National health programs are one of the measures taken by the government of India to improve the health status of the people.National health Programs useful to controlling or eradicating diseases which cause considerable morbidity and mortality in India
which are either centrally sponsored
2. INTRODUCTION:
The ministry of health, Government of India,
central health council launch programs aimed
at controlling or eradicating diseases which
cause considerable morbidity and mortality in
India.
3. HEALTH PROGRAMME
1. NATIONAL RURAL HEALTH MISSION
2. NATIONAL PROGRAMS RELATED TO MOTHER
AND CHILD CARE
1. Maternal and child health program (MCH)
2. Integrated child development service scheme (ICDS)
3. Child survival and safe motherhood program(CSSM)
4. Reproductive and child health program(RCH)
5. Integrated management of neonatal and childhood illness
4. NATIONAL PROGRAMS RELATED TO
COMMUNICABLE DISEASES
National program of immunization
Acute respiratory infection control program
Diarrheal disease control program
Revised national tuberculosis control program
Leprosy eradication program
National vector borne disease control programs
National malaria eradication program
National Filarial control program
KALA AZAR control program
National AIDS control program
5. NATIONAL PROGRAMS RELATED TO CONTROL
OF NUTRITIONAL DEFICIENCY DISORDERS
1. Special Nutritional program 1970
2. Mid-day meal program. 1957
3. Anemia prophylaxis program. 1970
4. National iodine deficiency disorders control
program. 1962
6. NATIONAL PROGRAMS RELATED TO
CONTROL OF NON COMMUNICABLE DISEASE
National School health program
National mental health program
National program for control of blindness
Vitamin A deficiency control program
National cancer control program
National diabetes control program
Child welfare program for disabled children
National water supply and sanitation program
National family welfare program
Minimum needs program
8. 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.
9. Population stabilization, gender and
demographic balance.
Revitalize local health traditions and
mainstream AYUSH
Promotion of healthy life styles
10. 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.
11. 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.
13. OBJECTIVES OF MCH:-
To reduce maternal, infant and
childhood mortality and morbidity.
To promote reproductive health
To promote physical and psychological
development of children and adolescent
within the family.
MATERNALAND CHILD HEALTH
PROGRAME
14. SERVICES
Servics delivered by multipurpose health workers
Record of occurrence of pregnancy
identify women with anemia
Administered 2 doses Tetanus Toxoid.
Provide iron and folic acid tablet to pregnant
women
15. Screen women identified as pregnant for any of
the risk factor
Risk
factor
Age less than
17 years or
over 35 years
height <145cm
Weight <40
kg or >70kg.
history of
bleeding in
previous
pregnancy
history still
births
history of
cesarean
section
16. CARE OF CHILDREN
Monitoring of growth of children to detect
malnutrition.
Immunization
Treatment of common ailments
Referral cases to higher centers
Implementation national health policies.
17. INTEGRATED CHILD DEVELOPMENT
SERVICE SCHEME (ICDS) (1975)
TARGET: holistic development of children
OBJECTIVE-
To improve the nutritional and health status of children in
the age group 0-6 years.
To reduce mortality, morbidity, malnutrition and school
dropout.
To lay the foundation for proper psychological, physical
and social development of the child.
18. To achieve effective co-ordination of policy and
implementation amongst the various departments
to promote child development
To enhance the capability of the mother to look
after the normal health and nutritional needs of
the child through proper nutrition and health
education.
19. BENEFICIARY SERVICES
Children of below 3 years age
group
Health checkup
Immunization
Referral services
Supplementary nutrition
Children of 3-6 year age group Non formal preschool education
Health checkup
Immunization
Referral services
Supplementary nutrition
Expectant and nursing women Health check up
Immunization against tetanus
of expectant
Nutrition and health education
Supplementary nutrition
Other women of 15 to 45 years Nutritional and health
education
20. CHILD SURVIVAL AND SAFE
MOTHERHOOD PROGRAM (1992)
AIMS
To reduce infant mortality.
Provide antenatal care to all
pregnant women.
Ensure safe delivery services.
Provides basic care to all
neonates.
Identify and refer these neonates,
who are at risk.
22. OBJECTIVES
The program integrates all interventions of
fertility regulation, maternal and child health
with reproductive health for both men and
women.
The service to be provided are client oriented,
demand driven, high quality and based on needs
of community through decentralized
participatory planning and target free approach.
23. The program up gradation of the level of facilities
for providing various interventions and quality of
care. The first referral Units (FRUs) being set-up at
sub district level provide comprehensive emergency
obstetric and new born care.
Facilities of obstetric care, MTP and IUD insertion
in the PHCs level are improved.
Specialist facilities for STD and RTI are available in
all district hospitals and in a fair number of sub-
district level hospitals.
25. SERVICES PROVIDED
For the children
Essential newborn care
Exclusive breastfeeding
Immunization
Appropriate management of ARI
Vitamin A prophylaxis
Treatment of anemia
26. For the mother
Tetanus Toxoid immunization
Prevention and treatment of anemia
Antenatal care and early identification of
maternal complications.
Delivery by trained personnel
Promotion of institutional deliveries
Management of obstetrical emergencies
Birth spacing
27. For the Eligible couple
Prevention of pregnancy
Safe abortion
For RTI/STD
Prevention and treatment of reproductive tract
infection and sexually transmitted diseases. RCH
program is a target-free program with voluntary
participation.
28. RCH PHASE – II 1ST APRIL, 2005
STRATEGIES
Essential obstetric care
Institutional delivery
Skilled attendance at delivery
Emergency obstetric care
Operational delivery
Operational PHCs and CHCs for round the clock
delivery services.
Strengthening referral system
30. Components:
Improvement of the case management
skills of health providers
Improvement in the overall health
system.
Improvement in family and community
health care practices.
Collaboration/coordination with other
Departments
31. IMNCI BENEFICIARIES
Care of Newborns and Young
Infants (infants under 2 months)
Care of Infants (2 months to 5
years)
32. PRINCIPLES OF IMNCI GUIDELINES
All sick young infants up to 2 months of age must
be assessed of “possible bacterial infection/
jaundice” and “diarrhea”.
All sick children aged 2 months up to 5 years
must be examined for general danger signs and
then for cough or difficult breathing, diarrhea,
fever or ear problem.
Cont……
33. All sick young infants and children 2 months up
to 5 years must also routinely be assessed for
nutritional and immunization status and feeding
problem.
Management procedures use a limited number of
essential drugs and encourages active
participation of caretakers.
Cont…….
34. Based on signs, the child is assigned to color coded
classification: “
- urgent hospital referral or admission
- specific medical Rx or advice
- home management
36. National program of immunization. 1985
Acute respiratory infection control program
Diarrheal disease control program (1971)
Revised national tuberculosis control program
1962
Leprosy eradication program 1955
National vector borne disease control programs
37. NATIONAL PROGRAM ON
IMMUNIZATION 1974
1974-WHO launched “Expended Programme Of
Immunization” (EPI)
1978-Govt. of India launched the same EPI
programme in India
1985 –EPI renamed as Universal immunization
programme
38. OBJECTIVES
To increase immunization coverage.
To improve the quality of service.
To achieve self sufficiency in vaccine production.
To train health personnel.
To supply cold chain equipment and establish a
good surviveillance network.
To ensure district wise monitoring
39. REVISED IMMUNIZATION SCHEDULE
Age Vaccines
Pregnant Women TT (2 doses/Booster)
Birth BCG, OPV-O, Hep B1
6 - 8 weeks DPT -1, OPV -1, Hep B2, Hib1
10-12 weeks DPT -2, OPV -2, Hib2
14-16 weeks DPT -3, OPV-3, Hep B, Hib3
7-9 months Measles
15-18 months DPT booster, OPV – Booster, Hib,MMR
2 years Typhoid
4-5 years DTP,OPV
5-10 years TT,MMR2,Hep B
15 year TT
40. 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
41. REVISED NATIONAL TUBERCULOSIS
CONTROL PROGRAMME (RNTCP) 1962
Goal
The goal of TB Control Program is to decrease
mortality and morbidity due to TB and cut
transmission of infection until TB ceases to be a
major public health problem in India.
42. OBJECTIVES:
To achieve at least 85 % cure rate of the newly
diagnosed sputum smear-positive TB patients
To detect at least 70% of new sputum smear-
positive patients after the first goal is met.
44. COMPONENT OF DOT,S
Political and administrative commitment
Good quality diagnosis.
Good quality drugs.
The right treatment, given in the right way.
Systematic monitoring and accountability.
46. CATEGORIES OF TB CASES AND THEIR
TREATMENT REGIMENS
Category Characteristic of a TB
case
Treatment regimen
Intensive phase Continuation phase
Category I New sputum smear-
positive Seriously ill,
sputum smear-negative
• Seriously ill, extra-
pulmonary
2 ( HRZE )3
24 does
4 ( HR )3
54 does
Category II Relapse Failure
Treatment after default
Others
2(SHRZE)3
+1( HRZE )3
36 does
5 ( HRE )3
66 does
Category HI Sputum smear-negative
Not seriously ill, extra-
pulmonary
2 ( HRZ )3
24 does
4 ( HR ) 3
54 does
47. 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
48. TREATMENT
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.
49. 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.
50. NATIONAL LEPROSY CONTROL
PROGRAM 1955
1955 -national leprosy control program 1955
1983 –national leprosy eradication program
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.
51. NATIONAL AIDS CONTROL PROGRAM
(1987)
1987-NACP
1991 –NACP PHASE 1
1992 -National AIDS control organization
1999 –NACP PHASE 2
2011 –NACP PHASE 3
52. Objective
Prevent infections
care, support and treatment .
Strengthen- infrastructure, systems and human
resources
Strengthen the Strategic Information Management
System
53. 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
54. 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.
56. 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)
57. 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
58. OBJECTIVES
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
59. 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.
60. 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)
61. 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.
62. 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.
64. Special nutritional program 1970
Mid-day meal program. 1957
Anemia prophylaxis program. 1970
National iodine deficiency disorders control
program
66. 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
68. 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.
69. 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.
70. 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
71. 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 )
72. 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
73. 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.
74.
75. 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)
77. 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
78. 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
79. NATIONAL MENTAL HEALTH
PROGRAM (1982)
components
1. Treatment of Mentally ill
2. Rehabilitation
3. Prevention and promotion of
positive mental health.
80. 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.
82. 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
83. 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.
84. BENIFICERY :- 6month -5 year children
STREATGY
Administration of vit A dose at a regular 6 month interval
VIT AADMINISTRATION SCHEDUALE
6-11 month:-100000 IU
1-5 year:-200000 IU /6 months
Child must receive total 9 does
VITAMIN A DEFICIENCY CONTROL
PROGRAM (1970)
85. 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)
86. 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
87. GOALAND OBJECTIVE
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.
88. 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.
89. 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
90. 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.
91. 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……
92. 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.
93. 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……
94. 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.
95. 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……
96. COMPONENTS:
Rural health
Rural water supply
Rural electrification
Elementary education
Adult education
Nutrition
Environment improvement of urban slums
Houses for landless laborers.
97. 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”