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National health programmes

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National health programmes Dr. M.L. Siddaraju National health programmes Perinatal period: Extends from the 28th week of gestation (or more than 1000 grams) to the ... – PowerPoint PPT presentation

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Title: National health programmes


1
National health programmes
  • Dr. M.L. Siddaraju

2
National health programmes
  • Perinatal period
  • Extends from the 28th week of gestation (or more
    than 1000 grams) to the 7th day of life.
  • Neonatal period
  • Early Birth to first 7 days.
  • Late 7 days to 28 days.

3
Perinatal mortality Rate(PMR)
  • Late fetal deaths(28 wks of gestation or more)
  • Early neonatal deaths in one year
  • Total no of births in one year

4
Perinatal mortality
  • Causes
  • a. Antenatal
  • 1. Maternal anemia, PIH, DM, Malnutrition.
  • 2. Pelvic/Uterine anomalies.
  • 3. Antepartum haemorrhage, Blood
    incompatibilities.

5
Perinatal mortality
  • b. Intranatal
  • 1. Birth asphyxia.
  • 2. Birth injuries.
  • 3. Obstetric complications.
  • c. Postnatal
  • 1. Prematurity.,LBW
  • 2. RDS.
  • 3. Infections.

6
Infant mortality rate
  • Most important direct indicator of health status
    of community and indirect indicator of socio
    economic status of the country.
  • No. of deaths of childrenlt1 yr of age in a
    yr1000
  • Total No. of live births in same year.

7
Infant mortality rate
  • Causes
  • A. Neonatal (0-4 wks)
  • 1. Low birth weight(IUGR)/Prematurity.
  • 2. Birth injuries/Birth asphyxia.
  • 3. Congenital anomalies.
  • 4. Infections.
  • 5. Hemorrhagic disease.
  • 6. Placental/cord conditions.

8
Infant mortality rate
  • B. Postnatal (1-12 months).
  • 1. ARI.
  • 2.Diarrhoea.
  • 3. Other communicable infections(VPDs)
  • 4. Malnutrition.
  • 5. Congenital anomalies.
  • 6. Accidents.

9
Infant mortality rate
  • Developed countries 6-8 /1000 live
    births(2000).
  • India 60/1000 live births(2000).
  • Karnataka 58 /1000 live births.
  • Lowest in Kerala 16 /1000 live births.
  • Highest in orissa 16 /1000 live births.

10
National health programmes
  • Nutritional Programmes.
  • Infection control programmes.
  • Immunization programmes.

11
Nutritional programmes
  • 1. Vitamin A prophylaxis programme.
  • Average prevalence of deficiency 6.0 among lt6
    years of age.
  • Immunization against xerophthalmia.
  • 2 lakh I.U. Oral oil preparation 6 monthly
    (1-6 years)
  • 1 lakh I.U. - lt1 year of age.

12
Nutritional programmes
  • Iodine deficiency disorders(IDD) Programme(1962).
  • 167 million are exposed to risk of IDD
  • - not only the Himalayan belt!!!
  • Various degree of intellectual impairment
  • - not only goitre!!!
  • Nation wide implementation
  • Iodized salt.
  • Monitoring surveillance training done.

13
Nutritional programmes
  • National Nutritional Anemia Prophylaxis
    Programme
  • At risk population
  • Pregnants, lactating mothers children upto 12
    years.
  • Mothers
  • 60 mg elemental iron(with 0.5 mg of folate)
  • Children
  • 20 mg elemental iron(with 0.1 mg of folate).

14
Nutritional programmes
  • Mid day meal programme
  • Ministry of education.
  • Retain children in school
  • nutritional supplement.

15
Mid day meal programme
  • Principles
  • 1. Meal a supplement not a substitute.
  • 2. 1/3rd of total calorie requirement.
  • ½ of total protein requirement.
  • 3. Ease of preparation.
  • 4. Locally available. Ingredients.
  • 5. Low cost.
  • 6. Menu should be changed frequently.

16
Infection control programmes
  • National malaria eradication programme.
  • NMCP 1953.
  • NMEP 1958.
  • 1970 Resurgence.
  • Modified plan of operations 1977

17
National malaria eradication
  • Malaria action programme(MAP)
  • 1994
  • high
  • Stratification medium risk areas
  • Low

18
Malaria action programme(MAP)
  • Management of serious/complicated malaria.
  • Prevention of mortality.
  • Control of outbreaks/epidemics.
  • Reduction of P. Falciparum containment of drug
    resistant malaria.

19
National tuberculosis control programme(NTP)
  • Operational since 1962.
  • DTP Backbone.
  • DTC Nucleus.
  • RNTCP 1992.
  • - Achievement of 85 cure rate.
  • - Detect at least 70 cases.
  • - Involve NGOs.

20
National tuberculosis control programme(NTP)
  • RNTCP
  • Short course chemotherapy free.
  • Intensive phase DOTS.

21
Diarrhoeal diseases control programme
  • ORS Packets to VHG.
  • DTU in medical college hospitals.
  • - in district hospitals.
  • Integrated into CSSM.
  • Educate mothers
  • - Home available fluids.
  • - Continue feeding during diarrhoea.
  • - Recognize early signs of dehydration.
  • Promote exclusive breastfeeding.
  • Proper weaning
  • Immunization vitamin A prophylaxis.

22
Acute respiratory disease(ARI) control programme
  • Integrated in CSSM
  • Standard case management of pneumonia lt5 years.
  • Train PHC staff.
  • Promote timely referral.
  • Improve maternal knowledge
  • - cough/cold/danger signs
  • EBF Weaning Immunization.

23
National AIDS control programme
  • 1992
  • National AIDS control organization(NACO)
  • Surveillance centers.
  • Identification of high risk group screening.
  • Guidelines for management follow up.

24
National AIDS control organization(NACO)
  • Formulating guidelines for blood banks, donors,
    dialysis units.
  • IEC activities.
  • Research.
  • Reduction of personal social impact of the
    disease.
  • Control of STD.

25
Immunization Programmes
  • Extended programme on immunization(EPI)
  • -January 1978.
  • -6 VPDs.
  • Now,
  • UIP- Universal immunization programme. November
    1985.

26
National immunization schedule
  • A) For infants
  • At birth BCG OPV-0
  • 6 wks BCG( if not given)
  • DPT-1,OPV-1
  • 10 wks - DPT-2,OPV-2
  • 14 wks - DPT-3,OPV-3
  • 9 mo Measles.

27
National immunization schedule
  • 16-24 mo DPT,OPV
  • 5-6 years DT
  • 10 years, 16 years TT
  • Pregnant women TT 2 doses at 1 mo interval.
  • Pulse polio Immunization
  • 1995
  • lt5 yrs of age
  • Replace wild strain of virus.

28
ICDS
  • Integrated child developmental services. 1975
  • 1. Supplementary nutrition.
  • 2. Immunization.
  • 3. Health checkup.
  • 4. Referral.
  • 5. Nutritional Health education for women.
  • 6. Non formal education upto 6 years.
  • Community developmental blocks
  • Anganwadi worker Focal point.

29
CSSM
  • Child survival and safe motherhood.-1992
  • Package of services.
  • For children
  • 1. Essential newborn care
  • 2. Immunization
  • 3. Appropriate management of Diarrhoea.
  • 4. Appropriate management of ARI.
  • 5. Vit A prophylaxis.

30
CSSM
  • For mothers
  • 1. Immunization.
  • 2. Prevention and treatment of anemia.
  • 3. ANC
  • 4. Delivery by TBA.
  • 5. Promotion of institutional deliveries.
  • 6. Obstetric emergencies- Management.
  • 7. Birth spacing.

31
CSSM
  • Essential newborn care
  • Resuscitation.
  • Prevention of hypothermia.
  • Prevention of infections.
  • EBF.
  • Referral of sick newborn.

32
Reproductive child health(RCH)
  • 1997
  • Family welfare
  • RCH
  • CSSM

33
RCH
  • Conceptual frame work

Family welfare/Plan
Client centered approach
CSSM
RTIs STDs
34
RCH
  • Primary goal
  • Encourage small families by helping families meet
    their own health family planning needs.
  • Priority services
  • Full range of MCH.

35
RCH
  • Performance measure
  • Quality of care
  • Client satisfaction.
  • Management approach
  • Decentralized.
  • Driven by client needs.
  • Gender sensitive.

36
RCH
  • Attitude to client
  • Listen.
  • Assess needs.
  • Inform, advise.
  • Accountability
  • To the client, community, health family welfare
    staff.

37
CSSM v/s RCH
38
CSSM v/s RCH
39
CSSM v/s RCH
40
Thank you
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