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 PSM

BONUS-BTR
Health care delivery in India
Hilly/tribal Plains Staff Beds
1 doctor/ 1000
Sub-centre 1 nurse/5000 population
(HWC) 1 lab tech /10k
A- 1 pharmacist /10k
B- 1 malaria microscope/ 25k
1 SET / 25k
PHC 1 TB microscope/ 1 lakh
A- 1 TB unit/ 5 lakh
B- 1 STLS /5 lakh
School health 1 ophthalmologist/5 lakh population or 5 CHC

U-PHC
CHC

U-CHC
Metro:
Health care delivery in India
ASHA AWW TBA VHG MPW (m) MPW (F)= HA/HV USHA
ANM

25-45yr Reports to Traine Educates Malaria ANC register

Married/divorce/widow Mukhya d by Sputum Delivery
Village panchayat selects sevika MPW Chlorination Vaccine
Trained by: (f)
Mobiliser, Toilets
JSY
Village action plan (VHSNC)
DOTS
NO:

Impact indicator:
Health management
Network analysis

•
NTEP saved Rupees 1000 cr
•
NTEP saved 1 lakh lives/ QALY gained
•
CBNAAT versus sputum in terms of cost
• Input-output analysis
Program Management and Review Critical Path Method
Technique (PERT)
 Communicable disease
Source: Transmits IP COMMUNIC IMPORTANT
Reservoir: Natural habitat ABLE
PERIOD
Host-Recipient VARICELLA Centrifugal, MC complication:
Primary-Sexual cycle VZIG:
Secondary-Asexual cycle MEASLES MC complication: MCC of mortality:

Malaria-
Hydatid- RUBELLA Seasonal, cyclical trend, Iceberg (?)

Healthy carriers:
DIPHTHERIA Iceberg
Case: Isolation+ Culture/Serum +Antibiotic+ Antitoxin

Contact: Culture+ Antibiotic+ Vaccine status

Droplet transmission (isolation):
COVID-19 ACE-2, TMPRSS-2 receptors-Type 2 Pneumocytes
COVID-19 vaccines
Tetanus PEP
MCH heath programs
HBYC: 5 visits
3,6,9,12,15 months
NTEP
GOALS-2025
No of TB deaths:
TB incidence:
Catastrophic costs:
NTEP

Rifabutin

Contacts:
DS TB: INH x 6m
Rifapentin+INH x3mon weekly

NTEP-High priority TB-HIV district:

NACP
MTCT:
Mother on ART >4weeks:

Mother not on ART :

Early infant diagnosis:

Blood donation: Breastfeeding:

Symptomatic:
Asymptomatic:
ANC-Opt out test HIV sentinel surveillance: Biennel-Unlinked,
anonymous
Proxy for general population (>1%):
Efficiency/Risk
Sexual 0.01-1% High-risk (>5%): CSW MSM TG
transmission Bridge group:
Blood 90% Single male migrants
Truck drivers
Needles 0.3%
Vertical 30%
NVBDCP
Malaria:
PvPo-
PfPm-
PfPm in NE -
Pregnancy: 1st trimester:
2/3rd trimester:
Chemoprophylaxis
<6wks
>6wks
Pregnancy:
Kala azar:
Chemical: Space spray:
Filariasis: Paris green= Malathion
Deltamethrin

Mass drug administration: Stomach poison Cyphenothrin -ITBN-2-3mon

Temephos/Abate Pyrethrum -LLIN:5-6mon

Biological: Gambisia Residual spray: 0.0475inch

Bacillus thuringiensis DDT (12-15weeks)
Malathion (6-8weeks)
Deltamethrin
NPSP and NLEP
NATIONAL POLIO SURVEILLANCE PROGRAM
Polio-free
P1-
P2-

OPV switch-
P3- Impact indicator: Prevalence <1/10k
Leprosy prophylaxis:
AFP surveillance: >20hrs a week
<15yrs with AFP >2yrs
SMO
2 stool samples 24hrs apart
>8g with reverse cold chain
Reach lab in 72hrs
Residual paralysis check:
Other programs
NIDDCP:
Impact indicator:
Principal impact and epidemiological indicator:

Process indicator:
Cold chain
Day carrier:

Vaccine carrier:

Small ILR:
Without electricity?

Large ILR and Deep freezer: CHC, district

WICR: District, state, zonal

Epidemiology
RATIO - RATE - PROPORTION
MMR

Prevalence

Incidence

Attack rate

Secondary attack rate

R0-

Case Fatality Rate 1:

>1:
<1:
Proportional mortality rate
Epidemiology
BIAS= systematic error Confounder RANDOMISATION BLINDING
Known and equal chance Remove:
Selection bias Best to remove: Remove: Single:
Attrition bias Known confounder Double:
Hawthorne bias Triple:
Recall bias Unknown confounder
Berksonian bias
Pygmalion bias
Biostatistics: Bonus
Prospective screening: Quantitative
Immigrants for TB, Yellow fever 1 group before after:
HIV during antenatal, STD 2 groups:
Blood donors 3 groups:

Type of prevention: Non-Parametric/ qualitative/ Proportions

1 group:
2 groups:
Sample size: 3 groups:

Ordinal:

External validity:
High-yield
Survey systems: No of live births in an area:100

Census No of BCG vaccines?

Last: No of pregnant females?
Min no of ANC registered?
SRS-CBR, CDR, MMR, IMR
VITALS
DUAL LEVEL: Luminous intensity: Candela
NFHS FLUX: Lumen
Last: Illuminance: Lux
Civil registration survey:
Birth/death:

Eligible Couple:

Target couple: