COVID testing not mandatory for services related to maternal, newborn: Health Ministry

Essential services related to reproductive, maternal, newborn, child and adolescent health should be continued in a restricted manner in areas defined as containment and buffer zones, the Union Health Ministry said, underlining that COVID testing is not mandatory for providing such services.

The ministry also said that mother and newborn should be nursed together as far as possible and breastfeeding must be initiated within 1 hour of delivery, irrespective of COVID-19 status. However, the mother should put on a face mask and practice hand hygiene before feeding the child.

In its 'Guidance note on Provision of Reproductive, Maternal, Newborn, Child, Adolescent Health Plus Nutrition (RMNCAH+N) services during and post COVID-19 pandemic' released on Wednesday, the ministry stressed that critical services for women, children and adolescent should be provided irrespective of their COVID-19 status.

"Under no circumstances should there be a denial of essential services," it highlighted.

The guidance note elaborates that services such as antenatal and newborn care, immunization, family planning and adolescent health among others are to be provided at different levels in accordance with the zonal categorization of containment zones, buffer zones and beyond these zones. In its document, the ministry said that in India, with the second largest global population, the growing epidemic of coronavirus requires that special efforts have to be made to continue the essential routine services.

"With more than 2.5 crore pregnancies each year in the country, it is important to ensure the availability of services during this period as any denial of services can have an impact on maternal and newborn mortalities, morbidities as well as the health care costs," it said.

Also unwanted pregnancies have a negative impact on maternal and newborn health and thus regulating fertility is thus a necessity. There is a need to enhance provision of safe abortion services besides post-partum and post abortion contraception, the ministry highlighted.

"India also has the largest adolescent and youth population. Therefore, in addition to the current priority for COVID-19 for health facilities and health workers, it is also vital that essential health services for vulnerable population like this segment are continued during the pandemic," it said.

According to the guidance note, any area exiting a ‘containment/ buffer zone’ can start such activities as listed in ‘areas beyond buffer zone’ after a minimum gap of 14 days following delisting. Not for Profit/private sector hospitals can be involved in provision of non-COVID essential services, wherever public sector capacity needs to be supported, it said,

According to the guidance note, practices of physical distancing, hand washing, and respiratory hygiene need to be maintained at all service areas by all beneficiaries and service providers and facilities should follow a staggered approach, wherein adequate seating space for beneficiaries and care-givers with physical distancing is ensured.

In case the number of beneficiaries is more, then additional sessions/clinics could be organized. Community based activities should have limited participation (5-10) at a time. The procedure site and all equipment should be sanitized properly before and after the clinics/sessions, it said. All COVID-19 suspects and positive cases should preferably be provided services at dedicated COVID facility.

"COVID-19 testing is not mandatory for RMNCAH+N service. ICMR testing guidelines need to be followed," it said, while underlining that tele-consultation services to be promoted at all levels to prevent overcrowding and reduce cross infection.

Drugs, commodities needed for continuing such services, should be treated as essential commodities and home deliveries of essential medicines like calcium, ORS, zinc, contraceptives etc. can be organized in containment zones.