learntoexplore: 2025

Tuesday, June 10, 2025

NMCP

National Malaria Prevention Program

Introduction

Malaria is a life-threatening disease caused by Plasmodium parasites and transmitted by infected Anopheles mosquitoes. In India, P. vivax and P. falciparum are most common.

History of Malaria Control in India

1953: National Malaria Control Programme (NMCP) launched.
1958: Upgraded to National Malaria Eradication Programme (NMEP).
1976: Malaria resurgence due to drug/insecticide resistance and poor infrastructure.
1977: Modified Plan of Operation (MPO) initiated.
1997: Enhanced Malaria Control Project (EMCP) with World Bank support.
2002: Integration into National Vector Borne Disease Control Programme (NVBDCP).
2017–2022: National Strategic Plan aimed at malaria elimination.

Objectives

Reduce malaria transmission to a non-public health problem level.
Maintain low transmission through state-level actions.

Control Strategies

1. Early Case Detection & Prompt Treatment (EDPT)

Chloroquine is main drug; alternatives used for resistance cases.
Drug Distribution Centres (DDCs) and Fever Treatment Depots (FTDs) established.

2. Vector Control

Chemical: Indoor residual sprays, larvicides, fogging.
Biological: Larvivorous fish, biocides.
Urban Malaria Scheme (UMS) active in 131 towns.

Urban Malaria Challenges

Unplanned urbanization, slums, poor sanitation, and water storage lead to mosquito breeding.
Overburdened health staff and lack of integrated vector control strategies.
Development projects without health assessment contribute to outbreaks.

Anti-Malarial Drug Policy

Drafted in 1982 due to chloroquine resistance.
Drugs used: Chloroquine, Primaquine, Artesunate, Sulfadoxine-Pyrimethamine, etc.

Key Milestones

NMCP (1953) → NMEP (1958) → MPO (1977) → EMCP (1995) → NVBDCP (2004)

Roles & Functions

NVBDCP: Central agency for malaria and other vector-borne diseases.
Coordinates policy, logistics, and monitoring.
Field-level implementation through District Malaria Units and Sub-centres.
ICMR & NIMR: Support with research, drug resistance studies, and evaluation of new tools.

NTCP

National Tobacco Control Programme (NTCP)

🔶 Background

Tobacco is a major risk factor for various non-communicable diseases (NCDs) including cancer, cardiovascular diseases, respiratory illnesses, and diabetes.
India is the second-largest producer and consumer of tobacco globally.
Around 275 million Indians use tobacco in some form.
The Cigarettes and Other Tobacco Products Act (COTPA), 2003 is the primary law for tobacco control in India.
In line with the WHO Framework Convention on Tobacco Control (WHO-FCTC), India launched the National Tobacco Control Programme (NTCP) in 2007–08.

📜 Legal Framework: COTPA, 2003

Key provisions of the Cigarettes and Other Tobacco Products Act (COTPA), 2003:

Ban on Smoking in Public Places (effective 2 Oct 2008).
Prohibition of Sale to Minors (under 18 years).
Ban on Sale within 100 Yards of Educational Institutions.
Mandatory Pictorial and Text Health Warnings on packaging.
Ban on Direct/Indirect Advertisements, Promotion, and Sponsorship.
Display of Tar and Nicotine Content on product packages.
Ban on sale through vending machines and by minors.
Restrictions on Point of Sale Advertisements.

🎯 Objectives of NTCP

Public Awareness through mass media campaigns.
Capacity Building of stakeholders (health workers, NGOs, school teachers, etc.).
Establishment of Tobacco Testing Laboratories.
Mainstreaming Tobacco Control in National Health Programs (e.g., NRHM).
Strengthening Law Enforcement through training and coordination with police and judiciary.
Monitoring and Evaluation through national-level surveys (like GATS – Global Adult Tobacco Survey).
Promoting Alternative Livelihoods for tobacco farmers.

🛠️ Key Components of NTCP

Level	Activities
National Level	Policy formulation, technical assistance, training, IEC material development.
State Level	State Tobacco Control Cells (STCCs), coordination, supervision.
District Level	District Tobacco Control Cells (DTCCs), IEC activities, enforcement.

📍 Implementation Phases

Pilot Phase (2007–08): 42 districts in 21 states/UTs.
Expanded Phase (12th Five Year Plan): All states and over 600 districts covered.
NTCP is implemented under the National Health Mission (NHM).

🧪 Tobacco Testing Laboratories

Purpose: Measure nicotine, tar, and other harmful contents.
These labs help in enforcing COTPA standards.

🏥 Integration with Healthcare

Primary Health Care settings encouraged to assess tobacco use in all patients.
Offer tobacco cessation advice and referral.
Dedicated cessation clinics established in many states.

🧾 Achievements of NTCP

Development and distribution of Operational Guidelines for NTCP.
Training of healthcare providers, police, and judiciary.
Pictorial warning implementation across tobacco products.
National Media Campaigns on anti-tobacco awareness.
Enactment of Food Safety Regulations, 2011 banning gutkha and pan masala with tobacco/nicotine.

⚠️ Diseases Caused by Tobacco

Disease Category	Conditions
Cardiovascular	Heart attack, stroke
Respiratory	Asthma, COPD, TB
Cancer	Oral, lung, throat, esophagus
Reproductive	Infertility, erectile dysfunction, birth defects, fetal death
Metabolic & Others	Type-II diabetes, dementia, immune suppression, vision loss

🌎 Global Adult Tobacco Survey (GATS) – India

Monitors adult tobacco use.
Tracks key tobacco control indicators.
Nationally representative, following WHO protocol.
Conducted in 2009–10 (GATS 1) and 2016–17 (GATS 2).

🛑 Second-hand & Third-hand Smoke

Second-hand Smoke (SHS): Smoke exhaled by user or from burning tobacco.
Third-hand Smoke (THS): Residue that clings to surfaces even after smoke clears — potential health hazard.

🤝 Collaborating Bodies

Ministry of Health and Family Welfare (MoHFW)
State/UT Health Departments
NGOs, Academic Institutions, WHO, HRIDAY, etc.
Coordination with Ministry of Education, Transport, Agriculture, and others.

📘 NTCP Guidelines and Documents

Operational Guidelines for NTCP
Guidelines for Law Enforcers, 2013
IEC and Training Modules
Guidelines for Tobacco-Free Educational Institutions

NFWP

National Family Welfare Programme:

4.2.4 Goals (By 2000 AD)

Reduce birth rate: 29 → 21 per 1000
Reduce death rate: 10 → 9 per 1000
Increase couple protection rate: 43.3% → 60%
Reduce family size: 4.2 → 2.3
Reduce infant mortality rate: 79 → <60 per 1000
Net Reproduction Rate (NRR): 1.48 → 1

4.2.5 Importance

2010–11: 34.9 million family planning users
(Sterilizations: 5M, IUD: 5.6M, Condoms: 16M, Pills: 8.3M)
Increased use of contraceptives over decades
Better performance in IUD insertions in states like Assam, UP, Gujarat, Bihar, etc.

4.2.6 Strategies

Integration with general health, MCH services
Focus on rural areas: Sub-centers, PHCs
Promote female literacy to reduce fertility
Encourage breastfeeding to prevent births
Raise marriage age: 21 (males), 18 (females)
Minimum Needs Programme: Improve living standards
Incentives: Limited success, focus on voluntary basis
Mass media: Awareness via TV, radio, folk arts

4.2.7 Role of Community Health Dept.

Counseling, sexuality and gender education
Adolescent care, growth monitoring, nutrition
Maternal care: Obstetrics, infection control, nutrition
Child care: Neonatal care, ORT, vitamin A, IMCI
Reproductive health: MTP, HIV/AIDS awareness
Surveys for IMR and MMR reduction

4.2.8 Role of Community Health Nurse

Conduct surveys and collect demographics
Identify pregnant women, eligible couples, and children
Record and maintain household data

4.2.9 Educational Role and Motivation

Educate public on importance of family planning
Use various teaching techniques to spread awareness
Motivate couples to use contraceptives
Promote permanent contraception options

Here’s a brief and organized summary of the provided content on the National Family Welfare Programme: