During 1992-93, an integrated maternal and child health (MCH) and Immunisation Programme was initiated. This Programme is called the Child Survival and Safe Motherhood Programme and is assisted by the World Bank and United Nations Projected.

Children’s Fund (UNICEF):

The Universal Immunisation Programme (UIP) started earlier had achieved high levels of coverage in some states. The CSSM Programme aims at sustaining such good performance, at the same time it attempts to strengthen to immunisation services in the states where the coverage is not satisfactory.

This Programme undertakes the augmentation of various activities under the Oral Rehydration Therapy (ORT) Programme, the universalisation of the prophylaxis schemes for the control of anaemia in pregnant women and activities for the control of blindness in children.

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Under the CSSM Programme, a Programme for the control of Acute Respiratory Infections (ARI) in children has also been undertaken. In districts with high infant mortality and maternal mortality rates, training of traditional birth attendants has been taken up in a big way under the Safe Motherhood component.

The other activities under the Safe Motherhood component, namely provision of aseptic delivery kits and strengthening of first referral units for dealing with high risk and obstetric emergencies are also being undertaken.

Under the Child Survival Component, the Universal Immunisation Programme (UIP) the Oral Rehydration Therapy (ORT) Programme, the Prophylaxis Schemes and essential care at the community level are being implemented in all the districts of the country. Activities for ARI control are being expanded.

The impact of the CSSM Programme has started becoming evident in many parts of the country. The infant mortality rate which was 129 in 1976 and 104 in 1984 has declined to 74 in 1996.

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In less developed states such as Bihar, Madhya Pradesh, Orissa, Rajasthan and Uttar Pradesh, the decline in the IMR during the last four years has been quite significant. In Uttar Pradesh, the IMR has declined from 118 in 1989 to 86 in 1995.

In Madhya Pradesh, it has declined from 117 in 1989 to 99 in 1995 and in Rajasthan it has declined from 96 in 1989 to 86 in 1995.