National Health Programs

Dr. Anil Vithal Jayawant

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 United nations, WHO
• United Nations, WHO, Million Death Study for
preparation of National Burden Estimates
(NBE).
• NBE- is a simple way to enable every country
to determine their local burden of diseases.

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 Death and Disability- 2017 Survey
National Institute of Medical Statistics
• Ischemic Heart Disease (9.6%)
• Perinatal Conditions (8.5%)
• Chronic Respiratory Diseases (5.7%)
• Diarrhea (4.7%)
• Respiratory Infections (4.5%)
• Cancer (4%)
• Stroke (3.6%)
• Road Traffic Injuries ( (3.3%)
• Tuberculosis (3.1%)
• Liver and Alcohol Related conditions (3%)
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 1. National Vector (mosquito) Borne Disease
Control Program(2003)
• Malaria
• Filariasis ( Elephantiasis)
• Kala-Azar
• Japanese Encephalitis
• Dengue
• Chikungunya

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 Know the world of mosquitos
• Pretty old arthropods
• 3500 varieties
• Life span Female- 45 to 60 days, Male- 10 to 20 days
• Females live on blood, males live on flowers, plant juices
• Can fly 1 to 11/2 KM
• Rate of wings movement 300 to 600 per second
• 200 egg laying at a time, every 3rd day or almost 10 times in her life
• Can fly up to 25 feet height at a time
• Can suck blood 3 times of its weight
• Attracted by Blood group ‘O’, Dark clothes, Carbon- di- oxide, heavy
breathers and smell of sweat

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 Main activities
• Formulation of policies & guidelines
• Technical guidance
• Planning
• Coordination-National Centre for Disease Control
• Coordination – WHO, World Bank, donor agencies
• Training
• Inter state, inter country border area

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 Stop breeding places of mosquitos
• General areas
• Fine mesh on septic tank vent
• Avoid garbage in rivers
• Closed drainage system
• Do not allow digging at common places
• Family areas
• Water stored should be covered after cleaning
• Change water from money plant/ flower pots
• Never store disposable materials on terrace
• Cover water tank and windows
• Change water from refrigerator outlet
• Dry day- Throw away the water stored once in 3 to 4 days
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 2. National Leprosy Eradication
program(1983)
• Launched in 1953
• Survey, Education, Treatment (SET)
• Information, Education, Communication
• Involvement of ASHA- Accredited Social
Health Activist

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 3. Revised National Tuberculosis Control
Program (RNTCP)(1997)
• Mycobacterium tuberculosis- AFB, Lung tuberculosis
• BCG vaccine- immunity against TBM
• Directly Observed Therapy Short Course (DOTs)
• TB notification
• Multi Drug Resistant TB (MDR TB)
• Extremely Drug Resistant TB (XDR TB)
• Pediatric Tuberculosis
• TB and Diabetes
• TB and HIV
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 4. National Sexually Transmitted Diseases
control program
• Yaws: 49 districts are affected in tribal areas
• Reported cases 3500 to nil from 1996 to 2004
• No new cases
• Syphilis
• Gonorrhea
• Pinta

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4. National AIDS control Program (1993)
• National AIDS control Organization (NACO)-Virus 1 &
2
• Donation by Bill Gates foundation
• Integrated Counseling and Testing Centre (ICTC)
• Routes of spread: Blood transfusion, Mother to fetus,
Sexual contact, Use of infected needles-drug addicts
• HIV & TB, Pediatric population having HIV
• Prevention: Safe blood transfusion, Anti-Retrovial
Drugs during pregnancy, Condom promotion, Needle
stick injury- Safe injection practices, A/D syringes
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 5. National Program for Control of
Blindness (1976)
• Night blindness- Vitamin A solution, Deworming
• Color blindness- Driving
• Myopic blindness- Young age
• Hypermetropia- At 40 years of age
• Cylindrical
• Injury to cornea- Accidents
• Iridocyclitis- Infections
• Cataract
• Glaucoma
• Blind spot
• Retinal detachment
• Retinopathy- DM, HTN
• Eye donation
• Vision 2020- The Right to Sight
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 6.Iodine Deficiency Disorder (IDD)program
(1962)
• Goiter- Puberty, Endemic , After surgery
• Mental retardation- long lasting effect on the
individual, family, society
• Obesity & Hypothyroidism
• Myxedema

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 7. Universal Immunization Program(1985)

• Seven diseases- Seven vaccines (Compulsory vaccines):

TB- BCG, Diphtheria, Pertussis, Tetanus – DPT (Triple),
Measles- Measles, Polio – Injectable, Oral; Viral
Hepatitis B-Hepatitis B
• Pregnancy – Two doses of Tetanus vaccine
• Polio- 5 doses, Polio Raviwar, Mop up survey
Optional vaccines
• MMR-Measles, Mumps, Rubella (MMR);Japanese
encephalitis (JE) ; Hemophilus Influenza B (Hib);
Chickenpox; Pneumococcal; Meningococcal
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 8.National Program for prevention and control
of Cancer, Diabetes, Cardiovascular diseases and
stroke ( 2010)
• 53% of deaths are due to Non Communicable Diseases.
• A. Cardiovascular diseases: Behavior and life style
changes, early diagnosis and management, build capacity
for early prevention, diagnosis and treatment, training to
health care givers, creative, palliative and rehabilitative
services.
• B. Cancer. Primary prevention by health education, early
detection, diagnosis, tertiary prevention
• C. Stroke: Hemorrhagic, Thromboembolic, TIA
• D. Diabetes: Checking BSL, monitoring BSL, Prevent and
treat complications
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 9.National Tobacco Control Program
( 2007-08)
• National Tobacco control program
• Legislation-25 February, 2004
• Public awareness
• Tobacco cessation activity

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10. National Mental Health Program (1982)

• Prevention and treatment of mental and

neurological disorders and associated
disabilities
• Use of mental health technology
• To improve quality of life

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 11. National Guineaworm eradication
program (1983-84)
• Health education to school children
• Rumors registration and investigation
• Notifiable disease
• Continue surveillance
• Supervision of hand pumps

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 12. National program for control and
treatment of occupational diseases (1998-99)
• Prevention, control and treatment of silicosis and
silico- tuberculosis
• Occupational health problems of tobacco harvesters
and their prevention
• Hazardous process and chemicals, database
generation, documentation and information
dissemination
• Research, education & training
• Health risk assessment of cottage industries
• Salt workers- prevention of health hazards
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 13. Nutritional program (1970-71)
• Mid day meal program in schools
• Aanganwadi children nutrition program

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14. National Family Welfare program (1951)

• Marriage age
• Spacing of children
• Target couples, eligible couples
• Abortion law
• Barrier contraceptives- Condom, Cu T, Loop, Gels,
Spermicides
• Hormonal- O.C. Pills
• Terminal methods- Tubectomy, Vasectomy
• Treatment of sterile couples
• Adoption law
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 15. National water supply and sanitation
program(1954)
• Accelerated water supply program
• Swa-jaladhara
• Ghar me pani, nalka pani
• Bharat nirman
• Nirmal Bharat abhiyan
• Swachh Bharat Mission- gramin, urban
• No open defecation
• Solid waste management
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 16. Minimum needs program (1974-78)

• Rural health
• Rural water supply
• Rural electrification
• Elementary education
• Adult education
• Nutrition
• Environmental improvement of urban slums
• Houses for landless laborers
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 17. National Anemia Prophylaxis Program
(1971)
• Iron & Folic acid tablets to all pregnant ladies
• Calcium tablet for pregnant ladies
• Iron + Calcium to children in Aanganwadi

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 The real data of progress (World Bank)
Comparisons Year 1992 Year 2019

population 0.9 billion 1.3 billion

GDP $ 288 billion $2.7 trillion

GDP per capita $ 317 $ 2,016

Life expectancy 58.85 years 69.16 years

Telephones 0.75/ 100 people 1.6/ 100 people

Mobiles 0/ per 100 people 87/ 100 people

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 The real data of progress (World Bank)
Comparisons Year 1992 Year 2019
Poverty ratio 45.3% ( in 1993) 21.9% ( in 2011)
Unemployment % of total 2.2% in 1994 5.3%
labour force

Infant mortality for 1000 84.2 29.9

live births

GINI index (Lower indicates 31.7 (in 1993) 35.7 (in 2011)
lower inequality)

CO2 emission (Metric 0.77 1.7

tones per capita)

Railway passengers Million 3,41,999 (in 1996) 11,49,835 (in 2017)

passengers / km

Air travellers per year 1,11,27,00 16,40,35,638 km (in 1996)

Railway lines 62,915 (in 1996) 67,368 km (in 2017)

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 Home work
• Out of these programs , in your opinion which
program is most important?
• Can you plot the priority based on some
statistical chart?
• Give substantial reasons.
• Give chronology of these programs. Give
reasons based on community health.

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