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Current National and State Current National and State Health ProgrammesHealth Programmes (2008-2012) (2008-2012)
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Outline of PresentationOutline of PresentationIntroductionClassification of National Health ProgrammesSalient features of the recent National Health
Programmes Salient features of important State Health
Schemes Role of the Nursing faculty in National Health
Programmes and State Health Schemes
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IntroductionIntroduction
“Let diseases and their causes be found and treatment effected accordingly”.
Thirukkural
“Those who would benefit most from a service are least likely to obtain it”
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IntroductionIntroduction1919 - Montague- Chelmsford reforms 1946- Health Survey and Development
Committee( Bhore Committee)1950 – Constitution of India1951-The Five Year Plans2002- National Health policy2002- 2007- Tenth Five year plan 2007-2012- Eleventh Five year plan
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Classification of National Health Classification of National Health ProgrammesProgrammes
I. Programmes related to provision of health care
II. Programmes aimed at controlling communicable diseases
III. Programmes aimed at controlling non- communicable diseases
IV. Programmes related to Maternal and Child Health and Special Groups
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Classification of National Health Classification of National Health Programmes cont.....Programmes cont.....V. National Nutritional ProgrammesVI. National Emergency Preparedness
PlanVII. Programmes related to
Environmental SanitationVIII. Poverty Alleviation ProgrammesIX. Minimum Needs Programme (Basic Minimum Service Programme)
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II. Programmes related to . Programmes related to provision of health careprovision of health care
National Health Mission
1. National Rural Health Mission (NRHM) 2005-12 2. National Urban Health Mission
(NUHM) 2008-12
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1.National Rural Health Mission1.National Rural Health Mission• NRHM - development of State Health
System.• NRHM - organized around Five pillarsi. Increasing Participation and Ownership by
the Communityii. Improved Management Capacityiii.Flexible Financingiv.Innovation of Human Resources
Development for the Health Sectorv.Setting of standards and norms with
monitoring
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Plan of Action under NRHMPlan of Action under NRHMAccredited Social Health Activist (ASHA)Strengthening of Health Sub CentresStrengthening of Primary Health CentresStrengthening of Community Health CentresDistrict Health PlanConverging Sanitation and HygieneStrengthening Disease Control Programme Public Private PartnershipNew Health Financing MechanismReorienting Health and Medical Education
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2.National Urban Health 2.National Urban Health MissionMission
• Aim : Address the health concerns of the urban poor by rationalizing and strengthening the existing facilities.
• Ensuring Community Participation in planning and management of health services by community Institutions like Mahila Arogya Samiti (20-100 households and Rogi Kalyan Samiti.
• Urban Social Health Activist (USHA) 1for1000-2500 urban poor population in 200-500households
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Urban Health Care Urban Health Care Delivery ModelDelivery Model
Referral
Primary Level
Sub-primary level
Community level
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Community Risk Pooling under Community Risk Pooling under NUHMNUHM
Mahila Arogya Samiti(MAS)
Slum Women
Seed Money and Performance Grant
Interest on savings
Interest on loans
Small loans
Savings
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II. Programmes aimed at II. Programmes aimed at controlling Communicable controlling Communicable DiseasesDiseases
1. National Vector borne diseases Control Programme (NVBDCP)
2. National Leprosy “Eradication” Programme (NLEP): National Action Plan
3. Revised National Tuberculosis Control Programme (RNTCP) Phase II
4. National AIDS Control Programme Phase III5. Rabies Control Programme6.Integrated Disease Surveillance Project
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1.National Vector borne diseases 1.National Vector borne diseases Control Programme (NVBDCP)Control Programme (NVBDCP)
• It is one of the most comprehensive and multi-faceted public health activities in the country.
• It is concerned with the prevention and control of vector borne diseases namely Malaria, Dengue, Kala azar, Filariasis, Chikungunya fever and Japanese Encephalitis.
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Three Pronged Strategy under NVBDCPThree Pronged Strategy under NVBDCP
1. Disease management
2. Integrated Vector management (for transmission risk reduction)
3. Supportive Interventions Behaviour Change Communication(BCC) Public Private Partnership(PPP)
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2.NLEP: National Action Plan2.NLEP: National Action Plan1. Decentralization and Institutional
Development2. Strengthening and Integration of Service
Delivery3. Disability Prevention ,Care and
Rehabilitation4. Information Education and Communication
(IEC)5. Training of staff of General Health
Services
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3. 3. RNTCP Phase IIRNTCP Phase II• Access services to hard-to-reach areas.• Strengthen intersectoral coordination and
involving Medical colleges • IEC activities.• Improving laboratory facilities for sputum
culture and drug sensitivity• Implementation of DOTS –Plus strategy
for Multi Drug Resistant Tuberculosis (MDR-TB)
• Paediatric patient-wise drug boxes
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4.National AIDS Control 4.National AIDS Control Programme (NACP) Phase IIIProgramme (NACP) Phase III
1. Prevention of new infection in high risk groups and general population
2. Providing greater care ,support and treatment to a large number of people living with HIV/AIDS.
3. Capacity building
4. Monitoring and Evaluation
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5.Rabies Control Programme5.Rabies Control Programme-Components-Components
1. Effective Co-ordination2. Post-Exposure Treatment with
recommended vaccines and immunoglobulin
3. Enhancement of indigenous production of tissue culture vaccines
4. Health Education5. Prophylaxis of people engaged in Anti-
rabies work6. Augmenting laboratory services
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III.Programmes aimed at controllingIII.Programmes aimed at controllingNon- Communicable Diseases(NCDs)Non- Communicable Diseases(NCDs)
1. National Programme for Prevention and Control of Diabetes, Cardiovascular Diseases and Stroke
2. National Programme for Control of Blindness (NPCB)- New Initiatives
3. National Mental Health Programme(NMHP)4. National Programme for Prevention and
control of Deafness5. National Oral Health Programme6. Integrated Disease Surveillance Project
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11.. National Programme for Prevention and National Programme for Prevention and Control of Diabetes, Cardiovascular Control of Diabetes, Cardiovascular Diseases and Stroke - ComponentsDiseases and Stroke - Components 1. Health Promotion for general population2. Professional Education3. Diagnosis and Management4. Surveillance of Risk factors5. Community Participation
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2.National Programme for Control of 2.National Programme for Control of Blindness (NPCB)- New InitiativesBlindness (NPCB)- New Initiatives
Construction of dedicated eye wards and eye operation theatre in district and sub-district hospitals in north-eastern states.
Ophthalmic Surgeons and Ophthalmic assistantEye donation Counsellors Grant-in-aid for NGOsVitamin A supplementation and MMR
vaccination
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3. National Mental Health 3. National Mental Health Programme (NMHP) –Thrust areasProgramme (NMHP) –Thrust areas
1. District Mental Health Programme to cover the entire country and be more effective
2. Modernization /Streamlining of Mental Hospitals
3. Upgrading Dept of Psychiatry in Medial Colleges and enhancing the psychiatric content.
4. Research and Training in the field of community mental health, substance abuse and child adolescent psychiatric clinics.
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4.National Programme for 4.National Programme for PreventionPreventionand control of Deafness- Activitiesand control of Deafness- ActivitiesTraining of all the manpowerInfrastructure buildingScreening, Early diagnosis and
ManagementProvision of Surgical and
Rehabilitative services as well as provision of hearing aid
IEC activities
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5.National Oral Health 5.National Oral Health ProgrammeProgrammeComponentsComponents1. Oral Health Education2. Formulation of Basic Package on oral
Health should be locally developed3. Manpower and Infra structure
requirement for Primary and Secondary Prevention of Oral Diseases.
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6. Integrated Disease 6. Integrated Disease Surveillance Project (IDSP) Surveillance Project (IDSP) - Activities- Activities1. Decentralizing and Integrating
Surveillance Mechanism2. Upgradation of laboratories3. Information Technology and
Communication4. Human Resources and Development5. Operational Activities and Response6. Monitoring and Evaluation
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IV. Programmes related to Maternal IV. Programmes related to Maternal and Child Health and Special Groupsand Child Health and Special Groups1. Reproductive and Child Health (RCH)
Programme Phase –II 20052. National Programme of Health Care of
Elderly 3.National Programmes and Schemes for
Disabled persons4.National Programme for Control and
Treatment of Occupational Diseases
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1.Reproductive and Child Health (RCH)1.Reproductive and Child Health (RCH)Programme Phase –II 2005: StrategiesProgramme Phase –II 2005: Strategies
1 .Essential Obstetric Care- Institutional Delivery- Skilled attendance at delivery
2.Emergency Obstetric Care- Operationalising First Referral Units- Operationalising PHCs and CHCs for
round the clock delivery services3. Strengthening Referral system4. Adolescent Health
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Emergency Obstetric Care Emergency Obstetric Care (EmOC)(EmOC)
• First Referral Units (FRUs) – availability of surgical interventions, new born care and blood storage facility on a 24 hr basis.
• Training MBBS doctors in life saving anaesthetic skills.
• Janani Suraksha Yojana (JSY)- reduce maternal mortality, institutional deliveries, focusing on BPL families.
• Vandemataram Scheme - any obstetric and gynaecology specialist, maternity home, lady MBBS doctor can volunteer for providing safe motherhood services.
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IMNCI- Plus strategy in RCH IIIMNCI- Plus strategy in RCH II
Newborn and Child health
IMNCI
Home & Community levelHBNC
Facility level
CARE AT
BIRTH
IMMUNIZATION
Behaviour Change Communication
& Community Participation Health System Strengthening
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2. National Programme of Health 2. National Programme of Health Care of Elderly : StrategiesCare of Elderly : Strategies
1. Home Based Health Service – early warning system and Psychological support
2. Community based Health Centre for the elderly providing a base for Educational and Preventive activity
3. Improved Hospital based Support Service with focused health care needs
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4.National Programme for Control and 4.National Programme for Control and Treatment of Occupational DiseasesTreatment of Occupational Diseases
Data base generation, documentation and information dissemination on hazardous process
Capacity buildingHealth Risk AssessmentPrevention and Control of Occupational
health Hazards
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..National Emergency Preparedness National Emergency Preparedness Plan: Disaster ManagementPlan: Disaster ManagementMedical Preparedness for Mass
Casualties ManagementEmergency Medical Relief (EMR)Bioterrorism/ Biological warfareSevere Acute Respiratory Syndrome
(SARS)Influenza Pandemics
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State Health SchemesState Health Schemes
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IntroductionIntroduction• The Government of Tamilnadu is committed
to provision of quality medical service.• Based on this commitment, innovative
schemes are formulated for implementation.• There is no slackness in the implementation
of people's welfare schemes .• The implementation of the welfare schemes
will meet the medical needs of the poor and down trodden people.
• The details of some of the important schemes are discussed .
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Chief Minister Kalaignar Chief Minister Kalaignar Insurance Scheme for life saving Insurance Scheme for life saving treatmentstreatments
• This is one of the fore most schemes of this Government brought for the benefit of the poor people.
• So far 1.44 crore families have been enrolled under the scheme.
• The scheme provides specialist treatment for 51 life threatening diseases in the 565 empanelled Government and Private Hospitals.
• Entire insurance premium is paid by the Government
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Reproductive and Child Health SchemesReproductive and Child Health Schemes
• Improvement of Quality of Health services in HSCs, PHCs and Referral centres
• Provision of Diet to Antenatal women ,Post natal mothers, and women who had undergone Sterilization
• Dr. Muthulakshmi Reddy Maternity Benefit Scheme• “108” Emergency Ambulance Service• Provision of Specialist services Obstetricians,
Anaesthetists for Emergency Obstetric Care and Paediatrician for Emergency Newborn care
• Gestational Diabetes Control Programme:
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Improvement of Quality of Health services in Improvement of Quality of Health services in HSCs, PHCs and Referral centres HSCs, PHCs and Referral centresAll the 1539 Primary Health Centres in Tamil
Nadu have been made 24X7 Primary Health Centres with the appointment of 3 Staff Nurses.
Primary Health Centres infrastructure were strengthened which enabled the Primary Health Centres to do more deliveries.
Prompt Referral system has improved Institutional deliveries to 99.7% in Tamil Nadu.
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Provision of Diet to Antenatal women ,Provision of Diet to Antenatal women ,Post natal mothers, and women who had Post natal mothers, and women who had undergone Sterilization undergone Sterilization
• Implemented from 15th Sep 2008 • The scheme of providing diet to the delivery
women, those who have undergone sterilization (Three times a day for two days).
• Antenatal Mothers in Tribal areas (Three times a day for 7 days with a female attendant.
• Antenatal Mothers (for one time) coming to Primary Health Centre for Scan, Blood test etc.
• So far 9, 30,794 Postnatal Mothers, Sterilization Mothers and AN Mothers were benefited by the Scheme.
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Dr. Muthulakshmi Reddy Dr. Muthulakshmi Reddy Maternity Benefit SchemeMaternity Benefit Scheme
• is implemented from 15.09.2006.• Under this scheme, cash assistance of
Rs.6000/- is given to the pregnant women of below poverty line to compensate the wage loss during pregnancy and to take nutritional food to avoid low birth weight babies.
• So far 19, 52,466 pregnant women are benefited and a sum of Rs.1000.00 crores is disbursed to them.
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““108” Emergency 108” Emergency Ambulance Service Ambulance Service
It is one of the laudable schemes widely appreciated by the public.
At present, 385 ambulances are deployed throughout Tamil Nadu and this will be increased to 445 ambulances soon.
Ambulance Services benefited 3, 80,840 persons and saved the lives of 17,000 persons who were in critical condition.
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Provision of Specialist services Provision of Specialist services Obstetricians, Anaesthetists for Emergency Obstetricians, Anaesthetists for Emergency Obstetric Care and Paediatrician for Obstetric Care and Paediatrician for Emergency Newborn careEmergency Newborn care
The lack of manpower in the FRUs has been managed through hiring of Obstetricians and Anaesthetists and Paediatrician for emergency obstetric care services and emergency newborn care.
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Gestational Diabetes Control Gestational Diabetes Control ProgrammeProgramme
• A scheme for early detection of gestational diabetes using the Glucose Challenge Test
• approach has been functioning at the block PHC level using the semi auto analyzers provided under RCH.
• It is now proposed to extend the scheme to all PHCs using the services of trained staff nurses wherever lab technicians are not available.
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Varumun Kappom ThittamVarumun Kappom Thittam• Enables diagnosis of diseases at incipient
stage and provision of appropriate treatment • 14,594 camps have been conducted so far.
The total beneficiaries are 141.07 lakhs.• Those who are identified for further
treatment and surgery for 51 diseases are given treatment in the empanelled hospitals under Kalaignar Insurance Scheme.
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Ilam Sirar and Palli Sirar Irudhaya Padhukappu Ilam Sirar and Palli Sirar Irudhaya Padhukappu ThittamThittamThe GOT launched the Young Children Heart
Protection Scheme in December 2007 and a special programme of screening of School Children for Heart Disease .
launched on the 85th birth day of Hon'ble Chief Minister on 3rd June 2008.
So far 3290 young children and School Children have undergone Heart Surgery in 28 accredited private hospitals.
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Dr. Kalaignar Palli Sirar Kannoli Dr. Kalaignar Palli Sirar Kannoli Kappom ThittamKappom Thittam 30,04,749 school children studying in
VI to VIII Std were screened. 1, 60,983 students have been
identified with Refractive errors and spectacles have been distributed to the students.
Implemented to the students of IX and X Std studying in the Government and Government Aided Schools.
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District Mental Health District Mental Health Programme:Programme:
District Mental Health Programme is implemented in 16 Districts of Tamilnadu.
Awareness on mental illness and remedies available under this programme is being disseminated among the public through various IEC activities.
10 bedded Psychiatric wards are available in all the Programme districts.
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Schemes for protection of Girl ChildSchemes for protection of Girl Child
Introduced in Tamilnadu in 1992Cradle Baby Scheme - allows families to
hand over unwanted female babies to the government, legal action against perpetrators of infanticide
Girl Child Protection Scheme (GCPS) which provide financial incentives to families with only daughters
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Urban Health programme:Urban Health programme:• Urban PHCs will be set up very shortly in the
60 municipalities• A novel programme is implemented through
the Community Medicine department of 14 Medical colleges by adopting one urban heath post from where the medical colleges are getting large number of primary referrals.
• These adopted Urban health centres have been provided with necessary equipments, materials as well as specialist manpower for specified days through the medical college.
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Pilot project for NCDsPilot project for NCDs Cardio Vascular Diseases Two districts Sivagangai and Virdunagar BCC -School level, Work place, Community basedScreening of Cervical Cancer Two districts- Theni and Thanjavur Women20-60 yrs VIA and VILI and if positive Colposcopic examination
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Role of Nursing Faculty in Role of Nursing Faculty in National Health Programmes National Health Programmes and State Health Schemesand State Health Schemes
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Programmes related to provision of Programmes related to provision of Health Care- NRHM/ NUHM Health Care- NRHM/ NUHM
Important role in strengthening the functions of HSCs, PHCs, UPHCs and CHCs for First Referral Care
Availability of nurses 24hrsx7 days in PHC Important role in Secondary and Tertiary
levels of health care Disease control programmes Reorienting health /medical and para
medical education
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Programmes aimed at controlling Programmes aimed at controlling Communicable DiseasesCommunicable DiseasesEarly Diagnosis of the diseaseAdministration of correct drug in the
specified dose Patient Counselling and building up of
rapportHealth Education –individual level,
group level and Mass levelCare of seriously ill patients
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Programmes aimed at ControllingProgrammes aimed at ControllingNon- Communicable Non- Communicable Diseases(NCDs)Diseases(NCDs)
Early detection of Risk factors of NCDs in the community
Screening of individuals for NCDs in the community.
School Health Programme for early detection of Rheumatic fever
Administration of correct dose of drugs Care of seriously ill individuals with
complicationsPsychosocial support
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Programmes related to Maternal and Programmes related to Maternal and Child Health and Special groupsChild Health and Special groups
• Essential Obstetric Care, Postpartum care• Essential Newborn Care- HBNC• Emergency Obstetric Care• Emergency New born Care• Immunization and Vit A administration• Growth Monitoring & Diet Counselling• Family Welfare activities• Maintenance of Registers• Psycho social support
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Role of Nursing Faculty in State Health SchemesRole of Nursing Faculty in State Health Schemes
• Crucial Role in Reproductive and Child Health Programme
• Availability of nurses in PHCs 24 hours X 7 days on shift duty by Three Staff nurses
• Crucial Role in Emergency Obstetric Care and Emergency Newborn Care at FRUs, District hospital and Medical college Hospital
• Conducting normal delivery in PHC• Providing New born care • Family welfare activities in Community , HSCs
and PHCs
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SummarySummaryI. Programmes related to provision of health careII. Programmes aimed at controlling
Communicable DiseasesIII. Programmes aimed at controlling
Non- Communicable Diseases(NCDs) IV. Programmes related to Maternal and Child
Health and Special GroupsV. State Health SchemesVI. Role of Nursing Faculty in National Health
Programmes and State Health Schemes
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THANK YOU THANK YOU