Eleventh Five Year Plan

92 Eleventh Five Year Planappropriate facility. Programme for newborn care isrelatively easy to implement in facilities because of thepresence of doctors, nurses, ANM/LHV, and supportingenvironment.3.1.138 It is also true that a large proportion ofdeliveries would continue to take place at home bythe TBAs. Under NRHM, newborn care skills shouldalso be imparted to TBAs in areas with high rate ofhome deliveries. For this they should be providedwith delivery kits. There are many good practicesall over the country related to low cost hygienic kitswhich can be taken on board and replicated, e.g.the one developed by Jan Swasthya Sahyog (JSS). Theoverall effort during the Eleventh Five Year Plan willbe to promote childbirth by skilled attendants athome and in institutions, both in the public andprivate sector.BREAST FEEDING PRACTICES3.1.139 Exclusive breastfeeding for the first six monthsof life is the single most important child survivalintervention. Successful breastfeeding also requiresthe initiation of breastfeeding within an hour afterbirth, and avoidance of prelacteals, supplementarywater, or top milk. Continued breastfeeding for twoyears or more, with introduction of appropriate andadequate complementary feeding from the seventhmonth onwards, further improves child survival ratesby a considerable percentage. According to NFHS-3,the proportion of exclusively breast fed infants at6 months of age was only 46.3%. Only 23.4% of mothersinitiated breastfeeding within the desired one hourafter birth, as against the Tenth Plan goal of 50%.Therefore, the Eleventh Five Year Plan will concentrateon promoting optimal breastfeeding practices amongwomen at home and in health facilities. Baby FriendlyHospital Initiative and Breastfeeding Partnership,two programmes involving all the key partners willbe encouraged.ARI, DIARRHOEA, AND VACCINE PREVENTABLE DISEASES3.1.140 Research has shown that most of the casesof ARI are not severe; community health workerscan effectively manage them and bring down IMR.Severe ARI cases require urgent referral to a facilityfor injectable antibiotic therapy and supportive care.Co-trimoxazole tablets are being provided at SCs andANMs are being trained to treat children with the infection.During the Eleventh Five Year Plan, attemptwill be made to eradicate polio from the country alongwith strengthening the routine immunization. Studieshave shown that the entire context, strategy, andimplementation of polio eradication activities need tobe reanalysed. The option of injectable polio vaccineshould also be kept open. Reduction will be done inthe mortality associated with diarrhoea and ARIthrough HBNC and IMNCI.3.1.141 During the Eleventh Five Year Plan, thus,IMNCI and HBNC will be rigorously implementedacross the country. The major strategies will be:• Essential new born care (home and facility based)• Standard case management of diarrhoea and pneumonia• Timely initiation of breastfeeding, exclusive breastfeedingfor six months and continued breastfeedingwith appropriate complementary feeding from theseventh month onwards• Increased usage of ORS and strengthened immunization.School Health3.1.142 School Health Programme should aim athelping children in attaining optimal potential forgrowth in physical, mental, educational, and emotionaldevelopment. The programme should provide healthknowledge and improve the health of children. Itscomponents will include school health services, healthpromoting school environment, and health educationcurriculum. In this area as well there are good practicesall over the country that can be taken on boardand replicated. Eleventh Five Year Plan will workon school going children’s health. One innovativeSchool Health Programme is under implementation,in PPP mode, in Udaipur district of Rajasthan. Inview of the low cost versus achievements, it is a goodcase for replicating in other parts of the country.However, to make it comprehensive, preventive,and promotive components of school health carewill have to be added to this programme. Some ofthe key features of the programme are given inBox 3.1.15.