✹ National health programme
Since independence, many efforts have been made in India to improve the health status of the people.
There are many steps in which one is known as the national health programme.
The national health programme and central health are dominated by the government.
International health agencies also help in such programmes.
These agencies mainly provide technical assistance and material and also provide financial help.
The control and development programmes are as follows.
✹ Vector born disease control programme
The director of the National anti malarial programme works as a national agency, which works especially for the prevention and control of vector born diseases.
Such vector born diseases like malaria, filaria, dengue fever are included. Accordingly,
National anti malarial programme
National Filaria control programme
Dengue feverish control programme
This programme was launched in 2002 to 2003 under the central sponsor scheme, whose post, central and state decide on their own and provide technical guides to administer the national anti malarial programme.
National health vector born disease control programme was started by the Indian government and the national government in 2003.
Two other diseases were also included under this programme.
This programme was started in India in 1953 and then the malaria control programme was introduced in 1958.
A lot was achieved in this programme, especially in the cases of malaria and the deaths due to it, there was a significant reduction, so this progesterone is covered in the national malaria eradication programme.
In 1968, this programme was carefully reviewed, in which this programme was very successful in the state of Kerala.
The government hoped that malaria would be eradicated in 1975 but in 1975 there were 6 million cases and 100 deaths.
After 6.4 million cases and 59 deaths in 1976, the government of India recommended effective control and eradication through an expert committee and revised strategy.
A modified plan of operation was established from 1st April 1977 and the operation was implemented.
According to this plan, a new strategy was added to it which was as follows.
Active surveillance should be carried out to detect fever cases as preventive treatment.
A mobile team should be provided with one health inspector, two sprine spots and necessary equipment, one team should be assigned an area of 10 PHCs and one team should be assigned an area of 5 PHCs.
In the PHCs that are involved in this, the MPHW should collect the blood slide of every fever case, as well as manage the drug distribution center in which the Panchayat staff, forest officer, VHG and other community health workers should be involved. Involve the above teachers, revenue staff etc. and appoint a DMO for supervision of the work.
✹ Objectives of new action plan
Manage various and complicated malaria cases.
Prevent cases in the high risk group that are a reference for mortality.
Reduction of malarial morbidity
Strengthen those things that could not be done and give efforts for it and maintain those in which success has been achieved.
To maintain agriculture and industrial product by taking anti malarial steps in some special areas.
✹ General activities for malaria control
Spraying
Surveillance
Entomological assessment
Treatment
Follow up
Health education
Reporting system 1.spraying
In areas with two or more cases, DDT is sprayed until vector control is achieved.
If the 1st spraying round is not effective, 3 rounds of spraying are recommended and if even then there is no effect, synthetic pyrethroid wiring is sprayed for a duration of 6 weeks, through which the effect of malaria is largely stopped.
2.Surveillance
Active and passive surveillance is continued in certain specific areas
Survey is done once every 75 years.
This is the key aliment of the modified plan operation.
Blood smear and exam are done through the survey.
3.Entomological assessment
Entomological key is done directly assessment.
Testing of suspected cases in the area is done and proper medicine for the pest is determined in that area.
4.Treatment
In this, especially preservative and radical treatment are given.
Radical treatment is given to effective cases.
5.Follow up
After the completion of medical treatment, blood smear is taken again.
In positive cases, monthly blood smear is taken regularly within a year.
6.Health education
To get people’s co-operation in malaria control activities, health education is given through different methods to bring awareness among the people.
7.Reporting system
Every two weeks, the report of malaria related activities has to be submitted to the CHC.
Such information is provided by the M.O. of the area.
The report sent by the CHC is sent to the district health quarter.
All the above activities are done through modified plan operation.
✹ Role of CHN in prevention and control of malaria
The role of CHN for malaria prevention is as follows,
To collect blood smear of ANC, PNC and infant of his area and send for testing.
To provide necessary preservative treatment to the family of his area.
To give radical treatment to positive test.
To refer the necessary case to PHC or CHC.
To provide health education, especially,
To provide information about the agent
host
environment
.
To explain about host protection.
To explain about household measures to reduce mosquito infestation.
To give people an explanation to prevent mosquitoes from entering the house.
To explain to people about the use of mosquito net.
To explain to people about spraying.
Promotion of health
To manage serious and complicated cases.
To try to reduce the mortality rate. Thus, nurses have an important role in the prevention and control of malaria.
This programme was implemented in 1955.
It is caused by an antigen called vector culex fatigans.
At that time, this programme was considered to be limited to the city area only, and under this programme, surveys were conducted and cases of Filaria were found out.
The Indian government in 1978 allocated the activities of this programme with the activities of urban malaria.
Currently, the above work is being done in the village area, the following activities are being done in the Filaria control programme,
Proper environmental sanitation
To explain the use of edible oil as anti malarial measures.
To solve the problem of the survey area and also to look into the issue of Filaria in the unsurvey area.
Anti mosquito and anti larval measures to be taken in effective areas.
To find positive cases of filaria, identify them and give them treatment.
To prevent mosquito breeding and develop underground drainage system.
If continuous cases are seen in endemic areas, preventive measures should be taken immediately.
To establish a clinic for reduction.
✹ Role of CHN in NFCP
Vector control
Promoting health
Diagnosis
Chemotherapy
Health education
Treatment
Good environmental sanitation
3.Dengue fever control programme
In 1996, a large number of cases of dengue fever were seen in Delhi.
Along with this, cases of this fever were seen in other states as well in small numbers.
Accordingly, an immediate plan was made.
In which the following points were included and the following steps were taken for the control of dengue.
Control measure
To conduct a survey for the identification of dengue fever outbreaks. (Determine from which area it came)
Cleanliness of all area
Management of cases.
Vector control
Health education
Reporting
The above can be prevented only if done carefully, and for this work
Prevention can be achieved only if the above work is done carefully, and facilities for investigation and technical assistance are created for this work.
TB is a major communicable disease of India.
The role of the nurse is very important for its control.
In this, it is not only necessary to see its physical weakness but also to see that it does not disturb socially and emotionally.
Today, the whole picture of TB has changed, in modern treatment, chemotherapy is a powerful weapon.
If there are drug failure cases, special care is taken.
Through this programme, they are given district treatment in home care or institute.
Recommendations of TB control by Bhore committee
Establish domiciliary services
Establish a clinic in every district and a mobile clinic in rural areas.
Formation of after care clinic
Training of workers in TB control
Work for TB control through the director of health services. Objectives of national TB control programme
BCG vaccination
domicilar treatment and anti TB drug
Setting and demonstration center for training
Isolation and treatment
rehabilitation
research
✹ District TB control programme
In 1962, the district TB control programme was launched by the National TB Institute of Bangalore.
The trained team required for it was as follows.
District TB officer – 1
Lab technician – 1
Treatment organizer – 1
X-ray technician – 1
Non-medical team leader – 1
Statistical assistant – 1
The above team is given 13 weeks of training by the National TB Control Institute.
In this, different steps are worked on according to the new approach for TB control.
Treatment is given directly at home in the community.
The main AIM of this programme was to identify infectious cases and give them for six to nine months.
Treatment is given until the sputum is negative.
General health services are provided for TB control measures in every PHC in India.
Activities of district TB center
Case finding
Treatment
BCG vaccination
Recording and reporting
Supervision
✹ RNTCP (Revised National TB Control Programme)
This programme was started by the Government of India in 1992.
Under this programme, 85% of infectious cases were cured.
Under this programme, short course therapy is provided under supervision in health institutes.
In this programme, NGOs (non-government organisations) are involved for information, education, communication as well as improvement and operation research.
Under this programme, DOTS therapy is provided to TB patients, in which treatment and health education are provided according to the category.
For this, 390 TB centres are functioning since 1997.
Also, for the success of this programme, general hospitals and railway hospitals are linked with health institutes in peripheral areas.
ESIS hospitals and other hospitals are managed by local bodies.
Religious institutions, voluntary organizations and private charitable organizations are also involved in this program.
This program is sponsored by the central government and provides free supply of anti TB drugs.
All drugs are provided free of cost by the Indian government to the state government and the center.
✹ Role of CHN in RNTCP
The role of CHN in the National TB Control Program is as follows.
The main task of CHN is to help PHC workers during the vict. Also, to help in finding symptomatic cases and to observe for the continued treatment of such cases.
To see that the work is done by considering scientific principles.
To see that TB patients are found out as soon as possible.
To control the diagnosed cases and help DTC (District Training Staff).
To advise and arrange for treatment to the responsible family member.
To explain environmental sanitation to the patient and family members and to explain the proper method for disposal of sputum through health talk.
To participate in community activities.
Conducting surveys in home clinics and communities and providing guidelines on TB.
Explaining the causes of TB spread, treatment and prevention in individuals or groups.
Giving appointments to every patient to meet you.
Taking history for weight.
Tuberculin testing.
Regular follow-up.
Providing health education.
Helping every member of the family in which TB has occurred for screening.
Checking the immunization of every member of the family and vaccinating if necessary.
Improving the nutritional status of TB patients.
Explaining about cross infection.
Maintaining records and reports of every patient.
Since AIDS was spreading from one country to another, a national AIDS control program was started.
For this, a task force was set up by the Indian government in 1985.
The first case of AIDS was detected in America in 1984, then in 1986 it was registered for the first time in India.
The Indian government implemented the national AIDS control program in 1987.
Then the program was modified and the national AIDS control organization was established in 1992.
The HIV, AIDS control project was implemented for five years from 1992 to 1997.
This project was implemented in every state and union territory.
It was 100% sponsored by the central government.
Later it was extended till 1999.
✹ Transmission of AIDS
sexual transmission
Blood contact
Maternal fetal transmission Major signs of AIDS
Weight loss below 10% for body weight
chronic diarrhea for more than 1 month
Prolonged fever for more than 1 month Minor signs of AIDS
persistent cough for more than 1 month
history of herpes zoster
generalized pruritic dermatitis
chronic progressive herpes simplex infection
generalized lymphadenopathy Methods of AIDS control
Preventive major
In which health education
prevention of blood born HIV infection
specific prophylaxis
primary health care – care of the AIDS patient
✹ Program activities
Preventive care
Servellence
STD control
IEC
Counseling and HIV testing
School AIDS Education Programme
Family health awareness
Prevention of HIV infection from mother to child
National AIDS telephone helpline
✹ Responsibilities of CHN in STD & AIDS control program
Signs of disease for inspection and observation and symptoms to find out the patient.
Help for adequate medical care.
Take the patient’s history very reliably and using timeliness so that the patient’s trust can be maintained and actual information can be obtained.
Help in epidemiology investigation.
Provide security to the patient during the interview so that his identity can be hidden.
Contact him by making home visits so that his needs can be emphasized during examination and treatment.
Make necessary arrangements for taking blood specimen and examination.
Provide appropriate teaching.
Provide sex education in schools and colleges to prevent disease.
Organize education program.
Create necessary resources in the community and use them to solve the social and emotional problems of the individual and family, making them capable.
Explain the technique of cleaning the eyes immediately at the birth of a new born baby in the family and teach the family about the disease.
Provide training to dai and midwife.
Do counseling.
Participate in epidemiological study work and participate in research related activities.
6.National programme for the control of blindness
This programme was implemented by the Indian government since 1976.
Strategies of programme
Strengthen service delivery.
To create eye care camps, its resources. For example, voluntary doctor, fund, voluntary institute etc..
To increase awareness and out activity among the people.
To increase the capacity of the service.
To make eye service comprehensive.
To conduct health programmes in schools.
To take steps for cataract and glaucoma.
To increase surgical facilities through eye camp approach.
To make voluntary institute a partner.
✹ Role of CHN
The role of nurses is different according to the different components of the program, which is as follows,
To perform their duties as O.T. nurse in O.T. during eye camp.
To provide regular vitamin-A solution to the children of their area.
To try to ensure that children get vitamin-A rich food and to explain from where vitamin-A is obtained, especially in the community, to explain which vegetables contain more vitamin-A, to explain which fruits contain more of it.
To also explain to them about the vitamins obtained from other foods mentioned above.
To provide early diagnosis, antibiotic and nursing care for the problem of trachoma and other eye problems in their area.
To be helpful during school health services, especially to provide special help during eye camp.
To provide health education on trachoma prevention, blindness and eye care.
To maintain a record of the work of their area.
Iodine deficiency is a major health problem.
According to a survey in 1993, iodine deficiency was found in 200 districts out of 243.
It was generally believed that this deficiency is found only in the area of Himachal Pradesh, but according to the survey, there was not a single state where there were no cases of iodine deficiency.
Mortality rate is seen in neonates due to severe iodine deficiency.
Apart from this, abortion, still birth, LBW and congenital deformity are also seen due to iodine deficiency.
Since such disorders can be prevented, the national goiter control programme was implemented in 1962.
Its main goal was to increase iodine intake among people in goiter endemic areas, but after 20 years of implementing this programme, no change was seen.
Therefore, in 1990, the new name of the national goiter control program was named national iodine deficiency program.
This program is multi-sectoral, so the ministry of health and family welfare, state department of civil are also involved in this program.
✹ Role of CHN in iodine deficiency disorder program
In the activities of this program, CHN takes action to ensure that every person gets iodized salt.
Explains the importance of iodized salt and convinces the public to use it, as well as places restrictions on other salts.
Explains to people about the diseases caused by iodine deficiency.
Every ANC mother is asked to use the supplied iodized salt by ICDS when she comes to the clinic, 1.5 kg of iodized salt is distributed to each ANC mother under the ICDS program.
In India, all states and union territories are made aware of the sale of iodized salt.
During CHN clinic, the village level public is made aware by showing pictures of Iodine deficiency cases.
Every ANC mother is surprised to check whether she uses this salt.
From the experience of Smallpox Eradication Programme, it was felt that immunization is a very effective weapon and it can protect against six killer diseases.
WHO officially implemented the global immunization programme in May 1974, which was known as the expanded immunization programme.
The main goal of which was to protect every child from six killer diseases and infectious diseases by the year 2000.
The goals for implementing this programme by the Indian Government were as follows,
To reduce the mortality and morbidity rate in childhood.
To become self-reliant in vaccination production.
To give injection T.T. to every ANC mother and to get 100% protection against tetanus.
The above immunization is provided in every unit through the health care delivery system.
Role of CHN in universal immunization program
Collects information about the number of antenatal mothers and children aged 0 to 5 years by conducting a survey in their area and whether they have been vaccinated or not.
Maintains the cold chain system of the vaccine and delivers it to the beneficiaries.
Checks whether vaccination is done in the clinic as per the national schedule.
Each center like MCH clinic, Subcenter, PHC or dispensary has the responsibility of delivering the vaccine.
Creates awareness among the public by informing them about the benefits of immunization.
Conducts mass vaccination in their area if needed.
Records and reports on immunization.
Cancer control program was started by the Indian government in 1975-76, in which 2.5 lakh rupees were allocated from the Central Government and the Health Institute to set up the necessary cobalt unit for cancer treatment.
This scheme was started during the Sixth and Seventh Five Year Plans.
The country’s largest institution was established as a regional cancer center, which was funded by the government.
In the Eighth Five Year Plan, emphasis was laid on its prevention and treatment.
The following scheme was implemented in 1990-1992.
Leprosy is also called Hansen’s disease.
Leprosy is an important health problem of the community which is seen in India as well as the whole world.
People in India consider it as a curse of God.
In India this disease is seen more in UP, MP, Bihar, Orissa and West Bengal.
For its eradication, National Leprosy Eradication Programme was implemented since 1983.
Strategy
Early detection of cases
Short term of MDT (multi drug therapy)
Health education
Rehabilitation Objectives
Early detection of cases
To provide domiciliary services and treatment
Drugs therapy
Health education
Awareness
Rehabilitation
✹ Role of CHN in leprosy control programme
The role of nurse in NLCP is as follows,
To make periodical home visits in the community.
In control of leprosy, one has to participate and work with the community.
In collaboration with other agencies, one has to start a leprosy clinic, which is her responsibility.
To maintain records, especially to check whether the patient is taking regular treatment, because many patients leave incomplete treatment.
This disease is a serious matter for the patient and his family, especially in sociological and psychological terms, the nurse understands this and explains to him that there is nothing wrong with it as he believes.
She constantly plays the role of counselor and health educator.
She gives guidelines to the patient at home and in the clinic during his deformity.
Children of infectious parents are given prophylaxis, ag: injection BCG
She finds all the useful resources and helps the patient, and also gets help in rehabilitation by getting cooperation from other agencies.
Through physiotherapy and reconstructive surgery, she shows people a worry-free way to live life.
She makes constant visits to the patient’s home and educates the patient and family about the disease, which is beneficial for them.
Recognizing the importance and significance of health in the progress of the nation, the government of India established the NRHM on 5 April 2005 to improve the quality of life of every citizen of the country, the period of which is from 2005 to 2012.
Through this mission, rural health is to be improved through the health care delivery system.
The main goal of NRHM is to provide accessible, affordable, effective and reliable primary health care.
Plan of action
In this mission, increase public health expenditure for health.
Reduce regional disparities in health infrastructure.
Create a chain of resources.
Ensure that health problems are managed from the district level by decentralizing them.
Increase partnership and awareness in the community and provide every facility in Subcenter and PHC.
To upgrade the health standard of the Indian public, convert each block CHC into a functional CHC.
✹ Strategies of NRHM
Two strategies are decided in NRHM,
Core strategy
Decentralized village and district level early planning and management.
Appoint ASHA to provide health services well.
Strengthening the delivery infrastructure in public health services, such as AYUSH (Ayurvedic Yoga Unani Siddhdha homeopathy).
Increasing social partnership to bring improvement in the community.
Regulating the private sector to improve performance.
Increasing public private partnership (PPP) and trying to achieve national goals.
-Reorienting medical education.
-Maintaining health security of poor people.
✹ Coverage of NRHM
This program covers and focuses on the entire country.
There are many states in the country that need special care. In such states, efforts are being made to strengthen the public health care system and there is a big challenge to improve key health indicators.
Under this program, the main national health programs of the country are covered, which include RCH-2, national health program, disease surveillance program, etc.
Explain the functional activities of NRHM OR progress under NRHM OR what work is being done by NRHM.
Under NRHM, ANC, during labor and PNC care are provided.
This benefit is available to every woman in the country.
If she is above 19 years of age and comes in the BPL list, she is given a cash amount of Rs 500 for the first two children.
ASHA
ASHA is like a link between poor ANC mothers and the health sector.
It is the responsible person for the poor states of the country.
ASHA is a branch of NRHM, which also plays an important role in safe abortion services.
2.link worker
In states where ASHA is not available, such link workers work in villages and tribal areas.
3.Infrastructure
In this, every year, ANM staff is given a human wage for the use of sub centers or for the purchase of goods.
4.Manpower
Appointment of 6232 doctors, 25987 ANM staff and 11537 staff nurses in states where there is shortage of staff.
5.Management support
Appointment of 1500 professional posts (CA and MBA) in the states in need through the support of NRHM.
6.Mobile unit
Starting a mobile unit in each district.
7.Immunization
A. ASHA was given the task of intensive monitoring in Polio progress services.
B. Revaccination should be done in the districts where vaccination is not done properly.
8.Institutional Delivery
Under the Janni Suraksha Yojana, emphasis should be placed on Institutional delivery and 100% delivery should be done in the Institute itself.
9.Neonatal care
For this, IMNCI was started.
Planning was done to provide Neonatal care by health person and it was decided that home care should be taken by ASHA.
10.Coverage
In many states, Anganwadi is doing good work at health and nutritional level.
In addition, school health programs were also started.
For pre-school age children, emphasis was placed on Anganwadi.
11.AYUSH
The best care is provided in PHC by AYUSH practitioner.
Those who are appointed on fixed salary also have their head quarters at the village level.
12.Training
In critical areas, SBA, MO, ANM etc. are trained to provide emergency obstetric care.
In addition, MOs are also given NSV training.
In the state, ANM schools have been upgraded.
New nursing schools have been started.
Attention has been paid to the training and activities of ASHA in 300 districts.
In addition, such centers have been established at the central level and state level.
Monitoring for basic work in the community has been completed.
14.Survey
The work done through the survey has been observed.
15.Financial management
Financial management is done by NRHM and the service is intensified by providing money as per the requirement.
16.IEC
Immunization, iodize salt and Beti Bachao are done through multimedia campaigns.
17.Health is organized in different states.
Emergency ambulance services: Free ambulance service is provided in this.
Good drug supply and distribution
Diagnostic facility improvement
Effective Chiranjeevi scheme for institutional delivery
Effective disease control and disease surveillance
Health camp- In which Anganwadi organizes health camp on a fixed day every month and mother and child are taken care of.