Capsule summary of

Important National Health Programs

Compiled by
Dr.Vishnu B S
Family medicine Specialist
KIMSHealth Trivandrum, Kerala
(National PG Coordinator, TSRIM)

(Taken from various National Health Programs and ministry of health websites)
This is not a complete document
Refer the corresponding official document for full reference
Not all programs are included here

The Spice Route India Movement (TSRIM) -AFPI

 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Sl No Topics Page
number
1.
Janani Shishu Suraksha Karyakaram (JSSK) 2

2.
Janani Suraksha Yojana 4

3.
Rashtriya Bal Swasthya Karyakram (RBSK) 6

4.
Rashtriya Kishor Swasthya Karyakram (RKSK) 9

5.
Mission Indhradhanush 11

6.
Pulse Polio Programme 17

7.
Mission POSHAN 19

8.
Labour Room Quality Improvement Initiative - ‘LaQshya’ 22

9.
National Programme for Prevention and Control of Cancers, Diabetes, 27
Cardiovascular Diseases and Stroke (NPCDCS)
10.
National Viral Hepatitis Control Program 30

11.
National Mental Health Programme 33

12.
National Tobacco Control Programme 36

13.
National Programme for Prevention and Control of Deafness 39
(NPPCD)
14.
National Programme for Control of Blindness and Visual Impairment 42

15.
National Sub-Mission to provide safe drinking water 45

16.
National Programme on Climate Change & Human Health 48

17.
National Programme for the Health Care for the Elderly 49

18.
National Rabies Control Programme 51

19.
Ayushman Bharat – Health and Wellness Centres 53

20.
National Programme for Control and Treatment of Occupational 55
Diseases
21.
National Program for Palliative Care 57

22.
National Iodine Deficiency Disorders Control Programme (NIDDCP) 59

23.
National Ayush Mission (NAM) 61

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Janani Shishu Suraksha Karyakaram

(JSSK)

Introduction

Government of India has launched the Janani Shishu Suraksha Karyakaram (JSSK) on 1st June, 2011. The
scheme is to benefit pregnant women who access Government health facilities for their delivery. Moreover
it will motivate those who still choose to deliver at their homes to opt for institutional deliveries. All the
States and UTs have initiated implementation of the scheme.

Situation

High out of pocket expenses being incurred by pregnant women and their families in the case of institutional
deliveries in form of drugs, User charges, diagnostic tests, diet, for C –sections.

The New Initiative

In view of the difficulty being faced by the pregnant women and parents of sick new- born along-with high
out of pocket expenses incurred by them on delivery and treatment of sick- new-born, Ministry of Health and
Family Welfare (MoHFW) has taken a major initiative to evolve a consensus on the part of all States to
provide completely free and cashless services to pregnant women including normal deliveries and caesarean
operations and sick new born (up to 30 days after birth) in Government health institutions in both rural and
urban areas.

The following are the Free Entitlements for pregnant women:

 Free and cashless delivery

 Free C-Section
 Free drugs and consumables
 Free diagnostics
 Free diet during stay in the health institutions
 Free provision of blood
 Exemption from user charges
 Free transport from home to health institutions
 Free transport between facilities in case of referral
 Free drop back from Institutions to home after 48hrs stay

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

The following are the Free Entitlements for Sick newborns till 30 days after birth.This has now been
expanded to cover sick infants:

 Free treatment
 Free drugs and consumables
 Free diagnostics
 Free provision of blood
 Exemption from user charges
 Free Transport from Home to Health Institutions
 Free Transport between facilities in case of referral
 Free drop Back from Institutions to home

Key features of the scheme

 The initiative entitles all pregnant women delivering in public health institutions to absolutely free
and no expense delivery, including caesarean section.
 The entitlements include free drugs and consumables, free diet up to 3 days during normal delivery
and up to 7 days for C-section, free diagnostics, and free blood wherever required. This initiative also
provides for free transport from home to institution, between facilities in case of a referral and drop
back home. Similar entitlements have been put in place for all sick newborns accessing public health
institutions for treatment till 30 days after birth.This has now been expanded to cover sick infants:
 The scheme aims to eliminate out of pocket expenses incurred by the pregnant women and sick new
borne while accessing services at Government health facilities.
 The scheme is estimated to benefit more than 12 million pregnant women who access Government
health facilities for their delivery. Moreover it will motivate those who still choose to deliver at their
homes to opt for institutional deliveries.
 All the States and UTs have initiated implementation of the scheme

Source: National Health Mission

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Janani Suraksha Yojana

Janani Suraksha Yojana (JSY) is a safe motherhood intervention under the National Rural Health Mission
(NHM). It promotes institutional delivery among pregnant women especially with weak socio-economic
status i.e. women from Scheduled Castes, Scheduled Tribes and BPL households. The scheme is under
implementation in all states and Union Territories (UTs), with a special focus on Low Performing States
(LPS)

Background
Janani Suraksha Yojana was launched in April 2005 by modifying the National Maternity Benefit
Scheme (NMBS). The NMBS came into effect in August 1995 as one of the components of
the National Social Assistance Programme (NSAP). The scheme was transferred from the Ministry
of Rural Development to the Department of Health & Family Welfare during the year 2001-02. The
NMBS provides for financial assistance of Rs. 500/- per birth up to two live births to the pregnant
women who have attained 19 years of age and belong to the below poverty line (BPL) households.
When JSY was launched the financial assistance of Rs. 500/- , which was available uniformly
throughout the country to BPL pregnant women under NMBS, was replaced by graded scale of
assistance based on the categorization of States as well as whether beneficiary was from rural/urban
area. States were classified into Low Performing States and High Performing States on the basis of
institutional delivery rate i.e. states having institutional delivery 25% or less were termed as Low
Performing States (LPS) and those which have institutional delivery rate more than 25% were
classified as High Performing States (HPS). Accordingly, eight erstwhile EAG states namely Uttar
Pradesh, Uttarakhand, Madhya Pradesh, Chhattisgarh, Bihar, Jharkhand, Rajasthan, Odisha and the
states of Assam & Jammu & Kashmir were classified as Low Performing States. The remaining States
were grouped into High Performing States.

Background on JSY
About 56,000 women in India die every year due to pregnancy related complications. Similarly, every
year more than 13 lakh infants die within 1year of the birth and out of these approximately 2/3rd of the infant
deaths take place within the first four weeks of life. Out of these, approximately 75% of the deaths take place
within a week of the birth and a majority of these occur in the first two days after birth.

In order to reduce the maternal and infant mortality, Reproductive and Child Health Programme under
the National Health Mission (NHM) is being implemented to promote institutional deliveries so that skilled
attendance at birth is available and women and new born can be saved from pregnancy related deaths.

Objective
Reducing maternal and infant mortality by promoting institutional delivery among pregnant women,
especially with weak socio-economic status i.e. women from Scheduled Castes, Scheduled Tribes and BPL
households.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Target Group and benefits

The scheme focuses on poor pregnant woman with a special dispensation for states that have low
institutional delivery rates, namely, the states of Uttar Pradesh, Uttarakhand, Bihar, Jharkhand,
Madhya Pradesh, Chhattisgarh, Assam, Rajasthan, Odisha, and Jammu and Kashmir. While these
states have been named Low Performing States (LPS), the remaining states have been named High
Performing states (HPS). In LPS, the financial incentive is available to all women regardless of age
and number of children for delivery in government / private accredited health facilities.

The scheme also provides performance based incentives to women health volunteers known as ASHA
(Accredited Social Health Activist) for promoting institutional delivery among pregnant women.
Under this initiative, eligible pregnant women are entitled to get JSY benefit directly into their bank
accounts. Cash entitlement for different categories of mothers is as follows:

Cash Assistance for Institutional Delivery (in Rs.)

Category Rural Area Urban Area

Mother’s package ASHA’s Mother’s ASHA’s

package* package package**

Low 1400 600 1000 400

Performing All women regardless of age and number of children
States - for delivery in government / private accredited
LPS health facilities

HPS All BPL/Scheduled Caste/Scheduled Tribe (SC/ST) 600 600 400

women delivering in a government/private
accredited health facility
700
In both LPS & HPS, BPL/SC/ST women are entitled for cash assistance in accredited private institutions
 *ASHA package of Rs. 600 in rural areas include Rs. 300 for ANC component and Rs. 300 for
facilitating institutional delivery
 **ASHA package of Rs. 400 in urban areas include Rs. 200 for ANC component and Rs. 200 for
facilitating institutional delivery

Cash assistance for home delivery

 BPL pregnant women, who prefer to deliver at home, are entitled to a cash assistance of Rs. 500 per
delivery regardless of the age of pregnant women and number of children.
Situation
 High out of pocket expenses being incurred by pregnant women and their families in the case of
institutional deliveries in form of drugs, User charges, diagnostic tests, diet, for C –sections.
How to apply
 To avail the scheme benefits, contact your nearest health care facility or contact your ASHA worker
or Anganwadi centre.
Source: National Health Mission

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Rashtriya Bal Swasthya Karyakram (RBSK)

Introduction

 Rashtriya Bal Swasthya Karyakram (RBSK) is a new initiative aiming at early

identification and early intervention for children from birth to 18 years to cover 4 ‘D’s viz.
Defects at birth, Deficiencies, Diseases, Development delays including disability.
 It is important to note that the 0 - 6 years age group will be specifically managed
at District Early Intervention Center ( DEIC ) level while for 6 -
18 years age group, management of conditions will be done through existing public health
facilities. DEIC will act as referral linkages for both the age groups.
 First level of screening is to be done at all delivery points through existing Medical Officers, Staff
Nurses and ANMs. After 48 hours till 6 weeks the screening of newborns will be done by ASHA at
home as a part of HBNC package.
 Outreach screening will be done by dedicated mobile block level teams for 6 weeks to 6
years at anganwadis centres and 6 - 18 years children at school.
 Once the child is screened and referred from any of these points of identification, it would be ensured
that the necessary treatment/intervention is delivered at zero cost to the family.

Target age group

The services aim to cover children of 0 -6 years of age in rural areas and urban slums in
addition to children enrolled in classes I to XII in Government and Government aided Schools. It is
expected that these services will reach to about 27 crores children in a phased manner. The broad category
of age group and estimated beneficiary is as shown below in the table. The children have been grouped in to
three categories owing to the fact that different sets of tools would be used and also different set of conditions
could be prioritized.

Target group under Child Health Screening and Intervention Service Categorie

Categories Age Group Estimated Coverage

Babies born at public health Birth to 6 weeks 2 crores

facilities and home

Preschool children in rural areas and urban slum 6weeks to 6 years 8 crores

School children enrolled in class 1st and 12th in 6yrs to 18 yrs 17 crores
government and government aided schools

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Health conditions to be screened

Child Health Screening and Early Intervention Services under RBSK envisages to cover 30 selected health
conditions for Screening, early detection and free management. States and UTs may also
include diseases namely hypothyroidism, Sickle cell anaemia and Beta
Thalassemia based on epidemiological situation and availability of testing and specialized support
facilities within State and UTs.

Selected Health Conditions for Child Health Screening & Early Intervention Services

Defects at Birth Deficiencies

1. Neural tube defect 10. Anaemia especially Severe anaemia

2. Down's Syndrome 11. Vitamin A deficiency (Bitot spot)
3. Cleft Lip & Palate / Cleft palate alone 12. Vitamin D Deficiency, (Rickets)
4. Talipes (club foot) 13. Severe Acute Malnutrition
5. Developmental dysplasia of the hip 14. Goiter
6. Congenital cataract
7. Congenital deafness
8. Congenital heart diseases
9. Retinopathy of Prematurity

Diseases of Childhood Developmental delays and Disabilities

15. Skin conditions (Scabies, fungal infection and 21. Vision Impairment
Eczema) 22. Hearing Impairment
16. Otitis Media 23. Neuro-motor Impairment
17. Rheumatic heart disease 24. Motor delay
18. Reactive airway disease 25. Cognitive delay
19.Dental conditions 26. Language delay
20. Convulsive disorders 27. Behavior disorder (Autism)
28. Learning disorder
29. Attention deficit hyperactivity disorder

30. Congenital Hypothyroidism, Sickle cell anemia, Beta thalassemia (Optional)

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Mechanisms for screening at Community & Facility level:

Child screening under RBSK is at two levels community level and facility level. While
facility based new born screening at public health facilities like PHCs / CHCs/ DH, will be by existing
health manpower like Medical Officers, Staff Nurses & ANMs, the community level screening will be
conducted by the Mobile health teams at Anganwadi Centres and Government and Government aided
Schools.

Screening at Anganwadi Centre

All pre-school children below 6 years of age would be screened by Mobile Block Health teams for
deficiencies, diseases, developmental delays including disability at the Anganwadi centre at least
twice a year. Tool for screening for 0-6 years is supported by
pictorial, job aids specifically for developmental delays. For developmental delays children
would be screened using age specific tools specific and those suspected would be referred to DEIC
for further management.

Screening at Schools - Government and Government aided

School children age 6 to 18 years would be screened by Mobile Health teams for deficiencies,
diseases, developmental delays including disability, adolescent health at the local schools at least
once a year. The too used is questionnaire (preferably translated to local or regional language) and
clinical examination.

Composition of mobile health team

The mobile health team will consist of four members- two Doctors (AYUSH) one male and one
female, at least with a bachelor degree from an approved institution, one ANM/Staff Nurse and one
Pharmacist with proficiency in computer for data management

Suggested Composition of Mobile Health Team.

S.No Member Number

1 Medical officers (AYUSH) -1male and 1 female at least with a bachelor 2

degree from an approved institution

2 ANM/Staff Nurse 1

3 Pharmacist with proficiency in computer for data management 1

*In case a Pharmacist is not available, other paramedics –Lab Technician or Ophthalmic Assistant

Source: National Health Mission

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Rashtriya Kishor Swasthya Karyakram (RKSK)

The Ministry of Health & Family Welfare has launched a health programme for adolescents, in the age group
of 10-19 years, which would target their nutrition, reproductive health and substance abuse, among other
issues.

The Rashtriya Kishor Swasthya Karyakram was launched on 7th January, 2014. The key principle of this
programme is adolescent participation and leadership, Equity and inclusion, Gender Equity and strategic
partnerships with other sectors and stakeholders. The programme envisions enabling all adolescents in India
to realize their full potential by making informed and responsible decisions related to their health and well-
being and by accessing the services and support they need to do so.

To guide the implementation of this programme, MOHFW in collaboration with UNFPA has developed a
National Adolescent Health Strategy. It realigns the existing clinic-based curative approach to focus on a
more holistic model based on a continuum of care for adolescent health and developmental needs.

The Rashtriya Kishor Swasthya Karyakram (National Adolescent Health Programme), will comprehensively
address the health needs of the 243 million adolescents. It introduces community-based interventions through
peer educators, and is underpinned by collaborations with other ministries and state governments.

The Vision

The strategy envisions that all adolescents in India are able to realise their full potential by making informed
and responsible decisions related to their health and well-being, and by accessing the services and support
they need to do so. The implementation of this vision requires support from the government and other
institutions, including the health, education and labour sectors as well as adolescents’ own families and
communities.

Building an agenda for adolescent health requires an escalation in the visibility of young people and an
understanding of the challenges to their health and development. It needs implementation of approaches that
will ensure a successful transition to adulthood. This requires that the multi-dimensional health needs and
special concerns of adolescents are understood and addressed in national policies and a range of programmes
at different levels.

Objectives

1. Improve nutrition
o Reduce the prevalence of malnutrition among adolescent girls and boys
o Reduce the prevalence of iron-deficiency anaemia (IDA) among adolescent girls and boys
2. Improve sexual and reproductive health
o Improve knowledge, attitudes and behaviour, in relation to SRH
o Reduce teenage pregnancies
o Improve birth preparedness, complication readiness and provide early parenting support
for adolescent parents

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

3. Enhance mental health

o Address mental health concerns of adolescents
4. Prevent injuries and violence
o Promote favourable attitudes for preventing injuries and violence (including GBV)
among adolescents
5. Prevent substance misuse
o Increase adolescents’ awareness of the adverse effects and consequences of substance misuse
6. Address NCDs
o Promote behaviour change in adolescents to prevent NCDs such as hypertension, stroke, cardio-
vascular diseases and diabetes

Target Groups

 The new adolescent health (AH) strategy focuses on age groups 10-14 years and 15-19 years with
universal coverage, i.e. males and females; urban and rural; in school and out of school; married and
unmarried; and vulnerable and under-served.

Strategies

1. Strategies/interventions to achieve objectives can be broadly grouped as:

o Community based interventions
o Peer Education (PE)
o Quarterly Adolescent Health Day (AHD)
o Weekly Iron and Folic Acid Supplementation Programme (WIFS)
o Menstrual Hygiene Scheme (MHS)
2. Facility based interventions
o Strengthening of Adolescent Friendly Health Clinics (AFHC)
3. Convergence
o Within Health & Family Welfare - FP, MH (incl VHND), RBSK, NACP, National Tobacco
Control Programme, National Mental Health Programme, NCDs and IEC
o With other departments/schemes - WCD (ICDS, KSY, BSY, SABLA), HRD (AEP, MDM),
Youth Affairs and Sports (Adolescent Empowerment Scheme, National Service Scheme, NYKS,
NPYAD)
4. Social and Behaviour Change Communication with focus on Inter Personal Communication

Source: National Health Mission

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Mission Indhradhanush
Mission Indradhanush (MI) was launched by the Ministry of Health and Family Welfare (MoHFW) on 25th
December 2014.

It is a special catch-up campaign under the Universal Immunization Program (UIP), conducted in the areas
of low immunization coverage to vaccinate all the children and pregnant women left out or dropped out from
Routine Immunization. The initiative's mammoth task is being fulfilled with the support of an integrated and
committed task-force, ensuring full immunization coverage.
Objective

The Mission Indradhanush aims to cover all those children who are either unvaccinated, or are partially
vaccinated against vaccine preventable diseases. India’s Universal Immunization Programme (UIP) provide
free vaccines against 12 life threatening diseases, to 26 million children annually. The Universal
Immunization Programme provides life-saving vaccines to all children across the country free of cost to
protect them against Tuberculosis, Diphtheria, Pertussis, Tetanus, Polio, Hepatitis B, Pneumonia and
Meningitis due to Haemophilus Influenzae type B (Hib), Measles, Rubella, Japanese Encephalitis (JE) and
Rotavirus diarrhoea. (Rubella, JE and Rotavirus vaccine in select states and districts).

Implementation

Focused and systematic immunization drive will be through a “catch-up” campaign mode where the aim is
to cover all the children who have been left out or missed out for immunization. Also the pregnant women
are administered the tetanus vaccine, ORS packets and zinc tablets are distributed for use in the event of
severe diarrhea or dehydration and vitamin A doses are administered to boost child immunity.

Mission Indradhanush Phase I was started as a weeklong special intensified immunization drive from 7th
April 2015 in 201 high focus districts for four consecutive months. During this phase, more than 75 lakh
children were vaccinated of which 20 lakh children were fully vaccinated and more than 20 lakh pregnant
women received tetanus toxoid vaccine.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

The Phase II of Mission Indradhanush covered 352 districts in the country of which 279 are medium focus
districts and remaining 73 are high focus districts of Phase-I. During Phase II of Mission Indradhanush, four
special drives of weeklong duration were conducted starting from October 2015.

Phases I and II of the special drive had 1.48 crore children and 38 lakh pregnant women additionally
immunized. Of these nearly 39 lakh children and more than 20 lakh pregnant women have been additionally
fully immunized. Across 21.3 lakh sessions held through the country in high and mid-priority districts, more
than 3.66 crore antigens have been administered.

Phase III of Mission Indradhanush was launched from 7 April 2016 covering 216 districts. Four intensified
immunization rounds were conducted for seven days in each between April and July 2016, in these districts.
These 216 districts have been identified on the basis of estimates where full immunization coverage is less
than 60 per cent and have high dropout rates. Apart from the standard of children under 2, it also focussed
on 5-year-olds and on increasing DPT booster coverage, and giving tetanus toxoid injections to pregnant
women.

Overall, in the first three phases, 28.7 lakh immunisation sessions were conducted, covering 2.1 crore
children, of which 55 lakh were fully immunised. Also, 55.9 lakh pregnant women were given the tetanus
toxoid vaccine across 497 high-focus districts. Since the launch of Mission Indhradhanush, full immunisation
coverage has increased by 5 per cent to 7 per cent. Mission Indradhanush has resulted in a 6.7 % annual
expansion in the immunization cover.

Phase IV of Mission Indradhanush was launched from 7 February 2017 covering the North-eastern states
of Arunachal Pradesh, Assam, Manipur, Meghalaya, Mizoram, Nagaland, Sikkim and Tripura. It has been
rolled out in rest of the country during April 2017.

The four phases of Mission Indradhanush have reached to more than 2.53 crore children and 68 lakh pregnant
women with life-saving vaccines.

The fifth phase of Mission Indradhanush was carried out in 190 lowest performing districts. At the end of
six phases of Mission Indradhanush, 554 districts across the country were covered. A survey (IMI- CES)
carried out in 190 districts covered in Intensified Mission Indradhanush (5th phase of Mission Indradhanush)
shows 18.5% points increase in full immunization coverage as compared to NFHS-4.

On completion of seven phases (from April 2015 to March 2020), 690 districts wherein 3.76 crore children
were reached and 94.6 lakh pregnant females were immunized. As of April 2021, during the various phases
of Mission Indradhanush, a total of 3.86 crore children and 96.8 lakh pregnant women have been vaccinated.
As of January 2022, ten phases of Mission Indradhanush have been completed covering 701 districts across
the country. As of October 2023, 12 phases have been completd and a total of 5.06 crore children and 1.25
crore pregnant women have been cumulatively vaccinated under the campaign.

The Ministry is being technically supported by WHO, UNICEF, Rotary International and other donor
partners. Mass media, interpersonal communication, and sturdy mechanisms of monitoring and evaluating
the scheme are crucial components of Mission Indradhanush.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Areas Under Focus

The following areas are targeted through special immunization campaigns:

1. High risk areas identified by the polio eradication programme. These include populations living in
areas such as:
o Urban slums with migration
o Nomads
o Brick kilns
o Construction sites
o Other migrants (fisherman villages, riverine areas with shifting populations etc.) and
o Underserved and hard to reach populations (forested and tribal populations etc.)
2. Areas with low routine immunization (RI) coverage (pockets with Measles/vaccine preventable
disease (VPD) outbreaks).
3. Areas with vacant sub-centers: No ANM posted for more than three months.
4. Areas with missed Routine Immunisation (RI) sessions: ANMs on long leave and similar reasons
5. Small villages, hamlets, dhanis or purbas clubbed with another village for RI sessions and not having
independent RI sessions.

Mission Indhradhanush - Districts covered

 Phase V - All districts across the country

 Phase V - 190 low performing districts
 Phase IV - The fourth phase of Mission Indradhanush covered North-eastern states - Arunachal
Pradesh, Assam, Manipur, Meghalaya, Mizoram, Nagaland, Sikkim and Tripura from 7th February
2017. It was rolled out in rest of the country in April 2017.
 Phase III - 216 districts
 Phase II - 352 districts
 Phase I - 201 districts

Strategy for Mission Indradhanush

Mission Indradhanush will be a national immunization drive to strengthen the key functional areas of
immunization for ensuring high coverage throughout the country with special attention to districts with low
immunization coverage.

The broad strategy, based on evidence and best practices, will include four basic elements-
1. Meticulous planning of campaigns/sessions at all levels: Ensure revision of microplans in all
blocks and urban areas in each district to ensure availability of sufficient vaccinators and all vaccines
during routine immunization sessions. Develop special plans to reach the unreached children in more
than 400,000 high risk settlements such as urban slums, construction sites, brick kilns, nomadic sites
and hard-to-reach areas.
2. Effective communication and social mobilization efforts: Generate awareness and demand for
immunization services through need-based communication strategies and social mobilization

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

activities to enhance participation of the community in the routine immunization programme through
mass media, mid media, interpersonal communication (IPC), school and youth networks and
corporates.
3. Intensive training of the health officials and frontline workers: Build the capacity of health
officials and workers in routine immunization activities for quality immunization services.
4. Establish accountability framework through task forces: Enhance involvement and
accountability/ownership of the district administrative and health machinery by strengthening the
district task forces for immunization in all districts of India and ensuring the use of concurrent session
monitoring data to plug the gaps in implementation on a real time basis.

The Ministry of Health and Family Welfare will establish collaboration with other Ministries, ongoing
programmes and international partners to promote a coordinated and synergistic approach to improve routine
immunization coverage in the country.

Intensified Mission Indradhanush (IMI)

The Intensified Mission Indradhanush (IMI) has been launched by the Government of India to reach each
and every child under two years of age and all those pregnant women who have been left uncovered under
the routine immunisation programme. The special drive focuses on improving immunization coverage in
select districts and cities to ensure full immunization to more than 90% by December 2018.

With a sharpened focus on high priority districts and urban areas, under IMI, four consecutive immunization
rounds were conducted for 7 days in 173 districts - 121 districts and 17 cities in 16 states and 52 districts in
8 north eastern states - every month between October 2017 and January 2018. Intensified Mission
Indradhanush covers low performing areas in the selected districts and urban areas. These areas have been
selected through triangulation of data available under national surveys, Health Management Information
System data and World Health Organization concurrent monitoring data. Special attention will be given to
unserved/low coverage pockets in sub-centre and urban slums with migratory population. The focus is also
on the urban settlements and cities identified under National Urban Health Mission (NUHM).

Intensified Mission Indradhanush will have inter-ministerial and inter-departmental coordination, action-
based review mechanism and intensified monitoring and accountability framework for effective
implementation of targeted rapid interventions to improve the routine immunization coverage. IMI is
supported by 11 other ministries and departments, such as Ministry of Women and Child Development,
Panchayati Raj, Ministry of Urban Development, Ministry of Youth Affairs among others. The convergence
of ground level workers of various departments like ASHA, ANMs, Anganwadi workers, Zila preraks under
National Urban Livelihood Mission (NULM), self-help groups will be ensured for better coordination and
effective implementation of the programme.

Intensified Mission Indradhanush would be closely monitored at the district, state and central level at regular
intervals. Further, it would be reviewed by the Cabinet Secretary at the National level and will continue to
be monitored at the highest level under a special initiative ‘Proactive Governance and Timely Implementation
(PRAGATI)’.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

This Intensified Mission is driven based on the information received from gap assessment, supervision
through government, concurrent monitoring by partners, and end-line surveys. Under IMI, special strategies
are devised for rigorous monitoring of the programme. States and districts have developed coverage
improvement plans based on gap self-assessment. These plans are reviewed from state to central level with
an aim to reach 90% coverage by December 2018.

An appreciation and awards mechanism is also conceived to recognize the districts reaching more than 90%
coverage. The criteria includes best practices and media management during crisis. To acknowledge the
contribution of the partners/Civil Society Organization (CSOs) and others, Certificate of Appreciation will
be given.

Intensified Mission Indradhanush (IMI) 3.0

The Government of India is committed to improve immunization coverage and achieve full immunization
coverage of 90 percent. Launch of massive routine immunization campaigns, such as Mission Indradhanush
(MI) and Intensified Mission Indradhanush (IMI), in part, reflects government’s efforts under Universal
Immunization Program to reduce child mortality and morbidity. To boost the RI coverage in the country,
Government is planning to introduce Intensified Mission Indradhanush 3.0 to ensure reaching the unreached
with all available vaccines and accelerate the coverage of children and pregnant women in the identified
districts and blocks from February 2021-March 2021.

The Intensified Mission Indradhanush 3.0 will have two rounds starting from February 22 and March 22,
2021 and will be conducted in pre-identified 250 districts/urban areas across 29 States/UTs in the country.
As per the Guidelines released for IMI 3.0, the districts have been classified to reflect 313 low risk; 152 as
medium risk; and 250 as high risk districts.

Focus of the IMI 3.0 will be the children and pregnant women who have missed their vaccine doses during
the COVID-19 pandemic. They will be identified and vaccinated during the two rounds of IMI 3.0. Each
round will be for 15 days each. Beneficiaries from migration areas and hard to reach areas will be targeted
as they may have missed their vaccine doses during COVID19.

The present eighth campaign will target achieving 90% Full Immunization Coverage (FIC) in all districts of
the country and sustain the coverage through immunization system strengthening and foster India’s march
towards the Sustainable Development Goals.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Intensified Mission Indradhanush 4.0

Intensified Mission Indradhanush 4.0 launched during Febraury 2022 had three rounds and was conducted
in 416 districts (including 75 districts identified for Azadi ka Amrit Mahotsav) across 33 States/UTs in the
country.

 In the first round (Feb-April 2022), 11 states conducted IMI 4.0. These are Assam, Uttarakhand,
Gujarat, Jammu & Kashmir, Meghalaya, Mizoram, Nagaland, Rajasthan, Sikkim, Tripura and
Chhattisgarh.
 The others (22 states) conducted the rounds from April to May 2022. These states/UTs
include Himachal Pradesh, Maharashtra, Andhra Pradesh, Manipur, Arunachal Pradesh, Odisha,
Bihar, Puducherry, Delhi, Punjab, Goa, Tamil Nadu, Haryana, Telangana, Jharkhand, Dadra & Nagar
Haveli and Daman & Diu, Karnataka, Uttar Pradesh, Kerala, West Bengal, Madhya Pradesh, A & N
Islands.

Intensified Mission Indradhanush 5.0

 IMI 5.0 ensures that routine immunization services reach the missed-out and dropped out children
and pregnant women across the country.
 For the first time the campaign is being conducted across all the districts in the country and includes
children up to 5 years of age (Previous campaigns included children up to 2 years of age).
 IMI 5.0 campaign aims to enhance immunization coverage for all vaccines provided under the
Universal Immunization Programme (UIP) as per the National Immunization Schedule (NIS). Special
focus is on improvement of Measles and Rubella vaccination coverage with the aim of Measles &
Rubella elimination by 2023 and use of U-WIN digital platform for Routine Immunization in pilot
mode across all districts in the country.
 IMI 5.0 was conducted in three rounds i.e., 7 -12 August, 11-16 September, and 9-14 October 2023
i.e., 6 days in a month with the inclusion of a Routine Immunization Day. All States/UTs except
Bihar, Chhattisgarh, Odisha and Punjab concluded all the three rounds of IMI 5.0 campaign by 14th
October 2023. These four states could not start the IMI 5.0 campaign in August due to some inevitable
circumstances. These states would complete by November 2023.

Source: Ministry of Health and Family Welfare

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Pulse Polio Programme

With the global initiative of eradication of polio in 1988 following World Health Assembly resolution in
1988, Pulse Polio Immunization programme was launched in India in 1995.

Children in the age group of 0-5 years administered polio drops during National and Sub-national
immunization rounds (in high risk areas) every year. Around 17.4 crore children of less than five years across
the country are given polio drops as part of the drive of Government of India to sustain polio eradication
from the country.

The last polio case in the country was reported from Howrah district of West Bengal with date of onset 13th
January 2011. Thereafter no polio case has been reported in the country. WHO on 24th February 2012
removed India from the list of countries with active endemic wild polio virus transmission.

Objective

The Pulse Polio Initiative was started with an objective of achieving hundred per cent coverage under Oral
Polio Vaccine. It aimed to immunize children through improved social mobilization, plan mop-up operations
in areas where poliovirus has almost disappeared and maintain high level of morale among the public.

Steps taken by the Government to maintain polio free status in India

 Maintaining community immunity through high quality National and Sub National polio rounds each
year.
 An extremely high level of vigilance through surveillance across the country for any importation or
circulation of poliovirus and VDPV is being maintained. Environmental surveillance (sewage
sampling) have been established to detect poliovirus transmission and as a surrogate indicator of the
progress as well for any programmatic interventions strategically in Mumbai, Delhi, Patna, Kolkata
Punjab and Gujarat.
 All States and Union Territories in the country have developed a Rapid Response Team (RRT) to
respond to any polio outbreak in the country. An Emergency Preparedness and Response Plan (EPRP)
has also been developed by all States indicating steps to be undertaken in case of detection of
a polio case.
 To reduce risk of importation from neighbouring countries, international border vaccination is being
provided through continuous vaccination teams (CVT) to all eligible children round the clock. These
are provided through special booths set up at the international borders that India shares with Pakistan,
Bangladesh, Bhutan Nepal and Myanmar.
 Government of India has issued guidelines for mandatory requirement of polio vaccination to all
international travelers before their departure from India to polio affected countries
namely: Afghanistan, Nigeria, Pakistan, Ethiopia, Kenya, Somalia, Syria and Cameroon. The
mandatory requirement is effective for travellers from 1st March 2014.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

 A rolling emergency stock of OPV is being maintained to respond to detection/importation of wild

poliovirus (WPV) or emergence of circulating vaccine derived poliovirus (cVDPV).
 National Technical Advisory Group on Immunization (NTAGI) has recommended Injectable Polio
Vaccine (IPV) introduction as an additional dose along with 3rd dose of DPT in the entire country in
the last quarter of 2015 as a part of polio endgame strategy.
 As per the current recommendation IPV is given at 6 and 14 weeks as per NIS.

Progress

 South-East Asia Region of WHO has been certified polio free.

 The Regional Certification Commission (RCC) on 27th March 2014 issued
certificate which states that “The Commission concludes, from the
evidence provided by the National Certificate Committees of the 11
Member States, that the transmission of indigenous wild poliovirus has been interrupted in all
countries of the Region.”
 India has achieved the goal of polio eradication as no polio case has been
reported for more than 3 years after last case reported on 13th January, 2011.
 WHO on 24th February 2012 removed India from the list of countries with active endemic wild polio
virus transmission
 There are 24 lakh vaccinators and 1.5 lakh supervisors involved in the successful implementation of
the Pulse Polio Programme

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Mission POSHAN
Government is implementing several schemes and programs under the Umbrella Integrated Child
Development Services Scheme as direct targeted interventions to address the problem of malnutrition in the
country. All these schemes address one or other aspects related to nutrition and have the potential to improve
nutritional outcomes in the country.

Malnutrition is not a direct cause of death but contributes to mortality and morbidity by reducing resistance
to infections. There are a number of causes of death of children such as prematurity, low birth weight,
pneumonia, diarrhoeal diseases, non-communicable diseases, birth asphyxia & birth trauma, injuries,
congenital anomalies, acute bacterial sepsis and severe infections, etc.

Prime Minister's Overarching Scheme for Holistic Nutrition (POSHAN) Abhiyaan (National Nutrition
Mission) is a flagship programme of the Ministry of Women and Child Development (MWCD), Government
of India, which ensures convergence with various programmes i.e., Anganwadi Services, Pradhan Mantri
Matru Vandana Yojana (PMMVY), Scheme for Adolescent Girls (SAG) of MWCD Janani Suraksha
Yojana (JSY), National Health Mission (NHM), Swachh-Bharat Mission, Public Distribution System (PDS),
Department Food & Public Distribution, Mahatma Gandhi National Rural Employment Guarantee Scheme
(MGNREGS) and Ministry of Drinking Water & Sanitation.

About the Mission

The goals of NNM are to achieve improvement in nutritional status of Children from 0-6 years, Adolescent
Girls, Pregnant Women and Lactating Mothers in a time bound manner during the next three years beginning
2017-18.

The National Nutrition Mission (NNM) has been set up with a three year budget of Rs.9046.17 crore
commencing from 2017-18. The NNM is a comprehensive approach towards raising nutrition level in the
country on a war footing. It will comprise mapping of various Schemes contributing towards addressing
malnutrition, including a very robust convergence mechanism, ICT based Real Time Monitoring system,
incentivizing States/UTs for meeting the targets, incentivizing Anganwadi Workers (AWWs) for using IT
based tools, eliminating registers used by AWWs, introducing measurement of height of children at the
Anganwadi Centres (AWCs), Social Audits, setting-up Nutrition Resource Centres, involving masses
through Jan Andolan for their participation on nutrition through various activities, among others.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Major impact

 The programme through the targets will strive to reduce the level of stunting, under-nutrition, anemia
and low birth weight babies.
 NNM targets to reduce stunting, under- nutrition, anemia (among young children, women and
adolescent girls) and reduce low birth weight by 2%, 2%, 3% and 2% per annum respectively.
Although the target to reduce Stunting is atleast 2% p.a., Mission would strive to achieve reduction
in Stunting from 38.4% (NFHS-4) to 25% by 2022 (Mission 25 by 2022).
 It will create synergy, ensure better monitoring, issue alerts for timely action, and encourage
States/UT s to perform, guide and supervise the line Ministries and States/UT s to achieve the targeted
goals.

Benefits & Coverage

 More than 10 crore people will be benefitted by this programme. All the States and districts will be
covered in a phased manner i.e. 315 districts in 2017-18, 235 districts in 2018-19 and remaining
districts in 2019-20 .
 To access the complete National Nutrition Mission: Administrative Guidelines, click here

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Mission POSHAN 2.0

Mission POSHAN 2.0 is an Integrated Nutrition Support Programme. It seeks to address the challenges of
malnutrition in children, adolescent girls, pregnant women and lactating mothers through a strategic shift in
nutrition content and delivery and by creation of a convergent eco-system to develop and promote practices
that nurture health, wellness and immunity. Poshan 2.0 will seek to optimize the quality and delivery of food
under the Supplementary Nutrition Program.

Mission Poshan 2.0 will contribute to human capital development of the country; address malnutrition
challenges; promote nutrition awareness and good eating habits for sustainable health & well-being and
address nutrition related deficiencies through key strategies. Under the programme, nutritional norms and
standards and quality and testing of THR will be improved and greater stakeholder and beneficiary
participation will be promoted besides traditional community food habits. Poshan 2.0 will bring 3 important
programmes/schemes under its ambit, viz., Anganwadi Services, Scheme for Adolescent Girls and Poshan
Abhiyaan.

Poshan 2.0 shall focus on Maternal Nutrition, Infant and Young Child Feeding Norms, Treatment of
MAM/SAM and Wellness through AYUSH. It will rest on the pillars of Convergence, Governance, and
Capacity-building. Poshan Abhiyan will be the key pillar for Outreach and will cover innovations related to
nutritional support, ICT interventions, Media Advocacy and Research, Community Outreach and Jan
Andolan.

Mission Poshan 2.0 will integrate several key strategies to fulfil its objectives, viz., Corrective strategies,
Nutrition Awareness strategies, Communication strategies and Creation of green eco-systems. The objectives
under Mission Poshan 2.0 will be realized through strong interventions-driven convergent activities with key
Ministries/Depts./Organizations.

Digital infrastructure under the “Poshan Tracker” rolled out by MoWCD on 1st March 2021 through National
e-Governance Division as a governance tool, will strengthen and bring about transparency in nutrition
delivery support systems.

Technology under Poshan Tracker is being leveraged for (i) dynamic identification of stunting, wasting,
under-weight prevalence among children; (ii) last mile tracking of nutrition service delivery.

Source : Poshan Abhiyaan

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Labour Room Quality Improvement Initiative - ‘LaQshya’

After launch of the National Health Mission (NHM), there has been substantial increase in the number of
institutional deliveries. However, this increase in the numbers has not resulted into commensurate
improvements in the key maternal and new-born health indicators. It is estimated that approximately 46%
maternal deaths, over 40% stillbirths and 40% newborn deaths take place on the day of the delivery.

A transformational change in the processes related to the care during the delivery, which essentially relates
to intrapartum and immediate postpartum care, is required to achieve tangible results within short period of
time.

‘LaQshya’ programme of the Ministry of Health and Family Welfare aims at improving quality of care in
labour room and maternity Operation Theatre (OT).

Goal

 Reduce preventable maternal and newborn mortality, morbidity and stillbirths associated with the
care around delivery in Labour room and Maternity OT and ensure respectful maternity care.

Objectives

 To reduce maternal and newborn mortality & morbidity due to APH, PPH, retained placenta, preterm,
preeclampsia & eclampsia, obstructed labour, puerperal sepsis, newborn asphyxia, and sepsis, etc.
 To improve Quality of care during the delivery and immediate post-partum care, stabilization of
complications and ensure timely referrals, and enable an effective two-way follow-up system.
 To enhance satisfaction of beneficiaries visiting the health facilities and provide Respectful Maternity
Care (RMC) to all pregnant women attending the public health facility.

Strategies

 Reorganizing/aligning Labour room & Maternity Operation Theatre layout and workflow as per
‘Labour Room Standardization Guidelines’ and ‘Maternal & Newborn Health Toolkit’ issued by the
Ministry of Health & Family Welfare, Government of India.
 Ensuring that at least all government medical college hospitals and high case- load district hospitals
have dedicated obstetric HDUs as per GoI MOHFW Guidelines, for managing complicated
pregnancies that require life-saving critical care.
 Ensuring strict adherence to clinical protocols for management and stabilization of the complications
before referral to higher centres.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Scope

Following facilities would be taken under LaQshya initiative on priority:

 All government medical college hospitals.

 All District Hospitals & equivalent healthy facilities.
 All designated FRUs and high case load CHCs with over 100 deliveries/60 (per month) in hills and
desert areas.

Institutional Arrangement

Under the National Health Mission, the States have been supported in creating Institutional framework for
the Quality Assurance - State Quality Assurance Committee (SQAC), District Quality Assurance Committee
(DQAC), and Quality Team at the facility level. These committees will also support implementation of
LaQshya interventions. For specific technical activities and program management, special purpose groups
have been suggested, and these groups will be working towards achievement of specific targets and program
milestones in close coordination with relevant structure.

Targets

Immediate (0-4 Months)

 80% of the selected Labour rooms & Maternity OTs assess their quality and staff competence using
defined NQAS checklists and OSCE.
 80% of Labour rooms & Maternity OTs have setup functional quality circles and facility level quality
teams.

Short Term (up to 8 Months)

 80% of Labour Room and OT Quality Circles are oriented to latest labour room protocols, quality
improvement processes and respectful maternity care (RMC).
 50% of deliveries take place in presence of the Birth Companions.
 60% of deliveries conducted using safe birth checklist and Safe Surgery Checklist in Labour Room
& Maternity OT respectively.
 60% of the deliveries are conducted using real-time par to graph.
 30% increase in Breast Feeding within one hour of delivery
 80% labour rooms and Maternity OTs take microbiological samples from defined areas every month.
 30% reduction in surgical site infection ratein r/o planned surgery in the Maternity OT.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Intermediate Term (Up to 12 Months)

 30% increase in antenatal corticosteroid administration in case of preterm labour.

 30% reduction in pre-eclampsia, eclampsia& PIH related mortality.
 30% reduction in APH/PPH related mortality.
 20% reduction in new-born asphyxia related admissions in SNCUs for inborn deliveries.
 20% reduction in newborn sepsis rate in SNCUs for inborn deliveries.
 20% reduction in Stillbirth rate.
 80% of all beneficiaries are either satisfied or highly satisfied
 60% of the labour rooms are reorganized as per 'Guidelines for Standardisation of Labour Rooms at
Delivery Points'.
 80% of lab our rooms have staffing as per defined norms.
 100% compliance to administration of Oxytocin, immediately after birth.
 30% improvement in OSCE scores of labour room staff.
 100% Maternal death, Neonatal Death audit and clinical discussion on near miss/maternal and
neonatal complications
 80% Labour Room and OTs are reporting zero stock-outs of drugs and consumables.

Long Term (up to 18 Months)

 60% of labour rooms achieve quality certification against the NQAS.

 50% of labour rooms are linked to Obstetrics HDU/ICU.
 15% improvement in short term & Intermediate targets.

After 18 months, this initiative would be continued through sustained mentoring.

Interventions

 Ensuring availability of optimal and skilled human resources as per case-load and prevalent norms
through rational deployment and skill upgradation.
 Ensuring skill assessment of all staff of LR & Maternal OT through OSCE (Objective Structured
Clinical Examination) testing as per Dakshata guidelines for delivery of ‘zero-defect’ quality obstetric
and newborn care. Enhance proficiency of labour room and operation theatre staff for management
of the complications through skill-lab training, simulations and drills. Ensuring that staff working in
the labour room and maternity OT are not shifted from maternity duty to other departments/ wards
frequently.
 Sensitising care-providers for delivery of respectful maternity care and close monitoring of language,
behaviour and conduct of the labour room, OT & HDU Staff.
 Creating an enabling environment for natural birthing process.
 Implementation of Clinical Guidelines, Labour Room Clinical Pathways, Referral Protocols, safe
birth checklist (in labour room and Obstetric OT) and surgical safety check-list.
 Ensuring round the clock availability of Blood transfusion services, diagnostic services, drugs &
consumables.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

 Ensuring availability of triage area and functional newborn care area.

 Ensuring systematic facility-level audit of all cases of maternal/neonatal deaths, stillbirth, and
maternal near miss etc. including with their mentor teams through clinical discussions, peer reviews
in teaching institutes, Videoconference, or other distance mode mechanisms for continuous
improvement and learning.
 Operationalisation of ‘C’ Section audit and corrective & preventive actions for ensuring that ‘C’
Sections are undertaken judiciously in those cases having robust clinical indications.
 Instituting an ongoing system of capturing of beneficiaries’ independent feedback through
mechanism ‘Mera- Aspataal’ or manual recording, or Grievance Redressal Help Desk and take action
to address concerns, for continual enhancement in their satisfaction.
 Ensuring availability of essential support services such as 24x7 running water, electricity,
housekeeping, linen and laundry, security, equipment maintenance, laboratory services, dietary
services, BMW management, etc.
 Use of digital technology for record keeping & monitoring for maternity wing (MIS), including use
of E partograph. Piloting of technology for managing care, such as Computer on Wheel,
Computerised Physician Order Entry.
 Use aggressive IEC, user friendly training material and IT-enabled tools. Facilitating branding of all
high case load facilities meeting quality standards to improve visibility and awareness.
 Using Quality tools for prioritisation, and gap closure such as Plan Do Check Act (PDCA), Root
Cause Analysis, Run Charts, Pareto chart and Mistake Proofing for achieving desired targets.
 Rapid Improvement Events - Six cycles of two months each as defined below will need to be
rigorously supervised and ensured. This will enable competency in all critical skills needed. For each
area, a targeted campaign would be launched for a two month duration, with the first month for the
roll-out, followed by sustaining such efforts during the subsequent month (Period for one event – 2
months).

 Suggested list of the themes for campaigns is given below :

o Cycle 1: Real-time Partograph generation including shift to electronic partograph & usage of
safe birth check-list & surgical safety check-list and strengthening documentation practices
for generating robust data for driving improvement.
o Cycle 2: Presence of Birth companion during delivery, respectful maternity care and
enhancement of patients’ satisfaction.
o Cycle 3: Assessment, Triage and timely management of complications including
strengthening of referral protocols.
o Cycle 4: Management of Labour as per protocols including AMTSL & rational use of
Oxytocin.
o Cycle 5: Essential and emergency care of Newborn & Pre-term babies including management
of birth asphyxia and timely initiation of breast feeding as well as KMC for preterm newborn.
o Cycle 6: Infection Prevention including Biomedical Waste Management.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Incentives

The Quality Improvement in labour room and maternity OT will be assessed through NQAS (National
Quality Assurance Standards). Every facility achieving 70% score on NQAS will be certified as LaQshya
certified facility. Furthermore, branding of LaQshya certified facilities will be done as per the NQAS score.
Facilities scoring more than 90%, 80% and 70% will be given Platinum, Gold and Silver badge accordingly.
Facilities achieving NQAS certification, defined quality indicators and 80% satisfied beneficiaries will be
provided incentive of Rs 6 lakh, Rs 3 lakh and Rs 2 lakh for Medical College Hospital, District Hospital and
FRUs respectively.

Source : National Health Mission

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

National Programme for Prevention and Control of Cancers,

Diabetes, Cardiovascular Diseases and Stroke (NPCDCS)
Background

The country is experiencing a rapid health transition with a rising burden of Non-Communicable Diseases
(NCDs) which are emerging as the leading cause of death in India accounting for over 60% of all deaths with
considerable loss in potentially productive years (aged 35-64 years) of life.

The NCDs like cardiovascular disease, cancer, chronic respiratory disease, diabetes and other NCDs are
estimated to account for over 60% of all deaths, making them the leading cause of death.

NCDs cause considerable loss in potentially productive years of life. Losses due to premature deaths related
to heart diseases, stroke and diabetes are likely to increase over the years.

According to National Family Health Survey 5 (NFHS-) 2019-21, 1 in every 5 persons suffers from
hypertension (defined as SBP ≥140mmg Hg and/or DBP ≥90mmg Hg or is taking medication to control
blood pressure) in 18 states/UTs. The prevalence of overweight/obesity (defined as BMI ≥25kg/m2), as most
states/UTs, is 1 of every 5 persons.

NAFLD, the abnormal accumulation of fat in the liver in the absence of secondary causes of fatty liver, such
as harmful alcohol use, viral hepatitis, or medications is a serious health concern as it encompasses a spectrum
of liver abnormalities, from a simple non-alcoholic fatty liver (NAFL, simple fatty liver disease) to more
advanced ones like non-alcoholic steatohepatitis (NASH), cirrhosis and even liver cancer. Over the last two
decades global burden of NASH has more than doubled. NAFLD is emerging as an important cause of liver
disease in India.

Epidemiological studies suggest the prevalence of NAFLD is around 9% to 32% of the general population
in India with a higher prevalence in those with overweight or obesity and those with diabetes or prediabetes.
Researchers have found NAFLD in 40% to 80 % of people who have type 2 diabetes and in 30% to 90 % of
people who are obese. Studies also suggest that people with NAFLD have a greater chance of developing
cardiovascular disease. Cardiovascular disease is the most common cause of death in NAFLD. Once the
disease develops, there is no specific cure available, and health promotion and prevention aspects targeting
weight reduction, healthy lifestyle, and control of aforementioned risk factors are the mainstays to disease
progression and prevent the mortality and morbidity due to NAFLD.

NAFLD is an independent predictor of future risk of cardiovascular diseases, type 2 diabetes and other
metabolic syndromes like hypertension, abdominal obesity, dyslipidaemia, glucose intolerance.

The cost implications of NCDs to society are enormous and run into thousands of crore of rupees that include
direct costs to people with illness, their families and indirect costs to society, due to reduced productivity.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Major risk factors for these NCDs are raised blood pressure, cholesterol, tobacco use, unhealthy diet, physical
inactivity, alcohol consumption, and obesity which are modifiable. The other non-modifiable risk factors
such as age, sex and heredity are also associated with the occurrence of NCDs. Hence a majority of cancers
and CVDs can be prevented and treated if diagnosed at an early stage.

About NPCDCS

 Considering the rising burden of NCDs and common risk factors to major Chronic Non –
Communicable Diseases, Government of India initiated an integrated National Programme for
Prevention and Control of Cancers, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) under
the National Health Mission.
 The focus of the Programme is on health promotion and prevention, strengthening of infrastructure
including human resources, early diagnosis and management and integration with the primary health
care system through NCD cells at different levels for optimal operational synergies.
 During the period 2010 - 2012, the programme was implemented in 100 districts across 21 States.
The programme at present covers the entire country.
 During February 2021, Ministry of Health and Family Welfare launched the operational guidelines
for Integration of NAFLD (Non-Alcoholic Fatty Liver Disease) with NPCDCS.

Objectives

1. Health promotion through behavior change with involvement of community, civil society,
community based organizations, media etc.
2. Outreach Camps for opportunistic screening at all levels in the health care delivery system from sub-
centre and above for early detection of diabetes, hypertension and common cancers.
3. Management of chronic Non-Communicable diseases, especially Cancer, Diabetes, CVDs and Stroke
through early diagnosis, treatment and follow up through setting up of NCD clinics.
4. Build capacity at various levels of health care for prevention, early diagnosis, treatment, IEC/BCC,
operational research and rehabilitation.
5. Provide support for diagnosis and cost effective treatment at primary, secondary and tertiary levels
of health care.
6. Provide support for development of database of NCDs through a robust Surveillance System and to
monitor NCD morbidity, mortality and risk factors.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Strategy

 Health promotion, Awareness generation and promotion of healthy lifestyle - The focus of health
promotion activities will be on
o Increased intake of healthy foods
o Salt reduction
o Increased physical activity/regular exercise
o Avoidance of tobacco and alcohol
o Reduction of obesity
o Stress management
o Awareness about warning signs of cancer etc.
o Regular health check - up
 Screening and early detection - Common cancers (breast, cervical and oral), diabetes and high blood
pressure screening of target population (age 30 years and above) will be conducted either through
opportunistic and/or camp approach at different levels of health facilities and also in urban slums of
large cities.
 Timely, affordable and accurate diagnosis
 Access to affordable treatment
 Rehabilitation

Source: Ministry of Health and Family Welfare.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

National Viral Hepatitis Control Program

Ministry of Health and Family Welfare has launched the ‘National Viral Hepatitis Control Program’, with
the goal of ending viral hepatitis as a public health threat by 2030 in the country.

Viral hepatitis in India

Viral hepatitis is increasingly being recognized as a public health problem in India. Hepatitis A Virus (HAV)
and Hepatitis E Virus (HEV) are important causes of acute viral hepatitis and Acute Liver Failure (ALF).
Due to paucity of data, the exact burden of disease for the country is not established. However, available
literature indicates a wide range and suggests that HAV is responsible for 10-30% of acute hepatitis and 5-
15% of acute liver failure cases in India. It is further reported that HEV accounts for 10-40% of acute hepatitis
and 15-45% of acute liver failure.

Hepatitis B surface Antigen (HBsAg) positivity in the general population ranges from 1.1% to 12.2%, with
an average prevalence of 3-4%. Anti-Hepatitis C virus (HCV) antibody prevalence in the general population
is estimated to be between 0.09-15%. Based on some regional level studies, it is estimated that in India,
approximately 40 million people are chronically infected with Hepatitis B and 6-12 million people with
Hepatitis C. Chronic HBV infection accounts for 40% of Hepato-cellular Carcinoma (HCC) and 20-30%
cases of cirrhosis in India. Chronic HCV infection accounts for 12-32% of HCC and 12-20% of cirrhosis.

A systematic review of available information from published studies and from large unpublished reliable
datasets, to assess the prevalence of chronic HCV infection in the Indian population has recently been done
to assess the prevalence of overall HCV infections, and by age, sex, risk factors and place in the country.
This meta-analysis data estimated that India (current population approx. 1.3 billion) has 5.2-13 million anti-
HCV positive persons. As the data on HCV viremia amongst the anti-HCV positive persons were not
available, data from elsewhere was used to estimate that India has about 3 million to 9 million persons with
active HCV infections.

Aim

 Combat hepatitis and achieve country wide elimination of Hepatitis C by 2030

 Achieve significant reduction in the infected population, morbidity and mortality associated
with Hepatitis B and C viz. Cirrhosis and Hepato-cellular carcinoma (liver cancer)
 Reduce the risk, morbidity and mortality due to Hepatitis A and E.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Key Objectives

1. Enhance community awareness on hepatitis and lay stress on preventive measures among general
population especially high-risk groups and in hotspots.
2. Provide early diagnosis and management of viral hepatitis at all levels of healthcare
3. Develop standard diagnostic and treatment protocols for management of viral hepatitis and its
complications.
4. Strengthen the existing infrastructure facilities, build capacities of existing human resource and raise
additional human resources, where required, for providing comprehensive services for management of
viral hepatitis and its complications in all districts of the country.
5. Develop linkages with the existing National programs towards awareness, prevention, diagnosis and
treatment for viral hepatitis.
6. Develop a web-based “Viral Hepatitis Information and Management System” to maintain a registry of
persons affected with viral hepatitis and its sequelae

Components

The key components include:

1. Preventive component: This remains the cornerstone of the NVHCP. It will include
o Awareness generation
o Immunization of Hepatitis B (birth dose, high risk groups, health care workers)
o Safety of blood and blood products
o Injection safety, safe socio-cultural practices
o Safe drinking water, hygiene and sanitary toilets
2. Diagnosis and Treatment:
o Screening of pregnant women for HBsAg to be done in areas where institutional deliveries are <
80% to ensure their referral for institutional delivery for birth dose Hepatitis B vaccination.
o Free screening, diagnosis and treatment for both hepatitis B and C would be made available at all
levels of health care in a phased manner.
o Provision of linkages, including with private sector and not for profit institutions,for diagnosis
and treatment.
o Engagement with community/peer support to enhance and ensure adherence to treatment and
demand generation.
3. Monitoring and Evaluation, Surveillance and Research Effective linkages to the surveillance system
would be established and operational research would be undertaken through Department of Health
Research (DHR). Standardised M&E framework would be developed and an online web based system
established.
4. Training and capacity Building: This would be a continuous process and will be supported by NCDC,
ILBS and state tertiary care institutes and coordinated by NVHCP. The hepatitis induction and update
programs for all level of health care workers would be made available using both, the traditional cascade
model of training through master trainers and various platforms available for enabling electronic, e-
learning and e-courses.

Source : Ministry of Health and Family Welfare

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

National Viral Hepatitis Surveillance Programme

Viral hepatitis is an inflammation of the liver caused by one of the five hepatitis viruses, referred to as types
A, B, C, D and E. The Government of India through the National Centre for Disease Control is implementing
the National Viral Hepatitis Surveillance Programme.

Objectives

 To establish laboratory network for laboratory based surveillance of viral hepatitis in different
geographical locations of India.
 To ascertain the prevalence of different types of viral hepatitis in different zones of the country.
 To provide laboratory support for outbreak investigation of hepatitis through established network of
laboratories.
 To develop technical material for generating awareness among healthcare providers and in the
community about waterborne and blood borne hepatitis.

Targets

 Establishment of laboratory based surveillance for viral hepatitis in the country for collection of data.
Development of testing and surveillance guidelines and its dissemination.

 A network of laboratories with quality testing for hepatitis markers will be established covering the
entire country
 Training of manpower/health care providers in 10 regional labs including NCDC i.e. the reference
lab.
 Development of IEC for providers and community.
 Establishment of baseline data for hepatitis to see the impact

Source: National Centre for Disease Control (NCDC)

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

National Mental Health Programme

Introduction

Psychiatric symptoms are common in general population in both sides of the globe. These symptoms – worry,
tiredness, and sleepless nights affect more than half of the adults at some time, while as many as one person
in seven experiences some form of diagnosable neurotic disorder.

Burden of Disease

The World Bank report (1993) revealed that the Disability Adjusted Life Year (DALY) loss due to neuro-
psychiatric disorder is much higher than diarrhea, malaria, worm infestations and tuberculosis if taken
individually. According to the estimates daily loss due to mental disorders are expected to represent 15% of
the global burden of diseases by 2020.

During the last two decades, many epidemiological studies have been conducted in India, which show that
the prevalence of major psychiatric disorder is about the same all over the world. The prevalence reported
from these studies range from the population of 18 to 207 per 1000 with the median 65.4 per 1000 and at any
given time, about 2 –3 % of the population, suffer from seriously, incapacitating mental disorders or epilepsy.

Most of these patients live in rural areas remote from any modern mental health facilities. A large number of
adult patients (10.4 – 53%) coming to the general OPD are diagnosed mentally ill. However, these patients
are usually missed because either medical officer or general practitioner at the primary health care unit does
not ask detailed mental health history. Due to the under-diagnosis of these patients, unnecessary
investigations and treatments are offered which heavily cost to the health providers.

Programme

The Government of India has launched the National Mental Health Program (NMHP) in 1982, keeping in
view the heavy burden of mental illness in the community, and the absolute inadequacy of mental health care
infrastructure in the country to deal with it.

NMHP has 3 components:

1. Treatment of Mentally ill

2. Rehabilitation
3. Prevention and promotion of positive mental health.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Aims

1. Prevention and treatment of mental and neurological disorders and their associated disabilities.
2. Use of mental health technology to improve general health services.
3. Application of mental health principles in total national development to improve quality of life.

Objectives

1. To ensure availability and accessibility of minimum mental health care for all in the forseeable future,
particularly to the most vulnerable and underprivileged sections of population.
2. To encourage application of mental health knowledge in general health care and in social
development.
3. To promote community participation in the mental health services development and to stimulate
efforts towards self-help in the community.

Strategies

1. Integration mental health with primary health care through the NMHP
2. Provision of tertiary care institutions for treatment of mental disorders
3. Eradicating stigmatization of mentally ill patients and protecting their rights through regulatory
institutions like the Central Mental Health Authority, and State Mental health Authority.

Mental Health care

1. The mental morbidity requires priority in mental health treatment

2. Primary health care at village and sub center level
3. At Primary Health Center level
4. At the District Hospital level
5. Mental Hospital and teaching Psychiatric Units

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

District Mental Health Programme

Components

1. Training programmes of all workers in the mental health team at the identified Nodal Institute in the
State.
2. Public education in the mental health to increase awareness and reduce stigma.
3. For early detection and treatment, the OPD and indoor services are provided.
4. Providing valuable data and experience at the level of community to the state and Centre for future
planning, improvement in service and research.

Agencies like World Bank and WHO have been contacted to support various components of the programme.
Funds are provided by the Govt. of India to the state governments and the nodal institutes to meet the
expenditure on staff, equipments, vehicles, medicine, stationary, contingencies, training, etc. for initial 5
years and thereafter they should manage themselves. Govt. of India has constituted central Mental Health
Authority to oversee the implementation of the Mental Health Act 1986. It provides for creation of state
Mental Health Authority also to carry out the said functions.

The National Human Rights Commission also monitors the conditions in the mental hospitals along with the
government of India and the states are currently acting on the recommendation of the joint studies conducted
to ensure quality in delivery of mental care.

Source: nihfw.nic.in

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

National Tobacco Control Programme

Introduction

Tobacco use is one of the main risk factors for a number of chronic diseases, including cancer, lung diseases,
and cardiovascular diseases. India is the 2nd largest producer and consumer of tobacco and a variety of forms
of tobacco use is unique to India. Apart from the smoked forms that include cigarettes, bidis and cigars, a
plethora of smokeless forms of consumption exist in the country.

The Government of India has enacted the national tobacco-control legislation namely, “The Cigarettes and
other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production,
Supply and Distribution) Act, 2003” in May, 2003.

India also ratified the WHO-Framework Convention on Tobacco Control (WHO-FCTC) in February 2004.
Further, in order to facilitate the effective implementation of the Tobacco Control Law, to bring about greater
awareness about the harmful effects of tobacco as well as to fulfill the obligations under the WHO-FCTC,
the Ministry of Health and Family Welfare, Government of India launched the National Tobacco Control
Programme (NTCP) in 2007- 08 in 42 districts of 21 States/Union Territories of the country.

Currently, the Programme is being implemented in all States/Union Territories covering over 600 districts
across the country.

Objectives

1. To bring about greater awareness about the harmful effects of tobacco use and Tobacco Control Laws.
2. To facilitate effective implementation of the Tobacco Control Laws.
3. The objective of this programme is to control tobacco consumption and minimize the deaths caused
by it. The various activities planned to control tobacco use are as follows:
o Training and Capacity Building
o IEC activity
o Monitoring Tobacco Control Laws and Reporting
o Survey and Surveillance

Coverage

National Tobacco Control Programme is being implemented in about 612 districts in all States/UTs presently.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Harmful effects of smoking and Second hand Smoke Exposure

Harmful effects of using smokeless tobacco

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Implementation

NTCP is implemented through a three-tier structure, i.e.

 National Tobacco Control Cell (NTCC) at Central level

 State Tobacco Control Cell (STCC) at State level &
 District Tobacco Control Cell (DTCC) at District level. There is also a provision of setting up
Tobacco Cessation Services at District level.

Benefits of quitting tobacco

 In 8 hours: Oxygen levels return to normal.

 In 24 hours: Risk of heart attack begins to decrease.
 In 72 hours: Lung function improves.
 In 1-9 months: Coughing and shortness of breath decreases.
 In 12 months: Risk of heart disease is half as compared to tobacco user.
 In 5 years: Stroke risk is reduced.
 In 10 years: Risk of lung cancer is less than half as compared to tobacco user.
 In 15 years: Risk of heart disease is similar to a person who never smoked.
 Reduced risk of diseases attributable to tobacco use
 Reduced health care expenditure means more money for other essential expenditures
 You become a role model for your children as well as for your society

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Major Achievements

 The prevalence of tobacco use has reduced by six percentage points from 34.6% to 28.6% during the
period from 2009-10 to 2016-17. The number of tobacco users has reduced by about 81 lakh (8.1
million).
 The Government launched the National Tobacco Cessation Quitline Services (1800-112-356) which
aims to guide tobacco addicts to quit tobacco.
 Large specified health warnings on tobacco products covering 85% on both side of the principal
display area of tobacco product packs and inclusion of Quitline Number (1800112356) in the
specified health warnings for creating awareness among tobacco users, and give them access to
counseling services to effect behavior change.
 'mCessation' initiative is being supported by Ministry to support tobacco users towards successful
quitting through text-messaging via mobile phones (011 22901701).
 Regulation of the use of Cigarettes and other tobacco products in films and TV programmes.
 Acceded to the Protocol to Eliminate Illicit Trade in Tobacco Products under the Article 15 of WHO
FCTC.
 Issued an Advisory to ban Electronic Nicotine Delivery System (ENDS) including e-Cigarettes, Heat-
Not-Burn devices, Vape, e-Sheesha, e-Nicotine Flavoured Hookah, and the like devices that enable
nicotine delivery except for the purpose & in the manner and to the extent, as may be approved under
the Drugs and Cosmetics Act, 1940 and Rules made thereunder.
 Established three National Tobacco Testing Laboratories
 Enacted The Prohibition of Electronic Cigarettes (Production, Manufacture, Import, Export,
Transport, Sale, Distribution, Storage and Advertisement) Act, 2019

Source: National Health Mission

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

National Programme for Prevention and Control of Deafness

(NPPCD)

Introduction

Hearing loss is the most common sensory deficit in humans today. World over, it is the second leading cause
for ‘Years lived with Disability (YLD)’ the first being depression. There are large number of hearing
impaired young people in India which amounts to a severe loss of productivity, both physical and economic.

An even larger percentage of our population suffers from milder degrees of hearing loss and unilateral (one
sided) hearing loss against the above background, The Ministry of Health and Family Welfare, Govt. of India
launched the pilot phase of National Program for Prevention and Control of Deafness (from 2006 to 2008)
in 10 States and 1 Union Territory in an effort to tackle the high incidence of deafness in the country, in view
of the preventable nature of this disability.

Programme Execution & Expansion

 The Programme was a 100% Centrally Sponsored Scheme during 11th Five Year Plan. However, in
as per the 12th Five Year Plan, the Centre and the States will have to pool in resources financial
norms of NRHM mutas mutandis.
 The Programme was initiated in year 2007 on pilot mode in 25 districts of 11 State/UTs. The
Programme has been expanded to 192 districts of 20 States/UTs. In the 12th Plan, it is proposed to
expand the Programme to additional 200 districts in a phased manner probably covering all the States
and Union territories by March, 2017.

Objectives of the Programme

1. To prevent the avoidable hearing loss on account of disease or injury.

2. Early identification, diagnosis and treatment of ear problems responsible for hearing loss and deafness
3. To medically rehabilitate persons of all age groups, suffering with deafness.
4. To strengthen the existing inter-sectoral linkages for continuity of the rehabilitation Program, for
persons with deafness
5. To develop institutional capacity for ear care services by providing support for equipment and
material and training personnel.

Long term objective: To prevent and control major causes of hearing impairment and deafness, so as
to reduce the total disease burden by 25% of the existing burden by the end of 12th Five Year Plan.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Components of the Programme

1. Manpower training and development– For prevention, early identification and management of
hearing impaired and deafness cases, training would be provided from medical college level
specialists (ENT and Audiology) to grass root level workers.
2. Capacity building – For the district hospital, community health centers and primary health center in
respect of ENT/ Audiology infrastructure.
3. Service provision – Early detection and management of hearing and speech impaired cases and
rehabilitation, at different levels of health care delivery system.
4. Awareness generation through IEC/BCC activities – For early identification of hearing impaired,
especially children so that timely management of such cases is possible and to remove the stigma
attached to deafness.

Strategies

 To strengthen the service delivery for ear care

 To develop human resource for ear care services.
 To promote public awareness through appropriate and effective IEC strategies with special
emphasis on prevention of deafness.
 To develop institutional capacity of the district hospitals, community health centers and primary
health centers selected under the Programme.

Expected Benefits of the Programme

The Programme is expected to generate the following benefits:-

1. Availability of various services like prevention, early identification, treatment, referral, rehabilitation
etc. for hearing impairment and deafness as the primary health center / community health centers /
district hospitals largely cater to their need.
2. Decrease in the magnitude of hearing impaired persons.
3. Decrease in the severity/ extent of ear morbidity or hearing impairment.
4. Improved service network/referral system for the persons with ear morbidity/hearing impairment.
5. Awareness creation among the health workers/grass root level workers through the primary
health centre medical officers and district health officers, which will percolate to the lower level
health workers functioning within the community.
6. Capacity building at the district hospitals to ensure better care.

Source: National Health Portal

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

National Programme for Control of Blindness and Visual

Impairment (NPCBVI)
National Programme for Control of Blindness was launched in the year 1976 with the goal to reduce the
prevalence of blindness from 1.4% to 0.3%. As per Survey in 2001-02, prevalence of blindness is estimated
to be 1.1%. Rapid Survey on Avoidable Blindness conducted under NPCB during 2006-07 showed reduction
in the prevalence of blindness from 1.1% (2001-02) to 1% (2006-07). Various activities/initiatives
undertaken during the Five Year Plans under NPCB were targeted towards achieving the goal of reducing
the prevalence of blindness to 0.3% by the year 2020. The National Blindness Survey (2015-19) has shown
reduction in the prevalence of blindness from 1% (2007) to 0.36% (2019).

In the beginning it was a 100% Centrally Sponsored scheme. From 12th FYP it is 60:40 in all States/UTs
and 90:10 in hilly states and all NE States. Nomenclature of the programme was also changed from National
Programme for Control of Blindness to National Programme for Control of Blindness & Visual Impairment
(NPCBVI) in 2017.

Main causes of blindness

1. Cataract (66.2 %)
2. Corneal opacity (7.4%)
3. Cataract surgical complications (7.2%)
4. Posterior segment disorders excluding DR and ARMD (5.9%) and
5. Glaucoma (5.5%).

Goal

 Under the National Health Policy (NHP), the target is to reduce the prevalence of blindness to 0.25%
by 2025.
Major activities under the Programme

1. Primary eye care services

 Preventive and promotive eye care services: under comprehensive primary health care Health and
Wellness Centres (HWC) are providing preventive and promotive eye care services.
 IEC activities for promotion and preventive eye care and eye donation.

2. Secondary eye care services

 Cataract surgeries: Reduction in the backlog of cataract by performing cataract surgeries in

Governmental, Non-Governmental Eye Hospitals and private practitioners.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

 Screening for Refractive errors and Distribution of free Spectacles: Screening of Children for
identification and treatment refractive errors and distribution of spectacles to those who are suffering
from refractive errors through school eye screening programme.
 Distribution of free spectacles to old persons suffering from presbyopia to enable them for
undertaking near work as a new initiative under the programme.
 Management of Visual impairment: The programme is now geared to take care of all categories of
visual impairment including low vision cases. Apart from cataract, now the focus of the programme
is on treatment and management of other eye diseases like glaucoma, diabetic retinopathy, vitreo
retinal diseases, Corneal blindness and childhood blindness.
 Use of Mobile Ophthalmic Units and Tele- ophthalmology network to expand coverage and reach of
the programme in disadvantaged and hard to reach areas.
 Eye banking Services: Strengthening of eye banking services and collection of donated eyes.

3. Tertiary Eye care Services:

Under the tertiary care component of NPCB&VI

 Grant in Aid for strengthening of Regional Institute of Ophthalmology and Medical Colleges to
provide super-speciality eye care services
 Hands on Training of Govt. Eye Surgeons for upgradation of their clinical and surgical skills.
 IEC campaigns
 Research and surveys

4. Infrastructure Development and Capacity building

 Grant in Aid for strengthening of eye care units at primary and secondary level.
 Training of Paramedical Ophthalmic Assistant and Eye donation counsellors.

5. Newer Initiatives/ Focus Areas under the program

 Revision of NPCBVI guidelines to provide Comprehensive eye health care through AB- Health and
Wellness Centers
 “Standards of eye banking in India 2020” have been launched for improvement in eye donation,
collection, processing, and maintenance of quality standards, equitable distribution of scarce corneal
tissue, strengthening of institutional capacity for corneal transplantation, community awareness and
training of health personnel.
 Development of a network of eye banks and eye donation centres and linked with medical colleges
and RIOs to promote collection and timely utilization of donated eyes in a transparent manner
 Focus on other causes of Visual impairment, besides Cataract, treatment/management of other eye
diseases like Diabetic retinopathy (DR), Retinopathy of prematurity (ROP). Corneal Blindness and
glaucoma has been increased. DR screening and glaucoma clinics have been made integral part at
district and sub-district hospitals.
 In order to achieve elimination of trachoma by the year 2020 as per WHO global action plan,
surveillance, case detection and treatment of Trachoma trichiasis (TT) is being executed which will
be followed by TT only survey in all previously trachoma endemic districts.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

 Issuing of COVID 19 guidelines to all stakeholders for safe ophthalmology practices to minimize and
avoid the spread of COVID 19 in eye care facilities.Setting up of super-specialty clinics for all major
eye diseases including diabetic retinopathy, glaucoma, retinopathy of prematurity etc. in state level
hospitals and medical colleges all over the country.
 Linkage of tele-ophthalmology centres at PHC/ Vision centres with super-specialty eye hospitals to
ensure delivery of best possible diagnosis and treatment for eye diseases, especially in hilly terrains
and difficult areas.

Source: National Programme for Control of Blindness & Visual Impairment (NPCBVI)

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

National Sub-Mission to provide safe drinking water

The National Sub-Mission to provide safe drinking water is to be completed on mission mode before March
2020. The urgency of implementation of the mission is due to:

1. Criticality and urgency of the matter

2. Requirement of significant increase in operational efficiency
3. Requirement of additional funds, robust monitoring and surveillance of those
4. Requirement of special technology, manpower and strategy to achieve the goal

Goal

 To cover of all the arsenic & fluoride affected habitations with safe & perennial surface water based
piped Water supply schemes as the permanent & sustainable solution.

Sub-mission phases

The sub-mission will have three phases namely:

1. Diagnostic phase: To correctly determine the action plan based on most recent and authentic data
2. Implementation phase: Roll-out of area specific schemes as per guidelines
3. Sustain phase: To ensure that schemes are running successfully with adequate monitoring and
surveillance

Standard drinking water quality

Bureau of Indian Standards has set specifications in its IS-10500-2012 standards for drinking water.
However, this standard is only voluntary in nature and not legally supported for enforcement. This standard
has two limits:

 Desirable limits
 Maximum permissible or cause for rejection limits

If any parameter exceeds the cause for rejection limit, that water is considered as contaminated. Broadly
speaking, water is defined as contaminated if it is biologically contaminated (presence of microscopic
organisms such as algae, Zoo-plankton, flagillates, E-coli etc) or chemical contamination exceeds
permissible limits (e.g. excess fluoride D1.5mg/l), salinity i.e.,

 Total Dissolved Solids (TDS) (>2,000mg/l),

 Dissolved iron D0.3mg/l),
 Arsenic [>0.01mg/l),
 Nitrates (>45mg/l) etc.).

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

In rural areas, more than 85% of drinking water sources are ground water based and in the short term,
chemical constituents in groundwater do not change much, therefore testing once in a year for chemical
contaminants is adequate. Testing for bacteriological contamination is recommended 4 times a year, once in
every season. However, every year it should be carried out at least twice i.e. during pre-monsoon and post-
monsoon seasons.

Steps to roll out the project

1. The action plan will contain unambiguous timelines, proposed schemes and corresponding village
coverage, scheme wise funding requirements, potential sources of funding and tasks to be executed
over the course of next four years to ensure the state is Arsenic/Fluoride free.
2. Identification of habitations: Identify the habitations, affected by water contaminated by Arsenic and
Fluoride. The habitations will be geo-tagged for all future uses. The geo-tagged location will be
accessible on the 'Mobile Application', Integrated Management Information System (IMIS) for real
time monitoring.

Priorities may be as below

o Habitations not covered by any other existing long term programme of central or state
government.
o Habitations having higher degree of contamination according to IMIS data.
3. Identification of Source: State has to identify, geo-tag and select the source on the basis of following
parameters
o Source/Aquifer must be contaminant free
o Source must be perennial in nature
o Source must be the most economically feasible (least lifecycle cost) option which has the
ability to provide clean drinking water in perpetuity
4. Quality testing of source: States have to follow the Uniform Drinking Water Quality Monitoring
Protocol published and widely distributed by the Ministry of Drinking Water and Sanitation.
5. Preparation of Schemes: On the basis of identification of habitation and source, State has to prepare
a proposal.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Mandatory Requirements

1. Per capita cost of supply of safe and adequate drinking water to the end user.
2. Operation and Maintenance cost.
3. Cost of implementation for all en-route non-arsenic/non-fluoride affected habitations, towns,
industries, and cities should be borne fully by the concerned State Government, Also clear break up
of capital costs for rural, en-route non-arsenic/non-fluoride affected habitations, urban town/city and
industries must be provided.
4. Detailed phase wise and time bound plan.
5. The State should firmly commit in providing, State matching share corresponding to release of
Central Share for Arsenic and Fluoride affected habitations and entire share corresponding to en-
route non-arsenic/ non-fluoride affected habitations.
6. Ground Level Service Reservoir (GLSR) / Over Head Tanks (OHT / ESR) should not be far away
from the source to minimize raising mains.
7. Ground Level Service Reservoir (GLSR) / Over Head Tanks (OHT / ESR) should be located so as to
give adequate distribution by gravity to cover maximum number of habitations.
8. The schemes should have recycling/reuse of filter bed washed water in Water Treatment Plants
(WTP).
9. The schemes should have sufficient capacity of chlorination plants including online booster
chlorination plants, so that end user should get purified /safe water,
10. All the mega water supply schemes shall have dedicated Three Phase electrical power Supply.
11. All Water Treatment Plants (WTP's) shall necessarily have a basic level water quality testing
laboratory with adequate manpower.
12. It is up to the State Government to decide the service level of water supply delivery, however in no
case the service level shall not be less than 40 liter per capita per day (LPCD) based on current
population,
13. All mega schemes shall be commissioned within a span of 24 months from the date of award of work.
14. The schemes should have the provision for bulk water meter before the entry point of Gram Panchayat
/ Habitation.

Advisory

1. It is advised to use renewable energy like Solar power / solar panels/solar light wherever necessary
and required to minimize the O&M cost and to the save electricity,
2. For all mega schemes utility of Supervisory Control and Data Acquisition (SCADA) system for real
time monitoring may be exploded.
3. It is advised to have sufficient number of flow meters in the scheme.
4. It is advisable that, the schemes should be designed so that, it makes minimum energy consumption.
5. It is advised to have necessary provision for extension, in future.
6. It is advised to have a suitable water tariff plan, if not existing already

Source: Ministry of Drinking Water and Sanitation

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

National Programme on Climate Change & Human Health

The Ministry of Health & Family Welfare launched the National Program for Climate Change and Human
Health (NPCCHH) in 2019.

Objectives

The NPCCHH objectives with some initially identified key actions are:

 To create awareness among general population (vulnerable community), health-care providers and Policy
makers regarding impacts of climate change on human health.
 To strengthen capacity of healthcare system to reduce illnesses/ diseases due to variability in climate
 To strengthen health preparedness and response by performing situational analysis at national/ state/
district/ below district levels.
 To develop partnerships and create synchrony/ synergy with other missions and ensure that health is
adequately represented in the climate change agenda in the country
 To strengthen research capacity to fill the evidence gap on climate change impact on human health

Key activities

 Development of IEC material on health impacts of Climate variability & change

 Advocacy on health impacts of Climate variability & change
 Strengthening of health care system in context of climate change
 Capacity building for vulnerability assessment at various levels and liaison with centre
 Develop/ strengthen the monitoring and surveillance systems for climate sensitive diseases
 Develop mechanisms for EWS/ alerts and responses at state, district and below district level
 Develop joint action plan with other deptt./ organizations In view of their capabilities and
complementarities
 Integrate, adopt and implement environment friendly measures suggested in other missions on climate
change
 Strengthening of healthcare services based on researches on climate variables and impact on human
health

Expected Output

 Awareness & Behaviour modification of general population for impact, illnesses, prevention and adaptive
measures for climate sensitive illnesses.
 Increase in trained healthcare personnel and equipped institutes/ organization towards achievement of
climate resilient healthcare services and infrastructure at district level in each state.
 Integrated monitoring system for collection and analysis of health related data with meteorological
parameters, environmental, socio-economic and occupational factors
 Regulation on key environmental determinants of health: air quality, water quality, food, waste
management, agriculture, transport.
 Evidence–based support to policy makers, programme planners and related stakeholders

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

National Programme for the Health Care for the Elderly

The National Programme for the Health Care for the Elderly (NPHCE) is an articulation of the International
and national commitments of the Government as envisaged under the UN Convention on the Rights of
Persons with Disabilities (UNCRPD), National Policy on Older Persons (NPOP) adopted by the Government
of India in 1999 & Section 20 of “The Maintenance and Welfare of Parents and Senior Citizens Act, 2007”
dealing with provisions for medical care of Senior Citizen.

Vision

 To provide accessible, affordable, and high-quality long-term, comprehensive and dedicated care
services to an Ageing population;
 Creating a new “architecture” for Ageing;
 To build a framework to create an enabling environment for “a Society for all Ages”;
 To promote the concept of Active and Healthy Ageing.

Specific Objectives

 To provide an easy access to promotional, preventive, curative and rehabilitative services to the
elderly through community based primary health care approach
 To identify health problems in the elderly and provide appropriate health interventions in the
community with a strong referral backup support.
 To build capacity of the medical and paramedical professionals as well as the care-takers within the
family for providing health care to the elderly.
 To provide referral services to the elderly patients through district hospitals, regional medical
institutions
 Convergence with National Rural Health Mission, AYUSH and other line departments like Ministry
of Social Justice and Empowerment.

Core Strategies

 Community based primary health care approach including domiciliary visits by trained health care
workers.
 Dedicated services at PHC/CHC level including provision of machinery, equipment, training,
additional human resources (CHC), IEC, etc
 Dedicated facilities at District Hospital with 10 bedded wards, additional human resources,
machinery & equipment, consumables & drugs, training and IEC
 Strengthening of 8 Regional Medical Institutes to provide dedicated tertiary level medical facilities
for the Elderly, introducing PG courses in Geriatric Medicine, and in-service training of health
personnel at all levels

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

 Information, Education & Communication (IEC) using mass media, folk media and other
communication channels to reach out to the target community
 Continuous monitoring and independent evaluation of the Programme and research in Geriatrics and
implementation of NPHCE

Supplementary Strategies

 Promotion of public private partnerships in Geriatric Health Care.

 Mainstreaming AYUSH – revitalizing local health traditions, and convergence with programmes of
Ministry of Social Justice and Empowerment in the field of geriatrics.
 Reorienting medical education to support geriatric issues.

Expected Outcomes

 Regional Geriatric Centres (RGC) in 8 Regional Medical Institutions by setting up Regional Geriatric
Centres with a dedicated Geriatric OPD and 30-bedded Geriatric ward for management of specific
diseases of the elderly, training of health personnel in geriatric health care and conducting research;
 Post-graduates in Geriatric Medicine (16) from the 8 regional medical institutions;
 Video Conferencing Units in the 8 Regional Medical Institutions to be utilized for capacity building
and mentoring;
 District Geriatric Units with dedicated Geriatric OPD and 10-bedded Geriatric ward in 80-100
District Hospitals;
 Geriatric Clinics/Rehabilitation units set up for domiciliary visits in Community/Primary Health
Centres in the selected districts;
 Sub-centres provided with equipment for community outreach services;
 Training of Human Resources in the Public Health Care System in Geriatric Care.

Source: Ministry of Health & Family Welfare

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

National Rabies Control Programme

Background

Rabies is responsible for extensive morbidity and mortality in India. The disease is endemic throughout the
country. With the exception of Andaman & Nicobar and Lakshadweep Islands, human cases of rabies are reported
from all over the country. The cases occur throughout the year. About 96% of the mortality and morbidity is
associated with dog bites. Cats, wolf, jackal, mongoose and monkeys are other important reservoirs of rabies in
India. Bat rabies has not been conclusively reported from the country.
To address the issue of rabies in the country, National Rabies Control Programme was approved during 12th FYP
by Standing Finance Committee meeting held on 03.10.2013 as Central Sector Scheme to be implemented under
the Umbrella of National Health Mission.

Objectives

 Training of Health Care professionals on appropriate Animal bite management and Rabies Post Exposure
Prophylaxis.
 Advocacy for states to adopt and implement Interdermal route of Post exposure prophylaxis for Animal
bite Victims and Pre exposure prophylaxis for high risk categories.
 Strengthen Human Rabies Surveillance System.
 Strengthening of Regional Laboratories under NRCP for Rabies Diagnosis.
 Creating awareness in the community through Advocacy & Communication and Social Mobilization.

Programme components

The Programme had two components – Human and Animal Components.

 Human Component for roll out in the all States and UTs through nodal agency National Centre for
Disease Control (NCDC), Ministry of Health & Family Welfare, Government of India
 Animal Health Component for pilot testing in Haryana and Chennai through nodal agency Animal
Welfare Board of India (AWBI) under the aegis of MoEF&CC, GOI.

Animal Health Component by AWBI has been ended with effect from 31.3.2017. The Human Health Component
has been rolled out in 26 States and UTs.
The Strategies of the National Rabies Control Program are as follows:

 provision of rabies vaccine & rabies immunoglobulin through national free drug initiatives
 training on appropriate animal bite management, prevention and control of rabies, surveillance and
intersectoral coordination
 strengthening surveillance of animal bites and rabies deaths reporting
 creating awareness about rabies prevention

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

National Action Plan For Dog Mediated Rabies Elimination

Ministry of Health & Family Welfare and Ministry of Fisheries Animal Husbandry & Dairying,
Government of India jointly launched ‘National Action Plan For Dog Mediated Rabies Elimination
(NAPRE) from India by 2030’. The stray dog population control and management of the stray dogs
is the mandate of the local bodies. The Central Government has framed the Animal Birth Control
(Dogs) Rules, 2023 which is to be implemented by the local authority to control the population of
stray dogs. The main focus of the rules is on anti-rabies vaccination of stray dogs and neutering of
stray dogs as means of population stabilization.

Source : NCDC

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Ayushman Bharat – Health and Wellness Centres

About Health and Wellness Centres

The Ayushman Bharat - Health and Wellness Centres (AB-HWCs) were launched under the Ayushman
Bharat Programme in a bid to move away from selective health care to a more comprehensive range of
services spanning preventive, promotive, curative, rehabilitative and palliative care for all ages. The National
Health Policy of 2017 envisioned these centres as the foundation of India’s health system.

Expanded range of services

These centres deliver a range of comprehensive health care services like maternal and child health, services
to address communicable and non-communicable diseases and services for elderly and palliative care. AB-
HWCs provide free essential medicines and diagnostic services, teleconsultation, and health promotion
including wellness activities like Yoga.

The expansion of services has been planned in incremental manner. As a first step, Screening, Prevention,
Control and Management of Non-communicable Diseases and Chronic Communicable diseases like
Tuberculosis and Leprosy has been introduced at HWCs.

 Care in pregnancy and childbirth.

 Neonatal and infant health care services
 Childhood and adolescent health care services.
 Family planning, Contraceptive services and Other Reproductive Health Care services
 Management of Communicable diseases: National Health Programs
 Management of Common Communicable Diseases and General Out-patient care for acute simple
illnesses and minor ailments
 Screening, Prevention, Control and Management of Non-Communicable diseases and chronic
communicable disease like TB and Leprosy
 Basic Oral health care
 Care for Common Ophthalmic and ENT problems
 Elderly and Palliative health care services
 Emergency Medical Services
 Screening and Basic management of Mental health ailment

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Key Components

 The delivery of CPHC through HWCs involve is complex task as it requires a paradigm shift at all
levels of health systems. The operationalization of HWCs requires several inputs.

Target

 1,50,000 Sub Health Centres(SHC), Primary Health Centres (PHC) and Urban Primary Health
Centres (UPHC) to be transformed as Health Wellness Centres by 2022.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

National Programme for Control and Treatment of Occupational

Diseases
Major Occupational Illness

National Institute of Occupational Safety & Health (NIOSH) has developed a priority list of 10
leading work-related illnesses and injuries. Three criteria were used to develop the list: a) the
frequency of occurrence of the illness or injury, b) its severity in individual cases, and c) its potential
for prevention. Occupational lung disease is first on the list. Silicosis, asbestosis and byssinosis are
still prevalent in many parts of the world. The prevalence of Occupational Asthma varies from 10%
to nearly all of the workers in certain high-risk occupations. NISOH considers occupational cancer
to be the second leading work-related disease, followed by cardio-vascular diseases; disorder of
reproduction, neurotoxicity, noise induced hearing loss, dermatological conditions, and psychological
disorders.

Categories of major occupational diseases

1. Occupational injuries
2. Occupational lung diseases
3. Occupational cancers
4. Occupational dermatoses
5. Occupational Infections
6. Occupation toxicology
7. Occupational mental disorders
8. Others

Grouping of Occupational disorders according to the etiological factors

1. Occupational injuries: Ergonomic related

2. Chemical occupational factors: Dust, Gases, Acid, Alkali, Metals etc.
3. Physical occupational factors: Noise, Heat, Radiation
4. Biological occupational factors
5. Behavioural occupational factors
6. Social occupational factors

In India, prevalence of silicosis was 6.2 - 34 % in mica miners, 4.1 % in manganese miners, 30.4% in lead
and zinc miners, 9.3% in deep and surface coal miners, 27.2% in iron foundry workers, and 54.6% in slate-
pencil workers. Prevalence of Asbestosis was extended from 3% in Asbestos miners to 21% in mill workers.
In textile workers the Bysinosis was as common as 28-47%. Nutritional status in terms of body mass indices
(BMI) of the workers is also significantly low.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Programme

Occupational health was one of the components of the National Health Policy 1983 and National
Health Policy 2002. Ministry of Health & Family Welfare, Govt. of India has launched a scheme
entitled "National Programme for Control & Treatment of Occupational Diseases" in 1998-99. The
National Institute of Occupational Health, Ahmedabad (ICMR) is the nodal agency for the same.

Global Strategy for Occupational Health

The global strategy for achieving occupational health for all (WHO-SEARO 1999) includes the following
ten major areas for action:

1. Strengthening of International and national policies for health at work and development of policy
tools.
2. Developing healthy work environments.
3. Developing healthy work practices and promoting health at work.
4. Strengthening occupational health services.
5. Establishing support services for occupational health.
6. Developing occupational health standards based on scientific risk assessment.
7. Developing human resources for occupational health.
8. Establishing registration and data system including development of information services for experts,
effective transmission of data, and raising public awareness through strengthened public information
system.
9. Strengthening research.
10. Developing collaboration in occupational health services and organisations.

Source: National Institute for Health and Family Welfare

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

National Program for Palliative Care

Sponsored by: Centrally sponsored scheme.
Funding pattern: 40% share from the states (10% in case of NE and Hill states)

Brief Description:
Palliative care is also known as supportive care which is required in the terminal cases of Cancer, AIDS
etc. and can be provided relatively simply and inexpensively. Effective palliative care requires a broad
multidisciplinary approach that includes the family and makes use of available community resources. It
can be provided in tertiary care facilities, in community health centres and even in patients’ homes. It
improves the quality of life of patients and families who face life-threatening illness, by providing pain
and symptom relief, spiritual and psychosocial support from diagnosis to the end of life and bereavement.

The Ministry of Health & Family Welfare, Government of India constituted an expert group on Palliative
care which submitted its report ‘Proposal of Strategies for Palliative Care in India’ in November, 2012.
On the basis of the Report, an EPC note for 12th Five Year Plan was formulated. No separate budget is
allocated for the implementation of National Palliative Care Program. However, the Palliative Care is part
of the ‘Mission Flexipool’ under National Health Mission (NHM).

A model PIP, a framework of operational and financial guidelines, for the states has been designed. On
the basis of a model PIP, the states/UTs may prepare their proposals related with Palliative Care and
incorporate them in their respective PIPs to seek financial support under NHM.

Beneficiaries: The terminal cases of Cancer, AIDS etc.

How to avail:
 On the basis of a model PIP (Guidelines), the states/UTs may prepare their proposals related with
Palliative Care and incorporate them in their respective PIPs to seek financial support under NHM.

Details of scheme:

Goal: Availability and accessibility of rational, quality pain relief and palliative care to the needy, as an
integral part of Health Care at all levels, in alignment with the community requirements.

Objectives:
 Improve the capacity to provide palliative care service delivery within government health programs such
as the National Program for Prevention and Control of Cancer, Cardiovascular Disease, Diabetes, and
Stroke; National Program for Health Care of the Elderly; the National AIDS Control Program; and the
National Rural Health Mission.
 Refine the legal and regulatory systems and support implementation to ensure access and availability of
Opioids for medical and scientific use while maintaining measure for preventing diversion and misuse
 Encourage attitudinal shifts amongst healthcare professionals by strengthening and incorporating
principles of long term care and palliative care into the educational curricula (of medical, nursing,
pharmacy and social work courses).
 Promote behaviour change in the community through increasing public awareness and improved skills
and knowledge regarding pain relief and palliative care leading to community owned initiatives
supporting health care system.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

 Develop national standards for palliative care services and continuously evolve the design and
implementation of the National program to ensure progress towards the vision of the program.
 (Note: NHM flexi-pool has mandate for the activities for district level and below and hence the PIPs
should be for seeking financial assistance for district palliative care unit and activities as well as
state palliative care cell for implementing the program)

Implementation mechanism

It is envisaged that activities would be initiated through National Program for prevention and control of
cancer, CVD, Diabetes & Stroke. The integration of national programs are being attempted under the
common umbrella for synergistic activities. Thus, strategies proposed will provide essential funding to build
capacity within the key health programs for non-communicable disease, including cancer, HIV/AIDS, and
efforts targeting elderly populations. Working across ministries of health and finance, the program will also
ensure that the national law and regulations allow for access to medical and scientific use of Opioids.

The regulatory aspects, as mentioned in the Program, for increasing Morphine availability would be
addressed by Department of Revenue in coordination with Central Drug Standards Control Organization.
Cooperation of international and national agencies in the field of palliative care would be taken for successful
implementation of the program.

The major strategies proposed are provision of funds for establishing state palliative care cell and palliative
care services at the district hospital.

Budget for District Hospital:

Non-Recurring:
 Infrastructure strengthening: (renovation of Palliative Care unit/OPD/beds/ miscellaneous
equipments etc.): Rs. 15 lakhs.
Recurring:
 Manpower:
 One Physician @ Rs 60,000 per month x 12 months
 Four nurses @ Rs. 30,000 per month x 12 months
 One Multi task worker @ Rs. 15,000 per month x 12 months
 Training: Rs. 2 lakh per training program consisting of 50 participants.
 Miscellaneous (Including travel/POL/stationary/communication/drugs etc.): Rs. 8 lakh
Total for a Palliative Care Unit at District: 48.4 Lakhs
State Palliative care cell:
 One Co-ordinator: Rs. 60,000 per month x 12 months
 One Data Entry Operator: Rs. 15,000 per month x 12 months
 Miscellaneous (Including workshop/stationary/POL/communication etc.): Rs. 50,000 to Rs. 1,00,000
per year
Total for Palliative Care Cell at state: Rs. 9.5 – Rs. 10.0 lakhs for a year.

 Note: The GOI:State share would be 60:40 and in NE & Hill states it would be 90:10. State Govt.
may submit the PIPs for consideration under ‘Mission Flexipool’ of National Health Mission.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

National Iodine Deficiency Disorders Control Programme

National Iodine Deficiency Disorders Control Programme (NIDDCP)

Introduction:

Iodine is an essential micronutrient required daily at 100-150 micrograms for normal human growth
and development. Deficiency of iodine can cause physical and mental retardation, cretinism,
abortions, stillbirth, deaf mutism, squint & various types of goiter. As per the surveys conducted by
the Directorate General of Health Services, Indian Council of Medical Research, Health Institutions
and the State Health Directorates, it has been found that out of 414 districts surveyed in all the 29
States and 7 UTs, 337 districts are endemic i.e where the prevalence of Iodine Deficiency Disorders
(IDDs) is more than 5% (Annexure-I).

Control Programme:
Realizing the magnitude of the problem, the Government of India launched a 100 per cent centrally
assisted National Goitre Control Programme (NGCP) in 1962. In August, 1992 the National Goitre
Control Programme (NGCP) was renamed as National Iodine Deficiency Disorders Control
Programme (NIDDCP) with a view of wide spectrum of Iodine Deficiency Disorders like mental
and physical retardation, deaf mutisim, cretinism, still births, abortions etc.. The programme is
being implemented in all the States/UTs for entire population.

Goal :

1. To bring the prevalence of IDD to below 5% in the country

2. To ensure 100% consumption of adequately iodated salt (15ppm) at the household level.

Objectives:
1. Surveys to assess the magnitude of Iodine Deficiency Disorders in the districts.
2. Supply of iodated salt in place of common salt.
3. Resurveys to assess iodine deficiency disorders and the impact of iodated salt after every 5 years in
the districts.
4. Laboratory monitoring of iodated salt and urinary iodine excretion.
5. Health Education and Publicity.

Policy: On the recommendations of Central Council of Health in 1984, the Government took a policy
decision to Iodate the entire edible salt in the country by 1992. The programme started in April, 1986 in a
phased manner. To date, the annual production of iodated salt in our country is 65 lakh metric tones per
annum.

Nodal Ministry: Ministry of Health & Family Welfare is the nodal Ministry for implementation of National
Iodine Deficiency Disorders Control Programme (NIDDCP).

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Financial assistance to all States /UTs for the following:

 Human resource of State IDD Cell i.e Technical Officer, Statistical Asst. & LDC and State IDD
monitoring laboratory i.e. Lab Technician & Lab Assistant.
 Health education and publicity activities including global IDD Day activities.
 Conducting district IDD survey/resurvey to assess magnitude of IDD.
 Procurement of salt testing kits by State/UTs for IDD endemic districts for creating awareness at the
community level about consumption of iodized salt and monitoring of salt for presence of adequate
iodine at household level ( since 2013-14).
 Performance based incentive to ASHA @ Rs. 25/- per month for conducting 50 salt samples testing
by STK at household/community level (since 2013-14).
 Under NIDDCP financial assistance is also being provided to Salt Commissioner’s Office, Jaipur,
(M/o Industries) which is responsible for promoting production of iodated salt, monitoring,
distribution and quality control of Iodated salt at the production level through nine quality control
laboratories.

Achievements:
 Over the years the Total Goiter Rate (TGR) in the entire country is reduced significantly.
 Production of iodized salt in the country reached to 65.00 lakh MT which is adequate to meet the
requirement of population.
 The consumption of adequately iodated salt at household level has been increased from 51.1%
(as per NFHS III report 2005-06) to 71.1% (as per CES report, 2009).
 Regulation 2.3.12 of Food Safety and Standards (Prohibition and Restriction on Sales), Regulation,
2011 restricts the sale of common salt for direct human consumption unless the same is iodized.
 National Reference Laboratory for monitoring of IDD has been set up at NCDC, Delhi. Four Regional
laboratories one each at NIN, Hyderabad, AIIH&PH, Kolkata, AIIMS and NCDC, Delhi have been
set up to conduct training, monitoring, quality control of salt and urine testing.
 For effective implementation of NIDDCP 35 States/UTs have established IDD Control Cells in their
State Health Directorate. 35 States/UTs have set up State IDD monitoring laboratories in their
respective States/UTs.
 Extensive IEC activities have been carried out to create awareness about the regular consumption of
iodated salt in prevention and control of IDD through Doordarshan, All India Radio, Directorate of
Field Publicity, Song and Drama, Directorate of Advertising and Visual Publicity.

o States/UTs have been conducting laboratory monitoring of salt and urine to estimate iodine
content and urinary iodine excretion (UIE) and also quality of iodated salt at
household/community level. In the year 2015-16, a total of 51163 salt samples and 15320
urine samples were analysed /tested by States/UTs and the results have indicated that the
iodine content of salt samples up to the standard (iodine content > 15ppm) was in the range
of 52 % to 100 % and UIE (optimal) >100 µg/l was in the range of 49 % to 100 %. A total of
5048528 salt samples at community/household level were tested by Salt Testing Kit (STK)
and the consumption of adequately iodated salt was in the range of 56 % to 100 %.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

National Ayush Mission (NAM)

Introduction

Centrally Sponsored Scheme of National AYUSH Mission (NAM) is a flagship scheme of Ministry of
AYUSH approved and notified on 29.09.2014. The basic objective of NAM is to promote AYUSH medical
systems through cost effective AYUSH services, strengthening of educational systems, facilitate the
enforcement of quality control of Ayurveda, Siddha and Unani & Homoeopathy (ASU &H) drugs and
sustainable availability of ASU & H raw-materials.

It envisages flexibility of implementation of the programmes which will lead to substantial participation of
the State Governments/UT. The NAM contemplates establishment of a National Mission as well as
corresponding Missions in the State level. NAM is likely to improve significantly the Department’s outreach
in terms of planning, supervision and monitoring of the schemes.

Union Cabinet has approved continuation of Centrally Sponsored Scheme of National AYUSH Mission
(NAM) on 15.12.2017 from 01.04.2017 to 31.03.2020. Union Cabinet on 14.07.2021 approved the
continuation of National AYUSH Mission (NAM) with financial implication of Rs. 4607.30 crores (Rs.
3000.00 Crore as Central Share and Rs. 1607.30 crores as State Share) with effect from 01.04.2021 to
31.03.2026, excluding AYUSH Health and Wellness Centres (AHWCs) component.

Union Cabinet also approved operationalization of 12,500 AYUSH Health and Wellness Centres (AHWCs)
component under AYUSHMAN BHARAT for implementation through National AYUSH Mission with a
financial outlay of Rs. 3399.35 Crores for a period of 5 years upto 2023-24.

Vision

1. To provide cost effective and equitable AYUSH health care throughout the country by improving
access to the services.
2. To strengthen preventive and promotive aspects in primary health care.
3. To establish a holistic wellness model based on AYUSH principles and practices
4. To improve educational institutions capable of imparting quality AYUSH education

Objectives

1. To provide AYUSH health care services throughout the country by strengthening and improving
AYUSH health care services.
2. To establish a holistic wellness model through AYUSH Health and Wellness Centres focusing on
preventive and promotive health care based on AYUSH principles and practices, to reduce the disease
burden and out of pocket expenditure.
3. To provide informed choice to the needy public through co-location of AYUSH facilities at PHCs,
CHCs and DHs resulting in medical pluralism
4. To emphasize the role of AYUSH in Public Health as per NHP 2017.
5. To enhance and strengthen the infrastructure of AYUSH educational institutions.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Components of the Mission

Mandatory Components

 AYUSH Services
 Educational Institutions

Flexible Pool

1. Yoga Wellness Centres

2. Tele-medicine
3. Sports Medicine through AYUSH
4. Reimbursement of Testing charges
5. IEC activities
6. Training and capacity building for teaching staffs, Medical Officers and other paramedical staffs
working in the educational institution and AYUSH Hospitals/ Dispensaries.
7. To meet the mitigation and restorative activities of natural calamities including outbreak of
epidemics/pandemics.
8. Incentive to frontline workers of AYUSH:- Multiple AYUSH activities are being added and various
AYUSH public health programs can be implemented only by effective community outreach by
frontline health workers. Therefore, provision for need-based engagement of frontline workers of
AYUSH may be provided in public health programs. State may provide the incentive as per local
criteria.
9. In AYUSH Dispensaries, wherever posts have been created but lying vacant due to administrative
reasons, the States/UTs may propose 01 AYUSH Medical Officer & 01 Pharmacist for maximum
limit upto 2025-26 or till the posts are filled up whichever is earlier on a need basis.
10. Support for HMIS and DBT tracking system- As per the direction of Direct Benefit Transfer Mission,
it is required to monitor the benefits being provided to beneficiaries in the States/UTs.
11. Accreditation of AYUSH Healthcare facilities by accreditation agencies like National Accreditation
Board Hospitals and Healthcare providers (NABH) or similar accreditation standards.

Supporting Facilities under Mission

1. In order to strengthen the AYUSH infrastructure both attached Central and State levels, financial
assistance for setting up of the Programme Management Units (PMU’s) will be provided. The PMU
will consist of management and technical professionals both at Central and State level and will be
essentially on contract or through service provider.
2. The PMU staff will be engaged from the open market on contractual basis or outsourcing and the
expenditure on their salary will be met out of admissible administrative and managerial cost for the
mission period. This PMU will provide the technical support to the implementation of National
AYUSH Mission in the State through its pool of skilled professionals like MBA, CA, Accounts and
technical Specialist etc. All appointments would be contractual and Central Government’s liability
will be limited only to the extent of Central share admissible for administrative and management costs
on salary head for the mission period.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

3. In addition to the Manpower cost for PMU, the States/UTs can avail the financial assistance for such
administrative costs like office expenditure, travelling expenditure, contingency, Annual
Maintenance Cost (AMC) of infrastructure including equipment’s, computer, software for HMIS,
Training and Capacity Building for concerned personnel under each component, audit, monitoring &
evaluation, project preparation consultancy and additional manpower for AYUSH Hospitals and
Dispensaries. A total 4% of the net funds available for the State is earmarked for State/UTs
administrative costs under the Mission.

Resource Allocation Framework

1. Funding Pattern: The funding pattern shall be Centre: 90% and State: 10% for North Eastern States
and Himalayan States of Uttarakhand, Himachal Pradesh and Union Territory of Jammu & Kashmir
whereas for the rest of the States and UTs with legislature except Jammu & Kashmir this ratio shall
be Centre: 60% and State: 40%. UT without legislature 100% funds shall be borne by the Centre.
2. The Resource Pool to the States from the Government of India under the Mission shall be
determined on the basis of following:
o Population with 70% weightage and 2 as multiplying factor for EAG States, Island UTs and
Hilly States.
o Backwardness determined on the basis of proxy indicator of per capita income will have 15%
weightage and
o Performance to be determined on inverse proportion of percentage of UCs due and pending
as on 31st March of previous financial year will have 15% weightage.
3. Performance-based budgeting- In order to incentivize good performing States/UTs, performance-
based budgeting has been made. For this purpose, 20% of total allocation of Flexipool budget may
be earmarked and this fund will be allocated to good performing States/UTs in the same proportion
in which main budget of NAM is allocated.

Action Plan

Preparationof State Annual Action Plan (SAAP) bytheStates/UTs:

For preparation of State Annual Action Plan (SAAP) the following steps will be taken:

 Indication of tentative State/UT allocation by Ministry of Ayush, Government of India: 31st January.
 Budget Provision by the State Government along with matching State Share: 28th February.
 Preparation of State Annual Action Plan by Executive Committee of the State AYUSH Society: 28th
February.
 The receipt of State Annual Action Plan in the Ministry of Ayush, Government of India: 15th March.

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 The Spice Route India Movement-AFPI
Capsule summary of few Important National Health Programs
Compiled by Dr.Vishnu B S (National PG Coordinator)

Monitoring and Evaluation

 Ministry of Ayush has created a dedicated NAM web portal for submission of the State Annual Action
Plans (SAAPs), Physical and financial progress reports of approved activities, submission of UCs
etc. The States/UTs are required to ensure for implementing aforesaid activities through NAM portal.
Dedicated MIS based monitoring and evaluation can be achieved through this web portal at Centre/
State level. States/UTs shall also carry out evaluation of National AYUSH Mission at regular interval.
 States/UTs are required to report the physical and financial progress on monthly, quarterly and yearly
basis to the Ministry of Ayush indicating physical progress of the work, attendance of the patients/
beneficiaries in the AYUSH unit, receptivity & acceptability of the facilities of health care rendered
from the unit for specific diseases as well as financial position of expenditure along with relevant
documents.
 The concurrent evaluation of the AYUSH Mission shall be carried out to know the implementation
progress and bottlenecks and scope for improvement. Third party evaluation will also be carried out
by mid of Financial Year 2023-24.

Expected Outcome

 Better access to AYUSH healthcare services through increased number of healthcare facilities
offering AYUSH services and better availability of medicines and trained manpower.
 Improvement in AYUSH education through well-equipped enhanced number of AYUSH Educational
institutions.
 To support in reduction of communicable/non-communicable diseases through targeted public health
programs under AYUSH system of medicine.

Source: Ministry of AYUSH

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