Abstract

PIP: This editorial commentary focuses on a review of past, present, and future maternal and child health (MCH) services in India. MCH was first initiated in the early 1900s, when maternity services were improved and rural midwives and birth attendants received training. MCH was voluntary work coordinated by the Maternal and Child Welfare Bureau under the Indian Red Cross Society. Madras state was the first to establish a separate Maternal Welfare section in the Office of Director of Health Services in 1931. In 1946, the Bhore Committee recommended the integration of MCH within General Health Services, but implementation occurred after 1955. Before 1953, MCH was unevenly distributed and delivered through maternity homes and midwives. WHO and UNICEF support contributed to the expansion of MCH services. The Mudaliar Committee in 1962 recommended, for instance, the expansion of MCH centers to include 1 ANM per 10,000 population. The Child Care Committee in 1960 prepared the first report on preschool child care and proposed several models of comprehensive child welfare services. In 1968, the Committee on Child Welfare Programs associated successful family planning (FP) with good MCH services. The 5-year plan for 1969-74 was the first to integrate FP with MCH. 1974 was a pivotal year. India established a National Policy for Children and a Children's Board. The 1983 National Health Policy identified 9 out of 17 goals as child-related. India today has an extensive set of MCH/FP services. Future child survival will depend upon increased immunization coverage. Future efforts should focus on establishing the community as the focus of updated and well-equipped services. Community volunteers will need to spread awareness and knowledge of FP and MCH. Programs must reduce poverty, expand schooling, empower women and girls, and treat domestic violence as a health issue. AIDS is another future challenge.