Indian RMNCH+A: Strategic Approach to Improve Healthcare Services

This report provides a detailed analysis of the Indian RMNCH+A strategic approach, a comprehensive healthcare initiative launched in 2013 by the Ministry of Health. It addresses critical issues related to reproductive, maternal, newborn, child, and adolescent health, aiming to improve healthcare services and reduce mortality rates. The report examines the context, stakeholders, policy formulation process, and implementation strategies of the RMNCH+A policy, focusing on its impact on vulnerable populations and its contribution to the nation's economic and social progress. It also highlights the role of various stakeholders, including the Indian government and international organizations, in supporting and monitoring the program's performance. The report underscores the importance of quality indicators, efficient service delivery, and preventive measures in achieving the policy's objectives and ensuring equal healthcare access across the country. Furthermore, it explores the policy's effectiveness in addressing health challenges and its contribution to the achievement of the Millennium Development Goals, emphasizing the need for continuous monitoring and development in the healthcare sector.

Running head: INDIAN RMNCH+A STRATEGIC APPROACH 1
Indian RMNCH+A Strategic Approach
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INDIAN RMNCH+A STRATEGIC APPROACH 2
Introduction
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.
Issues that led to the policy
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

INDIAN RMNCH+A STRATEGIC APPROACH 3
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.
Contextual assessment
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.
Policy stakeholders and their interests
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

INDIAN RMNCH+A STRATEGIC APPROACH 4
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.
Identification and prioritization of the issue
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,

INDIAN RMNCH+A STRATEGIC APPROACH 5
newborn, children and adolescent deaths requiring quality healthcare to the vulnerable
individuals
Policy formulation process and resultant policy
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.
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

INDIAN RMNCH+A STRATEGIC APPROACH 6
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

INDIAN RMNCH+A STRATEGIC APPROACH 7
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.
Implementation process
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

INDIAN RMNCH+A STRATEGIC APPROACH 8
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

INDIAN RMNCH+A STRATEGIC APPROACH 9
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

INDIAN RMNCH+A STRATEGIC APPROACH 10
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
Evaluation findings and comparative evidence
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

INDIAN RMNCH+A STRATEGIC APPROACH 11
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

INDIAN RMNCH+A STRATEGIC APPROACH 12
(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.
Strengths and weaknesses of RMNCH+A policy
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

INDIAN RMNCH+A STRATEGIC APPROACH 13
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

INDIAN RMNCH+A STRATEGIC APPROACH 14
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.

INDIAN RMNCH+A STRATEGIC APPROACH 15
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