Dr.chaitanya, progress and achievements of public health programs in india

1. Progress and Achievements
of
Public Health Programs in
India.
CHAITANYA.P
III MDS
Dept of Public Health Dentistry
1

2. CONTENTS:-
• Focus on Public health.
Achievement of programs related to:-
• Vector borne diseases.
• Programs on TB Control
• AIDS control programs.
• Iodine deficiency disorder control programs
• Leprosy eradication programs
• New Born action plan.
• Reproduction and child health.
2

3. • Progress in control of Non-communicable
diseases.
• Blindness control programs.
• Rural sanitation programs.
• Conclusion
• References.
3

4. What are the Health Problems in India?
1. Communicable disease
2. Non-Communicable disease
3. Nutritional problems
4. Medical care problems
5. Environmental Sanitation
6. Population Problem
4

5. The focus of public health intervention is to
improve health and quality of life through
prevention and treatment of disease.
5

6. National vector borne disease control programme
6
• 1953- NMCP (National Malaria Control Programme)
• 1958-NMEP (National Malaria Eradication Programme)
• 1997- EMCP (Enhanced Malaria Control Project )
• 1999-NAMP (National Anti Malaria Program )
• 2002-NVBDCP (National Vector Borne Disease Control Programme)
• 2008-NMCP (World Bank)
• 2010-New drug policy 2010
• 2012- Introduction of rapid diagnostic tests.
• 2013- New drug policy
World Malaria Day-
25TH April

7. Intensified Malaria Control Project (IMCP) is implemented
since October 2010 for a period of five years in 7 NE States.
The project area covers a population of 46 million in 89
districts.
7

8. Intensified Malaria Control Project (IMCP)
• Human resource such as Consultants and support staff for
project monitoring units at state and district level and
malaria technical supervisor, (MTS) and laboratory
technicians (Lts.) at sub-district level.
• Capacity building of District VBD consultant, MTS Medical
Officer/Lab. Technicians/ Health/Volunteers as ASHA, CHV
etc.
8

9. • Commodities such as Long-Lasting Insecticidal Nets
(LLINs), Rapid Diagnostic tests for quick diagnosis of
Malaria, drugs Artemesinin based Combination ACT- AC
Pv total of Pf malaria Therapy (ACT) and Inj. Artesunate
for treating severe malaria cases.
• Planning & administration including mobility support,
monitoring, evaluation and operational research (studies
on drug resistance and entomological aspects)
9

10. 10

11. 11

12. 12

13. 13
Ref:-GOVERNMENT OF INDIA NATIONAL VECTOR BORNE DISEASE CONTROL
PROGRAMME DIRECTORATE GENERAL OF HEALTH SERVICES last accessed on 26/2/2017

14. Lymphatic Filariasis
The disease is reported to be endemic in
255 districts in 21 states and UTs.
 The population of about 650 million in
these districts is at risk of lymphatic
filariasis.
14

15. 15

16. Annual Mass Drug Administration (MDA) of single dose of
DEC(DIETHYL CARBAMAZINE CITRATE) + Albendazole for a minimum
five rounds or more to the eligible population (except pregnant
women, children below 2 years of age and seriously ill persons) to
interrupt transmission of the disease.
Home based management of lymphoedema
cases and up-scaling of hydrocele
operations in identified CHCs/ District
hospitals /medical colleges.
16

17. Mass Drug Administration
REF:- ANNUAL REPORT- 2014-15.GOI -
NATIONAL VECTOR BORNE DISEASE
CONTROL PROGRAMME DIRECTORATE
MINISTRY OF HEALTH & FAMILY
WELFARE last accessed on 26/2/2017
17

18. DENGUE FEVER/DENGUE HAEMORRHAGIC FEVER:-
•Dengue Fever is an outbreak prone viral disease, transmitted by Aedes mosquitoes
•The risk of dengue has increased in recent years due to rapid urbanization, and deficient
water management including improper water storage practices in urban, peri-urban and
rural areas, leading to proliferation of mosquito breeding sites.
The cases peak after monsoon and it is not uniformly distributed throughout the year
18

19. 19

20. The Government of India in consultation with States has
identified 439 sentinel surveillance hospitals with laboratory
support for augmentation of diagnostic facilities in the endemic
states.
15 Apex Referral Laboratories have been identified and linked
with sentinel surveillance hospitals.
For early diagnosis ELISA based NS1 kits have
been introduced under the programme
which can detect the cases from 1st day of
infection.
IgM capture ELISA tests can detect the cases
after 5th day of infection
20

21. 21

22. The National Iodine Deficiency Disorders Control Programme (NIDDCP) started in our
country since Dec'1989. It is a 100% Central Plan Scheme.
22

23. OBJECTIVES OF IDD CONTROL PROGRAMME
• Surveys to assess the magnitude of the Iodine Deficiency
Disorders.
• 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 salt and urinary iodine
excretion.
• Health education & Publicity.
23

24. Achievements:-
• Out of 532 units of production of salt , there is an annual production
of 120lakh metric tonnes of iodised salt.
• Production & supply of iodised salt in 2013 - 58.4 Lakhs.
In 2014 – 55.08lakhs.
• Notification banning the sale of non-iodised salt for human
consumption is issued under FSSA act 2006, FSSA regulations 2011.
• For effective implementation of national iodine deficiency disorder
Control programme 33 states have established iodine deficiency
disorder cells in state health directorate.
24

25. 25

26. 26

27. Revised National TB Control Programme (RNTCP)
• National Tuberculosis programme(NTP)
1962.
DOTS Strategy
Revised national tuberculosis control
programme(RNTCP) - 1993.
• DOTS is most systematic & effective
approach to revitalize TB Control
programme.
27
World TB Day-
24TH March

28. The RNTCP is being implemented following the WHO-recommended Directly Observed
Treatment Short Course (DOTS) strategy that provides a sure cure for tuberculosis with 6-8
months course and is available free of cost to the patient in the entire country.
India’s DOTS programme is the largest in the world in terms of patients initiated on
treatment, placing on an average of more than 1, 25,000 patients on treatment every
month.
Since its inception, the RNTCP has initiated over 12.8 million TB patients on treatment,
thus saving more than 2.3 million lives.
The programme has started responding to new challenges like TB-HIV and MDR-TB. TB-HIV
collaborative services were initiated in the year 2000; currently, the entire country is
implementing TB-HIV collaborative services.
The program has initiated treatment of MDR-TB since 2007 and is currently being
implemented in 12 states. RNTCP has prioritised MDR-TB treatment services and these will
be available in the entire country by end-2011. 28

29. Achievements of RNTCP:-
• In 1999, the Indian expansion of RNTCP accounted
for 1/3 and in 2000 and 2001 for over 1/2 of the
global increase in DOTS coverage.
• In 2005 , 1.29 million TB patients - initiated on
treatment.
• In 2006, 1.39 million.
• In 2007, 1.48 million - enrolled for treatment.
• In 2008 over 1.51 million patients have been
initiated on treatment.
29

30. • India has contributed to approximately 24% of the total
global new cases detection during the year 2007 as per
the WHO Global Report 2009.
25% 86%
Success rate
tripled
Deathrate
cut 7 fold
29%
4%
30

31. Treatment
Success
rate
>85%.
NSP (new
sputum
positive)case
detection
rate close to
the global
target of
70%.
All states are currently implementing the ‘Supervision and Monitoring strategy’
Quality assured diagnostic facilities are available through more than 12,500 laboratories
across the country
To improve access to tribal and other marginalized groups the programme has developed
a Tribal action plan implemented with the provision of additional TB Units
31

32. Repeat population surveys indicate an annual decline in prevalence of disease
by 12%.
Over 2500 NGOs, 19500 private practitioners, and 150 corporate in the provision of
RNTCP services.
Presently, 267 medical colleges (including private colleges) have been involved in
RNTCP
To supplement and support the IRL(Intermediate Reference Laboratories )network the
programme is also involving Mycobacteriology laboratories of Government Medical
Colleges as well laboratories in the NGO and Private Sector.
Till date, two NGO labs (CMC-
vellore and BPRC-Hyderabad)
have been accredited and
about 12 such labs have
applied for accreditation. 32

33. 33

34. 34

35. On the eve of World Tuberculosis Day, Health Minister Shri. J.P. Nadda launched Bedaquiline
— new drug for Drug Resistant TB — as part of the national programme. The drug will be
introduced in 104 districts across five States.
Speaking at a press briefing, Mr. Nadda said the “process of fighting TB is continuous. Hence
there can be no dilution and no diversion. Our attention needs to be steadfast and
aggressive.” The programme would not suffer on account of budgetary allocation.
The new class of drug is a diarylquinoline that specifically targets Mycobacterial ATP
synthase, an enzyme essential for the supply of energy to Mycobacterium tuberculosis and
most other mycobacteria.
Bedaquiline is being introduced at six tertiary care centres across India. These sites have
advanced facilities for laboratory testing and intensive care for patients. Bedaquiline will be
given to multi-drug resistant TB patients with resistance to either all fluoroquinolone and/or
all second line injectables and extensive drug resistant TB.
35

36. National leprosy eradication Programme
• National leprosy control programme – 1955.
• Aim is to reduce case load to 1 or <1/10,000
population.
NLCP(national
leprosy control
programme)
NLEP(national
leprosy eradication
programme)
1955
1983
36
World Leprosy Day-
30TH January

37. • More emphasis is given on disability prevention &
medical rehabilitation services(DPMR) services to
affected persons.
• Incentive to each leprosy
affected person from BPL
undergoing reconstructive
surgery
Rs.5,000/-
• Provided to PMR centres
for each reconstructive
surgery conducted.Rs.5,000/-
37

38. • 41 NGO’s and 42 Government medical colleges have been
strengthened for providing reconstructive surgery to leprosy
affected persons for correction of disability.
• Free medical facilities like ulcers, selfcare training,counselling are
provided to leprosy affected people.
• Intensive IEC campaign with a theme of ``Towards leprosy free
India.’’ has been carried out in community.
• Micro cellular rubber foot ware
38

39. • Confirmed diagnosis of case brought by ASHA
workers given an incentive of:-
• Rs-100/- - rural areas.
• Rs.250/- - urban areas.
• 33 states/UT achieved the status of leprosy
elimination.
Yet to achieve
elimination of
leprosy.
39

40. 40

41. 41
World AIDS Day-
1ST December

42. NACP YEAR
I- PHASE 1992-99
II-PHASE 1999-06
III- PHASE 2007-12
IV-PHASE 2012-17
42

43. PHASES OF NACP:-
• Phase-I (1992 - 1999) was implemented across
the country with objective to slow the spread of
HIV to reduce future morbidity, mortality, and
the impact of AIDS by initiating a major effort in
the prevention of HIV transmission.
• Phase-II (1999 - 2006) was aimed at reducing
spread of HIV infection in India and strengthen
India's capacity to respond to HIV epidemic on
long term basis.
43

44. 44

45. 45

46. 46

47. Sl. No Deliverables
Targets
(2007-12)
Achievements
up to March,
2012
1 Setting up Targeted Interventions 2,100 1,821
2
Number of adults with sexually
Transmitted Infections (STI)
symptoms
accessing syndromicmanagement
150 lakh per year
(NACO and
NRHM)
98.83 lakh
(during 2011-12)
3
Set up blood component
separation units
162 (82 existing +
80 new proposed)
159
4 Set up district level Blood Banks 39 25
5
No. of ART centres established
(cumulative)
250 355
6
Treat persons living with HIV/AIDS
with ARV drugs
3,00,000 5,16,412
7 Community Care Centres 350 253
8
Integrated Counseling& Testing
Centres (cumulative)
4,955 10,515
9
Mothers Counseled& Tested at
ICTC
75 lakh per year
85.6 lakh
(during 2011-12)
10
Persons Counseled& Tested at
ICTC
145 lakh per year
109.12 lakh
(during 2011-12)
TARGETS AND ACHIEVEMENTS UNDER NACP-III (2007-12)
47

48. Antiretroviral Therapy (ART) – Management of HIV/AIDS -
REF:-http://www.erewise.com/current-affairs/national-aids-control-programme-4th-
phase-launched-by-naco_art5347dac085774.html#.VvehfOJ97IU
India’s position:
Launched on 1st April 2004 in eight government hospitals in six high prevalence
states
Currently we have 400 ART centers
Around 16,00,000 patients are registered in HIV care
6,00,000 patients are currently on ART
First line treatment is free
Alternate First line and Second line antiretroviral drugs to adults and children are
given as per their eligibility.
48

49. NACO Annual Report 2014-15
49

50. 50

51. 51

52. The biggest achievement of the immunization program is the
eradication of small pox.
 One more significant milestone is that India is free of
Poliomyelitis caused by Wild Polio Virus (WPV) for more than 33
months.
 Besides, vaccination has contributed significantly to the
decline in the cases and deaths due to the Vaccine Preventable
Diseases (VPDs).
Achievements:
52

53. 53

54. 54

55. A vision and a plan for India to end
preventable newborn deaths, accelerate
progress, and scale up high-impact yet cost
effective interventions.
June 2014 at the 67th World Health Assembly,
to advance the Global Strategy for Women s
and Children’s Health
55

56. As per the reports, the new vaccines, inactivated polio vaccine, adult Japanese
Encephalitis vaccine, Rotavirus vaccine and Measles Rubella vaccine, have been made
part of the 'India newborn' action plan.
Mission Indradhanush was launched by the Union Government of India on December
25, 2014. Over the period, the Centre has reportedly covered 40 lakh children of the 90
lakh it had mapped for this year.
56

57. 57

58. 58

59. Press Information Bureau
Government of India
Ministry of Health and Family Welfare
11-August-2015 13:18 IST
Achievements under Immunization Programme
The Universal Immunization Programme (UIP) has been operational in India since 1985.
However, the coverage has increased by only 4% in the last 4 years i.e. at the rate of 1%
per year. The Government of India launched “Mission Indradhanush” on 25 December
2014 as a special drive to expand full immunization coverage in India from 65% in 2014
to at least 90% children in the next five years.
Under “Mission Indradhanush”, 75.5 lakh children were vaccinated and a total of 19.7
lakh children were fully vaccinated. In addition, a total of 20.8 lakh pregnant women
were vaccinated for tetanus toxoid.
Since the launch of UIP in 1985, infant mortality rate and under-five mortality rate due
to vaccine preventable diseases has decreased considerably. India’s infant mortality
rate has declined from 80 per 1,000 live births in 1990 to 40 per 1,000 live births in
2013 and under-five mortality rate from 126 per 1,000 live births in 1990 to 49 per
1,000 live births in 2013. This has been possible due to child health interventions
including immunization.
The Health Minister, Shri J P Nadda stated this in a written reply in the Rajya Sabha
here today. 59

60. India was the first country to launch the National Programme for
Control of Blindness (NPCB) in 1976, as a 100% Centrally sponsored
Programme
60
World Blind Day-
13TH October

61. In 1983, national health policy in India, reiterated that blindness as public health problem.
The Programme was launched with the goal to reduce the prevalence of blindness
from 1.4 to 0.3%.
India has received technical impetus and financial assistance from World Bank, WHO,
DANIDA and other International NGOs for amelioration of blindness programme in the
country.
Currently , the programme is not dependent on any external funding.
61

62. ↑ SUCCESS RATE with cataract surgery with intraocular lens
implantation compared to conventional surgery.
9%-
1994
93%-
2014
Cataract surgeries
Increased supply of ophthalmic equipment for diagnosis and treatment of
common eye disorders.
62

63. Around 307 eye operation theatres
and eye wards built in district
hospitals.
Major achievements during 11th Five Year Plan (2007-12):-
· 294.07 lakh cataract surgeries were done.
· 27.19 lakh free spectacles were provided to school
children suffering from refractive errors.
· 2.21 lakh donated eyes were collected for corneal
transplantation.
· 1850 Eye surgeons were trained in various fields of
ophthalmology to provide better quality eye care services. 63

64. Major achievements during 12th Five Year Plan (2012-17):
(Upto November, 2015)
· 214.98 lakh cataract surgeries
· 23.06 lakh free spectacles distributed to school children
suffering from refractive errors.
· 1.93 lakh donated eyes collected for corneal
transplantation.
· 1225 Eye surgeons trained to provide better quality eye
care services in various fields of ophthalmology.
64

65. VISION 2020 is a global initiative that aims to eliminate avoidable blindness by the
year 2020.
It was launched on 18 February 1999 by the World Health Organization together
with the more than 20 international non-governmental organisations.
PROPOSED STRUCTURE PLAN OF VISION 2020
65

66. 66

67. 67
World Diabetes Day-
14TH November

68. It was implemented in 100 backward and inaccessible districts
across 21 States during 2010-12
The Programme was initiated in the
second half of 2010.
Focus on strengthening of
infrastructure, human resource
development, health promotion,
early diagnosis, treatment and
referral.
68

69. Opportunistic screening of persons above the age of 30 years for
diabetes and hypertension, at the point of primary contact with
any health care facility, be it the village, sub-centre, CHC and
District hospital.
800 doctors were trained for health promotion, prevention, early
detection and management of diabetes, hypertension,
cardiovascular diseases and stroke
69

70. 1.41 Crore target population have been screened
including 9.85 lakh population of urban slums
As on 21st January 2013,
• Health promotion activities were undertaken
to generate awareness regarding lifestyle
diseases.
70

71. • Facilities for Cardiac Care were established/
strengthened in 30 district hospitals by providing
financial assistance for establishing/strengthening
the cardiac care unit.
• To provide early diagnosis and
management, NCD clinics were started in
41 district hospitals and 16 CHCs.
71

72. Rural sanitation programmes in India:-
72

73. Construction of individual household tiolets for household extended to all Below Poverty
Line (BPL) Households and Above Poverty Line Households (APL) ,physically handicapped
and women headed households.
Assistance to Production Centres of sanitary materials and Rural Sanitary Marts, Provision of
construction of Community Sanitary Complexes.
Solid and Liquid Waste management (SLWM) to be taken up in project mode for each Gram
Panchayat (GP) with financial assistance capped for a GP on the basis of number of
household to enable all Panchayats to implement sustainable SLWM projects.
Provision of extensive capacity building of the stake holders like Panchayati Raj Institutions
(PRIs), Village Water and Sanitation Committees (VWSCs) and field functionaries for
sustainable sanitation.
Major activities covered under Nirmal Bharat Abhiyan:-
73

74. A total of 31.83 lakh toilets were built between April 2014
and January 2015 under this campaign, which is 25.4% of
the target for 2014-15.
Over the next 5 years, the government plans to invest
nearly Rs 2 lakh crore to construct 12 crore toilets across
India.
74

75. Between April 2014 and January 2015, 31.83 lakh toilets were built. As of August
2015, 80 lakh toilets have been constructed under the program.
Karnataka led all States in construction of toilets under the programme,
while Punjab built the least
As of 18 March 2016, 10 districts in India were ODF.(open defecation free India).
75

76. The city of Mysuru in Karnataka was named the cleanest city in India after the launch
of Modi’s Swachh Bharat Abhiyan.
76

77. 77

78. • Health system strengthening, human resource
development and capacity building and regulation in
public health are important areas within the health
sector.
• Making public health a shared value across the various
sectors is a politically challenging strategy, but such
collective action is crucial.
• “The health of people is the foundation upon which all
their happiness and all their powers as a state depend”.
CONCLUSION
78

79. REFERENCES:-
• National vector borne disease control programme annual report 2014-15 government
of india national vector borne disease control programme. last accessed on
25/02/2017.
• Government Of India National Vector Borne Disease Control Programme Directorate
General Of Health Services . last accessed on 25/02/2017.
• Dayaraj Cecilia Current status of dengue and chikungunya in India WHO South-East
Asia Journal of Public Health.2014;3 (1).
• National AIDS Control Programme Phase-IV | 2012-2017 strategy document –
government of India. last accessed on 25/02/2017.
• Ramesh Verma, Pardeep Khanna, Shankar Prinja, Meena Rajput, Varun Arora The
National Programme for Control of Blindness in India Australasian Medical Journal
AMJ 2011; 4(1);1-3.
79

80. • Govt. of India NRHM (2014-2015) Mission Document, MInistry of Health
& Family Welfare, New Delhi. last accessed on 25/02/2017.
• Govt. of India (2014), Annual Report 2014-15 MoHFW, New Delhi. last
accessed on 26/02/2017.
• Govt. of India (2008), Eleventh Five year plan (2007-2012), Social Sector,
vol II, Planning commission, Govt. of India. last accessed on 26/02/2017.
• Govt. of India (2012), Twelfth Five year plan (2012-2017), Social Sector,
vol III, Planning commission, Govt. of India. last accessed on 26/02/2017.
80

81. • Govt. of India (2012), National AIDS Control Programme Phase IV (2012-
2017) NACO, MoHFW, New Delhi.last accessed on 26/02/2017.
• Govt. of India (2004), National Programme for Control of Blindness in India,
MoHFW, New Delhi. last accessed on 26/02/2017.
• New medicine for drug –resistant TB launched. THE HINDU,March-22,2016.
last accessed on 27/02/2017.
• http://www.erewise.com/current-affairs/national-aids-control-programme-4th-
phase-launched-by-naco_art5347dac085774.html#.VvehfOJ97IU last accessed
on 27/02/2017.
81

82. 82