Unit IV:

National health intervention program for mother and child, National family
welfare program, National tobacco control program, National Malaria
Prevention Program, National program for the health care for the elderly, Social
health program; role of WHO in Indian national program.

National health interevention programme for mother and child-: [MCH]

It is a platform to provide ante natal / post partum care for pregnant women,
promote institutional delivery,immunization, family planning & nutritional
counselling.
Launched 15th October 1997 mother
MCH program reduce maternal and child morbidity and mortality.

Development of mother and child Health programme-

• In 1921 - The health service for mother and children started.
• In 1931- A maternal and child welfare service was founded by Red Cross
society.
• In 1938 -Indian Research Fund Associated. association investigated the
causes of maternal morbidity and mortality.
• 1954- First five year plan continued and BCG vaccine is introduced by
CDRI Lucknow.
• 1960- School health committee was formed.
• 1971- Parliament passed the medical Termination of pregnancy (MTP)
bill
• 1975- ICDS (Integrated child Development services )was launched.
• 1979- on world Health Day, A healthy child A sure future was the theme
• 1984-Childrens health ,tommorrows health was the theme
• 1995 -The ICDS was renamed IMCD (Integrated mother and child
Development)
• 1996- Prenatal diagnostic teq. act
-pulse polio immunization was launched.
Family welfare programme made target time.
Objectives -
• To reduce preterm birth.
• To reduce fetal and infant death
• To increases the proportion of mothers who breast feed their babies.
• To identify the case of high risk' and provide them special treatment.
• To prevent communicable & non communicable disease.
• To educate the mother to improve the health of her and her children.
• To provide expert advice to the couple's to plan their families
• Tо give useful knowledge to mother during pregnancy.

Aim
• To reduce fetal & Infant death.
• To increase immunization coverage.
• To improve the quality of service.
• To train Health personnel.
• To ensure district wise monitoring

Components of Reproductive and child Health-

• Prevention or management of STD and AIDS
• Family planning services
• Growth monitoring and nutritional education
• Child survival and safe motherhood programme (CSSM)
• Providing in counselling, information and communication service of
health.

Mother and child Health service

Antenatal care service - women are provided with this service during
pregnancy.
Goal:Provide a healthy mother and healthy baby at the end of & pregnancy.
Intra -Natal services. -Provide to women during childbirth
Goal:provide good intra natal care
Post Natal services: provide to mother after delivery.
Aim- care to mother and care to Newborn.
Neo-Natal services -: upon the birth of a child, this service is given.
In the first 24 to 48 hours after birth, the risk of death is highest
So for child early neonatal treatment in the first week if life i's most important.

This service provide :

1.Immunization
2. Breast feeding
3.Growth and development
4. Personal hygiene

National family welfare programme:

• India is one of the first country that started a national family planning in
the year 1953
• Since 1996, the family planning program had to be implemented under
the target force approach
• This program, then renamed as community needs Assessment Approach
in the year 1997.

Aim and objectives -

• To bring down population growth·
• To reduce maternal and child mother mortality rate
• To control the unwanted birth.
• To prevent abortion
• To ensure adequate supply of contraceptives to all couples

Functioning and outcome

Following are the targets and implementation steps of the program-
Natural method
• calendar method / safe benod
• Lactational amenorrhea method
Mechanical method.
• Intra-uterine device (copper T)
• Diaphragm / Dutch cap.
• Condom
Hormonal method
• oral pills
• Injection
• surgical method
• vasectomy
• Tubectomy

Impacts of National family welfare programme

• Infant mort mortality Rate: Reduced from 63 to 34
• Birth rate (%) Reduced from 25.8 to 20.14
• Death Rate (%) Reduced from 8.5 to 6.4
• Immunization (%)reduced from 53.3 to 63.9
• Sex Ration: Reduced from 901 to 900

[NTCP]

• One of the major risk factors for a variety of chronic disease such as
cancer, Lung disease, and cardivascular disease, is the use of tobacco.
• India is the 2nd largest tobacco producer and consumer.
• In may 2003, the Govt of India passed the National Tobacco control Act
2003
Important provisions of the act-
• Smoking prohibition in public area.
• Prohibition of the sale to people below the age of 10 of cigarettes and
other tobacco products.
• Display the warnings on cigarette packs.
• prohibition of Advertising of cigarette and other product, direct and
Indirect.
• Inhibition of the role of tobacco products in educational institutes.
Objectives -
• To make awareness regarding the Hazardous effects of tobacco
consumption.
• To reduce the production and supply of Tobacco products.
• To help the people quit tobacco use.
• Establishment of laboratories for tobacco products

List of disease caused by Tobacco

• Heart attack
• Throat cancer
• oral cancer
• Lung cancer
• Asthma
• Fetal Death.
• Chronic obstructive Pulmonary disease (COPD)
• Tuberculosis
• Type II diabetes mellitus.

Functioning & outcome -:

NTCP is implemented by the a three-tier structure.

1.At central level - A National Tobacco control cell (NTCC)

2.At State level - A State tobacco control cell (STCC)
3.:At district level- District Tobacco control cell (DTCC)

National Malaria Prevention program[NMPP]

• Malaria is a mosquito born disease
• Caused by plasmodium parasite
• Transmitted by the bite of infective female Anopheles mosquito
There are 4 plasmodium species:
P. Vivex
P. falciparum.
P. malarial
P. Ovale.

National malaria control Program (NMCP)

• Malaria is one of the serious public health problem in India
• At the time of Independence malaria was contributing 75 million cases
with 0.8 million death every year prior to the Launching National malaria
control program in 1953.
AIM
Provide an effective antimalarial drug
Objectives -:
• To reduce morbidity and mortality.
• To reduce cases of malaria related anaemia.
• To control malaria in urban area by reducing vectors.
• Early diagnosis & Treatment

Strategies
• Early case detection
• Vector control(mosquito nets & BDT spray)
 • Environmental management
• Monitoring & Evaluation of the program.
• community participation.

Functioning & outcome

• Residual insecticide spray.
• Availability of antimalarial drugs for malaria patient
• NMCP was transformed into the National malaria Education programane
(NMEP) by the Govt of India in 1950
• NMEP decreases malaria deaths cases and malarial cases
• In 1977 introduced MPO ( modified plan operation)
• Goal:preventing deaths and reducing morbidity due to malaria.
• In 1997 NMEP changed to National Anti- malarial program (NAMP)

National program for Health care of elderly [NPHCE]

• India has second largest number of older persons in the world.

• Launched by MOHFW in 2010.
• Program funds 80%. by central govt & 20 %0 by state govt.
• Total fund is 288 Cr. Announced by EFC (Expenditure Finance committee)
Vision / Aim/ objectives
• To provide affordable ,accessible, high quality, long term, comprehensive
care to ageing population
• To Collaborate with
AYUSH
National Rural Health mission
• To create an a atmosphere suitable society for all ages
• Providing elderly patient with referral services through district hospital
and regional medical institutions.
• To provide the elderly with easy access to preventive, promotional and
rehabilitative programms
OUTCOMES
• Rehabilitation whits are set up for home visits in the CHC / PHC of
selected districts
• Dedicated geriatric OPD & 10 bedded geriatric wards are being build in
20-100 district hospitals
• Preventive and promotive care.
• To provide training to the family of elderly patients to look after them.
• To provide a dedicated geriatric clinic with regular OPD service to elderly
patients.

Human health affected the immunity of society, social structures, culture,

politics and even economic
- Union ministry of Health and family welfare to implement various programme
on national scale in the area of health, prevention and control of major
communicable disease to promote medicine systems.

Given below are some of the national health programmes in India.

1.National programme for prevention and control of cancer, Diabetes,
cardiovascular Disease and stroke -:(CNPCDCS)
• cardiovascular disease, chronic respiratory. disease and diabetes are the
four major NCD that largely contribute to morbidity and mortality.
• The probability of dying between 30-70 years of age from these NCDC is
26%
• Use of tobacco unhealthy diet, lack of physical activity and harmful use
of alcohol are the behavioural risk factors majorly responsible for causing
these disease.
• Obesity, increases blood pressure, blood glucose level and blood total
cholestral level are the major metabolic risk factors.
• Premature deaths due to heart disease, Stoke and diabetes are
 • increased over the years
• The Indian govt. is implementing NPCDCS in all the states.

• AIM:Health promotion, early diagnosis, and prevent and control NCDs

2.National programme for prevention and control of fluorosis (NPPCF)

• Fluorosis is caused by excess intake of fluoride through drinking water/

food products/ industrial polluants over a long period.
• It is considered a public health problem as it causes major health
disorders like dental fluorosis, skeletal fluorosis and non skeletal
fluorosis.
• The NPPCE was initiated in the 11 five year Plan (2008-09) to prevent
and control fluorosis in the affected states.

Objective
• prevent and control fluorosis disease in the country.
• comprehensive management of fluorosis in the selected areas.

3.National programme on prevention and management of Burn Injuries

(NPPMBI)

• "Burn" is a major public Health programme all over the world.

• In fact, more people die due to burn injuries than malaria and
tubeculosis.
• As per WHO Report 2014, over 10 lakh people are moderately or
severaly burned every year
• Information received from 3 major Govt Hospitals in delhi approx 1.4
lakh people die of burn injuries annually.
• Aim: provide timely and adequate treatment to reduce mortality rate
 • MOHFW started a pilot programme. in the year 2010, named as pilot
programme for prevention of Burn Injuries (PPPBI) in medical Colleges
and district hospitals
• Aim- provides timely and adequate treatment from burn Injuries.
• Achievements - Indian Govt. approved the establishment of burn units in
60 medical colleges and 17 district Hospitals.

Role of WHO In India National Program -:

The WHO plays an important role in supporting India's National health program
specifically, WHO has been working closely. with the Indian govt to help
address public health challenges in the country and improve the overall health.

→ Some of the key areas where шно has been supporting India's National
health program Include:
1.Disease Control
• WHO has been providing technical assistance to India's national health
program in the control of Infections diseases such as tuberculosis, and
HIV/ AIDS.
• The organization has also been supporting the implementation of
national immunization programs to prevent the spread to vaccine
preventable disease.
2. Maternal and child Health
• WHO provides technical support to the Indian National health in
improving maternal and child Health.
• It provide maternal care, safe delivery, postnatal care and child health
services.