National Child Health Programme

1. KALPANA SHEE
FACULTY, SUM NURSING COLLEGE
SIKSHA 'O' ANUSANDHAN
(DEEMED TO BE UNIVERSITY)
NATIONAL HEALTH
PROGRAMME
RELATED TO CHILD
HEALTH AND
WELFARE

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
i. Maternal and child health program (MCH)
ii. Integrated child development service scheme (ICDS)
iii. Child survival and safe motherhood program(CSSM)
iv. Reproductive and child health program(RCH)
v. 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

5. NATIONAL PROGRAMS CONTINUE…
 National vector borne disease control programs
 National malaria eradication program
 National Filarial control program
 KALAAZAR control program
 National AIDS control program

6. NATIONAL PROGRAMS RELATED TO CONTROL
OF NUTRITIONAL DEFICIENCY DISORDERS
 Special Nutritional program 1970
 Mid-day meal program. 1957
 Anemia prophylaxis program. 1970
 National iodine deficiency disorders control program.
1962

7.  National School health program
 National mental health program
 National program for control of blindness
 Vitamin A deficiency controlprogram
 National cancer control program
NATIONAL PROGRAMS RELATED TO
CONTROL OF NON COMMUNICABLE
DISEASE

8.  National diabetes control program
 Child welfare program for disabled children
 National water supply and sanitation program
 National family welfare program
 Minimum needs program
NATIONAL PROGRAMS …

9. NATIONAL RURAL
HEALTH MISSION

10. 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.

11.  Population stabilization, gender and
demographic balance.
 Revitalize local health traditions and
mainstreamAYUSH
 Promotion of healthy life styles

12. 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 theASHA
 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.

13.  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.

14. NATIONAL PROGRAMS
RELATED TO MOTHER
AND CHILD CARE

15. 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

16. 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

17. Screen women identified as pregnant for any of the 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

18. 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.

19. INTEGRATED CHILD
DEVELOPMENT SERVICE
SCHEME (ICDS) (1975)
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.

20.  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.

21. INTEGRATED CHILD DEVELOPMENT
SERVICE SCHEME (ICDS), BENEFICIARY
AND SERVICES
BENEFICIARY
Children of below 3 years
age group
SERVICES
• Health check up
• Immunization
• Referral services
• Supplementary nutrition

22. BENEFICIARY AND SERVICES CONTINUEE…
BENEFICIARY
Children of 3-6 year age
group
SERVICES
 Non formal preschool education
 Health check up
 Immunization
 Referral services
 Supplementary nutrition

23. BENEFICIARY
Expectant and nursing
women
SERVICES
 Health check up
 Immunization against tetanus of
expectant
 Nutrition and health education
 Supplementary nutrition
BENEFICIARY AND SERVICES CONTINUEE…

24. BENEFICIARY
Other women of 15 to
45 years
SERVICES
Nutritional and health
education
BENEFICIARY AND SERVICES CONTINUEE…

25. 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.

26. 1997 RCH
CSSM
Family
welfare
REPRODUCTIVE & CHILD HEALTH(RCH)

27. 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.

28.  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.

29. COMPONENTS
Prevention
of RTI/STD
Adolscvence
Child
survival
Safe Familly
mothrhood welfreand
Planning
Community
participation
Client
participation

30. SERVICES PROVIDED
For the children
 Essential newborn care
 Exclusive breastfeeding
 Immunization
 Appropriate management ofARI
 Vitamin Aprophylaxis
 Treatment of anemia

31. 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

32. 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.

33. 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

34. NATIONAL PROGRAMS
RELATED TO CONTROL
OF COMMUNICABLE
DISEASE

35.  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

36. 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

37. 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

38. 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

39. 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.

40. 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.

41. MEDICINE

42. 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.

43. DRUG DOSE
Drug Dose adults children
• Isoniazid
• Rifampicin
• Pyrazinamide
• Ethambutol
• Streptomycin
600 Mg/kg
450*Mg/kg
1500Mg/kg
1200 Mg/kg
750 Mg/kg
10 –15 Mg/kg
10 Mg/kg
35 Mg/kg
30 Mg/kg
15 Mg/kg

44. 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

45. 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

46. 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.

47. NATIONAL AIDS CONTROL
PROGRAM (1987)
1987-NACP
1991 –NACP PHASE 1
1992 -National AIDS control organization
1999 –NACP PHASE 2
2011 –NACP PHASE 3

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

49. 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

50.  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.

51. NATIONAL VECTOR BORNE
DISEASE CONTROL
PROGRAM

52.  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)

53. 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

54. 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

55. 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.

56. 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.

57. NATIONAL PROGRAMS
RELATED TO CONTROL OF
NUTRITIONAL DEFICIENCY
DISORDERS

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

59. SPECIAL NUTRITION
PROGRAM 1970

60. 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

61. MIDDAY MEAL
PROGRAM
(1961)

62. 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.

63. 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.

64. 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

65. 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 )

66. 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

67. 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.

68. NATIONAL PROGRAMS
RELATED TO CONTROL OF
NON COMMUNICABLE
DISEASE

69. 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)

70. SCHOOL HEALTH
PROGRAMME (1977)

71. 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

72. 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

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

74. 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.

75. NATIONAL PROGRAM FOR
CONTROL OF BLINDNESS (1976)

76.  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

77. 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.

78. 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 DEFICIENCYCONTROL
PROGRAM (1970)

79. PREVENT VIT-A DEFICIENCYTHROUGH
 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 Astores)

80. 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

81. GOALANDOBJECTIVE
 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.

82.  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.

83. 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

84. 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.

85. 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 NationalAdvisory
Council for the physically challenged started.
Cont……

86. 3FYP-Attention was given to rural areas and facilitated
training and rehabilitation of the physically challenged.
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.

87. 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……

88. 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.

89. 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……

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

91. NATIONAL FAMILY WELFARE
PROGRAM (1952)
o 1951, 100% Centrally Sponsored, concurrent list
o First country in the world
o 1961 Family Welfare Dept.- created in 3rd FYP
o 4th FYP - integration of Family Planning services
with MCH services
o MTP Act introduced1972
o 5th FYP(1975-80) The ministry of Family Planning
was renamed “Family Welfare”