Sunday, June 22, 2025

School Health Promotional and Education


 School Health Promotion and Education (Sections 5.6 – 5.6.9)

5.6 HEALTH PROMOTION AND EDUCATION IN SCHOOL

  • Focuses on improving health through education and creating a healthy school environment.
  • Promotes awareness, healthy behavior, and supports academic success.
  • Key areas include policies, environment (physical & social), individual skills, community links, and health services.

5.6.1 CONCEPTS IN RELATION TO SCHOOLS

Six Components of Health Promotion in Schools:

  1. Healthy School Policies – Encourage wellness (e.g., anti-bullying, nutrition).
  2. Physical Environment – Safe, well-designed infrastructure.
  3. Social Environment – Positive relationships among students, staff, and families.
  4. Individual Health Skills – Age-appropriate learning and action for well-being.
  5. Community Links – Involvement of families and local organizations.
  6. Health Services – Access to care and support services in or linked to school.

5.6.2 OBJECTIVES OF SCHOOL HEALTH PROGRAM

  • Promote health and prevent diseases.
  • Provide safe and supportive environments.
  • Educate on healthful living.
  • Early detection and referral of health issues.
  • Involve all stakeholders in child health.

5.6.3 PRINCIPLES OF SCHOOL HEALTH PROGRAM

  • Based on children’s needs.
  • Involves schools, health personnel, parents, and the community.
  • Focus on prevention, education, and active participation.
  • Continuous and well-documented.

5.6.4 TARGETS OF HEALTH PROMOTION

  • Healthy environment for development.
  • Regular health evaluations.
  • Early detection and correction of health issues.
  • Develop healthy habits and care for handicapped children.

5.6.5 COORDINATED SCHOOL HEALTH PROGRAM

8 Key Components:

  1. Health Education
  2. Physical Education
  3. Health Services
  4. Nutrition Services
  5. Counselling, Psychological & Social Services
  6. Healthy School Environment
  7. Health Promotion for Staff
  8. Parent/Community Involvement

5.6.6 SCHOOL HEALTH TEAM

Members:

  • Principal, Teachers, Students
  • School Nurse, Medical Staff
  • Social Workers, Administrators
  • Maintenance & Food Service Workers
  • Parents

Role: Coordinate all components of the school health program.

5.6.7 PROGRAM OF SCHOOL HEALTH

  1. Health Promotion
  2. Health Hazard Prevention
  3. Medical Care
  4. Health Education

5.6.8 COMPONENTS OF SCHOOL HEALTH SERVICES

1. Health Promotive & Protective Services

  • Safe school environment (location, structure, sanitation)
  • Personal hygiene education
  • Nutritional services (e.g., mid-day meals)
  • Physical and recreational activities
  • Mental health promotion
  • Health education
  • Immunization

2. Therapeutic Services

  • Health check-ups, treatment, follow-up
  • First aid & emergency care
  • Specialized services

3. Rehabilitative Services

  • Support for handicapped children

4. School Health Records

  • Track health findings, services, and student progress

5.6.9 IMPORTANCE OF HEALTH EDUCATION

  • Builds knowledge, skills, and attitudes for lifelong health.
  • Covers physical, emotional, mental, and social health.
  • Prevents risky behaviours and lifestyle diseases.
  • Encourages healthy choices and habits from a young age.
  • Contributes to personal well-being and national development.

Reference

Malviya K, Sahoo S, Dasadiya D, Acharya V. Social and Preventive Pharmacy. 1st ed. Pee Vee (Regd.); 2021.

Friday, June 20, 2025

NUHM 2013

National Urban Health Mission (NUHM) 

1. Introduction

  • Launched: 1st May 2013
  • Under: National Health Mission (NHM)
  • Aim: Improve health of urban poor, especially slum dwellers and vulnerable populations.
  • Components: Health system strengthening, RMNCH+A, Communicable & Non-communicable diseases.

2. Objectives

  • Reduce Infant Mortality Rate (IMR)
  • Reduce Maternal Mortality Ratio (MMR)
  • Universal access to reproductive healthcare
  • Converge all health-related interventions

3. Salient Features

  1. City-specific, need-based urban healthcare system
  2. Institutional and management mechanisms
  3. Community and local body participation
  4. Resource availability for primary care
  5. Partnerships with NGOs and private sector

4. Key Initiatives Under NHM

S.No

Initiative

Description

1

ASHA

First contact for community healthcare

2

Rogi Kalyan Samiti (RKS)

Local hospital management by trustees

3

Untied Grants to Sub-Centres

Fund for patient welfare by ANMs

4

Health Care Contractors

Contractual staff for underserved areas

5

Janani Suraksha Yojana (JSY)

Cash incentive for institutional deliveries

6

Janani Shishu Suraksha Karyakram (JSSK)

Free delivery & treatment for mother and newborn

7

Rashtriya Bal Swasthya Karyakram (RBSK)

Child health screening & early interventions

8

Mother & Child Health Wings (MCH)

Additional beds in high-load facilities

9

Free Drug & Diagnostics Service

Reduces out-of-pocket healthcare expense

10

District Hospital & Knowledge Centre

Multi-specialty and telemedicine care hubs

11

National Iron+ Initiative

Iron/folic acid for all age groups

12

Tribal TB Eradication Project

TB elimination in tribal areas

5. NUHM Targets

  • IMR: ≤ 30/1000 live births
  • MMR: ≤ 1/1000 live births
  • Malaria: 50% mortality reduction
  • Kala Azar: 100% elimination
  • Filariasis: >80% MDA coverage
  • Dengue: 50% mortality reduction
  • Chikungunya: Outbreak control
  • TB: 85% cure rate via DOTS

6. Budget Allocation

  • Total: ₹30,000 Crores (12th Plan)
  • Centre:State ratio = 75:25

7. Core Strategies 

  1. Efficient public health system
  2. Household-level access
  3. Preventive & promotive care
  4. Revolving fund for healthcare access
  5. IT & e-Governance
  6. Stakeholder capacity building
  7. Focus on most vulnerable
  8. Quality healthcare services

8. Process/Throughput Indicators 

  • Cities/population covered
  • Health plans developed
  • Functional U-PHCs
  • Slum mapping
  • Health & Sanitation Days
  • MAS formed
  • Trained ASHAs
  • Programme Managers at U-PHCs

9. Output Indicators 

  • Increased OPD attendance
  • Referrals from U-PHCs
  • Institutional deliveries
  • Immunization for <12 months
  • Detection of malaria, TB, dental ailments
  • ANC and TT coverage
  • 100% birth & death registration

10. Impact Level Focus

  • 50% reduction in IMR
  • 40% reduction in MMR
  • 100% ANC coverage
  • Universal immunization
  • Access to reproductive health
  • Disease control targets

11. Mahila Arogya Samiti (MAS) 

  • Community women's group for health awareness, service linkage
  • Covers 50–100 HHs, led by elected members
  • Promoted by ASHA with support from ANM, AWW, NGOs
  • Focus: Preventive/promotive health, revolving fund management

12. Outreach Sessions by ANMs 

  • One monthly routine outreach per ANM
  • One weekly special outreach in slums
  • Services: Screening, lab tests, drug dispensing, counselling
  • Focus: Vulnerable groups (slum dwellers, rag pickers, etc.)
  • Mobility support: ₹500/month per ANM

13. Institutional Framework 

  • National: Mission Steering Group (Health Minister)
  • State: State Health Mission (CM), State Health Society (Chief Secretary)
  • City: Urban Health Missions or NHM structures
  • ULBs: Units of planning with facility norms
  • 1 U-CHC per 2.5 lakh population (5 lakh in metros)

14. Urban Health Care Facility Norms 

Population Level

Facility/Staff

50–100 HHs (250–500)

MAS, ASHA

1000–2500 people

1 ANM, Weekly outreach

Every 10,000

1 U-PHC

Every 50,000

Outreach expanded

Every 2.5 lakh (5 lakh metro)

U-CHC, 30–50 beds (100 in metros)

15. Role of NGOs 

  • Extend outreach and utilization
  • Involved in planning, slum mapping, IEC/BCC, capacity building
  • Strengthen community participation in urban health

Reference 

Malviya K, Sahoo S, Dasadiya D, Acharya V. Social and Preventive Pharmacy. 1st ed. Pee Vee (Regd.); 2021.


IDSP

 Integrated Disease Surveillance Program (IDSP) including its objectives, functioning, and outcomes:


Integrated Disease Surveillance Program (IDSP)


1. Introduction:

  • Launched in 2004 by the Ministry of Health and Family Welfare, Government of India.
  • Initially supported by the World Bank.
  • Now a key part of India’s public health surveillance system under the National Centre for Disease Control (NCDC).

2. Objectives:

  1. Early detection and rapid response to outbreaks of epidemic-prone diseases.
  2. Strengthen and maintain a surveillance system for communicable and some non-communicable diseases.
  3. Improve data collection, analysis, and use at all levels.
  4. Provide training to medical and paramedical staff for epidemic preparedness.
  5. Integrate surveillance efforts across state, district, and national levels.

3. Functioning:

a. Disease Surveillance:

  • Weekly reporting from health workers, doctors, and labs using:
    • S-form: Syndromic surveillance (based on symptoms)
    • P-form: Presumptive (clinical diagnosis)
    • L-form: Laboratory-confirmed cases

b. Information Flow:

  • Data is collected at the Primary Health Centre (PHC) level → Block → District → State → Central level (NCDC).
  • Online portal and now integrated with the IHIP (Integrated Health Information Platform).

c. Epidemic Detection and Response:

  • Early Warning Signals (EWS) are generated when unusual trends are seen.
  • Rapid Response Teams (RRTs) are activated to investigate and control the outbreak.

d. Training & Capacity Building:

  • Health staff are trained in disease surveillance, outbreak investigation, and data analysis.

e. Laboratory Support:

  • A network of public health laboratories supports diagnosis and confirmation of diseases.
  • Labs are equipped for testing diseases like malaria, dengue, cholera, H1N1, COVID-19, etc.

4. Outcomes & Achievements:

a. Improved Outbreak Detection:

  • Timely identification and control of outbreaks like:
    • Swine Flu (H1N1)
    • COVID-19
    • Dengue and Malaria
    • Nipah virus
    • Acute diarrheal diseases

b. Strengthened Surveillance Network:

  • IDSP has established surveillance units in almost all districts of India.
  • Supports 24x7 call centers and public health hotlines.

c. Better Data-Driven Policies:

  • Helps in planning vaccination drives, vector control, and emergency response.

d. Integration with Digital Platforms:

  • Transition to IHIP for real-time disease reporting.
  • Uses GIS mapping, mobile apps, and dashboards.

e. International Collaboration:

  • Supports India’s commitment to International Health Regulations (IHR 2005).


UIP 1985

3.7 Universal Immunisation Programme (UIP)

Launched in 1985 by the Government of India, the UIP aims to provide free vaccines to all children and pregnant women. It became part of the Child Survival and Safe Motherhood Programme in 1992 and is now a key component of the National Rural Health Mission since 2005. The program covers routine immunization, special campaigns (e.g., Polio, Measles, JE), AEFI monitoring, vaccine logistics, strategic communication, and training.

Evolution of the Universal Immunisation Programme (UIP)

  • 1978: Expanded Programme on Immunization (EPI) launched post-smallpox eradication; vaccines included BCG, DPT, OPV, Typhoid.
  • 1985: UIP launched nationwide; Measles vaccine added.
  • 1986: Technology Mission focused on infant coverage and monitoring.
  • 1990: Vitamin A supplementation introduced.
  • 1992: Merged with Child Survival and Safe Motherhood Programme.
  • 1995: National Polio Immunization Days began.
  • 1997: Integrated into Reproductive and Child Health (RCH I).
  • 2005: Continued under RCH II and National Rural Health Mission (NRHM).
  • 2011: Monovalent Hepatitis B and Pentavalent vaccines introduced.
  • 2014: Inactivated Polio Vaccine (IPV) added.
  • 2015: Mission Indradhanush launched to boost coverage.
  • 2016: Rotavirus vaccine rollout began.
  • 2017: Measles-Rubella (MR) and Pneumococcal Conjugate Vaccine (PCV) introduced.

Vaccines under UIP
Includes BCG, DPT, OPV, Measles, Hepatitis B, TT, JE (in select districts), and Pentavalent vaccine (DPT+HepB+Hib in select states).

Diseases Covered
Protects against Diphtheria, Pertussis, Tetanus, Polio, Tuberculosis, Measles, Hepatitis B, Japanese Encephalitis, Meningitis, and Pneumonia (due to Hib).

3.7.2 Goal
To reduce illness and death from vaccine-preventable diseases through quality immunization.

3.7.3 Key Objectives

  • Improve equitable and efficient service delivery.
  • Enhance awareness and access through advocacy.
  • Strengthen disease and AEFI surveillance.
  • Introduce new vaccines and technologies.
  • Reinforce health systems.
  • Support eradication of polio, measles, and neonatal tetanus.

3.7.4 Principles of UIP (Brief)

  1. Universal Coverage: Immunize all eligible groups as per national schedule.
  2. Equitable Access: Reach underserved and vulnerable populations.
  3. High Quality & Innovation: Ensure quality in vaccine handling via cold chain and innovation.
  4. Sustainability & Partnerships: Secure resources and build inter-sectoral collaborations.
  5. Governance: Use decentralized, bottom-up planning.
  6. Accountability: Ensure efficient, transparent implementation and monitoring.

Vaccine Vial Monitor (VVM) Indicator

  • Start point: Square lighter than circle – Use vaccine.
  • End point: Square matches circle – Do NOT use.
  • Exceeded: Square darker than circle – Do NOT use.

·        3.7.5 Mission Indradhanush
Launched in 2014 to immunize unvaccinated or partially vaccinated children against 7 diseases (diphtheria, pertussis, tetanus, polio, TB, measles, hepatitis B). Aim: Full coverage of under-fives by 2020.
Intensified Mission Indradhanush (IMI) targets children under 2 and pregnant women, with vaccination for under-5s on demand. Drives run for 7 working days monthly.

·        3.7.6 Strategy and Policy
Cold Chain & Logistics: Maintains vaccine potency from manufacture to beneficiaries using cold boxes, vans, and ice-packed carriers. Syringes are centrally procured and distributed.

·        Injection Safety & Waste Disposal: Safe injection practices and proper waste disposal are ensured with AD syringes, hub cutters, training, and adherence to CPCB guidelines.

·        AEFI (Adverse Events Following Immunization): Events may result from vaccine reaction, program errors, coincidental causes, or anxiety. Timely detection and correction are essential.

3.7.7 Routine Immunization (RI) Implementation
RI aims to vaccinate 26 million newborns and 100 million children (1–5 years) annually with primary and booster doses, plus 30 million pregnant women with TT. Around 9 million sessions are held yearly, mostly at village level. ASHA and AWW mobilize beneficiaries, with ASHA receiving Rs. 150/session.

Infrastructure & Support

  • 27,000+ cold chain points ensure vaccine potency.
  • Continuous supply of safe injection equipment is maintained.
  • Government supports training, monitoring, outreach, and logistics through the State Programme Implementation Plan (PIP).
  • Additional support includes: alternate vaccine delivery, deploying retired staff, mobility aid for supervision, and printed materials.
  • Central aid includes auto-disposable syringes, smaller BCG vials, cold chain maintenance, and vaccine van supply.

Immunization remains a vital, cost-effective public health strategy for preventing childhood illnesses and disabilities.

National Immunization Schedule (NIS)
For Pregnant Women:

  • TT-1: Early pregnancy
  • TT-2: After 4 weeks of TT-1
  • Booster: If 2 TT doses given in last 3 years
    (All 0.5 ml, intramuscular, upper arm)

For Infants:

  • BCG: At birth or till 1 year (0.1 ml, intradermal, left upper arm)
  • Hep B: Birth dose within 24 hrs (0.5 ml, IM, thigh)
  • OPV-0: At birth; OPV 1, 2, 3: 6, 10, 14 weeks (2 drops, oral)
  • Pentavalent: 6, 10, 14 weeks (0.5 ml, IM, thigh)
  • Rotavirus: 6, 10, 14 weeks (5 drops, oral)
  • IPV: 6 & 14 weeks (0.1 ml, intradermal, right arm)
  • MR, JE: At 9–12 months (0.5 ml, subcutaneous)
  • Vitamin A: At 9 months (1 ml oral)

For Children:

  • DPT Booster 1: 16–24 months
  • MR 2, JE 2, OPV Booster: 16–24 months
  • Vitamin A (2nd to 9th dose): Every 6 months till 5 yrs
  • DPT Booster 2 & TT: 5–6 yrs and at 10 & 16 yrs
    (All appropriate doses via IM, SC, or oral routes)

This schedule ensures comprehensive protection for pregnant women, infants, and children against key vaccine-preventable diseases.

Indian Academy of Pediatrics (IAP) Immunization Schedule (Brief)

IAP supports the national schedule and adds more vaccines for broader protection.

At Birth: BCG, OPV-0, Hepatitis B-1
6 Weeks: IPV-1, DTwP-1, Hep B-2, Hib-1, Rotavirus-1, PCV-1
10 Weeks: DTwP-2, IPV-2, Hib-2, Rotavirus-2, PCV-2
14 Weeks: DTwP-3, IPV-3, Hib-3, Rotavirus-3, PCV-3
6 Months: OPV-1, Hep B-3
9 Months: OPV-2, MMR-1
9–12 Months: Typhoid Conjugate Vaccine
12 Months: Hepatitis A-1
15 Months: MMR-2, Varicella-1, PCV Booster
16–18 Months: DTwP/DTaP Booster-1, IPV Booster-1, Hib Booster
18 Months: Hepatitis A-2
2 Years: Typhoid Booster
4–6 Years: DTwP/DTaP Booster-2, OPV-3, MMR-3, Varicella-2
10–12 Years: Tdap/Td, HPV (for girls: 3 doses at 0, 1–2, 6 months)

This schedule ensures comprehensive immunization from birth through adolescence.

Achievements of the Immunization Program (Brief):

  • Eradication of smallpox and elimination of wild poliovirus in India.
  • Significant reduction in cases and deaths from vaccine-preventable diseases (VPDs).
  • Coverage improvement from 1985–86 to 2014:
    • BCG: 29% → 91%
    • DPT (3 doses): 41% → 83%
    • TT (pregnant women): 87%
    • Measles: 83%
    • OPV (3 doses): 82%
    • Hepatitis B3: 70%
    • Hib3: 20%
Reference 
Malviya K, Sahoo S, Dasadiya D, Acharya V. Social and Preventive Pharmacy. 1st ed. Pee Vee (Regd.); 2021.

Thursday, June 19, 2025

Improvement in Rural Sanitation

🧼 Sanitation in Rural India – Summary Notes

🔹 Definition & Importance

Sanitation refers to hygienic practices that prevent human contact with waste, reducing disease spread. It covers disposal of human excreta, solid/liquid waste, food hygiene, and environmental cleanliness. Poor sanitation affects health, education (especially for girls), productivity, and overall national development.

🔹 Challenges

  • Open Defecation: Still prevalent in rural areas despite reduction.
  • Health Hazards: Diarrhea, infections, and 1 in 10 rural deaths are linked to poor sanitation.
  • Gender Issues: Women face safety and menstrual hygiene issues.
  • Low Toilet Usage: Even existing toilets are underutilized.
  • Economic Impact: Poor health reduces workforce productivity and growth.

🔹 Key Government Initiatives

1.     Central Rural Sanitation Programme (1986):
Aimed to provide privacy, dignity, and improve life quality in rural India.

2.     Total Sanitation Campaign (1999):
Goal to eliminate open defecation by 2012, promote toilet use, hygiene education, and cover schools.

3.     Nirmal Gram Puraskar (2003):
Award to villages achieving 100% sanitation coverage with prize money ₹50,000–₹5,00,000.

4.     Rural Sanitary Marts (RSMs):
Shops for sanitary materials and guidance on latrine construction.

🔹 Government Roles (Fig 5.5)

  • National Level: Planning, funding, monitoring, policy making.
  • State Level: Set standards, capacity building, resolve land issues.
  • Urban Local Bodies: City plans, awareness, implementation, and monitoring.

🔹 Improvement Measures

  1. Create Demand: Awareness, education, and communication campaigns.
  2. Meet Demand: Provide infrastructure and material access.
  3. Ensure Sustainability: Policy support, behavioral change.
  4. NGO Support: Implementation, awareness, and facility setup.
  5. District Models: Pilot projects to be scaled state-wide.
  6. Water & Waste Management: Systematic access to HWT and solid waste disposal.
  7. Public Participation: Citizens should demand accountability, maintain cleanliness.
  8. Media & Youth Involvement: Use media, education, and youth action for awareness.

🔹 Key Focus Areas for Sanitation  

      Human excreta management

  • Household wastewater reuse
  • Stormwater drainage & sewage
  • Solid waste recycling
  • Industrial & hazardous waste disposal

📝 Conclusion:
Achieving rural sanitation requires collective action from government, NGOs, and communities. Transparent implementation, strong policies, education, and consistent monitoring are key to sustainable change and a healthier India.

Reference 

Malviya K, Sahoo S, Dasadiya D, Acharya V. Social and Preventive Pharmacy. 1st ed. Pee Vee (Regd.); 2021

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Community Health Services and functions of PHC


🔹 5.1 INTRODUCTION TO COMMUNITY HEALTH & SERVICES

  • Community: A group sharing common geography and values.
  • Community Health: Health status of the community and factors affecting it.
  • Public Health: Organized efforts to prevent disease, promote health, and prolong life.
  • Community Service: Work done for community benefit, voluntary or compulsory.

🔹 5.1.1 OBJECTIVES OF COMMUNITY HEALTH

Health services are divided into three levels of prevention:

1.     Primary Prevention – Health promotion and protection

    • Safe water, waste disposal, hygiene, immunization, nutrition, health education

2.     Secondary Prevention – Early diagnosis and treatment

    • Mass screening, school checkups

3.     Tertiary Prevention – Disability control and rehabilitation

🔹 5.2 HEALTH CARE SYSTEM IN INDIA

India’s health care system includes five major sectors:

  1. Public Health Care System
  2. Private Health System
  3. Indigenous Systems of Medicine
  4. Voluntary Health Agencies
  5. National Health Programmes

🔹 5.2.1 Public Health Care System

Divided into 4 parts:

·        Primary Health Care

    • Primary Health Centres (PHCs), Sub-centres (SCs)

·        Hospitals/Health Centres

    • CHCs, District/Rural hospitals, Specialist & Teaching hospitals

·        Health Insurance Schemes

    • ESI, CGHS

·        Other Agencies

    • Railways, Defence services

🔹 5.2.2 Private Sector

Includes:

  • Private hospitals, nursing homes, clinics, dispensaries
  • General practitioners

🔹 5.2.3 Indigenous System of Medicine

Traditional systems of healing:

  • Ayurveda, Siddha
  • Unani, Tibbi
  • Homeopathy
  • Unregistered local practitioners

🔹 5.2.4 Voluntary Health Agencies

Examples:

  • Indian Red Cross
  • Kasturba Memorial Fund
  • Hind Kusht Nivaran
  • Family Planning Association of India
  • Indian Council for Child Welfare
  • Bharat Sevak Samaj
  • Central Social Welfare Board

🔹 5.2.5 National Health Programmes

Government-run programs addressing specific health issues like:

  • TB, Malaria, Leprosy, AIDS
  • Family welfare, immunization, blindness control

🔹 5.3 PRIMARY HEALTH CENTRES (PHC)

  • Introduced under Alma-Ata Declaration (1978) by WHO & UNICEF.
  • Aim: "Health for All by 2000 A.D."
  • Definition: Essential health care accessible and acceptable to all.
  • PHC provides:
    • Preventive, promotive, and curative care
    • Based on a three-tier rural structure depending on population size

📊 Table 5.1: Population Norms for Health Facilities

Health Facility

Plain Area

Hilly/Tribal Area

Sub-Centre

5,000

3,000

Primary Health Centre

30,000

20,000

Community Health Centre

1,20,000

80,000

🎯 5.3.1 Objectives of PHC

  • Deliver comprehensive primary health care
  • Ensure quality standards
  • Provide community-responsive services

🏥 5.3.2 Levels of Health Care

1.     First Level (Primary Care)

    • First contact with the system
    • Handled at: Sub-Centre, PHC, CHC (rural), dispensaries, MCH centers (urban)

2.     Second Level (Secondary Care)

    • First referral level
    • Complex cases managed at district hospitals

3.     Third Level (Tertiary Care)

    • Super-specialty care
    • Provided at regional/central institutions
    • Also serve as training and referral centers

🔹 Major Functions of Primary Health Centre (PHC)

1.     Medical Care

    • OPD (morning & evening)
    • 24×7 emergency care (e.g., injuries, bites, stabilization)
    • Referral & inpatient care (6 beds)

2.     Maternal & Child Health Care

    • Antenatal, intranatal, postnatal, and newborn care

3.     Family Planning Services

    • Counseling, infertility referral, vasectomy/tubectomy

4.     MTP Services

    • Medical termination of pregnancy via MVA

5.     Health Education

    • RTI/STI prevention and management

6.     Nutrition Services

    • Treat malnutrition, anemia, vit. A deficiency (coordination with ICDS)

7.     School & Adolescent Health Care

8.     Disease Surveillance & Epidemic Control

9.     Vital Event Reporting

    • Births, deaths, other records

10.  Sanitation Promotion

    • Toilet use, waste disposal, water testing & disinfection

11.  Implementation of National Health Programmes

12.  Referrals & Transport for Critical Cases

13.  Training and Capacity Building

14.  Basic Laboratory Services

15.  Monitoring, Supervision, & Record Maintenance

16.  Minor Surgical Procedures

    • Vasectomy, MTP, cataract, hydrocele (in O.T.-equipped PHCs)

17.  AYUSH Integration

    • Promoting traditional medicine systems

Reference 

Malviya K, Sahoo S, Dasadiya D, Acharya V. Social and Preventive Pharmacy. 1st ed. Pee Vee (Regd.); 2021

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Role of the WHO in the Indian National Programs

Role of WHO in Indian National Programs – Brief Overview

The World Health Organization (WHO), established in 1948, acts as the global leader in health coordination. In India, WHO has supported significant health achievements such as reduced maternal and child mortality, elimination of polio, neonatal tetanus, and yaws, and a sharp decline in HIV/AIDS cases.

Through the Country Cooperation Strategy (2019–2023), WHO aligns with India’s National Health Policy 2017, supporting goals like universal health coverage (UHC) and increased public health spending, especially for the poor and vulnerable.

Strategic Priority

Key Actions

1. Accelerate Progress on UHC

- Strengthen Ayushman Bharat and Health & Wellness Centres
- Improve service quality, especially in maternal & child health, TB, and NCDs
- Expand immunization and reduce vaccine-preventable diseases

2. Promote Health & Wellness by Addressing Determinants

- Address non-communicable diseases (NCDs), nutrition, mental health, and road safety
- Strengthen health promotion and digital health platforms

3. Protect Population Against Health Emergencies

- Improve disease surveillance, outbreak detection, and response
- Enhance preparedness (e.g., AMR, IHIP rollout)

4. Enhance India’s Global Health Leadership

- Improve access to quality-assured medical products
- Promote innovation, digital health, and global partnerships

WHO has played a vital role in shaping India’s health advancements through three main approaches:

1. Policy Shaping through Evidence & Advocacy

  • Revealed higher TB burden, prompting overhaul of India’s TB programme and increased funding.
  • Helped launch the National Viral Hepatitis Control Program with free treatment for Hepatitis B & C.
  • Contributed to Swachh Bharat Mission with data on open defecation.
  • Advocated for mental health services and expanded depression awareness.
  • Supported the National Multisectoral Action Plan for NCD control (2017–2022).
  • Promoted food safety through evidence on malnutrition and infections.

2. Support for Research

  • Backed polio strategy (e.g., fractional IPV dose trials).
  • Supported studies on typhoid vaccines and measles diagnostics.
  • Contributed to research on AMR, leading to national and state action plans.
  • Supported India TB Research Consortium and midwifery policy development.

3. Economic and Strategic Guidance

  • Provided economic analysis to guide tobacco tax policy.
  • Influenced health policies through impact assessments and burden of disease studies.

WHO’s evidence-based support has led to major health program reforms and innovations in India.

1. Technical Support

  • Helped develop key health policies and plans like the National Action Plan on AMR, Viral Hepatitis Control Program, and National Multisectoral Action Plan for NCDs.
  • Supported National Strategic Plan for TB (2017–2025) and air pollution strategies including the National Clean Air Programme.
  • Contributed to the National Action Plan on Climate Change and Health.

2. Capacity Building

  • Trained professionals in data collection, programme design, and M&E.
  • Strengthened quality surveillance (e.g., birth defects, maternal deaths, adolescent health).
  • Supported innovation to reach HIV 90-90-90 targets.
  • Built epidemic intelligence capacity for outbreak response.
  • Helped regulate traditional medicine in collaboration with AYUSH Ministry.

3. Health Data System Strengthening

  • Led development of IHIP as a unified health data platform.
  • Revamped IDSP with real-time, mobile-based disease reporting.
  • Set surveillance standards, prioritized diseases, and provided tech/data support.

WHO’s contributions have significantly strengthened India’s health systems, policies, and digital health infrastructure.

1. On-the-Ground Support

  • Polio Eradication Legacy: National Polio Surveillance Project now supports other vaccine-preventable diseases.
  • Immunization Success: WHO helped boost vaccine coverage (e.g., Mission Indradhanush, measles-rubella campaigns).
  • NTD Elimination: Field support for mass drug administration, leprosy, and kala-azar control.
  • TB Control: Supported public-private TB care models, DBT scheme, and real-time reporting via NIKSHAY.
  • Hypertension: 25 WHO medical officers deployed across districts for the India Hypertension Management Initiative.
  • Emergency Response: WHO assisted states like Kerala during 2018 floods with disease surveillance.

2. Transition in WHO’s Role

  • Shifting focus from field operations to policy support, advocacy, and addressing chronic diseases.
  • Increased collaboration beyond the health sector to include social and environmental determinants.

3. Monitoring & Evaluation Framework (CCS 2019–2023)

  • Track DALYs, output/impact targets of 4 strategic priorities.
  • Use Country Support Plans, program evaluations, and health impact reports.
  • Assess progress in enhancing India’s global health leadership.
Reference 

Malviya K, Sahoo S, Dasadiya D, Acharya V. Social and Preventive Pharmacy. 1st ed. Pee Vee (Regd.); 2021


Wednesday, June 18, 2025

Social Health Program


4.6 Social Health Programme – Summary

Definition of Health (WHO)

  • Health is complete physical, mental, and social well-being, not just absence of disease.
  • In 1986, WHO added: Health is a resource for daily life, not the goal of living.

Major Health Achievements in India

  • Polio eradicated (2014), Maternal & Neonatal Tetanus eliminated (2015), Yaws (2016).
  • Life expectancy rose from 62.5 (2000) to 68.8 years (2016).
  • Infant mortality reduced by 57%; under-5 mortality dropped from 125 to 39 per 1000 (1990–2016).
  • Maternal mortality dropped from 437 (1990) to 130 (2015).
  • HIV infections reduced by 66% (2000–2015); AIDS deaths declined by 55% (2007–2015).
  • Institutional deliveries increased from 39% to 79% (2005–2016).
  • Major decline in Neglected Tropical Diseases (NTDs):
    • 80% drop in kala-azar (2011–2017).
    • Leprosy eliminated in 29 states/UTs.
    • Filariasis eliminated in 88% districts.
  • Tobacco use declined from 34.6% to 28.6% (2009–2017); 8.1 million fewer users.

4.6.2 Role of Government in Health Sector

  • Health system strengthening
  • Health information & research systems
  • Regulation & enforcement
  • Health promotion
  • Human resource & capacity building
  • Public health policies
  • Identifying further areas for improvement

4.6.3 Intersectoral Coordination for Public Health

  • Address social determinants: living conditions, urban planning, rural infrastructure.
  • Improve education, nutrition, social security, food and social assistance.
  • Promote population stabilization, gender empowerment, climate resilience.
  • Encourage community participation, private sector, civil society & global partnerships.

Key Health Initiatives and Programs in India

1. Mental Healthcare Act, 2017

  • Ensures mental health services as a right.
  • Aims to provide dignified life to individuals with mental illness.

2. Efforts to Control NCDs

  • National Programme on NCDs (2017–2022): Focus on diabetes, CVDs, and stroke.
  • Target: Reduce premature NCD mortality by 25% by 2025.

3. Integrated Health Information Platform (IHIP)

  • EHR-based health data system for nationwide disease surveillance.

4. Mission Indradhanush

  • Goal: Achieve 100% immunization coverage for children and pregnant women.

5. National Programs

  • National Viral Hepatitis Control Programme: Prevention and treatment of hepatitis.
  • National TB Programme: Improve TB diagnosis and treatment.
  • Swachh Bharat Mission: Eliminate open defecation (goal achieved by 2019).
  • Ayushman Bharat (PM-JAY): Health insurance up to ₹5 lakh/year for poor families.

Other Important Initiatives

6. POSHAN Abhiyaan

  • Improve nutrition among women and children.
  • Promote breastfeeding and reduce malnutrition.

7. Midwifery Services

  • Skilled care for mothers at primary/district level facilities.

8. Mission MAA (Mothers’ Absolute Affection)

  • Encourage breastfeeding among women with children under 2 years.

9. Anemia Mukt Bharat

  • Reduce anemia in women, adolescents, and children.

10. National AYUSH Mission

  • Promote traditional medicine (Ayurveda, Yoga, etc.) via co-located centers in hospitals.

Reference 

Malviya K, Sahoo S, Dasadiya D, Acharya V. Social and Preventive Pharmacy. 1st ed. Pee Vee (Regd.); 2021


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