national health programme.ppt

NATIONAL
HEALTH
PROGRAMME FOR
CHILDREN IN
INDIA
BY
MRS. MALAR KODI

Introduction
Various national health
programs are currently in
operation for the
improvement of child
health and prevention of
childhood diseases.
There are mainly 6
national health programme

 The Government of India launched the
Reproductive and child health programme in15th
October ,1997as per recommendations of
international conference on population
development in 1994..

Prevention and treatment
of anemia

Early identification of maternal
complication and referral

Promotion of institutional
delivery

Exclusive breast feeding
and weaning

Adolescent health
Counseling on
family life and
reproductive
health
Prevention of
anemia
Prevention of RTI
and STD’S

Family welfare and planning
Promotion of contraception to
prevent unwanted pregnancies
Safe services
for MTP

RCH package
RCH phase I
RCH phase II

RCH phase 1
RCH I has integrated services with CSSM
Newer intervention in RCH I: :
 Essential Obstetric
care.
 24 hour delivery
services at PHC & CHC
 Emergency obstetric
care.
 MTP services
 Prevention of RTI
/STDs and AIDS
 District surveys

RCH Phase II
RCH Phase II began from 1st April 2005
To reduce maternal Mortality
To reduce child Mortality
More focus on rural health care

Universal immunization
programme
 The WHO launched global
immunization program in 1978 India ,
known as expanded program on
immunization (EPI), to Protect all
children of the world against six
killer diseases.
 EPI is now renamed as universal
child immunization, as per
declaration sponsored by UNICEF in
India, it is called as universal
immunization program(UIP) was
launched in 1985, November, for the
universal coverage of immunization
to the eligible population.

National immunization schedule

Other vaccines
 Rabies vaccines
 Haemophilus influenza vaccines (Hib)
 Japanese encephalitis (JE) vaccines

Intensified pulse polio
immunization campaign an pulse
polio programme
Pulse Polio is an immunization
campaign established by the
government of India in 1994
to eradicate poliomyelitis
(polio) in India by vaccinating
all children under age five
against poliovirus.
PULSE stands for "Post-
resuscitation and Initial
Utility in Life saving Efforts”

Every child (0-5 years of age) receives a dose of
Oral Polio Vaccine (OPV), a live, attenuated virus
which colonizes in the gastrointestinal tract. This
virus competitively inhibits , disease-causing
poliovirus. Not only does this prevent pernicious
infection in the host, it precludes transmission of
the poliovirus to other hosts. Since poliovirus
cannot survive outside a host for more than two
weeks, theoretically it would be eradicated,
resulting in the eradication of poliomyelitis

Recent news
Polio remains endemic in four countries – Afghanistan,
India, Nigeria and Pakistan are suspected of having re-
established transmission of poliovirus.
There have not been any cases reported for 2011, and
the number of cases for 2010 remains 42.
Most of India is polio-free. Persistent transmission of
poliovirus is localized in areas of western Uttar Pradesh
and central Bihar.

Integrated child development
services (ICDS)

"The Integrated Management of
Childhood Illness (IMCI)"
1992
UNICEF and WHO

At present, the most important
scheme in the field of child welfare is
the ICDS scheme.
In pursuance of the national policy
for children, Govt of India, started
ICDS program in 1975, under the
minister of social and women welfare.
It is designed for the both
preventive and development effort
through a integrated package
services.

To improve the health and nutritional status of
children in the age group 0-6 years,
To lay the foundation for proper psychological,
physical and social development of children,
To reduce the incidence of mortality, morbidity,
malnutrition and school drop-out,
To enhance the capability of the mother to look
after the normal health and nutritional need of the
child through proper nutrition and health education

Package
ICDS
Nutrition and
Health
Education
Health
Check-up
Im
muniz
ation
Supplementary
Nutrition
Non-formal
education

Delivery of services
CDPO ( child development project officer)- in
charge of ICDS projects
Community development black officer(4 supervisor)
supervisor or mukhyasevika (20-25 AWW)
AWW [Anganwadi Workers -for 1000 population]
Anganwadi Helpers (AWH)

Nutrition supply
 At present a combination 50g puffed rice, 15g
jaggery and 25 gram sattu is given to
beneficiaries which is a source of 300 calories
and 8-10 grams of protein.
 At present, the procurement of this is done by
the Deputy Commissioner through a contractor
finalized through tender process .

To promote positive
health
 To prevent diseases
Early diagnosis,
treatment and follow-up
of defects
Increasing health
awareness in children
about good and bad
health
To provide healthful
environment

Component Of School
Health Program
School
health
services
School health
environment
School
health
education

School health
services
Appraisal
aspects
Preventive
Aspects
Curative
aspects

1- Components of
Appraisal
History
Observation
Screening tests
Laboratory
investigations

Prevention and control of communicable
diseases
Early detection and correction of non-
communicable diseases
Early identification and education of
children with special disabilities
Emergency care and first aid services
2.Preventive Aspects

3.Curative aspects
School clinics provided by
general practitioners (GP)
Referral hospitals services

school Health Education
Formal
health
education.
Correlated
or
integrated
health
education
Seasonal
health
education

School health environment
• School schedules,
• Duration and timing of school
day,
• Amount and timing of
homework……..etc.
Psychosocial
Environment
• Classroom ventilation,
lighting, furniture
• Play facilities
• Garbage disposal
Physical
Environment

Special nutritional
program 1970
Mid-day meal program.
1957
Anemia prophylaxis
program. 1970
National iodine deficiency
disorders control program

SPECIAL NUTRITION PROGRAM
1970

OBJECTIVE
To improve the nutritional status of preschool
children, pregnant,and lactating mother of poor
socio economic groups in urban slums,tribal area
and drought prone rural area
Child up to one
year
200kcl and 8-10g
protein/day
child 1-6 years. 300 kcal 10-12g
proteins/day
women 500 kcal 25g
protein/day

OBJECTIVES
To raise the nutritional status of primary school
children
To improve attendance and enrolment in school.
To prevent dropouts from primary school. Children
belonging to backward classes, schedule caste, and
scheduled tribe families are given priority.

PRINCIPLES:-
 Should be a substitute.
 1/3 Total energy and ½ total protein
 Provided at the low cost
 It is easily prepared
 Locally available food
 Change menu frequently.

BENEFICIARY
School children in the age group 6-11
year
SERVICES
provides 300 calories and 8-12 g
protein/day for 200 days in year

ANEMIA CONTROL PROGRAM
(1970)
BENEFICIARY
Pregnant women,
Nursing mothers,
Women acceptors to terminal methods and IUD.
children 5 years
Daily dose of iron and folic acid tablets
women:80mg ferrous sulfate+0.5 mg folic acid.
Children:180mg ferrous sulfate+0.1 mg folic
acid.(2ml liquid )

NATIONAL IODINE DEFICIENCY
DISORDERS CONTROL PROGRAM (1962)
1962: NGCP launched
1984 : The central council of health approved the
Policy of Universal salt Iodization (USI): Private
sector to produce iodized salt
1992: NGCP renamed as NIDDCP
1997: sale and storage of common salt banned

OBJECTIVES:-
 Surveys to assess the magnitude of the IDD.
 Supply of iodated salt in place of common salt
 Resurvey after every 5 years to assess the extent
of iodine deficiency disorders and the Impact of
iodated salt.
 Laboratory monitoring of iodated slat and
urinary iodine excretion.
 Health education & publicity.

1. National school health program. 1977
2. National mental health program 1982
3. National program for control of blindness 1963
4. National cancer control program 1975-1976
5. National diabetes control program
6. Child welfare program for disabled children
7. National water supply and sanitation program 1954
8. National family welfare program 1952
9. Minimum needs program 1974-1978 (5th five year
plan)

AIMS AND OBJECTIVES
 Promotion of positive health
 Prevention of disease
 Timely diagnosis, treatment and follow up
 Health education to Inculcate awareness about
good and bad health.
 Availability of healthful environment

COMPONENT
 Health appraisal
 Remedial measures and follow up
 Prevention of communicable disease
 Healthful environment
 Nutritional services
 First aid facilities
 Mental health
 Dental health
 Eye health
 Ear health
 Health education
 Education of handicapped children
 School health record

NATIONAL MENTAL HEALTH
PROGRAM (1982)
components
1. Treatment of Mentally ill
2. Rehabilitation
3. Prevention and promotion of
positive mental health.

OBJECTIVES
 Provision of mental health services at district level.
 Improvements of facilities in mental hospitals.
 Training of trainers of PHC personnel in mental hospital
 Program for substance use disorder.

NATIONAL PROGRAM FOR
CONTROL OF BLINDNESS (1976)

 1963: Started as National Trachoma Control Program
 1976: Renamed as National Program for prevention of
Visual Impairment and Control of Blindness
 1982: Blindness included in 20-point program

OBJECTIVES
Dissemination of information about eye care.
Augmentation of ophthalmic services so that eye
care is promptly availed off.
Establishment of a permanent infrastructure of
community oriented eye health care.

BENIFICERY :- 6month -5 year children
STREATGY
Administration of vit A dose at a regular 6 monthinterval
VIT AADMINISTRATIONSCHEDUALE
6-11 month:-100000 IU
1-5 year:-200000 IU /6 months
Child must receive total 9 does
VITAMIN A DEFICIENCY CONTROL
PROGRAM (1970)

PREVENT VIT-A DEFICIENCY THROUGH
Promotion of breastfeeding and feeding of colostrums.
Encourage the intake of green leafy vegetable and
yellow colored fruit.
Increase the coverage of with measles (depletes
vitamin A stores)

NATIONAL CANCER CONTROL
PROGRAM
 1975-76: National Cancer Control Program
launched
 1984-86: Strategy revised and stress laid on
primary prevention and early detection of cancer
cases.
 1991-92: District Cancer Control Program
started
 2000-01: Modified District Cancer Control
Program initiated
 2004 : Evaluation of NCCP by NIHFW
 2005 : Program revised after evaluation

GOAL ANDOBJECTIVE
 Primary prevention of cancers by health education.
 Secondary prevention i.e. early detection and
diagnosis of common cancer of cervix, mouth, breast
and tobacco related cancer by screening method.
 Tertiary prevention strengthening of the existing
institutions of comprehensive therapy including
palliative therapy.

 Prevention of tobacco related cancer.
 Prevention of cancer of uterine cervix.
 Strengthening of diagnostic and treatment equipment
for cancer at medical colleges and major hospitals.

THE SCHEMES UNDER THE
REVISED PROGRAM ARE
 Regional cancer centre scheme
 Oncology wing development scheme
 District cancer control program
 Decentralized NGO scheme
 Research and training

NATIONAL DIABETES
CONTROL PROGRAM(7
FYP)
• OBJECTIVES
 Identification of high risk subjects at an early stage and imparting
appropriate health education.
 Early diagnosis and management of cases
 Prevention, arrest or slowing of acute and chronic metabolic as
well as chronic cardiovascular, renal and ocular complication of the
disease.
 Rehabilitation of the partially or totally handicapped diabetic
people.

CHILD WELFARE PROGRAM FOR
DISABLED CHILDREN
DISABILITY IN FIVE YEAR PLANS
1FYP -Launched a small unit by the ministry of
education for the visually impaired in 1947.
2 FYP- under ministry of education a National
Advisory Council for the physically challenged started.
3FYP-attention was given to rural areas and facilitated
training and rehabilitation of the physically challenged.
Cont……

 4FYP-more emphasis was given to preventive work.
 6FYP-national policies were made around for
provision of community oriented disability
prevention and rehabilitation services to promote
self reliance.

NATIONAL WATER SUPPLY AND
SANITATION PROGRAM 1954
OBJECTIVE
providing safe water supply and adequate
drainage facilities for the entire urban and
rural population of the country.
Cont……

SWAJALDHARA
(2002)
Swajaldhara is a community led participatory program,
which
AIMS
 providing safe drinking water in rural areas, with full
ownership of the community,
 building awareness among the village community on
the management of drinking water projects,
 promote better hygiene practices
 encouraging water conservation practices along
with rainwater harvesting.

MINIMUM NEEDS PROGRAM
(1974-78-5 FYP)
OBJECTIVES
To improve the living standards of the people.
It is the expression of the commitment of the
government for the “social and economic
development of the community particularly the
underprivileged and underserved population.”
Cont……

COMPONENTS:
 Rural health
 Rural water supply
 Rural electrification
 Elementary education
 Adult education
 Nutrition
 Environment improvement of urban slums
 Houses for landless laborers.

NATIONAL FAMILY WELFARE
PROGRAM (1952)
 1951, 100% Centrally Sponsored, concurrent list
 First country in the world
 1961 Family Welfare Dept.- created in 3rd FYP
 4th FYP - integration of Family Planning services
with MCH services
 MTP Act introduced 1972
 5th FYP(1975-80) The ministry of Family Planning
was renamed “Family Welfare”

Mid day meal program
 The Mid Day Meal is the world’s largest school
feeding programme
 Mid Day Meal in schools has a long history in
India. In 1925, a Mid Day Meal Programme was
introduced for disadvantaged children in Madras
Municipal Corporation
 To improving nutritional levels among children, the
National Programme of Nutritional Support to
Primary Education (NP-NSPE) was launched as a
Centrally Sponsored Scheme on 15th August
1995,

Special nutrition programme
(SNP)
 The programme was launched in the country in
1970-71.
 It provides supplementary feeding of about 300
calories and 10 grams of protein to preschool
children and about 500 calories and 25 grams of
protein to expect at and nursing mothers for six
days a week.
 This programme was operated under Minimum
Need Programme.

Beside this 6 national health programme
following programme are directly or
indirectly helping for child and welfare

ACUTE RESPIRATORY
INFECTIONS CONTROL
PROGRAM
 1990- Programme launched
 1992- the Programme was implemented as part of CSSM
The WHO protocol puts two signs as the “entry criteria” for
a possible diagnosis of pneumonia.
 cough
 difficult breathing.
Patient treated with antibiotics
 ampicillin 25-50 mg/kg/day
 gentamicin 5.0mg/kg/day.
for a period of 7 to 10 days

National tuberculosis control
programme

National leprosy eradication
program(1992 & 1998)
 1955 - Government of India launched National Leprosy
Control Programme
 1983 - Launched National Leprosy Eradication
Programme and introduced MDT for treatment
 2005 - India achieved elimination of leprosy at National
Level in December’ 05

NATIONAL LEPROSY
CONTROL PROGRAM
1955
SERVICES
Provide domiciliary treatment (MDT)
Provide services through mobile leprosy treatment
units with the help of PHCstaff.
Organize health education
deformity and ulcer care and medical rehabilitation
services.

National
anti malaria programme
Strategy: The strategy of control includes early case
detection and prompt treatment,
 Selective use of insecticides,
 Promotion of personal prophylaxis,
 Capacity building and epidemic preparedness.

National AIDS control programme

NATIONAL AIDS CONTROL
PROGRAM
(1987)
1987-NACP
1991 –NACP PHASE 1
1992 -National AIDS control organization

Objective
Prevent infections
care, support and treatment .
Strengthen- infrastructure, systems and human
resources
Strengthen the Strategic Information Management
System

STRATEGY
Surveillance of HIV infection as indicated
by serum positivity.
Surveillance of aids cases showing
clinical signs & symptoms.
Disease control strategies are targeted at
three main modes of spread
 Sexual activity .
 Self injection by drug addicts
 HIV infected blood transfusion

 Training programs for paramedical & general
practitioners to enhance their capability of effective
STD diagnosis.
 Counseling for HIV & AIDS patients
 Cheap availability of good quality condoms.
 Licensing of blood banks, encouraging voluntary
blood donation & screening of blood for HIV,
malaria, hepatitis B & C to be mandatory for all.

National surveillance programme
for communicable diseases

National vector borne disease
control programme

 2003- (NVBDCP) is an umbrella programme for
prevention and control of Vector borne diseases.
 1. Malaria
 2. Dengue
 3. Chikungunya
 4. Japanese Encephalitis
 5. Kala-Azar
 6. Filaria (Lymphatic Filariasis)

NATIONAL MALARIA ERADICATION PROGRAM
(1953)
 1953 National Malaria Control Programme
 1958 National Malaria Eradication Programme
 1977 Modified Plan of Operation (MPO).
 1995 Implementation of Malaria Action Plan
 1997 Enhanced Malaria Control Project in tribal
districts of the State (World Bank Assisted)
 2000 National Anti Malaria Programme

OBJECTIV
ES
 To prevent death due to malaria
 Agricultural and industrial production to be
maintained by undertaking intensive anti-
malarial measures in such areas.Early case
detection and promote treatment.
 Vector control by house to house spray in rural
areas with appropriate insecticide and by
recurrent anti larval measures in urban areas.
 Health education and community participation.
 Reduction in the period of sickness

NATIONAL FILARIA CONTROL PROGRAM
(1995)
ACTIVITES
Delimitations of the problem in
unsurved areas.
Control in urban area through:
(a)recurrent anti larval measures
(b)anti parasitic measures
Control in rural areas through detection
and treatment of microfilaria
carriers/persons.

 Anti-larval measures which include weekly
spray of approval larvacides and biological
control through larvivorous fishes.
 Source reduction through environmental and
water management
 Anti parasitic measure-diagnosis and treatment.
 community awareness through education
 Annual single dose (preventive)mass drug
administration of DEC (Diethylcarbamazine
citrate tablets)

KALA AZAR CONTROL PROGRAM
(1991)
STRATEGY
Interruption of transmission for reducing vector
population by undertaking indoor residual
insecticidal spray twice annually.
Early diagnosis and complete treatment of
kala- Azar cases.
Information education and communication for
community awareness and community
involvement.

PREVENTION AND CONTROL OF DENGUE
HEMORRHAGIC FEVER
STRATEGY
Surveillance for disease and vectors.
Early diagnosis and prompt case management
Vector control through community participation and
social mobilization.
Capacity building.

National iodine deficiency control
program

National mental health
program

GOALS
Reduction in IMR and MMR
Universal access to public health services
Prevention and control of communicable and
non communicable diseases.
Access to integrated comprehensive primary
health care.

Population stabilization, gender and
demographic balance.
Revitalize local health traditions and
mainstream AYUSH
Promotion of healthy life styles

STRATEGIES
enhance capacity of panchayti raj institutions to
own, control and manage public health services.
Promote access to improve health care at house
hold level through the ASHA
Health plan for each village through village
health committee of the panchayat
Strengthening sub-centre through an untied fund
to enable local planning and action and more
multi-purpose workers.

 Prepared by the district health Mission,
including drinking water, sanitation and hygiene
and nutrition.
 Technical support to National, State Block and
district levels traditions.
 Reorienting medical education to support rural
health issues including regulation of medical
care and medical ethics.
 Mainstreaming AYUSH revitalization local
health.

National diabetes control
program

National water supply and
sanitation programme

National diarrheal disease
control programme

CONTROL OF DIARRHEAL
DISEASE (CDD) PROGRAM
(1971)
STRATEGY :
To train medical and other health personnel in
standard case management of diarrhea.
Promote standard case management practices
amongst private practitioners.
Instruct mother in home management of diarrhea
and recognition sign which signal immediate care.
Make available the ORS (oral rehydration salts)
packets free of cost

TREATME
NT
 The rational treatment of diarrhea consists in
prevention of dehydration in a by oral rehydration
therapy(ORS)
 Breastfeeding should be continued.
 In dysentery given cotrimoxazole in addition to
ORS. If unsatisfactory response, nalidixic acid is
given for five days.
 Any program for diarrheal disease control must
include provision of portable water.

 Parent must be educated regarding
 storage of water and food in clear utensils,
 continue of breastfeeding,
 using of only freshly prepared weaning foods
 washing of hands with soap before handling
food.

national health programme.ppt

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