National Health

National Wealth Mission

Mission
2013
Combined NRHM
Combined NRHM +
+ NUHM
NUHM
By Ministry
By Ministry of
of Health
Health and
and Family
Family Welfare,
Welfare, GOI
GOI
ItIt includes
includes all
all other
other health
health programs
programs of
of India
India like
like
RMNCH+A, NPCBVI,
RMNCH+A, NPCBVI, NTEP,
NTEP, NLEP,
NLEP, NPCDCS,
NPCDCS, NTCP,
NTCP,
AMB etc.
AMB etc.
Major targets-
Major targets-
a. MMR
a. MMR <100/lac
<100/lac LB
LB (Currently
(Currently 113/lac
113/lac LB)
LB)
b. IMR
b. IMR <25/1000
<25/1000 LB
LB (Currently
(Currently 32/1000
32/1000 LB)
LB)
c. TFR
c. TFR- - 2.1
2.1 (Currently
(Currently 2.2)
2.2) (So,
(So, CPR
CPR shall
shall be
be
>60% and
>60% and NRRNRR shall
shall be
be 1)
1)
 Ayushman Bharat
Programme 2018
Pradhan Mantri Jan Aarogya Yojana (PM-JAY)

Provides cover of 5 lac per family per annum for

secondary and tertiary care across public and
private empanelled hospitals.

Covers more than 50 crore population in BPL

It subsumes other National Health Protection
schemes

1.5 lact Health and Wellness Centres will be

established
 National Tuberculosis
National Tuberculosis
Elimination Programme
Elimination Programme
ItIt is
is a
a new
new name
name for
for Revised
Revised National
National Tuberculosis
Tuberculosis
Control Programme
Control Programme (RNTCP)
(RNTCP) with
with aa new
new logo.
logo.
Category 1
Category 1 and
and 2
2 are
are treated
treated with
with the
the same
same regimen
regimen
of HRZE
of HRZE (2
(2 months
months Intensive
Intensive phase)
phase) ++ HRE
HRE (4
(4 months
months
Continuous phase)
Continuous
 Directly Observed
Directly Observed Treatment
Treatment
Shortcourse (DOTS)
Shortcourse (DOTS)
ICT based
ICT based adherence
adherence support-
support- DOTS
DOTS 99
99

Incentives-
Incentives- Patients
Patients 500/month
500/month

CXR and
CXR and CBNAAT
CBNAAT test
test in
in diagnosis
diagnosis

Daily regimens
Daily regimens and
and Fixed
Fixed dose
dose combinations
combinations
4 DOTS = Active case
Active case finding
finding

, \U > Drug resistant

Drug resistant TB
TB treatment
treatment
Pini
Nikshay
Nikshay
Online Tool
Online Tool For
For Monitoring
Monitoring and
and Surveillance
Surveillance ofTB
ofTB Control
Control
Programme. ... The word is combination of two Hindi
Programme. ... The word is combination of two Hindi
words NI
words NI and
and KSHAY
KSHAY meaning
meaning eradication
eradication of
of tuberculosis.
tuberculosis.
 Integrated Child
Integrated Child Development
Development
Services 1975
Services 1975
Heart of
Heart of ICDS-
ICDS- Anganwadi
Anganwadi
Ministry of
Ministry of Women
Women and
and Child
Child Development,
Development, GOI
GOI

Functional Unit-
Functional Unit- Community
Community Development
Development Block
Block

11 CD
CD Block
Block == 100
100 villages
villages (1
(1 lac
lac population)
population)
11 Anganwadi
Anganwadi Centre-
Centre- Per
Per 300-800
300-800 popn
popn in
in hills
hills

Per 400-800
Per 400-800 popn
popn in
in plains
plains
 Infantometer
Infantometer
Used to
Used to measure
measure length
length
up to
up to 2
2 years
years

Shakir's Tape
Shakir's Tape
Used to
Used to measure
measure Mid
Mid Arm
Arm
Circumference (MAC/MUAC)
Circumference (MAC/MUAC) on
on
field by
field by health
health workers
workers

Salter's Scale
Salter's Scale Age group
Age group -- 6
6 months
months to
to 5
5 years
years
Used to
Used to measure
measure
weight in
weight in ICDS
ICDS Severe Malnutrition
Severe Malnutrition (Red
(Red Zone)
Zone)
activities
activities
MAC
MAC < < 12.5
12.5 cm
ICDS Growth
ICDS Growth Charts
Charts
Used
Used to
to assess
assess malnutrition
malnutrition in
in ICDS
ICDS

URC- 50th
URC- 50th percentile
percentile for
for Boys
Boys
LRC- 3rd
LRC- 3rd percentile
percentile for
for Girls
Girls

Green
Green Zone
Zone is
is also
also ka
ka ROAD
ROAD TO
TO HEALTH
HEALTH

Weight-for-age GIRLS WarOrganization

heath « _—
vm ws —_— 5
Age (remy
ened wemtn eure
wed pare) oo mee os — coe
Birth to 6 months (z-scores)
Hove your child walghed at the AWC every month

wou Harpenden's Callipers

Harpenden's Callipers
WHO Growth Charts Used to measure skin fold thickness
POSHAN ®
Abhiyaan @ Poshan Abhiyaan
Poshan Abhiyaan
PM's Overarching ItIt is
is a
a multi-ministerial
the vision
the
multi-ministerial convergence
vision to
to ensure
convergence mission
ensure attainment
attainment of
mission with
with
of malnutrition
malnutrition
Scheme for Holistic free India
free India by
by 2022.
2022.

Nourishment Under Ministry

Under Ministry of
of Women
Women and
and Child
Child Development
Development
through Anganwadi
through Anganwadi Centres
Centres

Wel GIT
- eet VM,
 Mid Day
Mid Day Meal
Meal Scheme
Scheme
By Ministry
By Ministry of
of Human
Human Resource
Resource and
and
Development (Now
Development (Now known
known as
as Ministry
Ministry of
of
Education)
Education)
1/3rd Calories
1/3rd Calories and
and 1/2
1/2 proteins
proteins of
of RDA
RDA is
is
provided.
provided.
100 gg and
100 and 150
150 gg of
of cereals
cereals to
to primary
primary and
and
upper primary
upper primary children
children is
is provided
provided
respectively.
respectively.

Mid Day Meal Scheme

 National Family
National Family Planning
Planning
Programme
Programme
This logo
This logo has
has been
been set
set in
in use
use for
for the
the NFPP.
NFPP.

sitet freetare
At CelHeleOfetare
 Janani
Janani Shishu
Shishu Suraksha
Suraksha
Karyakram
Karyakram
Free diagnostics,
Free diagnostics, free
free drugs,
drugs, free
free delivery,
delivery, free
free diet,
diet, free
free
blood transfusion,
blood transfusion, free
free delivery
delivery are
are components.
components.
NewBorn
NewBorn Care
Care Corner
Corner

NewBorn
NewBorn Stabilization
Stabilization Unit
Unit

Special NewBorn
Special NewBorn Care
Care Unit
Unit

Home
Home based
based NewBorn
NewBorn Care

Janani Shishu Suraksha Karyakaram

 National Vector
National Vector Borne
Borne
Disease Control
Disease Control Programme
Programme
(NVBDCP)
(NVBDCP)
M/C
M/C Vector
Vector Borne
Borne Ds-
Ds- Malaria
Malaria

M/C Viral
M/C Viral Vector
Vector Borne
Borne Ds-
Ds- Dengue
Dengue
M/C Arboviral
M/C Arboviral VBDs-
VBDs- Dengue
Dengue

Programme includes
Programme includes Malaria,
Malaria, Dengue,
Dengue, Filariasis,
Filariasis,
NvVGBDCFP Kala Azar,
Kala Azar, JE
JE and
and CG
CG Fever.
Fever.
 National Leprosy
National Leprosy Elimination
Elimination
Programme (NLEP)
Programme (NLEP)
Uniform Multi
Uniform Multi Drug
Drug Therapy
Therapy for
for all
all patients
patients -- 33 drug
drug regimen
regimen of
of
Dapsone ++ Rifampicin
Dapsone Rifampicin ++ Clofazimine
Clofazimine

NIKUSTH-
NIKUSTH- ICT
ICT based
based online
online tracking
tracking and
and surveillance
surveillance
system for
system for leprosy
leprosy patients
patients in
in NLEP.
NLEP.

MDT Regimens
Each blister pack contains treatment for 4 weeks.

PB adult treatment:
Once a month: Day 1
- 2 capsules cf rifampicin ¢<300 me X 23
- 1 tablet cf dapsone £100 me}

Once a day: Days 2-25

- 1 tablet cof dapsone £100 me}

Full course: 6 blister packs.

PB adult blister pack

MB adult treatment:
Once a month: Day 1
- 2 capsules of rifampicin ¢300 me X 23
- 3 capsules of clofazimine {100me X 35
- 1 tablet of dapsone £100 me}
Snce a day: Days 2-28
- 1 capsuls cf clofazimine (SO mg}
- 1 tablet cof dapsone C100 mg}
MID AMS Bees Bahl eB Be ee ee I RR Re —
 National AIDS
National AIDS Control
Control
N AC O Programme 1987
(NACP) 1987
Programme (NACP)
1st case
1st case in
in India-
India- 1986
1986 (Chennai)
(Chennai)
ItIt iis
iis looked
looked after
after by
by NACO
NACO aa subunit
subunit of
of
National AIDS Control Organisation MOHFW, GOI
MOHFW, GOI
3 : :
India's Voice against AIDS ART initiated
ART initiated irrespective
irrespective of
of the
the CD4
CD4 count
count
— | Screening by
Screening by ERS
ERS Battery
Battery (ELISA,
(ELISA, Rapid
Rapid and
and
Simple tests)
Simple tests)

Integrated Counselling
Integrated Counselling and
and Testing
Testing Centre
Centre (ICTC)
(ICTC)
 suraksha
clinic
Sexual and Reproductive Health Services

A
COLOUR CODED STI/RTI DRUG KITS ACCORDING TO SYNDROME
AVAILABLE AT SURAKSHA CLINICS

COLOUR

KIT 1 GREY : URETHRAL DISCHARGE, CERVICITIS

KIT 2 GREEN : VAGINITIS

KIT 3 WHITE : GENITAL ULCERS

KIT 4 BLUE: GENITAL ULCERS

KIT S RED : GENITAL ULCERS

KIT 6 YELLOW : LOWER ABDOMINAL PAIN

KIT7 BLACK : SCROTAL SWELLING

 Mission Indradhanush
Mission Indradhanush
It includes
It includes 100%
100% coverage
coverage for
for 11
11 Vaccine
Vaccine
Preventable Diseases
Preventable Diseases by
by 2020
2020 through
through catch
catch up
up
campaigns.
campaigns.
TB, Polio,
TB, Polio, Diphtheria,
Diphtheria, Pertussis,
Pertussis, Tetanus,
Tetanus, Hepatitis
Hepatitis
om Wl, child B, Measles,
B, Measles, Rota
Rota virus,
virus, MR,
MR, IPV,
IPV, JE
JE

1 LOTT oat ete

The Switch The Switch

The Switch
H National Switch
National Switch Day
Day of
of India
India was
was 25th
25th April,
April,
=> 2016
2016
Switch from
Switch from trivalent
trivalent OPV
OPV (P1,
(P1, P2,
P2, P3)
P3) was
was
done to
done to bilavlent
bilavlent OPV
OPV (P1,P3)
(P1,P3)

tOPYV bOPV
 Vaccine Vial Monitor

©
Stage 1= good:
Utilize
@ x7
Stage 3 = bad:
Don't Utilize

CG @ Xx ©
Stage 2 = good: Stage 4 = bad:
Utilize Don't Utilize

The central square is lighter The central square is equal to, or

than the surrounding circle darker than the surrounding circle
Cold
Co | d Chain
Ch ain for
fo r Vaccines
Va ccines Dial Thermometer for using deep Freezer/ILR under Cold Chain system

Confirm WHO, Unicef standard

Dial thermometer
Dial thermometer and and
Alcohol Stem
Alcohol Stem
thermometer shown
thermometer shown in in
the images
the images toto recording
recording
temp in
temp in Cold
Cold Chain
Chain

Ice-Lined Refrigerators
Ice-Lined Refrigerators (ILR)
(ILR)
Located at
Located at PHC
PHC
Temp- 22 to
Temp- to 8°C
8° C
Storage of vaccines
Storage of vaccines
Temp is recorded twice a day
 Cold
Cold Chain
Chain for
for Vaccines
Vaccines

Ice Pack
Ice Pack
Smallest component
Smallest component of
of cold
cold chain
chain

22 vaccine
vaccine vials
vials can
can be
be kept
kept

Used
Used at
at the
the level
level of
of SubCentre
SubCentre or
or Villages
Villages

Maximum
Maximum failure
failure chances
chances

Vaccine
Vaccine Carriers
Carriers
16-20
16-20 vaccine
vaccine vials
vials can
can be
be carried
carried

Located
Located at
at level
level of
of Sub
Sub Centre
Centre or
or Village
Village

44 Ice
Ice Packs
Packs can
can be
be stored
stored
 National Programme
National Programme for
for
Control of
Control of Blindness
Blindness and
and Visual
Visual
Impairment
Impairment
Blindness- Vision
Blindness- Vision <
< 3/60
3/60 in
in best
best eye
eye with
with best
best possible
possible
correction.
correction.
ii
"

MCC- Cataract
MCC- Cataract >> Refractive
Refractive Errors
Errors

\
Prevalence is
Prevalence is 0.36%
0.36% and
and Goal
Goal is
is <
< 0.3%
0.3%

we
nn
NATONA/ 2

Wala’
VISION
VISION 2020
2020 India
India

Right to
Right to Sight
Sight Initiative
Initiative

5
hi\
To eliminate
eliminate all
all causes
causes of
of avoidable
avoidable blindness
blindness
|
To
- Cataract, RE,
Cataract, RE, Childhood
Childhood Blindness,
Blindness, Trachoma,
Trachoma, Diabetic
Diabetic
Retinopathy, Glaucoma, Corneal Blindness
Retinopathy, Glaucoma, Corneal Blindness
Vision Centre-->
Vision Centre--> Service
Service Centre-->
Centre--> Training
Training Centre-->
Centre-->
Centre of
Centre of Excellence-->
Excellence--> Apex
Apex
School- 11 teacher/150
School- teacher/150 students
students

Referral- Vision
Referral- Vision <6/9
<6/9
 Anemia Mukt
Anemia Mukt Bharat
Bharat (AMB)
(AMB) 2018
2018
To reduce
To reduce prevalence
prevalence of
of anemia
anemia by
by 3%
3% every
every year
year by
by 2022
2022

Strategy- 6
Strategy- beneficiaries ×
6 beneficiaries interventions ×
< 66 interventions X 6
6 institutional
institutional
mechanism
mechanism
 National Program
National Program for
for Prevention
Prevention
and Control
and Control of
of Diabetes,
Diabetes, Cardio-
Cardio-
Vascular Diseases
Vascular Diseases and
and Stroke
Stroke
(NPCDCS)
(NPCDCS)
Health promotion,
Health promotion, opportunistic
opportunistic screening,
screening, referral
referral ,,
diagnosis and management of none communicable diseases
diagnosis and management of none communicable diseases

National Program for Prevention and Control of

Cancer, Diabetes, CardioVascular Disease & Stroke
 Whole Community

= > hypertensive Subjects

Diagnosed Hypertension

Diagnosed and treated

Rule of Halves
Rule of Halves

Adequately treated Shown

Shown by
by Hypertension
Hypertension

Hypertension in
Community

Diabetes
Diabetes

Breast
Breast Cancer
Cancer
Awareness
Avararanace
 9 National Iodine
National lodine Deficiency
Deficiency
National ID D Disorder Control
Disorder Control Programme
Programme
Control (NIDDCP), 1992
(NIDDCP), 1992
Salt Iodinisation-
Salt lodinisation- 30
30 ppm
ppm at
at production
production level
level
Prog ramme 15 ppm
15 ppm at
at consumer
consumer level
level
 gu Mey, Ly

Z Pradhan Mantri
Pradhan Mantri Surakshit
Surakshit
Matritva Abhiyaan
Matritva Abhiyaan (SUMAN)
(SUMAN)
Free antenatal
Free antenatal care
care checkups
checkups on
on 9th
9th of
of every
every month
month
By MOHFW,
By MOHFW, GOI
GOI

Abu
Oth of Every Month
 INAP
India Newborn
Action Plan

National Health
National Health Insurance
Insurance National Tobacco
National Tobacco Control
Control Programme
Progran
Scheme (RSBY)
 Aarogya Setu
Aarogya Setu App
App
Aarogya Setu
Aarogya Setu isis aa mobile
mobile application
application
developed by the Government of
developed by the Government of India
India to
to
connect essential
connect essential health
health services
services with
with the
the
people of
people of India
India inin our
our combined
combined fight
fight
against COVID-19.
against COVID-19.

Aarogya Setu
Hara | er yeaa | wma geſan
 Employee State
Employee State Insurance
Insurance
Act,1940
Act,1940
By Ministry
By Ministry of
of Labour,
Labour, GOI
GOI
Contribution- Employer
Contribution- Employer 3.25%
3.25% of
of wages
wages
Employee 0.75%
Employee 0.75% of
of wages
wages

Sickness Benefit-
Sickness Benefit- 91
91 days
days (70%
(70% wages)
wages)
Extended Sickness
Extended Sickness Benefit-
Benefit- 22 years
years (80%
(80% wages)
wages)
Maternity Benefit-
Maternity Benefit- 26
26 weeks
weeks (100%
(100% wages)
 National Rural
National Rural Employment
Employment
Guarantee Act,
Guarantee Act, 2005
2005 (NREGA)
(NREGA)
>> 100
100 days
days of
of employment
employment per
per year
year
Max. 1member
Max. 1member per
per BPL
BPL family
family

Unskilled
Unskilled manual
manual labour
 Integrated Disease
Integrated Disease Surveillance
Surveillance
Project (IDSP)
Project (IDSP)
ntinel and
Encompasses Regular, Sentinel and Periodic
Periodic Surveillance
Surve illance

Forms for Syndromic Dx, Presumptive Dx and Lab confirmed

Dx.
National Disaster
National Disaster Response
Response Force
Force
It is
It is under
under National
National Disaster
Disaster Management
Management Authority
Authority
(NDMA)
(NDMA)
Chairperson- Prime
Chairperson- Prime Minister
Minister

Nodal Ministry-
Nodal Ministry- Home
Home Affairs
Affairs

Nodal
Nodal Centre-
Centre- District
District

World Disaster
World Disaster Reduction
Reduction Day-
Day- 13th
13th October
 Disaster Management
Disaster Management Cycle
Cycle
Health and
Health and Medical
Medical Relief:
Relief:

DISASTER
Primary phase-
Primary phase- (0-6hrs)
(0-6hrs) First
First aid,
aid, Medical
Medical care
care
MANAGEMENT
Secondary followup
Secondary followup (6-24
(6-24 hrs)
hrs) Transportation,
Transportation, Sanitation,
Sanitation,
Immunization
Immunization
Tertiary cleanup-
Tertiary cleanup- Food,
Food, Clothing,
Clothing, Shelter,
Shelter, Social
Social services
services and
and
Rehabilitation
 Pradhan Mantri
Pradhan Mantri Jan
Jan Dhan
Dhan
Yojana (PMJDY)
Yojana (PMJDY)
By Ministry
By Ministry of
of Finance,
Finance, GOI
GOI

UIDAI Aadhar
UIDAI Aadhar AADHAAR
 Unnati Jyoti
Unnati Jyoti by
by Affordable
Affordable
LEDs for
LEDs for All
All (UJALA)
(UJALA)
By Ministry
By Ministry of
of Power,
Power, GOI
GOI
Unnat Jyoti by Affordable LEDs For All Distribution of
Distribution of LEDs
LEDs at
at affordable
affordable and
and subsidized
subsidized
prices
 Pradhan Mantri
Pradhan Mantri Ujjwala
Ujjwala
Yojana (PMUY)
Yojana (PMUY)
By Ministry
By Ministry of
of Petroleum
Petroleum and
and Natural
Natural Gas,
Gas,
GOl
GOI
Free LPG
Free LPG connections
connections to
to BPL
BPL families
families and
and gas
gas
ws tn. 27m ran !| cylinders at
cylinders at subsidized
subsidized rates
rates

\PA SAB
3) 9/
 UJJAWALA Yojana
UJJAWALA Yojana
A Comprehensive
A Comprehensive SchemeScheme forfor Prevention
Prevention ofof
trafficking and
trafficking and Rescue,
Rescue, Rehabilitation
Rehabilitation and
and Re-
Re-
integration of
integration of Victims
Victims of
of Trafficking
Trafficking and
and Commercial
Commercial
Sexual Exploitation
Sexual Exploitation

By Ministry
By Ministry of
of Women
Women and
and Child
Child Development,
Development, GOI
Ministry of Women and
Child Development
 Beti Bachao
Beti Bachao Beti
Beti Padhao
Padhao
Abhiyaan
Abhiyaan
By Ministry
By Ministry of
of Women
Women and
and Child
Child Development
Development

Lea, |

ae} Jain
Save the girl child
 AYUSH
AYUSH
Department of
Department of Ayurveda,
Ayurveda, Yoga
Yoga and
and Naturopath,
Naturopath,
Unani, Siddha
Unani, Siddha and
and Homeopathy
Homeopathy
MOHFW, GOI
MOHFW, GOI

Ministry of Health & Family Welfare

Government Of India
 International Day
International Day of
of Yoga
Yoga
21st June
21st June

Yoga for Harmony & Peace

 Food Safety and Standards Authority of Ind/a

Indian
Indian Standards
Standards
Institution
Institution Food Safety
Food Safety and
and Standards
Standards Authority
Authority of
of India
India
FSSAI is
FSSAI is responsible
responsible for
for protecting
protecting and
and promoting
promoting public
public health
health
The ISI
The ISI mark
mark isis aa standards-
standards- through the
through the regulation
regulation and
and supervision
supervision of
of food
food safety.
safety.
compliance mark
compliance mark forfor industrial
industrial
products in
products in India
India since
since 1955.
1955.

Bureau
Bureau of
of Indian
Indian
Standards
Standards
BIS is
BIS is the
the National
National Standard
Standard
AGMARK
AGMARK Body of
Body of India
India established
established
AGMARK is
AGMARK is aa under the
under the BIS
BIS Act
Act 2016
2016 for
for
certification mark
certification mark the harmonious
the harmonious
employed on
employed on
agricultural products
agricultural products
Alda: J development of
development of the
the
activities of
activities of standardization,
standardization,
in India,
in India, assuring
assuring that that Bureau of Indian Standards marking and
marking and quality
quality
they conform
they conform to to aa set
set certification of
certification of goods
goods and
and for
for
of standards.
of standards. matters connected
matters connected
therewith or
therewith or incidental
incidental
thereto.
James Lind
James Lind
He worked
He worked on
on Scurvy
Scurvy and
and naval
naval hygiene
hygiene

Edward
Edward Jenner
Jenner
He coined
He coined the
the term
term Vaccination
Vaccination
He developed the first vaccine
He developed the first vaccine (Small
(Small Pox)
Pox)
 Sir Louis
Sir Louis Pasteur
Pasteur
Father of
Father of Microbiology
Microbiology
He was
He was a
a French
French microbiologist.
microbiologist.

He invented
He invented vaccines
vaccines of
of Cholera,
Cholera, Anthrax
Anthrax and
and
Rabies
Rabies
He
He also
also invented
invented Pasteurization
Pasteurization

He disapproved
He disapproved the
the Theory
Theory of
of Spontaneous
Spontaneous
Generation of Disease given by Aristotle
Generation of Disease given by Aristotle

He gave
He gave the
the Germ
Germ Theory
Theory of
of Disease
 John Snow
John Snow
Father of
Father of Epidemiology
Epidemiology

Father of
Father of Modern
Modern Epidemiology
Epidemiology

He
He worked
worked onon Cholera
Cholera and
and therefore
therefore Cholera
Cholera is
is
regarded as Father of Public Health
regarded as Father of Public Health
National Institute
National Institute of
of Epidemiology
Epidemiology -- Chennai,
Chennai, India
India
 Epidemiology

Time ;
+ Time characteristics
7 * Incubation/latency
___* Length of disease process
* Trends and cycles

Epidemiological Triad Epidemiological Triangle

Epidemiological Triangle
Epidemiological Triad
 / \ rere R

Web of
Web of Causation
Causation Theory
Theory
Pal
Given by
Given by Mcmohan
Mcmohan and
and Pugh
Pugh
Physical Activity
Hormones

Obesity Genetic

Smoking
|
Hardening of the
Factors

Arteries Hypertension

HIGATT
Disease
Stroke Hypertensive
Disease

factorial causation theor

—
Cause
(cultural
Cause J} factor) Cause
(economic | ~ (psycholo
factor) l gical)
W
, | Cause
\,—| (genetic
Multifactorial Causation
Multifactorial Causation Theory
Theory factor)

Given by
Given bv Pattenkoffer
Pattenkoffer
 Iceberg
Iceberg
phenomenon
phenomenon
VISIBLE
Diagnosed
COVID-19 Cases

— INVISIBLE
* Misdiagnosed Case
« Undignosed Case

Lead Time
Lead Time
SARS-CoV2

detected =
%.
through screening | Lead time =
‘SARS-Cov2 I Perceived _® survival time | Death
Infection = ~
J =

[ -. detected |
COVID19 from symptoms ,
 Evaluation of an
outcome

Present Outcome

Exposed Ti =

Outcome

Study Risk factors

participants present

Outcome
Not CT:
Exposed No
outcome

Begin study End study

Prospective Cohort
Prospective Cohort study
study Retrospective Cohort study

Measure exposure
=,
I
and confounder
variables

Baseline Se — Outcome

Study begins here

 Analytical Studies
TULTGAL y GIWUE WLEUUIVY

PAST PRESENT

Exposed
(e.g. smokers)
Population with the Event
(e.g. Lung Cancer)

RR Review of history
Case Sample

[Cee Mea
A

Population with no event

(e.g. smokers) (e.g. healthy volunteers)

RJ. Review of history

Control Sample

Not-Exposed 4
(e.g. non-smokers

Cross-Sectional Study Design

Case Control
Case Control Study
Study
[Exposed|
Non-
Sample Cases
Population

Non-
Exposed Non-
Cases
 Population Distribution
Developed Countries-
Developed Countries- Spindle
Spindle shaped
shaped
Developing Countrues-
Developing Countrues- Pyramid
Pyramid

Male 00% 0.0% Female Male 0.0% 0.0% Female

S288,

0.0% 0.0%
0.0% 0.0%
0.0% | 0.0%
0.1%}.0.1%
x 2
SF
EEEetsE eds
a Ov
es gy 2 fF
=>

10% 5% 4% % 0% % 2% %

United States of America - 2017 Nigeria - 2017

Population: 326,474,013 Population: 191,835,936
 BARRIER CONTRACEPTIVES
LEI HEME
NE = BY WWW LET wal UE
W oe

Male Condom

Male Condoms
Male Condoms Vaginal Sponge
Vaginal Sponge (TODAY)
(TODAY)
Pearl Index-
Pearl Index- 2-14/HWY
2-14/HWY hoe
Pearl Index-
Pearl Index- 9-20/HWY
9-20/HWY
a We omg
EXP 2014/03

1 43

Female Condom

Female Condoms
Female Condoms Vaginal Diaphragm
Vaginal Diaphragm
Pearl Index-
Pearl Index- 5-21/HWY
5-21/HWY Pearl Index-
Pearl Index- 5-20/HWY
5-20/HWY
 Intra-Uterine Contraceptive
Device
Device
Pearl
Pearl Index-
Index- 1-5
1-5
Best method
Best method of
of emergency
emergency contraception
contraception Pd RJ

CuT 380A
CuT 380A
Lippes Loop
Lippes Loop 2nd generation
2nd generation IUCD
IUCD
1st
1st generation
generation IUCDIUCD Bioactive
Bioactive
Highest failure
Highest failure among
among A signifies
A signifies vertical
vertical length
length of
of limb
limb
IUCD's
IUCD's
380 signifies
380 signifies surface
surface area
area ofof Cu
Cu
Non-medicated and
Non-medicated and Inert
Inert used
used

Mirena
Mirena
3rd generation
3rd generation IUCD
IUCD
Levonorgestrel medicated
Levonorgestrel medicated IUCD
 CONTRACEPTION|
CONTRACEPTION
% Medroxyprogesterone Injection \.P. 150 malm\
8 Tablets
Contraceptive Injection

‘TCHROMAN TABL
PR ETS |.p.
Celie lee ST dA
J
TWICE a week for
first 3 months
Once a Week ofte
r 3 months

Bl.
g Government of | ndia |
FREE SUPPLY, Not
for Sale

Antara
Antara
Chhaya
Chhaya IM injectable
IM injectable hormonal
hormonal contraception
contraception
Also ka
Also ka Saheli/Centchroman
Saheli/Centchroman Depot
Depot Metroxy
Metroxy Progesterone
Progesterone Acetate
Acetate
Once aa week
Once week pill
pill (DMPA)
(DMPA)

Levonorgestrel and Et
hin yioestradioli
With Ferrous Fumarate Tablets 1,
Tablets LP,
Combined Oral
Combined Oral Contraceptive
Contraceptive PillsPills (COCP)
(COCP)
Yuzpee and
Yuzpee and Lancer
Lancer Regime
Regime (4(4 pills
pills taken
taken at
at a
a
time 12
time 12 hrs
hrs apart
apart within
within 72
72 hrs)
hrs)
Ethinyl Estradiol
Ethinyl Estradiol -- 30
30 mcg
mcg
=
.
4 ES SN
=
JS.
Levonorgestrel -- 150
Levonorgestrel 150 mcg
mcg
77 tablets
tablets ofof Ferrous
Ferrous sulphate
sulphate 6060 mgmg
Danvl Index-
Pearl InARnY ANA 1 WNIV
0.1-2/HWY
 Sterilization
Permanent method
Permanent method of of contraception
contraception
Pearl Index
Pearl Index -- <
< 0.1/HWY
0.1/HWY

Fallopian tubes
tied and cut

SN

Tubectomy

Tubectomy
Tubectomy Vasectomy
Vasectomy
Most commonly
Most commonly used
used method
method Advice post
Advice post vasectomy-
vasectomy-
MC technique-
MC technique- Pomeroy's
Pomeroy's Use barrier
Use barrier method
method for
for
technique
technique 33 months
months
Billings Ovulation Method

Simple, Natural . Sffeclive

Natural Method
Natural Method of
of
Contraception
Contraception
 2 days 4 days 3 days
Total time = 9 days
Install faucets Install fixtures Install carpeting

Build house Finished house

Dig foundation Build walls Build roof |

Total time = 40 days
Path
10 days 20 days 10 days

Critical Path
Critical Path is
is the
the longest
longest path
path in
in terms
terms of
of duration
duration
ItIt is
is the
the method
method used
used in
in Network
Network Analysis
Analysis in
in health
health management
management
In above
In above case
case the
the one
one marked
marked red
red is
is the
the critical
critical path
 H10-Vicdicai vaste Secgregarion ic dri

© Post Operative
ELE
Body Parts
YELLOV

9s Ee:
- Placenta
- Plaster of Paris (POP}
- Pathological WasSte
- Cotton Waste
* Dressing Materials
= - Beddings

© >a - Body Fluid Contaminated

- Face Mask, Cap
* Cytotoxic, Expired &
Paper and Cioth

Discarded Medicines
- Microbiology, Bictechnology Lab Waste

WHITE - Needles
(Translucent) 2 - - Syringes with fixed needtes

CT —\ ©
- Blades
- Scaltpels
“Lise 7% Hypo CaMonSs Schmon for crnanfocting Giess 4 Wenat Share
 Autoclave
Autoclave
Temp- 121°C
Temp- 121° Catat 15
15 psi
psi for
for 15
15 min
min
Control- Geobacillus
Control- Geobacillus stearothermophilus
 Gaussian Curve
Measures of
Measures of Central
Central Tendency
Tendency
Areas under the normal curve that lie between 1,2,and3
standard deviations on each side of the mean

68.3% of data

— 95.5% of data —

— 99.7% of data —

j I
T
-3SD -2SD -1SD MEAN +1SD +2SD +3SD

Mean
Median Median
Mode
Mode —
eh)

Positive Symmetrical Negative

 International Organizations
TIILETIIGQUtiVvViIa: WI SOUONnIaaltlul i)

World Health
World Health Organization
Organization its) United Nations
United Nations (UNO)
(UNO)
(WHO)
(WHO) VB YY Established- 1945
Established- 1945
1945
Established- 1945
Established- HQ- York
New York
HQ- New
Constitution- 7th
Constitution- 1948
April 1948
7th April
(World Health
(World Health Day)
Day) @ | f
HQ- Geneva
HQ- Geneva

United Nation's
United Nation's Children's
Children's
Emergency Fund
Emergency Fund
HQ- New York
Launched GOBI-FFF Campaign
 International Organizations

TERS
& =\= The World Bank (0p
©,O
“i
5
= Ne
*
International Red
International Red Cross
Cross
International Labour
International Labour
Organization
Organization
HQ- Geneva
HQ- Geneva
FOOD AND AGRICULTURE HQ- Geneva
HQ- Geneva
ORGANIZATION
OF THE UNITED NATIONS
FAO
FAO
HQ- Rome,
HQ- Rome, Italy
Italy
Launched FFHC Campaign
Pawn AR AA FOP IE CA nA RAIA
 Demographic Cycle
Te OO

Population Population Population Population Population

Population Stationary grows grows becomes declines

1210.19
growth —> | slowly | rapidly | Stationary | z

| | | : _3
| | 2 .
; Birth rate | Ea = = E |
at\! 3| SOCCURCECEEE
| l

£25252
232 Ez E EK E E
Death rate 4— Demographi ! ”
Birth and | i \ 9, | 1921- Year
1921- Year of
of Big/Great
Big/Great Indian
Indian Divide
Divide
death rates 4 1
l LS 0
i | | 1 India - Sex Ratios
_
| | 1 976
1 1 1 980
I | I be

|
I
|
|
|
1
|
I
seo
I | I 1 940
1 | 1 1
1 1 1 L =

Demographics High Early Late Low Stage of 9s

Stages —Þ stationary expanding expanding Stationary decline ae
stage stage stage stage 880 1951 1961 1971 1981 1991 2001 2011

— Overall Sex Ratio —_ ild Sex Ratio

India-
Indi a- 3rd/Late
3rd / Late expanding
expanding stage
Stage From: WE) avg: NS GAME

Sex
Sex Ratio-
Ratio- 940
Chid Sex Ratio - 918
 Mosquitoes and Larvae

© 2002 Stephen L. Doggett Eee Heaps

Female Anopheles
Female Anopheles Mosquito
Mosquito Aedes aegypti
Aedes aegypti Mosquito
Mosquito
Vector for
Vector for Malaria
Malaria Vector for
Vector for Dengue,
Dengue, YF,
YF, CG
CG Fever
Fever and
and Zika
Zika
Black spots
Black Spots on
on wings
wings virus
virus
45* angle
45° angle with
with surface
surface White spots
White spots so
so aka
aka Tiger
Tiger Mosquito

Larva parallel to water surface Larva suspends from water surface

 Mosquitoes and Larvae

Culex Mosquito
Culex Mosquito Mansonia Mosquito
Mansonia Mosquito
Vector for
Vector for Japanese
Japanese Encephalitis,
Encephalitis, WNF,
WNF, Vector for
Vector for Brugyian
Brugyian Filariasis
Filariasis
Lymphatic Filariasis
Lymphatic Filariasis Sparkling on
Sparkling on legs
legs and
and wings
wings
Hunchback appearance
Hunchback appearance
Larvae along
Larvae along rootlets
rootlets of
of aquatic
aquatic plants
Larva suspended from water surface
 Measles (Rubeola)
Measles (Rubeola)
Rash (Image
Rash (Image 1)
1)
Koplik spots
Koplik spots (Image
(Image 2)2)
IP- 10-14
IP- 10-14 days
days
Vaccine strain-
Vaccine strain- Edmonstron
Edmonstron Zagreb
Zagreb strain
strain
NIS- 2
NIS- 2 doses
doses ofof MR
MR vaccine
vaccine
(9 months
(9 months and and 16-24
16-24 months)
distribution distribution
of smalipox of chickenpox

Chicken Pox
Chicken Pox (Varicella)
(Varicella)
Aka Human
Aka Human Herpes
Herpes Virus
Virus (HHV
(HHV 3)3)
IP- 14-21
IP- 14-21 days
days
Centripetal distribution
Centripetal distribution of of rash
rash
Rash in
Rash in different
different stages
stages
Dew drop
Dew drop lesions
lesions
Vaccine strain-
Vaccine strain- OKA
OKA strain
 Methods of Communication

Sociogram
Sociogram
Focused Group
Focused Group Discussion
Discussion

ORS
ORS Demonstration
Demonstration
 Instruments

Sling Psychrometer
Sling Psychrometer _
Used Air
measure Air
to measure
Wind
Wind
= Vane
Vane|
Used to
Humidity
Humidity Used for Direc
Used for Direction of
tion of
wind
wind

Kata
Kata Thermometer
Thermometer
Used to
Used to measure
measure Low
Low air
air
velocity/ Cooling
velocity/ Cooling power
power of
of air
air
 Horrock's Apparatus
Horrock's Apparatus
Used for
Used for estimation
estimation ofof Chlorine
Chlorine
demand
demand
11 black
black beaker
beaker of
of Starch
Starch Iodide
lodide

Chloroscope
Chloroscope
Used
Used to
to measure
measure amount
amount ofof
free residual
free residual Chlorine
Chlorine in
in
water
narnAton
 Nutrition and Health

Bitot'
Bitot'sS Spots
Spots |
Vit. A
Vit. A deficiency
deficiency (Xerophthalmia)
(Xerophthalmia)
Class X1B
Class X1B
Secondary Sign
Secondary Sign Lathyrism
Lathyrism
Due to
Due to adulteration
adulteration of of
Kesari Dal
Kesari Dal in
in other
other pulses
pulses
Toxin- BOAA
Toxin- BOAA (Beta-
(Beta- Oxylyl
Oxylyl
Amino Alanine)
Amino Alanine)
Golden Rice
Golden Rice Neurological and
Neurological and Skeletal
Skeletal
Genetically Modified
Genetically Modified
Crop manifestations
manifestations
Crop
Rich in
Rich in Iron
Iron and
and Beta-
Beta-
Carotene
 aes os RADIATION
Dental Fluorosis
Dental Fluorosis HAZARD

my

| \y/ NON-IONIZING
J 4 RioHazard
RADIATION
BioHazard
 Point source Single Exposure,
Single Exposure, Point
Point Source
Source
No of cases
Epidemic
Epidemic
20
Clustering of
Clustering of cases
cases inin one
one incubation
incubation
15 period
period
10 Sudden rise
Sudden rise and
and sudden
sudden fall
fall
Eg. Food
Eg. Food Poisoning
Poisoning
5

9 X / Time

NY
Duration ~ Incubation time

An Epi Curve for a Common Source

Outbreak with Continuous Exposure
Multiple Exposure,
Multiple Exposure, Point
Point
Source Epidemic
Source Epidemic

Number of Cases
Sudden Rise
Sudden Rise
Secondary waves
Secondary waves duedue toto multiple
multiple
exposure
exposure 9

1234567 8 9 1011 12 13 14 15
Multiple clustering
Multiple clustering of of cases
cases of Oy
Da nset

Eg. Typhoid
Eg. Typhoid due
due toto contaminated
contaminated
water in
water in pond/well
pond/well
 ” Avg. incubation time for hepatitis A: 28-32 days
2 Propogated Epidemic
Propogated Epidemic
3 * Only with
Only with diseases
diseases showing
showing Person-
Person-
8 to-person transmission
to-person transmission
7 wlll Slow rise
Slow rise and
and slow
slow fall
fall with
with a
a plateau
plateau
= #4 I Eg. Hepatitis
Eg. Hepatitis A,A, TB,
TB, HIV
HIV
, |
3 00 al ol Dts 00
EEE SE SE SES SE EF ESE SF Ef &
of eo S se’ & H 4 && S my ae we se gf of JF a

# cases Of
a disease Epidemic:
Endemic: Usual in excess of normal
occurrence In a (1 case of rabies in Newton)
geographic area
Time — Pandemic
Pandemic
Country to
Country to country
country spread
spread of
of aa disease
Eg. COVID-19, H1N1, HIV
 Trends of Disease
a
©
©
Number of lynx trapped
©

4000 -

2000 -

1 '
1 820 1 840 1 860 Moy 1900 1920

350,
Secular
Secular Trend
Trend 3004
Long term
Long term fluctuations
fluctuations Oo
32 2504
o
cs
a

EE 200;
=

©8 1504
©

32 100]
s
=a
50 |
Number of tuberculosis cases

oO Se Sese we se sles Saslenr

FEUEPFE EEE IGFET ISS FEESese ZHEEZ
ale Tae
TSP ese weve TE
PPTs FTE EES
FIT S|
2012 2013 2014 2015 2016 2017 2018

Cyclical Trend
Cyclical Trend
Increase or
Increase or decrease
decrease every
every few
few years
years
Periodic
Periodic fluctuations
fluctuations
+
+
+
+
+
4
+
+
+
4

4
007

007
007

009
009
007

008
008
008
008

SRSRRSSRSR ;
SESSERSSS s
PERIL ag ag

—— Observed
Seasonal Trend
Seasonal Trend
— Fit Periodic
Periodic fluctuations
fluctuations
 Louse

I
an.

Head louse Body louse Crab louse

Photo: Lorenza Beati Photo: James Gathany Photo: Matt Bertone
Used with permission Public Health Image Library (PHIL) Used with permission
Public domain

Louse transmitted
Louse transmitted diseases
diseases --
Epidemic Typhus
Epidemic Typhus
Relapsing Fever
Relapsing Fever
Trench Fever
Trench Fever
Pediculosis
Pediculosis
a. Pediculosis
a. Pediculosis Capitis-
Capitis- Head
Head louse
louse
b. Pedivulosis
b. Pedivulosis Corporis-
Corporis- Body
Body louse
c. Pediculosis Pubus- Crab louse
 VECTORS
YU ba ws FE tw Et

1. Sandfly
1. Sandfly (Phlebotomous
(Phlebotomous sp.)-
sp.)- Visceral
Visceral Leishmaniasis
Leishmaniasis
1 (Kala Azar),
(Kala Azar), Cutaneous
Cutaneous Lesihmaniasis
Lesihmaniasis (Oriental
(Oriental sore,
sore,
Delhi boil,
Delhi boil, Baghdad
Baghdad boil)
boil)

2. Reduvid
2. Reduvid Bug-
Bug- American
American Trypanosomiasis
Trypanosomiasis
(Chagas disease)
(Chagas disease)

3. Rat
3. Rat flea
flea (Xenopsylla
(Xenopsylla cheopsis)-
cheopsis)- Bubonic
Bubonic plague
plague

Endemic Typhus,
Endemic Typhus, Chiggerosis
Chiggerosis

2 3

- JESHTE
 Ticks
Class Arachnida

Soft Ticks Hard Ticks

Argasidae Ixodidae

Tick
Tick transmitted
transmitted diseases
diseases
Soft Tick-
Soft Tick- QQ fever,
fever, KFD(outside
KFD(outside India),
India), Relapsing
Relapsing Fever
Fever
Hard Tick-
Hard Tick- KFD(India),
KFD(India), Indian
Indian tick
tick typhus,
typhus, Babesiosis,
Babesiosis, Tick
Tick
encephalitis and
encephalitis and Tick
Tick hemorrhagic
hemorrhagic fever,
fever, Tularemia
Tularemia
 Sampling

Population

Population
8 it
Sample (every 3”)

Simple Random
Simple Random Sampling
Sampling Systematic Random
Systematic Random Sampling
Sampling
 Sampling

En" _

Sample -- [> Lo |

® ®
©
Sample
(2 clusters)
Cluster Population
Population

Stratified Random
Stratified Random Sampling
Sampling Cluster Random
Cluster Random Sampling
Sampling
Done in
Done in various
various levels
levels (strata)
(strata) Done in
Done in various
various clusters
clusters
 Statistical Graphs
wWeUtIWVtIwUui wi wp iw

35

30 +

25 +

20 +

Frequency
15 +

10 +

10 15 20 25 30 35 40
Class Interval 2

Ba cece taco
25+

Histogram
Histogram
. | Py
HistogramI On X-axs TS words

20+
16 | |
HEE oni raed Smooth Frequency
pl | Curved| |
12 sees

2 | |
~
it
Frequency

2 { 1

38
E
>t
~

26 aa Z| |
4 |
| 2 | | a

\— | | =>
20 30 40 FIT [295
29.5 395 5 | 495 | 595 | 69.5 795 895
{==}Of
El
=
Number of words typep per minute | |

Y
4
Class intervals

Frequency
Freaquencv Polygon
Polvgon Frequency Curve
Frequency Curve
 Statistical Graphs

21,500

21,000

20,500
Simple Bar
Simple Bar Charts
Charts
Number of Cases

20,800

13,500

19,8900

18,500

18,000

17,500 90 4
2002 20053 7009 2008 2008 07 2008 2009 201
80 +
Year
70 +

60 +

50 + E Plant 1

= Plant 2
40 -

Multiple Bar
Multiple Bar Charts
Charts 30 +
= Plant 3

20 +

10 -

Feb Mar Apr May Jun Jul

160

140

120 +

100
= blood gp O
= Blood gp AB
= Blood gp B
= blood gp A
Component Bar
Component Bar
Charts
Charts
city x city Y city Z
 Statistical Graphs

Line diagram OGIVE

1.2
. Be diagrams are used to show the trend of events with the passage of
ime.
* Line diagram showi the malaria cases reported throughout the word
excluding African region during 1972-78
0.8

0.6

0.4
W IQ

0.2
a
In > |

1972 73 74 75 76 77 78

OGIVE-- Cumulative
OGIVE Cumulative Frequency
Frequency
Scatter diagram Diagram (Frequency
Diagram (Frequency only
only
increases)
——>
Diastolic BP (mmHg)

as

es

so a> so eo

Average time of exercise per Gay fmirutes}