National Health Programme Part 2

1stYear MSc Nursing
Medical Surgical Nursing
MIMS CON

1. NATIONAL HEALTH PROGRAMME Prepared by Ms. Theertha P Krishna 1 st Year MSc Nursing

2. UNIVERSAL IMMUNIZATION PROGRAMME

3. UNIVERSAL IMMUNIZATION PROGRAMME WHO launched Expanded Programme on Immunization(EPI) in 1974 against six , most common, preventable disease viz diphthehria , pertusis , tetanus, polio, tuberculosis polio., tuberculosis, and measeles .

4. UNIVERSAL IMMUNIZATION PROGRAMME The UNICEF in 1985 renamed it as “ Universal Child Immunization”(UCI). The Government of India launched EPI in 1978. Objective: reducing the mortality and morbidity resulting from vaccine preventable disease of childhood and to achieve self suffiency in the production of vaccines.

5. UNIVERSAL IMMUNIZATION PROGRAMME Universal Immunization Programme was started in India in 1985. Component : immunization of pregnant women against tetanus and immunization of children in their first year of life agaianst the six EPI target diseases. The aim was to achieve 100 per cent coverage of pregnant women with 2 doses of tetanus toxoid (or a booster dose), and at least 85 per cent coverage of infants with 3 doses each of DPT, OPV, one dose of BCG and one dose of measles vaccine by 1990.

6. PULSE POLIO IMMUNIZATION PROGRAMME Pulse Polio Immunization Programme was launched in the country in the year 1995 . In this programme children under five years of age are given additional oral polio drops in December and January every year on fixed days . As on 25th Feb 2012, India was removed from the list of polio endemic countries , and on 27th March 2014, India was certified as polio-free country.

7. INTRODUCTION OF HEPATITIS-B VACCINE In 2010-2011 , Government of India universalized hepatitis B vaccination to all States/UTs in the country . Monovalent hepatitis B vaccine is given as intramuscular injection to the infant at 6th, 10th and 14th week alongwith primary series of DPT and polio vaccines

8. INTRODUCTION OF JE VACCINE The programme was introduced in 2006. Single dose of JE vaccine was given to all children between 1 to 15 years of age through campaigns

9. INTRODUCTION OF PENTAVALENT VACCINE (DPT + Hep -B + Hib ) India introduced pentavalent vaccine containing DPT, hepatitis B and Hib vaccines in two states viz. Kerala and Tamil Nadu under routine immunization programme from December 2011 . DPT and hepatitis B vaccination require 6 injections to deliver primary doses.

10. MISSION INDRADHANUSH The Government of India launched Mission Indradhanush on 25th December 2014 , to cover children who are either unvaccinated or partially vaccinated against seven vaccine preventable diseases, i.e., diphtheria, whooping cough, tetanus, polio , tuberculosis, measles and hepatitis B . The goal is to vaccinate all under-fives by the year 2020.

11. NATIONAL RURAL HELATH MISSION Govt. of India launched NRHM on 5 th April 2005 for a period of 7years (2005-2012).

12. Plan of action Creation of a cadre of Accredited Social Health Activist (ASHA) Strengthening of sub- centres Strengthening of primary health centres Strengthening community health centres Promotion of “ Rogi Kalyan Samiti ”

13. SELECTION OFASHA ASHA must be resident of thevillage . Women married/ widow/divorced. Age group of 25 to 45 years, with formal education upto 8 th . Having communication skills and leadership qualities. One ASHA for 1000 population.

14. REPRODUCTIVE AND CHILD HEALTH PROGRAMME

15. REPRODUCTIVE AND CHILD HEALTH “People have the ability to reproduce and regulate their fertility, women are able to go through pregnancy and child birth safely ,the outcome of pregnancies is successful in terms of maternal and infant survival and well being and couples are able to have sexual relations free of fear of pregnancy and contracting disease”. Programme launched on 15 th October 1997

16. RCH I PHASE COMPONENT F amily planning Child survival and safe motherhood component Client approach to health care Prevention/management of RTI/ STD/AIDS.

17. INTERVENTIONS OF RCH PHASE I Essential obstetric care Emergency obstetric care 24 hour delivery services at PHCs / CHCs. Medical termination of pregnancy Control of RTI/ STD Immunization Essential newborn care

18. INTERVENTIONS OF RCH PHASE I Diarrheal disease control Acute respiratory disease control Prevention and control of Vitamin A deficiency in children Prevention and control of anemia in children RCH camps RCH out reach scheme

19. INTERVENTIONS OF RCH PHASE I Boarder District Cluster Strategy (BDCS) Introduction of Hepatitis B vaccination Training of Dias.

20. Rch phase ii Began from 1 st April,2005. Focus is to reduce maternal and child morbidity and mortality with emphasis on rural health care.

21. Strategies of rch phase ii Essential obstetric care Institutional delivery Skillled attendenceat delivery Emergency obstetric care Operating first referral units Operating phcs / chcs for round the clock delivery services.

22. Strategies of rch phase ii S trengthening referral system Newer initiatives: Training of MBBS doctors in life saving anesthetic skills of emergency obstetric care. Setting up of blood storage centers at frus according to government of india guidelines.

23. Janani suraksha yojana Launched on 12thApril 2005. The National Maternity Benefit scheme is modified to JSY. Objective; reducing maternal mortality and infant mortality through encouraging delivery at health institutions and focusing at institutional care among women in below poverty line families .

24. Vandemataram scheme A voluntary scheme wherein any obstetric and gynecologist specialist, maternity home, nursing home, lady doctor/ MBBS doctor can volunteer themselves fro providing safe motherhood services.

25. Janani Shishu Suraksha Karyakram (JSSK) Govt.of India launched the new initiative, to make better health facilities for women and child.

26. Navjat shishu suraksha karyakram NSSK NSSK is a programme aimed to train health professionals in basic newborn care and resuscitation.

27. NATIONAL PROGRAMME FOR PREVENTION AND CONTROL OF CANCER, DIABETES, CARDIOVASCULAR DISEASES AND STROKE (NPCDCS)

28. OBJECTIVES OF DCS ,OF NPCDCS 1) Prevent and control common NCDs through behavior and life style changes, 2) Provide early diagnosis and management of common NCDs through opportunistic screening 3) Build capacity at various levels of health care for prevention, diagnosis and treatment of common NCDs.

29. OBJECTIVES OF NPCDCS 4) Train human resource within the public health setup viz doctors, paramedics and nursing staff to cope with the increasing burden of NCDs 5) Establish and develop capacity for palliative & rehabilitative care

30. CANCER COMPONENT OF NPCDCS National Cancer Control Programme launched in 1975-76. Objective: prevention, early diagnosis and treatment. Programme revised in 1984-85 and subsequently in December 2004. In 2010 programme integrated with National Programme on Prevention and Control of Diabetes, Cardiovascular Disease and Stroke.

31. SCHEMES UNDER REVISED PROGRAMME Regional cancer center scheme Oncology wing development scheme Decentralized NO scheme IEC activities at central level Research and training

32. Health Facility Packages Of Services Sub centre 1. Health promotion for behavior change. 2.‘Opportunistic’ Screening using B.P measurement and blood glucose by strip method. 3. Referral of suspected cases to CHC.

33. Community health centre 1 . Prevention and health promotion including counseling. 2. Early diagnosis through clinical and laboratory investigations. 3. (Common lab investigations: Blood Sugar, lipid profile, ECG, Ultrasound, X ray etc.) 4. Management of common CVD, diabetes and stroke cases (out patient and in patients.) 5. Home based care for bed ridden chronic cases. 6. Referral of difficult cases to District Hospital/higher health care facility

34. District Hospital 1. Early diagnosis of diabetes, CVDs, Stroke and Cancer 2. Investigations: 3. Blood Sugar, lipid profile, Kidney Function Test (KFT),Liver Function Test ( LFT), ECG, Ultrasound, X ray, colposcopy , mammography etc.(if not available, will be outsourced) 4. Medical management of cases (out patient , inpatient and intensive Care). 5. Follow up and care of bed ridden cases. 6. Day care facility. 7. Referral of difficult cases to higher health care facility. 8. Health promotion for behavior change.

35. Tertiary Cancer Centre Comprehensive cancer care including prevention, early detection, diagnosis, treatment, minimal access surgery after care, palliative care and rehabilitation.

36. Role of Nurse Organizer Educator Supervisor Manager Potentiator Team Leader Collaborator

37. NATIONAL FAMILY WELFARE PROGRAMME

38. History Of Family Welfare Programme It was started in year 1951 . India launched family planning programme in 1952. In 1977, the govt. of India redesignated the “ national family planning programme “ as the “ national family welfare programme “, and also changed the name of the ministry of health and family planning to ministry of health and family welfare

39. Aim & Objectives Of Family Welfare Programme To promote the adoption of small family size norm, on the basis of voluntary acceptance. To promote the use of spacing methods. To ensure adequate supply of contraceptives to all eligible couples within easy reach. To arrange for clinical and surgical services so as to achieve the set targets. Participations/ local leaders/ local self government, in family welfare programme at various levels.

40. Strategies of family welfare programme Integration with health services Concentration in rural areas Literacy Raising the age for marriage

41. Delivery of Family Welfare Programme take place at the following levels: At The Centre Level ADMINISTRATIVE APPARATUS Department Of Family Welfare ( DoFW ) create in 1966 Central Ministry of Family and Health Welfare Department of Family Welfare Presided by Secretary of MoHFW Assisted by: 1. Special Secretary (Advisor) 2. Joint Secretary

42. Central Family Welfare Council of State Health Ministers. Population Advisory Council (1982) constituting 1. Member of Parliaments 2. Union Health Ministers and 3. Health experts . Works as Think Tank to analyse the implementation of programmes Advise the government suitably. Cabinet sub-committee headed by Prime Minister. Periodic review of progress. National Institute of Health and Family Acts as an Apex Technical Institute for Education, Training services, Research and Evaluation.

43. At State Level State Family Welfare Bureau It is a part of State Health and Family welfare directorate. At present 25 State Family Welfare Bureaus are functioning. Regional Office for Health and Family Welfare (1979)

44. At District Level District Family Welfare Bureau Consists of three divisions- 1 . Administrative division : headed by District Family Welfare Officer. 2. Mass Education and Media division : headed by District Mass Education and Media Officer. 3. Evaluation Division : headed by the Statistical Officer.

45. At Community Health Centre All family planning services including laparoscopic sterilization and safe abortion services. Follow up services and training and supervision of field level staff. 24x7 specialist services.

46. Primary Health Centres Medical officers trained to provide MTP , sterilization and copper-T IUD insertion . Follow up services, counseling and appropriate referral. Training and supervision of field workers like- ASHA, ANM, MPWs .

47. At Sub- centres Staffed by one male and one female health worker. Provide family planning motivation, services and supplies in spacing methods . ANC, PNC and immunization visits. Delivery facility is NOT available at Type A subcentre . IUCD insertion. Follow up and referral services.

48. At The Village Level Village Health Guides- One per each village or a population of 1000 Spreading knowledge and information to the eligible couples. Provision of nirodh and oral pills.

49. At The Village Level Trained Dais- National target is 1 dai per 1000 population. Conduct safe deliveries in rural areas Counseling and motivation for family planning.

50. At The Village Level ASHA- Counseling of couples To provide drug kits Follow up of IUCD, sterilization and post partum clients and referral

51. New Initiatives in Family Welfare Programme 1) Home Delivery of Contraceptives (HDC) ASHA delivers contraceptives at doorstep of the beneficiaries ASHA charges a nominal amount from the beneficiaries. 2) Ensuring Spacing at Birth (ESB) ASHA counsels the newly married couples for spacing methods. Scheme currently operational in 18 states.

52. New Initiatives in Family Welfare Programme 3) Pregnancy Testing Kits NISHCHAY– Home based pregnancy test kit available to ASHAs and at sub- centres .