Lesson 1 of 10 · 6 min

Reproductive health and the RCH programmes

NCERT §3.1

Every Saturday Dr Meera runs a counselling clinic at the primary health centre in Thrissur. Her first visitor today is not a patient at all: a Class 12 teacher wants to know why a clinic about reproduction also talks about feelings, families and the law.

The story this chapter follows: Dr Meera's Saturday clinic

Dr Meera runs a Saturday counselling clinic at a primary health centre in Thrissur, Kerala. Each lesson follows one visitor, from a teacher asking what reproductive health means to a couple seeking help after 2 years of trying for a child. Numbers carried through: a 28-day cycle with the fertile period on days 10-17, a 21 + 7 day pill strip, 72 hours, 12 and 24 weeks, and the 8-blastomere limit. The names are illustrative; the science is exact.

The lesson in notes

In short

Reproductive health is more than healthy, normally working reproductive organs. WHO defines it as total well-being in every aspect of reproduction: physical, emotional, behavioural and social.

A society counts as reproductively healthy when its people's reproductive organs are normal in structure and function, and their emotional and behavioural dealings in all sex-related matters are normal too.

India began national 'family planning' programmes in 1951 and reviewed them over the decades. The wider programmes running today are called Reproductive and Child Health Care (RCH) programmes.

Their two main jobs: make people aware of reproduction-related matters, and provide the facilities and support a reproductively healthy society needs.

Awareness spreads through audio-visual and print media, government and non-government agencies, parents, relatives, teachers and friends. Sex education in schools gives the young correct information and stops myths and misconceptions.

Useful information includes reproductive organs, adolescence and its changes, safe and hygienic sexual practices, STDs and AIDS; couples also need to know about birth control, care of pregnant mothers, post-natal care of mother and child, breast feeding, and equal opportunities for boys and girls.

Medical care is needed for pregnancy, delivery, STDs, abortions, contraception, menstrual problems and infertility, which needs infrastructure, trained professionals and material support.

Amniocentesis draws some amniotic fluid to study the foetus's cells and dissolved substances; it tests for genetic disorders such as Down syndrome, haemophilia and sickle-cell anaemia and for the foetus's survivability. Its use for sex determination is banned by law to check female foeticide.

Research is supported too: Saheli, an oral contraceptive for females, was developed by scientists at the Central Drug Research Institute (CDRI), Lucknow.

Signs of improved reproductive health: better awareness, more medically assisted deliveries, better post-natal care (so lower maternal and infant mortality rates), more small families, STDs found and cured more often, and more medical facilities overall.