What Impact Have SARS-CoV-2/Covid-19 Pandemic on the Reproductive and Child Health Programme of India over the 3 months after nationwide Lock down announcement in March 2020 -A brief analysis.

Background: The delivery of reproductive and child health services is of utmost importance and prime concern in India particularly because of huge population with limited resources, poor infrastructure and huge demand on healthcare system. The SARS-CoV-2 pandemic had presented a challenge even for developed healthcare systems around the world. Objectives: The main aim of this research is to nd out Impact of SARS-CoV-2 pandemic on the Reproductive and Child Health Programme in India over the 3 months after Lockdown imposition countrywide in March 2020 due to Covid-19 pandemic. Settings & Design: Different indicators group of RCH programme 2020 (immunisation, maternal & child health, family planning) for India were collected from Ministry of Health & Family Welfare, Government of India and compared from previous year 2019 data for the period of three months(April/May/June) and presented in tables and graphs to understand the situation. Materials & Methodology: Secondary data from HMIS of Ministry of Health & Family Welfare Government of India for 3 month of April, May, June 2019 & 2020 were taken for analysing and understanding the impact of pandemic on RCH programme over 3 months after nationwide lock down announced in march 2020 viz. April/May/June 2020. The data obtained is analysed by using Microsoft Oce software. Result: The analysis of secondary data obtained from HMIS of Ministry of Health & Family Welfare website (Provisional gure & mentioned free for distribution) for RCH programme of India shows that the lock down period & initial early phase of SARS-CoV-2 during above mentioned 3 months pandemic have a negative impact over the delivery of Reproductive & Child Health services reected through important indicators of which are also affected negatively. Besides the pandemic the Nation is also having lack of resources, manpower poor infrastructure as well as lack of positive deviance at community level. These are the barriers in fact beside the epidemic. It seems that there is lack of proper plan to deal with such pandemic situation. Conclusion: India has taken various strategies to ensure delivery of RCH services but it seems to be insucient to give the desired results. The barriers of healthcare system and delivery of services constraints should be rectied added with a proper dynamic plan to carry on usual RCH services even in pandemics


Introduction
The delivery of reproductive and child health services is of utmost importance and prime concern in India particularly due to high population load with limited resources, poor infrastructure and huge demand on healthcare system. The women & child group are considered vulnerable group hence this topic needs essential attention.
The SARS-CoV-2 pandemic had presented a challenge even for developed healthcare systems around the world. A sense of fear gripped the whole world due to pandemic and India is not an exception. The scarce healthcare resources including manpower, infrastructure, transportation (ambulance services) etc. have been largely deployed to tackle the situation of pandemic of Covid-19. This shift has tremendous effect of ongoing various health programmes running previously before the pandemic era. The women and children's seem to suffer more.
Pregnant mother & children's are especially more vulnerable groups. The OPD/IPD services also suffered a lot due to pandemic impact as well as eld health services are also compromised. The Pandemic situation challenged not only the health system but also community. The people have a sense of fear in meeting others particularly with peoples of healthcare system until unless there is some sort of acute emergency. Moreover most of the beds were reserved for covid-19 patients and as per protocols the community and system both have constrains erupting from the sudden situations of pandemic.
The advocacy for maternal and child health, women empowerment have been done and emphasised by many national and international organisation for several decades considering them especially vulnerable groups in times of disaster such as pandemic. The Covid-19 pandemic has clearly disclosed the weakness of health system to protect above mentioned vulnerable groups. The situation also produced a demand of separate cadre to protect mother and child health in situations of disaster like pandemic. It seems many protective bene cial health services were not delivered in covid-19 era which may produce undesirable and detrimental effects at mass level in coming future.
To understand the real impact of covid-19 on maternal and child health the data analysis for the month of April to June 2020 is compared with previous year 2019 data of 3 months and the facts are presented as table and charts.

Objectives
The main aim of this research is to nd out impact of SARS-CoV-2 pandemic on the Reproductive and Child Health Programme of India over the next 3 months after Lockdown imposition countrywide in Following items are considered to know the impact of Pandemic on delivery of health services to mother and child under RCH programme.

Methodology
All the data obtained were analysed using Microsoft o ce software. The analysis report is presented as graphs and also in letters. The data for analysis is obtained from MoHFW Govt. Of India web site services.

Results
Results of data analysis regarding RCH performance of India during the month of April to June 2020 as compared to previous year 2019 for same months were compared for RCH services.
The immunisation services had been adversely affected during the months analysed as compared to previous year 2019. It seems that not only newborn children but even the older ones have missed proper immunisation services as evident from the data analysis. The ANC services and institutional deliveries are important to assess the status of maternal care.
Although home deliveries are reduced but at the same time the institutional deliveries also reduced which is a matter of great concern. The scenario is as below: Although there is a general trend of increase in all above indicators every year as the population of India is growing rapidly. The decrease of such important indicators clearly signi es that covid-19 pandemic have a negative impact on delivery of important health services such as maternal and child health. The role of family planning is very important in context of India. All important family planning programmes show a decrease from previous year timeline for the same months indicating that the population control strategy of India also suffered during this period.

Discussion
The analysis of secondary data obtained from HMIS of Ministry of Health & Family Welfare website for RCH programme India shows that the lockdown period & initial early phase of SARS-CoV-2 pandemic have a negative impact over the delivery of RCH health services as well as the indicators are also affected negatively.
Besides the pandemic India is also having lack of resources, manpower poor infrastructure as well as positive deviance at community level. These are the barriers in fact beside the epidemic. It seems that there is lack of proper plan to deal with such pandemic situation. Providing RCH (reproductive and child health) service is always a big concern for populous nations particularly India with high levels of fertility. During the pandemic era it's more challenging to deliver such essential services due to fear factors at community as well as personal level of healthcare staff. Decreasing rate of immunisation can lead to emergence of diseases which is being controlled by such programmes. At the same time poor ANC services can put maternal as well as foetus life in danger. The decrease in family planning services might add more to ongoing population explosion putting more stress on available resources.
Although the Nation have imposed various measures but it seems to be ineffective to get positive results on RCH programme. The need is to develop a separate cadre for RCH services in order to reap the bene ts of demographic dividend in coming years. The Government of India should develop a strong strategy to protect maternal and child health in conditions of distress such as covid-19 pandemic. For this the barriers and promoters of RCH programme needs to be dealt in proper way to achieve the maximum output.

Conclusion
India has done a lot to deal with covid-19 pandemic but it seems that insu cient attention have been paid to very essential services such as RCH to give the desired results. The barriers of healthcare system and delivery of services should be recti ed added with a proper dynamic plan to carry on usual health delivery services even in pandemics & other situations of distress. The country needs to develop an exclusive plan to tackle such situations to ensure delivery of very essential services such as RCH during pandemics or any other natural calamities.

Declarations
Financial Support & sponsorship Nil

Con icts of Interest
There are no con icts of interest DECLARATION: This paper has not been previously published and is not currently under consideration by another journal.
The whole work is solely done by the author. The document is Microsoft word with English (India) language. 2322 words

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