National health programs in pediatrics (1).pptx

Information on national programme in peadetrics in India.

1. National health programs in pediatrics By-Dr. Ashwinkumar Badure & Dr. Aaditya Joshi

2. 2 Sr. No NATIONAL PROGRAMME YEAR 1 Universal Immunization Program 1985 2 The Diarrhoea Disease Control Program 1981 3 Acute Respiratory Infection Control Program 1990 4 Child Survival and Safe Motherhood 1992 5 Reproductive and Child Health i )Phase I ii)Phase II 1997 2005 6 National Rural Health Mission 2005 7 Reproductive, Maternal, New-born, Child and Adolescent Health 2013 8 National Health Mission 2013 9 India New-Born Action Plan 2014 10 Mission Indradhanush 2014 11 Home Based Care of Young Child 2018 12 Ayushman Bharat 2018

3. Universal immunisation programme Launched in 1985. Aims and Objectives : To reduce Mortality and Morbidity dur to 6 VPD’s Indigenous vaccine production capacity enhanced Cold chain establishment. Phased implementation; all districts should be covered by 1989-1990. Monitory and evaluation system implementation.

4. Initially comprised of six vaccines

5. DIARRHEA DISEASE CONTROL PROGRAM (DDCP) Launched in Year-1981 Aims Long Term Better MCH care Maternal nutrition Child nutrition Promotion of breast feeding Appropriate weaning practices Supplementary feeding Vitamin A supplementation Preventive strategies Sanitation Health education Immunisation Fly control Control of Diarrhoea epidemic. Short Term Appropriate clinical management Fluid therapy (Oral and IV) Use of Antibiotics Zinc supplementation

6. DDCP also includes Intensified Diarrhea Control Fortnight(IDCF) Launched in 2014 Observed in the months of June and July every year. Home visits by health care workers of children aged less than 5 years and distribution of free ORS sachets is exercised. Objectives: To reduce number of deaths due to diarrhea Use of ORS and Zinc Supplementation. Maintenance of hydration. Awareness of diarrhoea.

7. ORS Preparation:

8. ACUTE RESPIRATORY INFECTION CONTROL PROGRAM Launched in year 1990. Includes: URTI Common cold Pharyngitis ASOM and CSOM LRTI Laryngitis Bronchitis Pneumonia

9. Prevention: Improving primary medical care services. Developing better methods for early detection, treatment and prevention of ARI’s Feeding children with adequate nutrition to boost immune system. Immunization Measles vaccine H. Influenza vaccine Pneumococcal Vaccine Vitamin A administration Exclusive breast feeding upto first 4-6 months of child. Proper weaning.

10. CHILD SURVIVAL AND SAFE MOTHERHOOD (CSSM) Launched in year 1992. It includes: Maternal: Better ANC Promote Institutional Deliveries. Advanced emergency obstetrics care. Anemia prophylaxis and therapy. Birth timing and spacing. Child: Universal Immunization Program (UIP) Diarrheal Disease Control Program (DDCP) Acute Respiratory infections Control Program (ARCP) Vitamin A supplementation Essential New-born Care.

11. REPRODUCTIVE AND CHILD HEALTH PROGRAM (RCH) Launched in year 1997 (Phase-I) People have ability to regulate and reproduce fertility. Women are able to go through pregnancy and child birth safely. Maternal and infant wellbeing. Couples are able to have sexual relations free of fear of pregnancy and STD’s. RCH includes : CSSM Program for Family planning. Reproductive Tract Infections . RTI’s

12. Objectives: To improve efficiency, quality and coverage of Family Wellness Services. To reduce Maternal Mortality Rate and Infant Mortality Rate. Regulate fertility and ensure safe pregnancy and child birth. Control of Reproductive tract infections, UTI and STDs and other infections. Management and prevention of unwanted and accidental pregnancies. Interventions: Essential and Emergency Obstetric and new-born care. 24 hr. delivery services at PHC. Prevention and control of Vit A Deficiency and Anemia in children. Training of Dai’s.

13. REPRODUCTIVE AND CHILD HEALTH PROGRAM (RCH) PHASE II Launched on 1 st April 2005 (Phase-II) Reduce maternal and child morbidity & mortality with emphasis on rural health care Promotion of adolescent health. Major Strategies- Essential obstetric care Institutional delivery Skilled attendants at delivery Policies to permit use of drugs in emergency by ANM’s/LHV’s/SN’s to reduce maternal mortality Emergency obstetric care Operationalising first referral units Operationalising PHC’s and CHC’s for round the clock delivery services 3. Strengthening referral services

14. RMNCH+A Reproductive, Maternal, New-born, Child and Adolescent Health Program. Launched in Feb. 2013. Involves 3 tiered health system and employment of 9.15 lakh ASHA workers. Links MCH to Reproductive Health , Family Planning, Adolescent Health , HIV, Gender pre conception and Prenatal diagnostic techniques. Implemented 184 high priority districts and 5x5 matrix. Targets (By 2017) Reduction of Infant Mortality Rate to 25/1000 live births. Reduction of Maternal Mortality Rate to 100/1lakh live births. Reduction of total Fertility rate to 2.1.

15. Interventions: Adolescent Nutrition: Iron and Folic acid supplementation. Facility based adolescent reproductive and sexual health services. Information and counselling. Menstrual hygiene. Preventive Health checkups.

16. MISSION INDRADHANUSH Launched on 25 Dec,2014. It is immunization drive for: TB, Diphtheria, Tetanus, Polio, Hepatitis-B, Pneumonia ,H. Influenza-B, Measles, Rubella , Japanese Encephalitis and Rota Virus. Rubella, JE and Rota in selective states and districts . It aims for 90% coverage by the year 2020. Objectives: To vaccinate all vaccinated and partially vaccinated children. To vaccinate pregnant women (TT), supplementation of zinc& ORS (for diarrhea/dehydration) and Vitamin A to boost child’s immunity.

17. Phases Launched on Districts coverage Population Coverage Children Pregnant Women I 7 April, 2015 201 75 lakh 20 Lakh II October 2015 352 279 medium focus 73 High focus 1.48 Cr 38 Lakh III (Focused on DPT Booster and TT) 7 April, 2016 216 (where immunization coverage is low) 2.1 Cr 56 Lakh IV 7 February ,2017 North-Eastern States 2.53 Cr 68 Lakh V 2018 190 Lowest performing districts - - VI 2019 554 - - VII Till March 2020 690 3.76 Cr 94.6 Lakh

18. National Rural Health Mission (NRHM) Launched on 5 April, 2005. For a period of 5 years (till 2012) Focuses on decentralization. Investment in Public Health. Improvement in community health center. Objectives: Accessible, Affordable, Effective and Reliable Primary Health Care. Appointing ASHA workers. Integrated multiple vertical programs at different levels.

19. In 2005 RCH and NRHM were merged to better focus on Maternal and Child Health Care. Principles: Deployment of 9 Lakh ASHA workers. Increase in intake of ANM, Nurses and Doctors. Strengthening Primary Health Care Infrastructure. Creating Emergency transport network.

20. National Health Mission Launched in May 2013. It integrates NRHM & NUHM. Components: RMNCH+A Control of Communicable and Non Communicable Diseases. Objectives: Promotion of institutional delivery (JANANI SURAKSHA YOJANA) Emphasis on new-born care to reduce Mortality and Morbidity. Setting of special new-born care units(SNCU),New-Born stabilization units (NBSU) and New-Born Care Corners(NBCC) Vitamin K injection at birth, Antenatal Cortico-steroids for pre-term labour , Kangaroo mother care and using injection Gentamicin in suspected cases of sepsis. Free Drugs, Diagnostics and Diet Consultations. Setting up training units for Doctors, ANM, Nurses.

21. Kangaroo Mother Care (KMC)

22. HOME BASED CARE OF YOUNG CHILD (HBYC) Launched IN 2018 3 monthly home visits by ASHA workers of children aged between 3 months-15 months. Includes: Introduction of complementary feed at 6 months with adequate nutrition. Continuing breast feeding . Counselling for immunization. Early care seeking in Diarrhea and Pneumonia. Growth monitoring and care of undernourished. Early childhood development. Ensure hygiene and sanitation.

23. INDIA NEWBORN ACTION PLAN Launched IN June,2014. Reduction of preventable new-born deaths and still births. Goals: Single digit neonatal mortality and still birth rates by 2030. Action plans: Preconception and antenatal care Care during labour and child births Immediate new-born care. Care of healthy new-born Care of small and sick new-born Care beyond new-born survival

24. Interventions

25. AYUSHMAN BHARAT PROGRAMME Launched in February 2018. Aims to cover preventive and health promotive interventions at primary, secondary and tertiary care system. It includes: Health and Wellness Centre: Under this 1.5 lakh health centers will bring health care near homes of every person. It will also provide non-communicable diseases and maternal and child health services. Will provide drugs and diagnostic facilities.

26. 2) National Health Protection Scheme: Also called as Pradhan Mantri Jan Arogya Yojana (PMJAY). More than 80 % of Indian population does not have Health care and spends on an average 10% of total income on health care. PMJAY will put cap on medical bills and help reduce expense of people. PMJAY will give 5 lakh per family per year for secondary and tertiary care. PMJAY will target poor population including SC, ST’s and OBC. It aims in making all the transactions cashless and schemeless. PMJAY will give preference to families under Rastriya Swasthya Bima Yojana (RSBY).

27. REFERENCES Essential Pediatrics: O. P. GHAI Preventive and Social Medicine: K PARK https://nhm.gov.in https://mohfw.gov.in

28. THANK YOU