NATIONAL HEALTH AND FAMILY WELFARE PROGRAMMES

Why National Health Programs?

Disease burden is high

Geogrpahical spread Proven strategies for prevention and control are available Adequate infrastructure is in place

Resources for programme impelmenation are available.

Programmes for Communicable Diseases

1. 2. 3. 4. 5. 6.

7.
8.

National Vector Borne Diseases Control Programme (NVBDCP) Revised National Tuberculosis Control Programme National Leprosy Eradication Programme National AIDS Control Programme Universal Immunization Programme National Guinea worm Eradication Programme Yaws Control Programme Integrated Disease Surveillance Programme

Programmes for Non Communicable Diseases

1. 2. 3. 4. 5. 6.

National Cancer Control Program National Mental Health Program National Diabetes Control Program National Program for Control and treatment of Occupational Diseases National Program for Control of Blindness National program for control of diabetes, cardiovascular disease and stroke

National Nutritional Programs

Integrated Child Development Services Scheme Midday Meal Programme Special Nutrition Programme (SNP) National Nutritional Anemia Prophylaxis Programme National Iodine Deficiency Disorders Control Programme

Programmes for Maternal and Child Health

Reproductive and Child Health Programme National Family Welfare Programmes National Rural Health Mission All India Hospital Postpartum Programme

Other Programmes

National Water supply and Sanitation Programme Minimum needs Programme 20 Point Programme

1.National Vector Borne Diseases Control Programme (NVBDCP)

National Vector Borne Disease Control Programme is implemented in the states for prevention and control of vector borne diseases namely; Malaria, Filariasis, Kala-azar, Japanese encephalitis, dengue chikun gunya

MALARIA

1953 Launching of National Malaria Control Programme ( NMCP ) 1958 NMCP was changed to National Malaria Eradication Programme 1965 Cases reduced to 0.1 million Early 1970s Resurgence of malaria 1977 Modified Plan of Operation implemented

1997 World Bank assisted Enhanced Malaria Control Project ( EMCP ) launched 1999 renaming of programme to National Anti Malaria Programme ( NAMP ) 2002 Renaming of NAMP to National Vector Borne Control Programme 2005 Global Fund assisted Intensified Malaria Control Project ( IMCP ) 2005 introduction of RDT in the programme

2006 ACT introduced in areas showing chloroquine resistance in falciparum malaria 2008 ACT extended to high Pf predominant districts covering about 95% Pf cases 2008 world Bank Supported National Malaria Control Project launched 2009 Introduction of LLINs

ELIMINATION OF LYMPHATIC DISEASES

Launched in 1955 The strategy of lymphatic filariasis elimination is through; Annual Mass Drug Administration ( MDA ) of single dose of antifilarial drug for 5 years or more to the eligible population Home based management of lymphoedema cases and upscaling of hydrocele operations in identified CHCs / district hospitals / medical colleges

KALA-AZAR

The strategies for kala-azar elimination are: Enhanced case detection and complete treatment including introduction of PK 39 rapiddiagnostic kits and oral drug miltefosine for treatment of kala-azar cases. Interruption of transmission through vector control Communication for behavioral impact and intersectoral convergence

Capacity building Monitoring, supervision and evaluation Research guidelines on prevention and control of kala-azar have been developed andcirculated to the state

JAPANESE ENCEPHALITIS

Strategy for Prevention and Control 1. Strengthening early diagnosis and prompt case management at PHCs CHCs and hospitals through training of medical and nursing staff. 2. IEC for community awareness to promote early case reporting, personal protection, isolation of amplifier host, etc.; 3. Vector control measures mainly fogging during outbreaks, space spraying in animal dwellings, and antilarval operation where feasible; and 4. Development of a safe and standard indigenous vaccine. Vaccination for high risk

3. Vector control measures mainly fogging during outbreaks, space spraying in animal dwellings, and antilarval operation where feasible; and 4. Development of a safe and standard indigenous vaccine. Vaccination for high risk population particularly children below 15 years of age.

DENGUE & DANGEU HEMORRHAGIC FEVER

Strategy 1. Surveillance for disease and outbreaks 2. Early diagnosis and prompt case management 3. Vector control through community participation and social mobilization 4. Capacity building

NATIONAL LEPROSY ERADICATION PROGRAMME

Strategy 1. Early detection through active surveillance by the trained health workers; 2. Regular treatment of cases by providing MultiDrug Therapy (MDT) at fixed in or centres a nearby village of moderate to low endemic areas/district; .

3. Intensified health education and public awareness campaigns to remove social stigma attached to the disease; and 4. Appropriate medical rehabilitation and leprosy ulcer care services

REVISED NATIONAL TUBERCULOSIS PROGRAMME

started in 1962 Strategy 1.Early detection and treatment thereby converting infectious cases to noninfectious and preventing noninfectious cases from becoming infectious with treatment. 2. Diagnosis through radiology and sputum microscopy. 3. Free Domiciliary treatment through Primary Health Care Services

4. Establishing District Tuberculosis Centre in every district. 5. Extend coverage under Short Course Chemotherapy (SCC). 6. Strengthen state TB training and Demonstration centres.

NATIONAL AIDS CONTROL PROGRAMME

National AIDS Control Programme Phase I (!992-99) National AIDS Control Programme Phase II (1999-2004) National AIDS control and prevention Phase III

UNIVERSAL IMMUNIZATION PROGRAMME

1974- the WHO launched its expanded programme on immunization against vaccine preventable diseases 1978 - India launched EPI 1985 - renamed EPI as universal child immunization 1989- 90 - The programme become operational in all the districts of the country 1992 - become a part of CSSM program

NATIONAL GUINEA WORM ERADICATION PROGRAMME

India is the first country in the world to establish the National Guinea Worm Eradication Programme in1983-84 as a centrally sponsored scheme

Strategy: 1. GW case detection and continuous surveillance through active case search operations and regular monthly reporting 2. GW case management 3. Vector Control by the application of Tempos in unsafe water sources eight times a year and use of fine nylon mesh/double layered cloth strainers by the community to filter Cyclops in all the affected villages 4. Health education

5. Trained manpower development and 6. Provision and maintenance of safe drinking water supply on priority in GW endemic villages 7. Concurrent evaluation and operational research

PROGRAMMES FOR NON COMMUNICABLE DISEASES

NATIONAL CANCER CONTROL PROGRAMME

OBJECTIVES Primary prevention of cancers by by health education Secondary prevention ie . early detection and diagnosis of common cancers by screening / self examination method Tertiary prevention i.e strengthening of the existing institutions of comprehensive therapy including palliative care

SCHEMES UNDER REVISED PROGRAMME:

Regional cancer centre scheme Oncology Wing Development Scheme: Decentralised NGO scheme: IEC activities at central level: Research and Training:

NATIONAL MENTAL HEALTH PROGRAM

The Government of India has launched the National Mental Health Programme (NMHP) in 1982

Strategies 1.Integration mental health with primary health care through the NMHP; 2. Provision of tertiary care insitutions for treatment of mental disorders; 3. Eradicating stigmatization of mentally ill patients and protecting their rights through regulatory institutions like the Central Mental Health Authority, and State Mental health Authority.

NATIONAL PROGRAM FOR CONTROL OF BLINDNESS

1. 2. 3. 4. 5. 6.

7.
8.

Activities Cataract Operation Involvement of NGOs: Civil Works: Training: Commodity Assistant: Information Education and Communication Management Information System Monitoring and Evaluation

NATIONAL NUTRITIONAL PROGRAMS

Integrated Child Development Services Scheme

Integrated Child Development Service (ICDS) scheme was launched on 2nd October, 1975 Beneficiaries 1.Children below 6 years 2. Pregnant and lactating women 3. Women in the age group of 15-44 years 4. Adolescent girls in selected blocks

The Package of services provided by ICDs

1. Supplementary nutrition, Vit-A, Iron and Folic Acid, 2. Immunization, 3. Health check-ups, 4. Referral services, 5. Treatment of minor illnesses; 6. Nutrition and health education to women; 7. Pre-school education of children in the age group of 3-6 years, and 8. Convergence of other supportive services like water supply, sanitation, etc.

PROGRAMMES FOR MATERNAL AND CHILD HEALTH

Reproductive and Child Health Programme

Essential Components of RCH Programme 1. Prevention and management of unwanted pregnancy. 2. Maternal care that includes antenatal, delivery and postpartum services. 3. Child survival services for newborns and infants. 4. Management of Reproductive Tract Infection (TRIs) and Sexually Transmitted Infections (STIs).

Strategy Bottom-up Planning Decentralized Participatory Planning & Implementation Strengthening Infrastructure Integrated Training Package Improved Management

RCH - 11

The main goals of RCH- 11 are; Immediate objective: To address the unmet needs of contraception, health care infrastructure and provide integrated service delivery for basic RCH care with special focus on Empowerment Action Group. Medium Term Objective: Inorder to bring the Total Fertility Rate ( TFR ) to replacement level by 2010 through co ordinate implementation of the intersectorial linkages.

Long Term Objective : To achieve a stable population by 2045, at a level consistent with the requirements of sustainable economic growth, social development and environmental protection.

NEW INITIATIVES:

Training of MBBS doctors in life saving anaesthetic skills for emergency obstetrics care Setting up of blood storage centres at FRUs according to Govt. of India guidelines Janani Suraksha Yojana Vandemataram scheme Safe abortion services

Village health and nutrition day : Maternal death review Pregnancy tracking

NATIONAL FAMILY WELFARE PROGRAMME

India launched a nation wide family planning programme in 1952 During the third five year plan 1961-66,family planning was declared as the very centre of planned development 1965- introduction of the lipples loop 1966- a full fledge department of family welfare was set up family planning bureau were set up at state and district levels

In 1983 the national health policy was approved by the parliament The national health policy defined the specific goals to be achieved under health and family welfare. The major demographical to be achieved for the country is to attain a replacement level of fertility by the year 2000. from 1992 - programs where integrated under child survival and safe motherhood programme During the 9th five year plan the RCH programme (started in 1994) integrates all the related programs of 8th plan

NATIONAL RURAL HEALTH MISSION

The government of India launched national rural health mission on 5 th April 2005 for a periodof seven years (2005-12)

Plan of action to strengthen infra structure creation of a cadre of ASHA strengthening sub centers by adequate supply of essential drugs provision of multipurpose worker , sanction of new sub centre , stengthening existing sub centre with untied fund of RS 10000 per year 3.

strengthening of PHCs adequate and regular supply of essential supply and equipments provision for 24 hrs services following standard treatment guidelines; up gradation of all PHCs for 24 hr referral service and provision of a second doctor on the basis of felt need strengthening the CHC for the first referral care units by

ALL INDIA HOSPITAL POSTPARTUM PROGRAMME

The Post Partum Programme - a maternitycentred hospital based approach to family welfare - was initiated in 1966 with the aim of motivating women within the reproductive age group (15-44 years) and their husbands for adoption of small family norm

Main Goals 1To provide mother and child care services. 2. To encourage temporary contraception so as to reduce MMR & IMR and to increase the gap between two children. 3.to train the medical & paramedical staff in family welfare. 4. to provide community outreach services within designated areas. 5. to offer health education so as to spread awareness in people. 6. To provide referral services to high risk mothers.

. OTHER PROGRAMMES:

NATIONAL WATER SUPPLY AND SANITATION PROGRAMME

was initiated in 1954- with the object of providing safe water and supply and adequate drainage facilities for the entire urban and rural populationof the country. In 1972 a special programme known as the accelerated rural water supply programme was started

MINIMUM NEEDS PROGRAMME (MNP)

Rural health Rural water supply Rural electrification Elementary education Adult education Nutrition Environmental improvement of urban slums

Houses for landless labors the facilities under MNP are to be first provided to those areas which are at present underserved so as to remove the disparities between different areas the facilities under MNP should be provided as a package to an area through inter sectoral area projects, to have a greater impact

20 POINT PROGRAMME

in 1975 , the government of India initiated aspecial activity . On august 20 , 1986 , the existing 20 point programme was restructured.

INVOLEMENT OF NGOs IN THE NATIONAL HEALTH AND FAMILY WELFARE PROGRAMME: RCH- IEC Activities through Zila Saksharatha Samities: Village Health Guide Scheme: Post Partum Programme: Urban Revamping Scheme & Urban Family Welfare Centre Sterilization Bed Schemes: Mahila Swasthya Sangh: Swasthya Mela: Population research centres:

ROLE OF NURSE IN NATIONAL HEALTH AND FAMILY WELFARE PROGRAMMES Health Monitor Provider of Nursing Care To The Sick And Disabled Health Teacher Counsellor Change Agent Community Organizer

Team Member Trainer, Supervisor, Manager Coordinator Of Health And Related Services Researcher Role Model