NATIONAL HEALTH PROGRAMME OBJECTIVES AND
TARGETS
STRATEGIC TARGET :Improving the health status of the population and
enhancing the related quality of life through:
• Creating conditions and developing personal motivation, knowledge and skills
to choose healthy lifestyle and undertaking actions for improving own health
and that of the others.
• Creating environments supportive to health, work and education.
• Reducing inequalities in health and access to health services.
National
Tuberculosis
Programme
TUBERCULOSIS
• 1962
Revised National
Tuberculosis
Control
Programme
• 1992
• DOTS (Directly Observed
Treatment Short Course
Chemotherapy)
National
Tuberculosis
Elimination
Programme
• 01.01.2020
• Lined with SDG3
• Targets- decrease
incidence by 80% and
mortality by 90%
NTEP
END TB STRATEGY:
• VISION: A world free of tuberculosis – 0 deaths; disease and suffering due to TB
• GOAL: End the global TB epidemic.
• PRINCIPLES:
• Government stewardship and accountability with monitoring and evaluation.
• Strong coalition with civil society organizations and communities.
• Protection and promotion of human rights, ethics and equity.
• Adaptation of the strategy and targets at country level, with global collaboration.
• The Global plan’s targets are designed as 90-90-90 targets.
• 90% of all people with TB.
• 90% of the key population.
• 90% treatment success.
National Polio Elimination Programme (NPEP)
• Routine immunization- OPV, IPV
• AFP surveillance
• For age group 0-15 years
• Done by MBBS
• ‘Reverse cold chain’
POLIO
• SWITCH- tOPV  bOPV
• National switch day 25th April 2016
• National Validation Day 9th May 2016 (India to be declared free of tOPV
• Destroy all tOPV on/ after 25th April 2015
National Leprosy Elimination Programme
• Aim: Is to reduce case load to 1 or less than 1 per 10,000 population.
Components of the programme:
1. Decentralized integrated leprosy services through general healthcare system.
2. Capacity building of all general health services functionaries.
3. Intensified information, education and communication.
4. Prevention of disability and medical rehablitation.
5. Intensified monitoring and supervision.
LEPROSY
• SPARSH LEPROSY AWARENESS CAMPAIGN:
• Aim: Is to generate awareness, reduce stigma and improve self
reporting of the cases.
• IEC:
• 1. Was focus on communication for behavioural changes in general
public against the stigma and discrimination against leprosy affected
people.
• 2. Making the public aware about availability of MDT, correction of
deformity through surgery.
MALARIA
• National Vector Born Disease Control Programme (NVBDCP)
• National Framework for Malaria Elimination in India (2016-2030)
• IMNCI  other diseases: Diarrhoea, Measles, Malnutrition, Pneumonia , Malaria
NATIONAL VECTOR BORN DISEASE CONTROL
PROGRAMME (NVBDCP)
• Malaria
• Filariasis
• Japanese Encephalitis
• Dengue
• Chickungunya
• Kala-Azar
different Mosquitoes
Sand flies
NATIONAL VECTOR BORN DISEASE CONTROL
PROGRAMME (NVBDCP)
• STRATEGIES:
• 1. Disease management including early case detection and complete
treatment, strengthening of referral services, epidemic preparedness
and rapid response.
• 2. IVM
• 3. Behavioural Change Communication (BCC)
PNEUMONIA
• The Integrated Global Action Plan for the Prevention and Control of
Pneumonia and Diarrhoea
• IMNCI
• SAANS by NHM
• Routine Immuniation
DIARRHOEA
• The Integrated Global Action Plan for the Prevention and Control of
Pneumonia and Diarrhoea
• IMNCI
PNEUMONIA & DIARRHOEA
• The Integrated Global Action Plan for the Prevention and Control of
Pneumonia and Diarrhoea
• IMNCI
National Programms for Communicable diseases
1. Integrated Disease Surveillance Programme (IDSP)
2. National Tuberculosis Elimination Programme
3. National Leprosy Eradication Programme (NLEP)
4. National Centre for Vector Borne Diseases Control
5. Programme for Prevention and Control of leptospirosis
6. National AIDS Control Programme (NACP)
7. Pulse Polio Programme
8. National Viral Hepatitis Control Program
9. National Rabies Control Programme
10. National Programme on Containment of Anti-Microbial Resistance (AMR)
National AIDS Control Programme (NACP)
• The ministry of health and family welfare has set up national AIDS control
organization (NACO) as a separate wing to implement and closely monitor the
various components of the programme.
Aim:
1. To prevent further transmission of HIV.
2. To decrease morbidity and mortality associated with HIV infection.
3. To minimize the socio-economic impact resulting from HIV infection.
SERVICES:
• Prevention Services:
• Targeted Intervention for High Risk Group
• Prevention interventions for migrant population at source, transit and
destination.
• Prevention and control of sexually transmitted infections/reproductive tract
infections.
• Prevention of parent to child transmission.
• Condom promotion.
• Information, education and communication and behaviour change
communication (BCC).
• Care, support and treatment services:
• Laboratory services for CD4 testing and other investigations.
• Free first-line and second-line Anti-retroviral therapy (ART) through ART
centres and link ART centres (LACs).
• Early infant diagnosis for HIV exposed infants and children below 18 months.
• HIV/TB coordination (cross referral, detection and treatment of co-infections).
• Treatment of opportunistic infections.
• Suraksha Clinic has developed a communication strategy (or
generating demand for these services).
• Pre-packed STI/RTI Colour Coded Kits:
• Kit 1 – Grey, for urethral discharge, ano-rectal discharge and cervicitis.
• Kit 2 – Green, for vaginitis.
• Kit 3 – White, for genital ulcers.
• Kit 4 – Blue, for genital ulcers.
• Kit 5 – Red, for genital ulcers.
• Kit 6 – Yellow, for lower abdominal pain.
• Kit 7 – Black, for inguinal bubo.
• National strategic plan for HIV/AIDS and STI 2017-2024
National Rabies Control Programme
Categories of contact with suspect rabid
animal
Category I – Touching or feeding animals,
licks on intact skin
Post exposure porphylaxis measures
Category II – Nibbling of uncovered skin,
minor scratches or abrasions without
bleeding.
Immediate vaccination and local treatment
of the wound
Category III – Single or multiple
transdermal bites or scratches, licks on
broken skin; contamination of muscous
membrane with saliva from licks, contacts
with bats.
Immediate vaccination and administration of
rabies immunoglobulin; local treatment of
the wound
None
Post exposure prophylaxis:
• Essen regimen: The 5-dose regimen prescribes 1 dose on each of days 0, 3, 7, 14
and 28. Dose – 0.5 ml route IM .
• Zareb regimen: The 4-dose abbreviated multisite regimen. Prescribes 2 doses on
day 0, followed by 1 dose on each of days 7 and 21. Dose – 0.5 ml route IM.
• Post exposure prophylaxis for previously vaccinated individuals:
• Give by ID route on day 0 and 3.
• Rabies immunoglobin. Dose – 20 IU/kg body weight for equine immunoglobin
and F(ab)2 product. It is 40 IU/kg body weight.
National Programms FOR Non-communicable diseases
1. National Tobacco Control Programme(NTCP)
2. National Programme for Prevention and Control of Cancer, Diabetes,
Cardiovascular Diseases & Stroke (NPCDCS)
3. National Programme for Control Treatment of Occupational Diseases
4. National Programme for Prevention and Control of Deafness (NPPCD)
5. National Mental Health Programme
6. National Programme for Control of Blindness& Visual Impairment
7. Pradhan Mantri National Dialysis Programme
8. National Programme for the Health Care for the Elderly (NPHCE)
9. National Programme for Prevention & Management of Burn Injuries
(NPPMBI)
10. National Oral Health programme
NATIONAL TOBACCO CONTROL PROGRAMME (NTCP)
Main components:
1. Public awareness / Mass media.
2. Establishment of tobacco product testing lab, to build regulatory capacity.
3. Monitoring and evaluation including surveillance.
4. School programmes.
5. Provision of Tobacco Cessation.
NATIONAL PROGRAMME FOR PREVENTION AND CONTROL OF
CANCER, DIABETES, CARDIOVASCULAR DISEASES & STROKE
(NPCDCS)
Major objectives:
1. Prevent and control common NCDs through behaviour and lifestyle changes.
2. Provide early diagnosis and management.
3. Build capacity at various levels of healthcare for prevention, diagnosis and treatment of
common NCDs.
4. Train human resources within the public health setup through doctors, paramedics and
nursing staff.
5. Establish and develop capacity for paliative and rehabitative care.
PREVENTION OF HYPERTENSION (PRIMARY)
Modification
Recommendation
Approximate Systolic BP
Reduction, Range
Weight reduction
Maintain normal body weight
(BMI 18.5-24.9)
5-20mm Hg/10 kg
weight loss
Adopt DASH eating plan
Consume a diet rich in fruits,
vegetables and low-fat dairy products
with a reduced content of saturated
fat and total fat
8-14 mm Hg
Dietary sodium reduction
Reduce dietary sodium intake to
no more than 100 mEg/d (2.4g
sodum or 6g sodium chloride)
2-8 mm Hg
Physical activity
Engage in regular aerobic physical
activity such as brisk walking (at least
30 mins per day, most days of the
week)
4-9 mm Hg
Moderation of alcohol
consumption
Limit consumption to no more
than 2 drinks per day (1 oz or
30 ml ethanol eg. 24 oz beer,
10 oz wine) in most men, and
no more than 1 drink per day
in women and lighter weight
people
2-4 mm Hg
SECONDARY PREVENTION
• Early case detection
• Treatment: aim of the treatment should be BP
below 140/90 mmHg.
• Patient compliance: patient should be
motivated to continue life long intake of
medicine by providing adequate health
education.
PREVENTION OF DIABETES
• Primary Preventions:
• 1. Population strategy – The main focus is primordial prevention in
type 2 diabetes such as maintenance of normal body weight through
physical activity and healthy nutritional habits. Proper protein intake,
high intake of dietary fibre and avoidance of sweet fruits.
• 2. High risk strategy –The target population groups are people living a
sedentary lifestyle over nutrition, obesity, consumption of alcohal,
oral contraceptives, smoking, high triglyceride levels.
• Secondary preventions:
• Diabetes is already detected, now the aims of treatment are:
• 1. To maintain blood glucose level as close within normal limits.
• 2. To maintain ideal body weight.
• 3. To maintain a diet and taking prescribed oral anti-diabetic drugs.
• 4. Self-care.
Tertiary preventions:
• Diabetes is the major cause of disabilities:
• 1. Blindness
• 2. Kidney function
• 3. Coronary thrombosis
• 4. Gangrene of lower extremities
• Main objective is to organize, specialized clinics and units capable of
providing diagnostic and management skills of a high order.
Measurement
Diagnostic cut-off value
Fasting venous of capillary
Plasma glucose
126 mg/dL
2-hour post-load venous
Plasma glucose
200 mg/dL
2-hour post-load capillary
Plasma glucose
220 mg/dL
Random plasma glucose
200 mg/dL
HbA1c
6.5% (48mmol/mol)
National Programme for Control Treatment of
Occupational Diseases
• The following research project have been proposed by government:
• 1. Prevention, control and treatment of silicosis and silico-TB in agate
industry.
• 2. Occupational health problem of tobacco harvesters and their
prevention.
• 3. Hazardous process and chemicals, database generation,
documentation and information dissemination.
• 4. Capacity building to promote research, education and training at
national institute.
• 5. Health risk assessment and development of intervention
programmes.
• 6. Prevention and control of occupational health hazards among salt
workers in remote desert areas.
National Mental Health Programme
• Aim:
• 1. Prevention and treatment of mental and neurological disorders and
their associative disability.
• 2. Use of mental health technology to improve general health
services.
• 3. Application of mental health principles in total national
development to improve quality of life.
• Objectives:
• 1. To ensure availability and accessbility of minimum mental health
care for all in the forseeable future.
• 2. To encourage application of mental health knowledge in general
health care and in the social development.
• 3. To promote community participation in the mental health services
development, and to stimulate efforts towards self-help in the
community.
National Programme for Control of Blindness &
Visual Impairment
• Objectives:
• 1. To continue three ongoing signature activities i.e. performance of
66 lacs cataract operations per year; school eye screening and
distribution of 9 lacs free spectacles per year to children suffering
from refractive errors.
• 2. To reduce the backlog of avoidable blindness through
identifications and treatment of curable blind at primary, secondary
and tertiary levels.
• 3. Develop and strengthen the strategy of NPCB for “Eye Health For
All”.
• 4. Strengthening the existing infrastructure facilities and developing
additional human resources.
• 5. To enhance community awareness on eye care and lay stress on
preventive measures.
Vision 2020: The Right to Sight
• 1. Target diseases are cataract, refractive errors, childhood blindness,
corneal blindness, glaucoma, diabetic retinopathy.
• 2. Human resource development as well as infrastructure and
technology development at various levels of health system. The
proposed four tier structure includes Centres of Excellence (20),
Training Centres (200), Service Centres (2,000) and Vision Centres
(20,000).
National Programms for NUTRITION
• National Iodine Deficiency Disorders Control Programme
• MAA (Mothers’ Absolute Affection) Programme for Infant and Young Child Feeding
• National Programme for Prevention and Control of Fluorosis (NPPCF)
• National Iron Plus Initiative for Anaemia Control
• National Vitamin A prophylaxis Programe
• Integrated Child Development Services (ICDS)
• Mid-Day Meal Programme
National Iodine Deficiency Disorders Control Programme
Objectives:
• Surveys to assess the magnitude of the Iodine Deficiency Disorders in
districts.
• Supply of iodized salt in place of common salt.
• Resurveys to assess iodine deficiency disorders and the impact of
iodized salt after every 5 years in districts.
• Laboratory monitoring of iodized salt and urinary iodine excretion.
• Health education and publicity.
National Iron Plus Initiative for Anaemia Control
• Includes the focus of Poshan Abhiyan on the first 1,000 days of the child which
includes the 9 months of pregnancy, 6 months of exclusive breastfeeding and the
period from 6 months to 2 years.
• It will reduce both infant mortality rate and maternal mortality rate.
• Attention is also given on children in the age group of 3 to 6 years.
National Vitamin A prophylaxis Programme
•
•
•
•
Recommended oral dose of Vitamin A according to the child’s age:
<6 months = 50,000 IU
6-12 months or if weight <8 kg = 100,000 IU
>12 months = 200,000 IU
INTEGRATED CHILD DEVELOPMENT SERVICES (ICDS)
• Main focus on supplementary nutrition.
• Vitamin A prophylaxis, Iron and folic acid distribution.
• The beneficiaries are preschool children below 6 years and adolescent girls 11 to
18 years, pregnant and lactating mothers.
• The workers at the village level are called aanganwadi workers which covers a
population of 400 to 800 and mini aanganwadi covers 150 to 400 population.
MID-DAY MEAL PROGRAMME
Principles are:
1.
The meal should be a supplement and not a substitute to the home diet.
2.
Meal should supply at least one third of the total energy requirement, and half of the
protein needed.
3.
Cost of the meal should be reasonably low.
4.
Meal should be such that it can be prepared easily in schools; no complicated cooking
process should be involved.
5.
As far as possible, locally available foods should be used; this will reduce the cost of the
meal.
6.
Menu should be frequently changed to avoid monotony.
National ProgrammEs for Reproductive, Maternal,Neonatal, Child
and Adolescent health
1.
Janani Shishu Suraksha Karyakaram (JSSK)
2.
Rashtriya Kishor Swasthya Karyakram(RKSK)
3.
Rashtriya Bal SwasthyaKaryakram (RBSK)
4.
Universal Immunisation Programme
5.
Mission Indradhanush / Intensified Misson Indradhanush
6.
Janani Suraksha Yojana (JSY)
7.
Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA)
8.
Navjaat Shishu Suraksha Karyakram (NSSK)
9.
National Programme for Family planning
HEALTH SYSTEM STRENGTHENING PROGRAMS
•
•
•
•
•
•
Ayushman Bharat Yojana
Pradhan Mantri Swasthya Suraksha Yojana (PMSSY)
LaQshya’ programme (Labour Room Quality Improvement Initiative)
National Health Mission
Ayushman Bharat Digital Mission (ADHM)
PM Ayushman Bharat Health Infrastructure Mission
THANK YOU