1stYear MSc Nursing Medical Surgical Nursing MIMS CON

1. NATIONAL HEALTH
PROGRAMME
Prepared by
Ms. Theertha P Krishna
1st Year MSc Nursing

2. UNIVERSAL IMMUNIZATION
PROGRAMME

3. UNIVERSAL IMMUNIZATION PROGRAMME
• WHO launched Expanded Programme on
Immunization(EPI) in 1974 against six ,most
common, preventable disease viz diphthehria,
pertusis, tetanus, polio, tuberculosis polio.,
tuberculosis, and measeles.

4. UNIVERSAL IMMUNIZATION PROGRAMME
• The UNICEF in 1985 renamed it as “Universal
Child Immunization”(UCI).
• The Government of India launched EPI in
1978.
• Objective: reducing the mortality and
morbidity resulting from vaccine preventable
disease of childhood and to achieve self
suffiency in the production of vaccines.

5. UNIVERSAL IMMUNIZATION PROGRAMME
• Universal Immunization Programme was started in
India in 1985.
• Component: immunization of pregnant women against
tetanus and immunization of children in their first year
of life agaianst the six EPI target diseases.
• The aim was to achieve 100 per cent coverage of
pregnant women with 2 doses of tetanus toxoid (or a
booster dose), and at least 85 per cent coverage of
infants with 3 doses each of DPT, OPV, one dose of
BCG and one dose of measles vaccine by 1990.

6. PULSE POLIO IMMUNIZATION PROGRAMME
• Pulse Polio Immunization Programme was
launched in the country in the year 1995.
• In this programme children under five years of
age are given additional oral polio drops in
December and January every year on fixed days.
• As on 25th Feb 2012, India was removed from the
list of polio endemic countries, and on 27th
March 2014, India was certified as polio-free
country.

7. INTRODUCTION OF HEPATITIS-B
VACCINE
• In 2010-2011, Government of India
universalized hepatitis B vaccination to all
States/UTs in the country.
• Monovalent hepatitis B vaccine is given as
intramuscular injection to the infant at 6th,
10th and 14th week alongwith primary series
of DPT and polio vaccines

8. INTRODUCTION OF JE VACCINE
• The programme was introduced in 2006.
• Single dose of JE vaccine was given to all
children between 1 to 15 years of age through
campaigns

9. INTRODUCTION OF PENTAVALENT VACCINE
(DPT + Hep-B+ Hib)
• India introduced pentavalent vaccine
containing DPT, hepatitis B and Hib vaccines
in two states viz. Kerala and Tamil Nadu under
routine immunization programme from
December 2011.
• DPT and hepatitis B vaccination require 6
injections to deliver primary doses.

10. MISSION INDRADHANUSH
• The Government of India launched Mission
Indradhanush on 25th December 2014, to
cover children who are either unvaccinated or
partially vaccinated against seven vaccine
preventable diseases, i.e., diphtheria,
whooping cough, tetanus, polio, tuberculosis,
measles and hepatitis B.
• The goal is to vaccinate all under-fives by the
year 2020.

13. NATIONAL RURAL HELATH MISSION
Govt. of India launched NRHM on 5th April 2005
for a period of 7years (2005-2012).

14. Plan of action
• Creation of a cadre of Accredited Social
Health Activist (ASHA)
• Strengthening of sub-centres
• Strengthening of primary health centres
• Strengthening community health centres
• Promotion of “Rogi Kalyan Samiti”

16. SELECTIONOFASHA
• ASHA must be resident of thevillage.
• Women married/ widow/divorced.
• Age group of 25 to 45 years, with formal
education upto 8th.
• Having communication skills and leadership
qualities.
• One ASHA for 1000 population.

17. REPRODUCTIVE AND CHILD HEALTH
PROGRAMME

18. REPRODUCTIVE AND CHILD HEALTH
• “People have the ability to reproduce and
regulate their fertility, women are able to go
through pregnancy and child birth safely ,the
outcome of pregnancies is successful in terms
of maternal and infant survival and well being
and couples are able to have sexual relations
free of fear of pregnancy and contracting
disease”.
• Programme launched on 15th October 1997

19. RCH I PHASE COMPONENT
• Family planning
• Child survival and safe motherhood
component
• Client approach to health care
• Prevention/management of RTI/ STD/AIDS.

20. INTERVENTIONS OF RCH PHASE I
• Essential obstetric care
• Emergency obstetric care
• 24 hour delivery services at PHCs / CHCs.
• Medical termination of pregnancy
• Control of RTI/ STD
• Immunization
• Essential newborn care

21. INTERVENTIONS OF RCH PHASE I
• Diarrheal disease control
• Acute respiratory disease control
• Prevention and control of Vitamin A deficiency
in children
• Prevention and control of anemia in children
• RCH camps
• RCH out reach scheme

22. INTERVENTIONS OF RCH PHASE I
• Boarder District Cluster Strategy (BDCS)
• Introduction of Hepatitis B vaccination
• Training of Dias.

23. Rch phase ii
• Began from 1st April,2005.
• Focus is to reduce maternal and child
morbidity and mortality with emphasis on
rural health care.

24. Strategies of rch phase ii
• Essential obstetric care
 Institutional delivery
 Skillled attendenceat delivery
• Emergency obstetric care
 Operating first referral units
 Operating phcs/chcs for round the clock
delivery services.

25. Strategies of rch phase ii
• Strengthening referral system
Newer initiatives:
1. Training of MBBS doctors in life saving
anesthetic skills of emergency obstetric care.
2. Setting up of blood storage centers at frus
according to government of india guidelines.

26. Janani suraksha yojana
• Launched on 12thApril 2005.
• The National Maternity Benefit scheme is
modified to JSY.
• Objective; reducing maternal mortality and
infant mortality through encouraging delivery
at health institutions and focusing at
institutional care among women in below
poverty line families.

27. Vandemataramscheme
• A voluntary scheme wherein any obstetric and
gynecologist specialist, maternity home,
nursing home, lady doctor/ MBBS doctor can
volunteer themselves fro providing safe
motherhood services.

28. Janani Shishu Suraksha Karyakram (JSSK)
• Govt.of India launched the new initiative, to
make better health facilities for women and
child.

29. Navjat shishusuraksha karyakram NSSK
• NSSK is a programme aimed to train
health professionals in basic newborn
care and resuscitation.

30. NATIONAL PROGRAMME FOR PREVENTION
AND CONTROL OF CANCER, DIABETES,
CARDIOVASCULAR DISEASES AND STROKE
(NPCDCS)

31. OBJECTIVES OF DCS ,OF NPCDCS
1) Prevent and control common NCDs through
behavior and life style changes,
2) Provide early diagnosis and management of
common NCDs through opportunistic
screening
3) Build capacity at various levels of health care
for prevention, diagnosis and treatment of
common NCDs.

32. OBJECTIVES OF NPCDCS
4) Train human resource within the public health
setup viz doctors, paramedics and nursing staff
to cope with the increasing burden of NCDs
5) Establish and develop capacity for palliative
& rehabilitative care

33. CANCER COMPONENT OF NPCDCS
• National Cancer Control Programme launched
in 1975-76.
• Objective: prevention, early diagnosis and
treatment.
• Programme revised in 1984-85 and
subsequently in December 2004.
• In 2010 programme integrated with National
Programme on Prevention and Control of
Diabetes, Cardiovascular Disease and Stroke.

34. SCHEMES UNDER REVISED PROGRAMME
• Regional cancer center scheme
• Oncology wing development scheme
• Decentralized NO scheme
• IEC activities at central level
• Research and training

35. Health Facility Packages Of Services
• Sub centre
1. Health promotion for behavior change.
2.‘Opportunistic’ Screening using B.P
measurement and blood glucose by strip
method.
3. Referral of suspected cases to CHC.

36. Community health centre
1. Prevention and health promotion including counseling.
2. Early diagnosis through clinical and laboratory
investigations.
3. (Common lab investigations: Blood Sugar, lipid profile,
ECG, Ultrasound, X ray etc.)
4. Management of common CVD, diabetes and stroke
cases (out patient and in patients.)
5. Home based care for bed ridden chronic cases.
6. Referral of difficult cases to District Hospital/higher
health care facility

37. District Hospital
1. Early diagnosis of diabetes, CVDs, Stroke and Cancer
2. Investigations:
3. Blood Sugar, lipid profile, Kidney Function Test
(KFT),Liver Function Test ( LFT), ECG, Ultrasound, X
ray, colposcopy , mammography etc.(if not available,
will be outsourced)
4. Medical management of cases (out patient , inpatient
and intensive Care).
5. Follow up and care of bed ridden cases.
6. Day care facility.
7. Referral of difficult cases to higher health care facility.
8. Health promotion for behavior change.

38. Tertiary Cancer Centre
• Comprehensive cancer care including
prevention, early detection, diagnosis,
treatment, minimal access surgery after care,
palliative care and rehabilitation.

39. Role of Nurse
• Organizer
• Educator
• Supervisor
• Manager
• Potentiator
• Team Leader
• Collaborator

40. NATIONAL FAMILY WELFARE PROGRAMME

41. History Of Family Welfare Programme
• It was started in year 1951.
• India launched family planning programme in
1952.
• In 1977, the govt. of India redesignated the
“national family planning programme “ as
the “national family welfare programme “,
and also changed the name of the ministry of
health and family planning to ministry of
health and family welfare

42. Aim& Objectives Of Family Welfare Programme
• To promote the adoption of small family size norm,
on the basis of voluntary acceptance.
• To promote the use of spacing methods.
• To ensure adequate supply of contraceptives to all
eligible couples within easy reach.
• To arrange for clinical and surgical services so as to
achieve the set targets.
• Participations/ local leaders/ local self government,
in family welfare programme at various levels.

43. Strategies of family welfare programme
• Integration with health services
• Concentration in rural areas
• Literacy
• Raising the age for marriage

44. Delivery of Family Welfare Programme take
place at the following levels:
• At The Centre Level
ADMINISTRATIVE APPARATUS
Department Of Family Welfare (DoFW) create in 1966
Central Ministry of Family and Health Welfare
Department of Family Welfare
• Presided by Secretary of MoHFW
• Assisted by:
1. Special Secretary (Advisor)
2. Joint Secretary

45. • Central Family Welfare Council of State Health Ministers.
• Population Advisory Council (1982) constituting
1. Member of Parliaments
2. Union Health Ministers and
3. Health experts.
• Works as Think Tank to analyse the implementation of
programmes
Advise the government suitably.
• Cabinet sub-committee headed by Prime Minister.
Periodic review of progress.
• National Institute of Health and Family
Acts as an Apex Technical Institute for Education,
Training services,

46. At State Level
State Family Welfare Bureau
• It is a part of State Health and Family
welfare directorate.
• At present 25 State Family Welfare Bureaus
are functioning.
• Regional Office for Health and Family
Welfare (1979)

47. At District Level
• District Family Welfare Bureau
• Consists of three divisions-
1. Administrative division: headed by District
Family Welfare Officer.
2. Mass Education and Media division: headed
by District Mass Education and Media Officer.
3. Evaluation Division: headed by the Statistical
Officer.

48. At Community Health Centre
• All family planning services including
laparoscopic sterilization and safe abortion
services.
• Follow up services and training and
supervision of field level staff.
• 24x7 specialist services.

49. Primary HealthCentres
• Medical officers trained to provide MTP,
sterilization and copper-T IUD insertion.
• Follow up services, counseling and appropriate
referral.
• Training and supervision of field workers
like- ASHA, ANM, MPWs.

50. At Sub-centres
• Staffed by one male and one female health
worker.
• Provide family planning motivation, services and
supplies in spacing methods.
• ANC, PNC and immunization visits.
• Delivery facility is NOT available at Type A
subcentre.
• IUCD insertion.
• Follow up and referral services.

51. At The Village Level
• Village Health Guides-
• One per each village or a population of 1000
• Spreading knowledge and information to the
eligible couples.
• Provision of nirodh and oral pills.

52. At The Village Level
• Trained Dais-
• National target is 1 dai per 1000 population.
• Conduct safe deliveries in rural areas
• Counseling and motivation for family
planning.

53. At The Village Level
• ASHA-
• Counseling of couples
• To provide drug kits
• Follow up of IUCD, sterilization and post
partum clients and referral

54. New Initiatives in Family Welfare Programme
1) Home Delivery of Contraceptives (HDC)
• ASHA delivers contraceptives at doorstep of the
beneficiaries
• ASHA charges a nominal amount from the
beneficiaries.
2) Ensuring Spacing at Birth (ESB)
• ASHA counsels the newly married couples for
spacing methods.
• Scheme currently operational in 18 states.

55. New Initiatives in Family Welfare Programme
3) Pregnancy Testing Kits
• NISHCHAY– Home based pregnancy test kit
available to ASHAs and at sub-centres.