing health to the people (Khandelwal, Radhika, Surbhi, & Tanusree, 2014). Individuals from rural areas can access health services as there is an increasing number of health officials in the disadvantaged regions of a nation.

Monitoring the performance of RMNCH+A policy is vital in identifying areas which require development for quality health services. It is necessary to offer equal health care services to individuals from all parts of a nation for increased production in the economy. Efficient service delivery makes it possible to handle issues facing mothers, newborns, children and adolescents in the society. The public health officers are required to develop preventive measures for the most vulnerable individuals in the community as it ibis cheaper than the cure of the conditions facing the community. RMNCH+A policy focuses on education to improve prevention measures that will assist in ensuring that there is quality healthcare to the people. The needs of the targeted community require being adequately accessed to provide a stable performance of the health sector through quality services. The policy offers firm outlines that are needed to be followed by healthcare practitioners to ensure a continuous development of the health sector. Healthcare is an essential sector of the economy requiring the similar provision of the services to all individuals in the community (Llewellyn & Suzanne, 2016). Reproductive healthcare aims at increasing the sexual health to the mothers. The policy is evidence-based practices which require the development of services offered to mothers, newborns, children, and adolescents for improved productivity in the society.

RMNCH+A policy aim at providing economic and social progress through quality healthcare services. The policymakers are required to analyze the formulation process to forecast the result of the plan to the development of the nation. Training and development of staff are essential in achieving the set goals of a policy through quality services to the targeted consumers. The RMNCH+A policy was formulated to focus on the vulnerable individuals in India in less disadvantaged locations such as rural areas (NHM, 2014). The plan has dramatically improved the public health in the nation making it possible for an individual to attain their potentials through a reduced mortality rate. Social and economic development is highly dependent on the healthcare sector requiring proper formulation of policies that will focus on quality services to the public. The policy of RMNCH+A  is highly effective in India as it assists in solving issues facing the community through quality healthcare to mothers, newborns, children and adolescents from disadvantaged areas of the nation (Shikha, Shah, & Gaonkar, 2017). Health reduces poverty in a country as people are healthy and safe to engage in economic activities of the country. The formulation of a policy is required to be balanced to ensure that the targeted individual needs are fully satisfied with economic development.

Identification and prioritization of the issue

RMNCH+A policy implementation process involved identification of the highly vulnerable districts in India. The indicators were used to identify the areas with low healthcare services which require improvement for the social and economic progress of the regions. The programs were started to ensure that there is improved healthcare to mothers, newborns, children and adolescents in the area. The RMNCH+A policy has implemented this policy from grass root level to the upper level where the rural areas were first considered in the plan. The ministry of health was required to formulate a program that will provide improved maternal and child care for the districts that are disadvantaged. (Khandelwal, Radhika, Surbhi, & Tanusree, 2014)The government intervention to ensure that there is improved healthcare to the vulnerable individuals of the community aims at providing that a country can achieve set millennium goals. District health teams were required to implement the RMNCH+A policy focusing on reproductive, maternal, newborn, child and adolescent health. The policy ensured that there is increased assistant to the community through easily accessible healthcare in the region. The research institutes were used to identify the issues facing the community to develop a strategy that will effectively deal with the problem facing the citizens. The underserved groups are identified where the RMNCH+A program started to ensure that there is a smooth flow of business operations through quality healthcare (Bertman, 2016). The unfortunate individuals in rural areas are the most vulnerable; thus the program began in the regions to reduce the mortality rates.

Ministry of Health provided a guideline to the healthcare practitioners for a proper understanding of the policy. The intervention of the government produced a smooth flow of healthcare services to the high priority districts in the regions. The gap analysis was used to develop acceptable and available services to the community (Muennig & Mark, 2016). The interventions were used in providing the evidence-based experience of the health issue in a community. The problems were handled by the implementation of RMNCH+A policy that facilitated health services to the vulnerable individuals of the society. Ministry of Health was required to monitor the success of the strategy in reaching out to the people in rural areas for quality healthcare services (NHM, 2014). The facilities used were developed in ensuring that there is a meeting of set medical standards which is necessary for improving the health services to the identified gaps in the community. Medical staff was highly trained to ensure that the program achieves the set goals of reducing the mortality rate in the society through quality health services to the disadvantaged community (Morgan, Tim, & Hugh, 2016). These decisions were made to ensure that there is a valid implementation of RMNCH+A policy which is vital in improving public health in the nation.

RMNCH+A policy implementation required to consider the effect of the process to political, social, economic and cultural institutions of the nations. The policy had a positive influence of the factors as it aims at maximizing on healthcare services provided to the people. The policy implemented is required to be nation building through the increase of various sectors of the nations. Gathering and analyzing data is ensures a smooth flow of the community as it assists in the decision making of the community. The complex issues in the community are identified to develop a strategy that will positively impact the performance of the nation (Joumard & Ankit, 2015). Nongovernmental and other stakeholders were relevant in the effective implementation of the RMNCH+A policy. Reliable information is used in the implementation of the procedures in the most disadvantaged areas of the nation for a smooth economic progress. The RMNCH+A policy was implemented starting from the highly vulnerable areas mainly rural areas to the less sensitive areas. The process was highly efficient as it handled the risks involved in dealing with issues of reproductively, mother, newborn, child and adolescent health. RMNCH+A policy was implemented by the Indian government with collaboration with other international healthcare stakeholders to handle national issues related to reproductive, maternal, newborn, child and adolescent health of the nation. The policy implementation required assessment of the healthcare environment of the country for a smooth implementation of the RMNCH+A policy in achieving reduced mortality rate of newborns, children, mothers, and adolescents. The financial and technical efforts were essential in the implementation of RMNCH+A policy to the targeted community of India

Policy formulation process and resultant policy

The RMNCH+A policy has positively impacted the social and economic progress in India by offering quality services to the disadvantaged individuals. The government of India uses a scorecard to identify the impact of the policy on health provision to the people. RMNCH+A policy is essential in achieving the set National Rural Health Mission (NRHM) of the nation through quality healthcare services to the community. The RMNCH+A policy was developed by USAIS, WHO and the Indian Government for a stable performance in the nation. The rural people are highly vulnerable requiring the government to develop strategies that will reach out to the individual for a smooth flow of the economy (Prince et al. 2015). The mortality rate of newborns, children, mothers, and adolescents significantly reduced making it possible for the nation to achieve its potential through a sustainable health sector. The government of India implemented the strategy aimed at reducing the maternal and child mortality as required by the Global Child Survival Call to Action program (USAID, 2014). The policy has increased the survival rate of children in India, and this has improved the economic and social progress of the nation. RMNCH+A policy is effective in achieving Millennium Development Goals through child survival and development. The commitment of the government to focus on mothers, newborn, children and adolescent were due to their vulnerability to health issues facing the society. The policy makes health services highly accessible and affordable to people in India for a continuous development of the nation (Wagner, Julia, Deepti, & Matthew, 2017). The strategic guidance of RMNCH+A policy has provided healthcare centers with a plan to offer quality services to the people. Health leadership and administration is required to focus on RMNCH+A policy in ensuring that there is focus on the welfare of the public which contributes to the economic stability.  

The policy has provided a continuous development of the health sector of India through a focus on the highly vulnerable individuals. RMNCH+A policy prioritized 184 districts which required active intervention for reproductive, maternal, newborn, child and adolescent health (USAID, 2014). The government used other partners to finance the program which would continuously develop the performance of the nation by handling pressing health issues. The Child mortality rate in India is higher compared to that of USA requiring the government to implement effective RMNCH+A policy. United Nations Children’s Fund was used to ensure that the preventable deaths of children are managed through a life-saving strategy of RMNCH+A policy. The support from different stakeholders of the program has improved the effectiveness of the programs to all parts of the nation (Duran, Joseph, & Nata, 2014). UNICEF indicated the need for implementation of the RMNCH+A policy due to the rising number of children deaths globally where 7.6 million die before reaching their fifth birthday (USAID, 2014). The initiative was essential in reducing child deaths by dealing with maternal and child health for an extended survival of an individual. In India, the under-five mortality rate before the RMNCH+A policy was at 115 per 1000 lives birth, and after the plan, the rate was reduced to 59 per 1000 lives birth which is progress to the nation (USAID, 2014).  The use of RMNCH+A policy has continually provided a continuous protection of the vulnerable persons in the country for a stable economic and social progress. The maternal rates vary from different states requiring the government to perform a continuous analysis to identify the high priority areas to implement the program (Levin & Elizabeth, 2014). The lifecycle approach to dealing with public health has handled different challenges facing the community.

The health sector in India has developed through quality services to the patients for the achievement of set long-term goals of the nation. The NRHM has improved a successful implementation of RMNCH+A policy in the country. Causes leading to increased maternal and child mortality are identified through analysis of the available data. The analyzed information is used to develop measures that will handle the roots to maximize on healthcare to the public. Healthcare stakeholders can identify that defects at birth, diseases, and deficiencies are the leading causes of deaths in children requiring a use of an effective strategy to deal with the purposes of fatalities (Bhawan, 2013). The RMNCH+A policy needs equal focus on each level of life for an increase in achievement of the potential for people in the nation. The vulnerable populations and disadvantaged groups of India are documented to improve their healthcare services (Rathi, 2017).  RMNCH+A policy provides reinforcement practices to the individual to ensure that there are improved services in the health sector. The RMNCH+A policy has been highly effective in India by having high focus districts to prioritize for a stable health sector.

There are several strengths and weaknesses of RMNCH+A policy in dealing with issues facing the community. The strengths of the RMNCH+A policy include; one is the reduction of maternity and children mortality rate through the use of highly advanced techniques to deal with the issue. The stakeholders identify the needs of handling the rising maternity and child mortality by the implementation of RMNCH+A policy in the health sector (van Ginneken, 2015). The progress of the community is based on the sustainability of the healthcare services. Two is a friendly healthcare environment that deals with the issues of adolescents. The government India has implemented the RMNCH+a policy to ensure that the health needs of the adolescent are efficiently handled by professionals for a healthy community (Parthasarathy, Yuko, & Niveditha, 2015). The adolescent makes up a large population of a nation requiring the government to develop strategies to deal with the individuals. Three is the identification of the high focus district to ensure that there is steady economic and social progress of the community. The analysis of the vulnerable individuals in the society by the healthcare stakeholders improves services provided to the group. The high focus districts in India are the areas where the RMNCH+A program was first established to ensure that the people can acquire quality healthcare services for a stable performance of the nation (Mehta, Chandresh, Paragkumar, & Dipak, 2016). Proper analysis of the population makes it possible for the government to develop programs and strategies to satisfy the needs of the people (Bhandari, 2015). The report of the community was vital in implementing the RMNCH+A policy in India focusing on the vulnerable individuals in the society.

Four is the use of advanced systems and qualified professional to reduce the mortality rate of children, adolescents, and mothers in the society. The professionals provide standardized services which are essential to ensuring that the community is safe and healthy. Lastly is where the RMNCH+A policy is aimed at achieving the set National Health Mission and National Rural Health Mission (NRHM) in India. The health policy provides the need of utilizing the healthcare services to improve the performance of the community (Nair, Leena, & Ajithkumar, 2016). The weakness of the RMNCH+A is that it does not adequately reduce the preventable mortality rates of newborns, children, mothers, and adolescents in India. Therefore it is vital for the government to ensure that the policy is highly implemented and improved to adequately deal with preventable deaths in the nation (Grob, 2014). The development of the policy will improve the social and economic performance of India through the health focus to the people.

Conclusion

From the discussion, it is evident that RMNCH+A policy has positively contributed to the achievement of National Rural Health Mission (NRHM) in India through quality services to the people. The policy focuses on the vulnerable and disadvantaged groups in the community for an increase in the performance of the nation. The plan focuses on all stages of life from newborn, children, adolescents and mothers in acquiring a health community.

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