1. Mission Indradhanush
The Ministry of Health &
Family Welfare has launched “Mission Indradhanush”, depicting seven colours of
the rainbow, to fully immunise more than 89 lakh children who are either
unvaccinated or partially vaccinated; those that have not been covered during
the rounds of routine immunisation for various reasons. They will be fully immunised
against seven life-threatening but vaccine preventable diseases which include
diphtheria, whooping cough, tetanus, polio, tuberculosis, measles and
hepatitis-B. In addition, vaccination against Japanese Encephalitis and
Haemophilus influenza type B will be provided in selected districts/states of
the country. Pregnant women will also be immunised against tetanus.
The first round of the first
phase started from 7 April 2015-World Health Day- in 201 high focus
districts in 28 states and carried for more than a week. This will be followed
by three rounds of more than a week in the months of April, May June and July
2015, starting from 7th of each month. The 201 high focus districts
account for nearly 50% of all unvaccinated or partially vaccinated children in
the country. Of these, 82 districts are in just four states of UP, Bihar,
Madhya Pradesh and Rajasthan and account for nearly 25% of all unvaccinated or
partially vaccinated children of the country.
Within the districts, the Mission
will focus on 4, 00,000 high risk settlements identified as pockets with low
coverage due to geographic, demographic, ethnic and other operational
challenges. These include nomads and migrant labour working on roads,
construction sites, riverbed mining areas, brick kilns, and those living in
remote and inaccessible geographical areas and urban slums, and the underserved
and hard to reach populations dwelling in forested and tribal areas.
In addition second phase was
launched on 7th October 2015 in 352 districts of the country. During
second phase, four special intensified immunization drives are being conducted
for 7 days starting from 7th October and are planned to be repeated on the same
date for four consecutive months i.e. 7th November, 7th December 2015 and 7th
January, 2016 covering all children under two years of age, and pregnant women
for tetanus toxoid vaccine.
Achievements
of Mission Indradhanush:-
- As per data available,
during the first phase of Mission Indradhanush, 9.4 lakh sessions were
held, during which 1.89 crore vaccines were administered to the children
and pregnant women. During these immunization rounds more than 75 lakh
children were vaccinated and about 20 lakh children were fully vaccinated.
Also, more than 20 lakh pregnant women were vaccinated with tetanus toxoid
vaccine during these four rounds. To combat the problem of diarrhea, zinc
tablets and ORS packets were freely distributed to all the children to
protect them against diarrhea. More than 16 lakh ORS packets and about 57
lakh zinc tablets were distributed to the children during these four
rounds of Mission Indradhanush.
- As per the data available on
26th Nov 2015, during Phase II of Mission Indradhanush, 4.49 lakh sessions
were held, during which about 70 lakh vaccines were administered to the
children and pregnant women. During these immunization rounds more than 27
lakh children were vaccinated and about 8 lakh children were fully
vaccinated. Also, more than 6 lakh pregnant women were vaccinated with
tetanus toxoid vaccine during these four rounds. To combat the problem of
diarrhoea, zinc tablets and ORS packets were freely distributed to all the
children to protect them against diarrhea. More than 5 lakh ORS packets
and about 17 lakh zinc tablets were distributed to the children during
these four rounds of Mission Indradhanush.
The preparation and learning during the implementation
of the four rounds have led to health systems strengthening in terms of drawing
up detailed micro plans; designing sturdy framework for stringent monitoring
and evaluation of the immunisation rounds in the states(more than 3600 state
and central level monitors have been deputed); training of nearly 9 lakh
frontline workers; identification and analysis of limiting factors in different
states leading to creating effective structures to mitigate them.
2. Maternal and Neonatal Tetanus
Eliminated (MNTE)
All the States/UTs of India have
been validated for Maternal and Neonatal Tetanus Elimination (MNTE) well before
the global target date of December, 2015. The Maternal and neonatal tetanus
validation in India started in 2003 in a phased manner. Andhra Pradesh was the first
state to validate MNT elimination. Nagaland was the last state in the country
where the validation exercise was completed on 17th April 2015.
A formal communication has been
received from Dr. Flavia Bustreo, Assistant Director-General, WHO
congratulating India on achieving the milestone of Maternal and Neonatal
Tetanus elimination in 2015.
Maternal and Neonatal Tetanus
Elimination (MNTE) is defined as less than one neonatal tetanus case per
thousand live births per year in every district. In 1989, global deaths from
Neonatal Tetanus (NT) were estimated at 7.87 lakh per year and India
contributed to approximately 2 lakh deaths.
India has achieved this
validation through the system strengthening including improvement of
institutional delivery, which is also a proxy indicator for clean delivery and
clean cord care practices and by strengthening Routine Immunization. Strategies
to improve clean delivery have been included in the innovative Janani Suraksha
Yojana (JSY) and Janani Shishu Suraksha Karayakaram (JSSK).
3. Decision to Introduce New Vaccines
In a bid to protect the children
from more vaccine preventable diseases, new vaccines are proposed to be
introduced as part of India’s Universal Immunisation Programme (UIP).
Introduction of these vaccines will be done in a phased manner over a period of
time, depending upon the field level assessments and preparedness. In addition,
it has been decided to introduce an adult vaccine against Japanese Encephalitis
(JE) in the high burden districts. The new vaccines are:
a. Inactivated Polio Vaccine (IPV)
India
is Polio free but to maintain this status, the Inactivated Polio Vaccine was
introduced on 30th October 2015. The vaccine has been initially
introduced in six states: Bihar, Uttar Pradesh, Madhya Pradesh, Gujarat, Assam
and Punjab. This will benefit 2.7 crore children every year.
b. Adult Japanese Encephalitis (JE)
vaccine
21
high burden districts have been identified in Assam, Uttar Pradesh and West
Bengal for adult JE vaccination in the age-group of 15-65 years. This will cut
down deaths and morbidity due to Japanese Encephalitis in adults as well.
c. Rotavirus vaccine
Rotavirus
is the leading cause of severe diarrhoea among infants and young children in
the world. Each year India loses approximately 2 lakh children to diarrhoea out
of which 1 lakh deaths are caused by Rotavirus. Rotavirus vaccine implemented
to full scale would save approximately 1 lakh lives every year. The vaccine is
planned to be introduced in first quarter of 2016 in four states initially i.e.
Odisha, Himachal Pradesh, Haryana and Andhra Pradesh.
d. Measles Rubella vaccine
·
Measles
Rubella vaccine eliminates measles and controls Rubella in the country. The
vaccine will help to reduce incidence of Congenital Rubella Syndrome. As on
date, approximately 25,000 cases of CRS are estimated each year and if the
child survives, this adds to the disabilities in the country.
·
MR
vaccination campaign will be carried out after appropriate planning and will
cover 45 crore children.
4. Child Health
Special New born Care Units (SNCUs)
In order to strengthen the care of sick, premature
and low birth weight newborn Special New born Care Units (SCNU) have been
established at District Hospitals and tertiary care hospitals. These are 12-20
bedded units, with 4 trained doctors and 10-12 nurses and support staff with
provision of 24x7 services to sick newborns. Presently 602 SNCUs are reported
operational and more than 7.5 lakh newborns treated in these in 2014-15.
Graph showing the progressive increase in number of
SNCUs along with the number of admissions (For 2015-16, data is till September
2015)
MoHFW provides free entitlement of care at these
centres under Janani Shishu Suraksha Karyakaram. Each SNCU is expected to
provide: Care at birth including resuscitation of asphyxiated newborn, sick
newborn and routine postnatal care. Follow up of high risk newborn and
Immunization/Referral Services are also provided for. Once the baby is
discharged to home ASHA (Accredited Social Health Activist) will do the follow
up of these babies for one year. District Early Intervention Centre (DEIC) have
also been linked with SNCU to provide specialized care to the babies with
special needs and delays.
National Deworming Day: A Fixed
Day Fixed Site strategy
Government of India for effective
deworming coverage
Like many other countries across the globe, India is
also endemic for Soil Transmitted Helminths. More than 241 million children are
estimated to be at risk of parasitic intestinal worm infections leading to impaired
physical growth, cognitive development, fatigue, internal bleeding. They also
cause micronutrient deficiencies leading to poor school performance and
absenteeism in children. Albendazole tablets, once in 6 months, is a simple
drug proven to reduce the worm load.
NDD launch by the Honorable HFM
at Jaipur
Understanding the negative impact of worm load in
children effecting their growth and development, Ministry of Health and Family
Welfare, Government of India, ambitiously launched – National Deworming Day
(NDD) on 10th February, 2015 followed by mop-up activities to be carried up to
14th February, 2015 across all Government/ Government aided schools and
Anganwadi centers of 11 States/UT.
NDD was implemented in 277 districts across 11
States/UT namely Assam, Bihar, Chhattisgarh, Dadra Nagar Haveli, Haryana,
Karnataka, Madhya Pradesh, Maharashtra, Rajasthan, Tamil Nadu and Tripura. More
than 4.70 lakh schools and 3.67 lakh Anganwadi centers were covered under the
ambitious NDD program. With an achievement of 85 percent coverage, a total of
8.98 crore children aged 1-19 years, received deworming tablet against a target
of 10.31 crore during the National Deworming Day.
Number of Children dewormed
against the target-
Number of sites where deworming was undertaken on
NDD
Intensified Diarrhoea Control Fortnight
(27 July- 8 August 2015)
In order to accelerate efforts towards reduction of
Childhood mortality, which is one of the prime goals of National Health
Mission. Diarrhoea contributes to around 11 percent under-five deaths in
country- most of these deaths are clustered around Summer and Monsoon season.
To effectively address the issue, Intensified Diarrhoea Control Fortnight
(IDCF) was implemented from 27th July to 8th August 2015, with an aim of
achieving improved coverage of essential life-saving commodity of ORS, zinc
dispersible tablets and practice of appropriate child feeding practices during
diarrhoea.
The chief activities during IDCF involved doorstep
ORS distribution by ASHA to house with under-five children, counselling for
infant and young child feeding, referral of children with diarrhoea for
treatment, capacity building of frontline workers for management of childhood
diarrhoea, setting up of ORS-zinc corners along with multi-sectoral involvement
of Anganwadi centres for growth monitoring of all children, PRI meetings on the
subject of childhood diarrhoea, hand-washing sessions in schools.
ORS was pre-positioned in houses of 6.6 crore
children to enable timely management of diarrhoea. 36.3 lakh children were
treated with both zinc and ORS during the fortnight. 3.4 lakh ORS-zinc corners
were established and 5.4 lakh schools participated and 3.2 lakhs village level
meetings were undertaken.
ORS & Zinc Corners
Involvement of schools
Rally by school children to advocate hand washing
practices
Rashtriya Bal Swasthya Karyakram
(RBSK)
The Rashtriya Bal Swasthya Karyakram (RBSK) has been
launched to provide child health screening and early interventions services by
expanding the reach of mobile health teams at block level. These teams will
also carry out screening of all the children in the age group 0-6 years
enrolled at Anganwadi Centres at least twice a year. RBSK covers 30 common
health conditions. States/UTs may incorporate a few more conditions based on
high prevalence/endemicity. An estimated 27 crore children in the age group of
zero to eighteen years are expected to be covered in a phased manner.
The strategic interventions to
address birth defects, disabilities, delays and deficiencies are:
Screening of children under RBSK- Child health
screening and early intervention services to with an aim to improve the overall
quality of life of children through early detection of birth defects, diseases,
deficiencies, development delays including disability (4 Ds) and reduce out of
pocket expenditure for the families. Dedicated mobile medical health teams (for
screening purpose) at block level, comprising of four health personnel
viz. two AYUSH doctors (One Male, One Female), ANM/ SN, and a Pharmacist. Under
this intervention, 10.66 crore children have been screened (FY 2014-15), so far
by 9774 teams and 51.78 lakh children have been referred for management of 4
Ds, 22.18 lakh children have been managed for the 30 health conditions. In Q1
(April-June) 2015-16; 1.79 crore children have been screened; 14.03 lakh
children have been referred to health facilities; 4.64 lakh children have
received secondary and tertiary care.
5. Maternal Health
“Daksh”
For improving the skills of
healthcare providers and to enhance their capacity to provide quality
(Reproductive, Maternal, Neonatal, Child & Adolescent Health) RMNCH+A
services, Government of India has established five National Skills lab
‘’Daksh’’ at Delhi and in NCR region with support from Maternal health
division, Government of India and Liverpool school of tropical Medicine(LSTM)
at:
1. Jamia Hamdard
2. Trained Nurses
association of India(TNAI)
3. National Institute of
Health and Family Welfare(NIHFW)
4. Safdarjung Hospital.
5. Lady Hardinge Medical
College.
These skills lab will handhold
and guide creating skills lab and also train state trainers. National Skills labs are being attached
to all the states and UTs so that there is an optimum utilization of the
National Skills lab. 30 stand-alone skills lab has been established at
different states such as Gujarat, Haryana, Bihar, Maharastra, MP, West Bengal,
Odisha, Tamil Nadu and Telangana. Additionally 188 MCH wings have been approved
across the country which has in built skills lab.
The linkages of
National Skills lab with states are:
|
Skills Lab
|
States
|
|
TNAI
|
UP,
Uttarakhand, Karnataka ,Kerala Chandigarh, D&N Haveli, Nagaland
|
|
LHMC
|
Assam
,JK ,Tamil Nadu, Punjab, Arunachal Pradesh, Meghalaya, Mizoram
|
|
NIHFW
|
Odisha,
Rajasthan, Haryana, AP, Goa, HP, Sikkim, Daman & Diu,
|
|
Jamia
Hamdard
|
MP,
Chattisgarh, West Bengal, Telangana, A&N island, Puducherry
|
|
SJH
|
Bihar,
Jharkhand, Maharastra, Gujarat, Lakshadweep, Manipur, Tripura
|
The skills lab has 5
skill cabin and comprises of 16 skill stations where the trainees learn 40 key
RMNCH+A skills through practicing skills on mannequins, simulation exercise,
demonstration videos and presentation spread over 6 days. Pre validate tools
like OSCE (Objective structured clinical examination), emergency drills,
supportive supervision and hand holding exercise at their place of work are few
things which distinct them from other training programmes. Skills labs serves as a prototype demonstration and
learning facility for health care providers with competency based training. The
labs have an edge over other didactic methods by providing the opportunity for
repetitive skill practice, simulating clinical scenarios under the supervision
of a qualified trainer.
The
objectives of Skills lab are to : A) Facilitate acquisition/ reinforcement of
key standardized technical skills and knowledge by service providers for
RMNCH+A services b) Ensures the availability of skilled personnel at health
facilities c) Improves the quality of pre service training d) Provides
continuing Nursing education / Continuing medical education. The target
audience of 6 days skills lab training are Obstetricians and Gynaecologists,
Paediatricians, Medical Officers, staff Nurses, Auxiliary Nurse Midwife (ANM),
state trainers and faculty of Nursing School/ colleges and Medical College who
can adapt it for strengthening pre service teaching.
National Skills lab
‘Daksh’ at National Institute of Health and Family Welfare(NIHFW), R.K. Puram,
New Delhi was inaugurated by Shree Jagat Prakash Nadda Hon’ble Union Health and
Family Welfare Minister on 9th March,
2015.
Till date
797 health personnel have been trained at National Skills lab with different
cadre including Nursing tutors, Skills lab trainers, Professors, Medical
officers, skills lab trainer etc.
The Government of India’s latest
initiative of Skills Labs to target preventable causes of death directly can be
a major breakthrough in saving women’s lives.
Glimpses
of 6 day training at National skills lab 
6. Family Planning
(1) Expanding Basket of Choices:
Three
new choices are now being introduced in the National Family Planning program.
a. Injectable DMPA: The Drugs Technical
Advisory Board (DTAB) agreed to the introduction of the injectable
contraceptive DMPA in the public health system under the National Family
Planning Programme.
b. POP: Progesterone only pill
for the lactating mothers
c. Centchroman: A non-hormonal once a
week pill.
(2) Improved Contraceptive Packaging:
The packaging for
Condoms, OCP and ECP has now being improved so as to influence the demand for
these commodities.
7. Adolescent Health
Rashtriya Kishor Swasthya
Karyakram (RKSK)
The Rashtriya Kishor Swasthya Karyakram (RKSK) was
launched in January 2014 with an overarching aim to address sexual and
reproductive health, nutrition, injuries and violence (including gender based
violence), prevention of non-communicable diseases, mental health and substance
misuse related concerns of 253 million adolescents of our country through
effective and coherent implementation of programmes and schemes. The short term
goal is to ensure holistic health and development of adolescents and the long
term outcome will be increased social and economic productivity of our nation.
The programme is underpinned by the principles of
equity and inclusion; rights based approach, adolescent and community
participation and strategic partnership. The key components of the program are
community based interventions; facility based interventions; social and
behavior change communication; and inter-sectoral convergence.
Community
based interventions-
Peer Education Programme
To build a community of proactive and confident
adolescents, who are well informed and are capable of taking appropriate
decisions about their health and wellbeing, is one of the key drivers of RKSK
programme. The Ministry of Health and Family Welfare in its Operational
Guideline for RKSK proposed to select and orient four peer educators i.e. two
male and two female peer educators per village or 1000 population. These
community level peer educators will receive standardized information and
knowledge on sexual and reproductive health, nutrition, injuries and violence,
prevention of non-communicable diseases, mental health and substance misuse
through structured orientation sessions.
After orientation, peer educators are expected to
form group of 15-20 boys and girls and to conduct weekly participatory sessions
on adolescent health, facilitate organization of Adolescent Health Day and ensure
linkages with Adolescent Friendly Health Clinics (AFHCs) and Adolescent
Helpline. During the first phase of implementation of PE programme, 50% Blocks
in 213 RKSK districts have been selected. Further to this, two PHC under each
of these selected CHCs have been identified for roll-out of PE programme. PE
selection and trainings are in the process of being conducted in all villages
under the two identified PHCs, this will be facilitated by village ASHA with
active involvement of ANMs, school teachers and local committees such as
VHNSC. Villages under approximately 1800 Primary Health Centres will be
covered in the first phase of implementation of PE scheme. During the course of
the year, around 2 lakhs peer educator will be selected through a community led
and community based process and trained.
Weekly Iron Folic Acid
Supplementation (WIFS) programme
WIFS entails provision of weekly supervised IFA
tablets to in-school boys and girls and out-of-school girls for prevention of
iron and folic acid deficiency anaemia, and biannual albendazole tablets for
helminthic control. The programme is being implemented across the country in
both rural and urban areas, covering government, government aided schools,
municipal schools and Anganwadi centres. Screening of targeted adolescents
population for moderate/ severe anaemia and referral of these cases to an
appropriate health facility; and information and counselling for prevention of
nutritional anaemia are also included in the programme.
The programme is been implemented through
convergence with key stakeholder ministries- the Ministry of Women and Child
Development and Ministry of Human Resource Development, with joint programme
planning, capacity building and communication activities. The programme aims to
cover a total of 11.2 crore beneficiaries including 8.4 crore in-school and 2.8
crore out-of-school beneficiaries.
Scheme for Promotion of Menstrual
Hygiene among Adolescent Girls in Rural India
The Ministry of Health and Family Welfare has
launched Scheme for Promotion of Menstrual Hygiene among adolescent girls in
the age group of 10-19 years in rural areas as part of the Adolescent
Reproductive Sexual Health (ARSH) in RCH II, with specific reference to
ensuring health for adolescent girls. The major objectives of the scheme are:
-
To increase
awareness among adolescent girls on Menstrual Hygiene
-
To increase
access to and use of high quality sanitary napkins to adolescent girls in rural
areas.
-
To ensure
safe disposal of Sanitary Napkins in an environmentally friendly manner.
Under the scheme a pack of 6 sanitary napkins is
provided under the NRHM’s brand ‘Freedays’. These napkins are sold to the
adolescents girls at Rs. 6 for a pack of 6 napkins in the village by the
Accredited Social Health Activist (ASHA). On sale of each pack, the ASHA gets
an incentive of Rs. 1 per pack besides a free pack of sanitary napkins per
month. This initial model of the scheme was rolled out in 112 selected
districts in 17 States through central supply of sanitary napkin packs.
Since 2015-16, the scheme had been decentralized and
funds were approved in the State Programme Implementation Plans for procurement
of sanitary napkin packs, for safe storage and disposal, and for training of
ASHA and nodal teachers. The states have been advised - to undertake
procurement of sanitary napkins packs at prices decided through competitive
bidding. The funds have been approved for state-level procurement of sanitary
napkin packs in 162 districts across 20 states in 2015-16 RoPs.
Facility
based interventions:-
1.
Strengthening
of existing Adolescent Friendly Health Clinics (AFHC )
2.
Setting up of
new AFHCs
3.
Ensuring
availability of trained human resource at AFHCs- medical officer, ANM and
counsellors
Adolescent Friendly Health Clinics act as the first
level of contact of primary health care services with adolescents. These
clinics are being developed across all level of care to cater to diversified
health and counselling need of adolescent girls and boys. These broad objectives
will be achieved through establishment of optimally functional AFHCs at
District Hospitals, Community Health Centres and Primary Health Care centres in
prioritized districts.
Trainings of medical officer, ANMs and counsellors
positioned in AFHCs are being ensured through development of a structured
training plan for capacity building. The training of human resource positioned
in AFHCs operationalized in RKSK districts is being prioritized. Adolescent
Health Division of Ministry of Health and Family Welfare has already completed
National Level Training of Trainers for Medical Officers, ANMs/LHVs and
Counsellors. These master trainers are further providing state/district level
training to service providers at designated district training sites.
Convergence:-
Under RKSK, convergence structures have been
institutionalized with constitution of State Committee for Adolescent Health
and District Committee for Adolescent Health. The committees will be holding
regular meetings with both intra-departmental and inter-departmental
representation.
-
Within
Health & Family Welfare
– Family Planning, Maternal Health, Rashtriya Bal Swathya Karyakram, NACP,
National Tobacco Control Programme, National Mental Health Programme,
Non-communicable Disease and IEC
-
With other
departments/ schemes
- WCD (ICDS, BSY, SABLA), HRD (AEP, MDM), Youth Affairs and Sports (Adolescent
Empowerment Scheme, National Service Scheme, NYKS, NPYA)
Social and Behaviour Change
Communication with focus on Inter Personal Communication:-
Communication material for WIFS, Menstrual Hygiene
Program and issue related to Adolescent Pregnancy has been developed and shared
with States.
After wide spread consultations, a comprehensive
communication strategy has been developed by AH division in collaboration with
UNICEF country office. The strategy provides overall guidance to state and
district programme managers on formulation of communication campaign for
adolescents on six priority areas identified under RKSK. An implementation
guideline has also been developed to supplement the communication strategy and
to aid its roll-out. Both the strategy and implementation guideline were shared
with state programme mangers during the National Review of RKSK programme in
June 2015. To further strengthen the understanding of communication for
adolescent health, strategy has also been shared with state and district level
managers during RKSK regional reviews held in November- December 2015.
Extensive Media Campaign for WIFS has been organized
with support from UNICEF country office which includes write-ups from subject
experts and articles on Nutrition, Anaemia and WIFS program in prominent
newspapers across all the States besides engagement with UNICEF goodwill
ambassador Priyanka Chopra for awareness generation on Nutrition and Anaemia in
adolescents.
8. The National Health
Mission (NHM)
The National Health Mission (NHM) encompasses its
two Sub-Missions, the National Rural Health Mission (NRHM) and the National
Urban Health Mission (NUHM). The main programmatic components include Health
System Strengthening in rural and urban areas, Reproductive-Maternal-
Neonatal-Child and Adolescent Health (RMNCH+A), and Communicable and
Non-Communicable Diseases. The NHM envisages achievement of universal access to
equitable, affordable & quality health care services that are accountable
and responsive to people’s needs.
National Rural Health Mission (NRHM): NRHM seeks to
provide accessible, affordable and quality health care to the rural population,
especially the vulnerable groups. Under the NRHM, the Empowered Action Group
(EAG) States as well as North Eastern States, Jammu and Kashmir and Himachal
Pradesh have been given special focus. The thrust of the mission is on
establishing a fully functional, community owned, decentralized health delivery
system with inter-sectoral convergence at all levels, to ensure simultaneous
action on a wide range of determinants of health such as water, sanitation,
education, nutrition, social and gender equality.
National Urban Health Mission (NUHM): NUHM seeks to
improve the health status of the urban population particularly urban poor and
other vulnerable sections by facilitating their access to quality primary
health care. NUHM covers all state capitals, district headquarters and other
cities/towns with a population of 50,000 and above (as per census 2011) in a
phased manner. Cities and towns with population below 50,000 will continue be
covered under NRHM.
Progress under NHM:-
Augmentation of Human Resources
NRHM has attempted to fill the gaps in human
resources by approving nearly 2.3 lakh additional health human resources to
the States, including 10,027 Medical Offiders, 4,023 Specialists, 78,168
ANMs, 53,456 Staff Nurses, 35,514 AYUSH Doctors etc. on contractual
basis. Apart from providing support for health human resource, NRHM has also
focused on multi-skilling of doctors at strategically located facilities
identified by the states e.g. MBBS doctors are trained in Emergency Obstetric
Care (EmOC), Life Saving Anaesthesia Skills (LSAS) and Laparoscopic Surgery.
Accredited Social Health Activist
(ASHA)
Under the Framework for Implementation of NRHM, a
female community health worker called Accredited Social Health Activist (ASHA)
has been engaged in each village in the ratio of one ASHA per 1000 population
or one ASHA per habitation in tribal areas. Up to June, 2015, 9.15 lakh ASHAs
and link workers have been selected in entire country, out of which 8.42
lakh have been given the orientation training and engaged Further, 8.82 lakh
ASHAs have been provided with drug kit.
Infrastructure
strengthening/upgradation
NRHM seeks to strengthen public health delivery
system at all levels. During the last 10 years (up to June 2015), 30,750 new
constructions and 32,847 renovation/upgradation projects for various health
facilities including SC, PHC, CHC, SDH and DH were sanctioned.
24x 7 Services and First Referral
facilities
2,706 Referral Hospitals were strengthened to act as
First Referral Units (FRUs). 13,667 PHCs/CHCs were strengthened to provide 24x7
services. 14,441 Newborn Care Corners(NBCC), 575 Special Newborn Care Units
(SNCU) and 2,020 Newborn Stabilization Units NBSU) were established under
NHM to improve newborn care and reduce neonatal mortality and morbidity.
Mobile Medical Units
In order to provide services to the most
remote and hard to reach areas, States have been supported with Mobile
Medical Units (MMUs). Over the 10 years of NRHM, 333 out of 672 districts have
been equipped with MMUs. So far 1,107 MMUs are operational in the country.
National Ambulance Services
31 States/UTs have the facility where people
can dial 108 or 102 telephone number for calling an ambulance. Dial
108 is predominantly an emergency response system, primarily designed
to attend to patients of critical care, trauma and accident victims
etc. Dial 102 services essentially consist of basic patient transport aimed
to cater the needs of pregnant women and children though other
categories are also taking benefit and are not excluded. JSSK entitlements
e.g. Free transfer from home to facility, inter facility transfer in case of
referral and drop back for mother and children are the key focus of 102
service. This service can be accessed through a toll free call to a
Call Centre.
Presently, 7,358 Dial 108, 7,836 Dial 102 and 400
Dial 104 Emergency Response Service Vehicles are supported under NHM,
besides 6,290 empanelled vehicles for transportation of patients,
particularly pregnant women and sick infants from home to public health
facilities and back.
Mainstreaming of AYUSH
Mainstreaming of AYUSH has been taken up by
allocating AYUSH facilities in 10042 PHCs, 2732 CHCs, 501 DHs, 5714 health
facilities above SC but below block level and 421 health facilities other than
CHC at or above block level but below district level.
Community Participation
To ensure involvement of the communities in
over-seeing the provisioning of health care and to redress public
grievances, 31,763 Rogi Kalyan Samitis or Hospital Management Committees
at health facilities above the Primary Health Centre level and over 5.01 lakh
Village Health Sanitation. Nutrition Committee (VHSNCs) at village
level have been constituted across the country.
Financial Progress
One of the key mandates of NHM has been to increase
the public expenditure in health sector. Since 2005, there has been a
significant improvement in the utilization. Since the inception of NRHM, Rs. 1,
34,137.31 crore (up to October 2015) has been released to States/UTs under NHM.
Reproductive and Child Health
Services
(i) The MMR, i.e. number of maternal deaths per
100,000 live births, has declined from 560 per 100,000 live births in 1990 to
167 per 100,000 live births in 2011-13. Percentage annual compound rate of
decline in MMR during 2005 to 2011-13 accelerated to 5.8% from 5.1% observed
during 1990 to 2005. India is poised to achieve the Millennium Development Goal
of MMR at the present rate of decline.
(ii) Infant Mortality Rate (IMR): The IMR in
India declined from 80 in 1990 to 40 in the year 2013. Percentage annual
compound rate of decline in IMR during 2005-2013 has accelerated to 4.5% from
2.1% observed during 1990-2005.
(iii) Total Fertility Rate (TFR): The TFR in India
declined from 3.8 in 1990 to 2.3 in the year 2013. The percentage annual
compound rate of decline in TFR during 2005-2013 has accelerated to 2.9% from
1.8% observed during 1990-2005.
(iv) India achieved a historical milestone and was
certified as 'Polio-free’ by WHO in March 2014 on having no wild polio case
since 13th Jan, 2011.
Mother and Child Tracking System
It is a name based tracking system, launched by the
Government of India as an innovative application of information technology
directed towards improving the health care service delivery system and
strengthening the monitoring mechanism. MCTS is designed to capture information
on and track all pregnant women and children (0-5Years) so that they receive
‘full’ complement of maternal and child health services, thereby contributing
to the reduction of maternal, infant and child morbidity and mortality. A total
of 1, 18, 68,505 pregnant women were registered in MCTS during 2015-16 (till
Oct’) which indicates a registration of 67.57% as against estimated number of
pregnant women in 2015-16. Similarly, a total of 82, 38,820 children under 5
year age have been registered in MCTS till Oct, 2015.
Mother and Child Tracking
Facilitation Centre (MCTFC)
MCTFC has been operationalised from National
Institute of Health and Family Welfare (NIHFW). It is being operated by 80
Helpdesk Agents (HAs). It validates the data entered in MCTS in addition to
guiding and helping both the beneficiaries and service providers with up to
date information on Mother and Child care services through phone calls and
Interactive Voice Response System (IVRS) on a regular basis. MCTFC is creating
awareness about Government mother and child health related programmes and also
seeking feedback on services being provided.
National Urban Health Mission
National Urban Health Mission (NUHM) was
approved as a Sub-Mission under an overarching National Health Mission
(NHM) by the Cabinet on 1st May 2013 for providing equitable and quality
primary health care services to urban population with focus on slum dwellers
and other vulnerable population like migrant workers, homeless, etc.
NUHM aims to create Primary health care service delivery infrastructure
which is largely absent in cities/towns by strengthening of existing
Urban Family Welfare Centres (UFWCs), Urban Health Posts (UHPs),
dispensaries and establishment of new Urban Primary Health Centers (U-PHC)
and Urban Community Health Centres (U-CHC) as per the need.
The approvals conveyed under NUHM
for the last two years i.e. 2013-2014 and 2014-15 are as follows:
-
Strengthening
of 3,995 existing facilities such as Urban Family Welfare Centers, Urban Health
Posts and dispensaries as Urban Primary Health Centers (U-PHCs)
-
1,426 new
U-PHCs were sanctioned
-
Support
provided for strengthening of 99 First Referral Units (FRUs)
-
Establishment
of 35 new Urban Community Health Centers
-
2,353
full-time Medical officers, 2,973 part-time Medical officers, 17,584 ANMs, 7,209
Staff Nurses, 2,978 Pharmacists and 3,231 Lab Technicians were approved
-
For slum
habitation – 92,173 Mahila Arogya Samitis (MAS) and 56,002 ASHAs approved (One
MAS covers 50-100 households and one ASHA covers 200 to 500 households)
Key Initiatives under NHM:
Launch of National Quality
Assurance Framework for Health facilities: To improve quality of health care in over 31000
public facilities and provide a clear roadmap to states, Quality Standards for
District Hospitals (DHs), CHCs and PHCs under National Quality Assurance
Framework were rolled out in November, 2014.
Launch of Kayakalp- an initiative
for Award to Public Health Facilities: Kayakalp- initiative has been launched to
promote cleanliness, hygiene and infection control practices in public health
facilities. Under this initiative public healthcare facilities shall be
appraised and such public healthcare facilities that show exemplary performance
meeting standards of protocols of cleanliness, hygiene and infection control
will receive awards and commendation. Further, Swachhta Guidelines for public
health facilities to promote Cleanliness, Hygiene and Infection Control
Practices in public health facilities were released on 15th May, 2015. The
Guidelines provide details on the planning, frequency, methods, monitoring etc
with regard to Swachhta in public health facilities.
Launch of National Family Health
Survey (NFHS)–IV:
NFHS-IV was launched in mid-2014 to provide essential data and information on
important emerging health and family welfare elements to track progress on key
parameters and provide evidence for policy and programme. The field work of
NFHS-IV is under progress. This survey results are expected in 2016 and will
provide national, state and district level data.
Launch of India Newborn Action
Plan (INAP):
Currently, there are estimated 7.47 lakh neonatal deaths annually. In September
2014, INAP was launched for accelerating the reduction of preventable newborn
deaths and stillbirths in the country - with the goal of attaining ‘Single
Digit Neo-natal Mortality Rate (NMR) by 2030’ and ‘Single Digit Still Birth
Rate (SBR) by 2030’. The neo-natal deaths are expected to reduce to below 2.28
lakh annually by 2030, once the goal is achieved.
Launch of Mission Indradhanush: Mission Indradhanush was
launched in December 2014 to reach 90 Lakh unimmunized/partially immunized
children by 2020. It has been implemented in 201 districts in 1st Phase, 297
additional Districts are to be covered in 2nd Phase. About 20 lakh children
received full immunization during the Phase-1 of Mission Indradhanush.
Approval of four new vaccines- Approval of four new vaccines
namely rotavirus, Inactivated Polio Vaccine (IPV), Measles-Rubella vaccine,
Japanese Encephalitis vaccine extended to adults. This will significantly
reduce vaccine preventable morbidity, disability and mortality.
Free Drugs Service Initiative: An incentive of up to 5%
additional funding (over and above the normal allocation of the state) under
the NHM is provided to those States that introduce free medicines scheme. Under
the NHM-Free Drug Service Initiative, substantial funding is available to
States for provision of free drugs subject to States/UTs meeting certain
specified conditions. Detailed Operational Guidelines for NHM- Free Drugs
Service Initiative have also been released to the States on 2nd July 2015.
Free Diagnostics Service Initiative: The NHM- Free Diagnostics
Service Initiative was launched in 2013 to provide free essential diagnostic
services at public health facilities under which substantial funding was
provided to States within their resource envelope. The Operational Guidelines
on Free Diagnostics Service Initiative have been developed by the Central
Government and shared on 2nd July, 2015 with the states various mechanisms
adopted for providing free essential diagnostic services include:-
-
Strengthening
of the existing systems in public health facilities such as Lab infrastructure,
provision of Lab Technician, equipment, etc.
-
Out Sourcing
of High Cost -low frequency diagnostic services.
-
Contracting
in of services of essential Human Resources (e.g. Radiologist, Lab Technician) on
a need basis.
Bio Medical Equipment Maintenance: States have been asked to plan
interventions for comprehensive equipment maintenance for all functional
medical equipment/machinery. The Ministry has circulated model contract
documents for guidance. Support for comprehensive equipment maintenance for all
functional medical equipment/machinery is intended to ensure optimum
utilisation of medical equipment.
Comprehensive Primary Health Care: Primary health care including
preventive and promotive health care enables early detection and prompt
treatment and serves a gate-keeping function to secondary and tertiary care,
and also reduces the cost of care. In December 2014, the MoHFW constituted a
Task Force to provide a report on roll out of comprehensive Primary Health
Care. The Committee was charged with identifying current challenges to
rolling out comprehensive primary health care, finalizing components of service
delivery, clarifying the institutional structures and service organizations,
developing guidelines for the PHC team, and coordinating with other Task Forces
set up by the MoHFW working on Human resources for Health and developing Standard
Treatment Guidelines. Nine areas for action to make primary health care
comprehensive and universal are proposed. They include:
-
Strengthen
Institutional Structures and Organization of Primary Health Care Services.
-
Improve
access to technologies, drugs and diagnostics for comprehensive Primary Health
Care
-
Increase
utilization of Information, Communication and Technology (ICT) - empowering
patients and providers
-
Promote
Continuity of care- making care patient centric
-
Enhance
Quality of Care
-
Focus on
Social Determinants of Health
-
Emphasize
Community Participation and Address Equity Concerns in Health
-
Develop a
Human Resource Policy to support primary health care
-
Strengthen
Governance including financing, partnerships and accountability.
States are also offered support through the PIPs of
the NHM to strengthen existing sub centers, as Health and Wellness centers with
a primary health care team, headed by a mid-level service provider (who would
be either an AYUSH or Nurse Practitioner trained through a bridge course in
primary health care or public health). Other members of the team include the
ANMs, ASHAs, and AWW of the sub center area. One important innovation that is
being planned is the provision of performance based team incentives linked to
achievement of key indicators build around comprehensive primary health care.
Kilkari & Mobile Academy: To create proper awareness among
pregnant women, parents of children and field workers about the importance of
Anti Natal Care (ANC), institutional delivery, Post-Natal Care (PNC) and
immunization, it was decided to implement the Kilkari and Mobile Academy
services in pan India in phased manner. In the first phase Kilkari would be
launched in 6 states viz. Uttrakhand, Jharkhand, Uttar Pradesh, Odisha,
Rajasthan (HPDs) & Madhya Pradesh (HPDs). The Mobile Academy would be
launched in 4 states viz. Uttrakhand, Jharkhand, Rajasthan & Madhya
Pradesh.
Kilkari is an Interactive Voice Response (IVR) based
mobile service that delivers time-sensitive audio messages (Voice Call) about
pregnancy and child health directly to the mobile phones of pregnant women,
mothers of young children and their families. The service covers the critical
time period – where the most maternal/infant deaths occur - from the 4th month
of pregnancy until the child is one year old. Families subscribe to the service
receive one pre-recorded system generated call per week. Each call will be 2
minutes in length and serve as reminders for what the family should be doing
that week depending on woman’s stage of pregnancy or the child’s age. Kilkari
services will be available to states in regional dialect.
Mobile Academy is an anytime, anywhere audio
training course on interpersonal communication skills that the ASHA can access
from her mobile phone. It gives ASHAs tips on how to convince families to
adopt priority RMNCH behaviors, while refreshing her existing knowledge. The
course is 240 minutes long and consists of 11 chapters with 4 lessons each. At
the end of each chapter there is a quiz for them and all ANM/ASHAs passes the
course will be provided with a printed certificate.
These services will be hosted centrally by MoHFW and
single source of information for these services will be Mother and Child
Tracking System (MCTS). Also these services will be free of cost to States/ UTs
and the Beneficiaries.
Launch of Nationwide Anti-TB drug
resistance survey:
Drug resistant survey for 13 TB drugs was launched to provide a better estimate
on the burden of Multi-Drug Resistant Tuberculosis in the community. This is
the biggest ever survey in the world with a sample size of 5214 patients.
Results are expected by 2016.
Kala Azar Elimination Plan : To reduce the annual incidence
of Kala-Azar to less than one per 10,000 population at block PHC level by the
end of 2015, Kala-Azar elimination Plan was rolled out, which inter-alia
includes,
-
New thrust
areas launched for UP, Bihar, West Bengal and Jharkhand.
-
New Action
Plan to include active search, new drug regimen, coordinated Indoor Residual
Spray (IRS) etc.
-
New
non-invasive Diagnostic kit launched.
Criteria
for incentives to States under the NHM were revised. States that show improved
progress made on key Outcomes/Outputs such as IMR, MMR, immunization, number
and proportion of quality certified health facilities etc. will be able to
receive additional funds as incentives.
9. Nursing Sector
School for ANM &GNM
The Government of India has initiated action for
opening of 132 Auxiliary Nurse Midwife (ANM) and 137 General Nursing and
Midwifery (GNM) schools in 278 identified districts in 29 states under
Central Sponsored Scheme-Strengthening/Upgradation of Nursing Services, where
there is preferably no such school. As on date, Govt. has approved for
establishment of 128 ANM School and 137 GNM Schools. Funds to the tune of Rs.
725.oo Crore have already been released (Centre: State share as 85:15). The
components that are covered under the scheme include civil work, laboratory
equipment, teaching aids, library, computers, furniture, transport, rent for
building for 18 months or till construction is completed, salary of staff,
contingencies, etc. Objective of the Scheme:-
-
To meet the
shortage of Nurses.
-
The Government
has initiated action for the opening of 132 Auxiliary Nurse Midwife (ANM) and
137 General Nursing Midwifery (GNM)) schools in those districts of 23 high
focus states the country where there is no such school. This will create 13500
additional intake capacities of candidates per year. So far 128 ANM schools and
137 GNM schools have been approved across the Country.
The Govt. of India has also initiated works under
another Scheme - Development of Nursing Services by way of Training of Nurses, upgradation
of School of Nursing into College of Nursing and by giving Florence Nightingale
National Awards Nurses who work for the people. Objective of the Scheme are-
-
In order to
update knowledge and skills of nursing personnel, continuing nursing education
programme has been started in various specialty areas.
-
To increase
the availability of Graduate Nurses.
10. New Initiatives
Indian Nurses Live Register: - In order to get the latest,
correct and real-time census of the current human resources in the field of
Nursing in India, MOHFW has initiated the development of a technology platform
called the Live Register in collaboration with INC. The Live Register will
include capturing up-to date and latest information of the currently practicing
nurses, which would help the Government of India in better manpower planning
and for making policy level decisions for the nursing professionals in India.
The proposed system would help in providing a uniform registration across all
the states. It will also help in linking reciprocal system and the migration of
the nurses abroad. This provides us the real-time census of data as to how many
nurses are presently working in India and outside India.
Nursing Scheme Monitoring System:
- Ministry of
Health and Family Welfare, GoI has developed a software module, namely,
“Nursing Scheme Monitoring Software” to effectively monitor the implementation
of the Schemes and to expedite the processes. This will help in knowing the
exact status of Schemes both physical / financial progress and facilitate in
better Planning and budgeting for both the Centre and State Governments.
National Nursing and Midwifery
Portal: - The
Nursing and Midwifery Portal is an online resource centre for State Nursing
Councils and the entire nursing & midwifery cadre. The portal aims to bring
all the nursing related information like Government Of India Initiatives in the
field of Nursing, Information regarding Nursing and Midwifery education and
human resource availability in the country (according to INC statistics),
Circulars, Notifications, Job Opportunities, Publications, Journals,
Pre-service and in-service education, e-learning and links to other related
website under a common umbrella for easy access by the various stake holders.
The e-learning modules will be added in the in-service education section on the
website to provide new areas of knowledge related to nursing to the registered
nursing professionals through e-learning mode.
11. National Programme for
Control of Blindness
India
was the first country to launch the National Programme for Control of Blindness
in 1976 as a 100% centrally sponsored scheme with the goal to reduce the
massive burden of avoidable blindness, mainly due to cataract and
trachoma, to 0.3% by 2020 from its current level of 1.49%.
Millions
of people in India were suffering from avoidable blindness. A strategy was,
therefore, developed to bring the ophthalmic eye care providers under one
umbrella, provide them technical know-how, supply necessary equipments, develop
logistics, train the requisite staff required and launch an outreach
programme to take eye care services to the far flung and remote areas of the
country, where eye care services were severely lacking.
The
three signature blindness control activities that were undertaken at mega level
included cataract operation by various partners, the collection of corneas from
deceased eye donors and school eye screening scheme to pick up eye defect like
refractive errors, squint and amblyopia, vitamin A deficiency with associated
xero-phthalmia and night blindness. A massive initiative was launched to
treat and eradicate trachoma.
Four
major surveys to find out major causes of avoidable/unavoidable blindness were
undertaken during the years, 1974, 1986-89, 2001-02 and 2006-07. Cataract
and refractive errors emerged to be the major causes of avoidable blindness.
World Bank Project under NPCB
Looking
at the gravity of blindness in India, funds were mobilized from World Bank
during the years 1994-2002 for development of eye care infrastructure, supply
of ophthalmic equipments, training of manpower etc. Consequently, the
prevalence of blindness in the country came down from 1.40% during 1986-89 to
1.1% during 2001-02.
Decentralized Approach during 10th Five
Year Plan (2002-2007)
The
programme continued with the same enhanced zeal with the provision of funds
from domestic budget and technical know-how from a number of agencies including
WHO. State Blindness Control Societies were formed, under whose
supervision, District Blindness Control Societies started functioning and
delivering eye-care services in all the districts of the country. The
concept/aim was to establish a bottom up approach in dealing with blindness
through multi sectoral and coordinated efforts. These societies are
responsible for identifying the blind in every village, organize diagnostic
screening camps at suitable locations, arrange transportation of patients to
the designated surgical facilities and ensure follow up.
NGO
Eye Hospitals from all over the country contributed in tackling blindness in a
major way, thus bringing down prevalence of blindness. Regional
Institutes of Ophthalmology, Medical Colleges, District Hospitals, Sub-district
Hospitals became major partners of NPCB in implementation of the programme in
Government Sector. By the end of 10th Five Year Plan, the
prevalence of blindness came down to 1% (rapid survey 2006-07).
11th Five Year Plan (2007-12)
During
11th Plan, NPCB became a comprehensive eye care programme by
including provision for treatment/management of other eye diseases like,
diabetic retinopathy, glaucoma, corneal transplantation, vitreo-retinal
surgery, treatment of childhood blindness, involvement of private
practitioners, construction of eye wards and eye OTs in backward and remote
areas, in addition to already existing activities including cataract
operations, distribution of free spectacles to school children suffering from
refractive errors, eye banking, IEC, training to ophthalmic personnel,
development of eye care infrastructure in medical colleges, district hospitals
etc, .An amount of approx. Rs.1092.80 crore were spent during the 11th Five
Year Plan to carry out the NPCB activities.
Major
achievements during 11th Five Year Plan (2007-12):-
·
294.07
lakh cataract surgeries were done.
·
27.19
lakh free spectacles were provided to school children suffering from refractive
errors.
·
2.21
lakh donated eyes were collected for corneal transplantation.
·
1850
Eye surgeons were trained in various fields of ophthalmology to provide better
quality eye care services.
12th Five
Year Plan (2012-17)
During
the 12th Plan, the NPCB activities shall be pursued with
enhanced vigour, zeal, technical input and funds. Upgraded revised
targets have been set for expanding volume of eye care services. In
addition to the ongoing activities, following new initiative have been included
under the programme:
-
Provision
for launching Multipurpose District Mobile Ophthalmic Units for the
outreach activities to cover remote, underserved areas including hilly terrains
of North East region.
-
Provision
for distribution free spectacles to old persons suffering from
pressbyopia.
Major
achievements during 12th Five Year Plan (2012-17):
(Upto
November, 2015)
·
214.98
lakh cataract surgeries
·
23.06
lakh free spectacles distributed to school children suffering from refractive
errors.
·
1.93
lakh donated eyes collected for corneal transplantation.
·
1225
Eye surgeons trained to provide better quality eye care services in various
fields of ophthalmology.
Implementation
of the scheme in North-Eastern States
Development
of eye care infrastructure in NE States including Sikkim has remained a
priority area under the programme. In addition to taking care of cataract
and other eye diseases, major activities initiated for development of eye care
services in these States include setting up of tele-ophthalmology units to
intensify coverage area and construction of Eye OTs/Wards in District Hospitals
for development of eye care infrastructure.
Conclusion
With
the inclusion of modern sophisticated ophthalmic equipments, skilled manpower,
intensification of IEC, strengthening of Government sector hospitals and
involvement of NGO eye hospitals in various eye care activities, the programme
is marching with steady pace towards achieving its ultimate goal of bringing
down the level of avoidable blindness in the country to the desired level of
0.3% by the year 2020.
12. National Programme for
Health Care of the Elderly (NPHCE)
Keeping
in view the recommendations made in the “National Policy on Older Persons” as
well as the State’s obligation under the “Maintenance & Welfare of Parents
& Senior Citizens Act 2007”, the Ministry of Health & Family Welfare
has initiated the “National Programme for the Health Care of Elderly” (NPHCE)
during the 11th Plan period to
address various health related problems of elderly people.
The objectives of the
NPHCE are:-
·
To
provide easy access to preventive, promotive, curative and rehabilitative
services to the elderly.
·
To
make use of the community based primary health care approach and strengthen
capacity of the medical and paramedical professionals as well as the
care-takers within the family for caring practices of the elderly.
·
To
identify health problems in the elderly and provide appropriate health
interventions in the community with a strong referral backup support.
·
To
provide referral services to the elderly patients through district hospitals,
medical colleges and strengthen health manpower development in the field of
geriatric medicine,
·
Development
of treatment models for the elderly persons in our country.
The
programme was initiated in October, 2010 towards the end of the XI Plan i.e.
2010-11and 2011-12 in 100 backwards and remote districts of 21 States. The
major component of the NPHCE during 11th Five Year Plan were
establishment of 30 bedded Department of Geriatric in 8 identified Regional
Medical Institutions (Regional Geriatric Centres) in different regions of the
country and to provide dedicated health care facilities in District Hospitals,
CHCs, PHCs and Sub Centres level in 100 identified districts of 21 States.
Funds have so far been released to 24 States/UTs (covering 104 districts) and
all the 8 Regional Geriatric Centres (Regional Medical Institutes) selected under
the programme.
It
was proposed to cover the remaining districts under the programme during the 12th
Five Year Plan in a phased manner (@ 100 districts per year and develop 12
additional Regional Geriatric Centres in selected Medical Colleges of the
country (in the first three years).
The
regional institutions will provide technical support to the geriatric units at
district hospitals whereas district hospitals will supervise and coordinate the
activities down below at CHC, PHC and Sub-Centres.
Developing
Geriatric Department in Medical Colleges
The
following eight Regional Medical Institutions (Regional Geriatric Centres) in
different regions of the country has been selected under the programme in
2010-12 (11th FYP).
1.
All
India Institute of Medical Sciences, New Delhi
2.
Institute
of Medical Sciences, Banaras Hindu University, Uttar Pradesh
3.
Sher-e-Kashmir
Institute of Medical Sciences, Srinagar, Jammu & Kashmir
4.
Govt.
Medical College, Thiruvananthapuram, Kerala
5.
Guwahati
Medical College, Guwahati, Assam
6.
Madras
Medical College, Chennai, Tamil Nadu
7.
SN
Medical College, Jodhpur, Rajasthan
8.
Grants
Medical College & JJ Hospital, Mumbai, Maharashtra
It
is proposed to develop 12 additional Regional Geriatric Centres in selected
Medical Colleges of the country in addition to 8 Regional Geriatric Centres
being developed during the 11th Plan in the first three years. The
regions and Medical College proposed are:
§ Punjab, Haryana &
Chandigarh- PGIMER, Chandigarh
§ Uttar Pradesh- KGIMS,
Lucknow
§ Jharkhand- Ranchi Medical
College, Ranchi
§ West Bengal- Kolkata
Medical College, Kolkata
§ Andhra Pradesh- Nizam
Institute of Medical Sciences, Hyderabad
§ Karnataka- Bangalore
Medical College, Bengaluru
§ Gujarat- B.J.Medical
College, Ahmadabad
§ Maharashtra-
Government Medical College, Nagpur
§ Orissa- S.C.B. Medical
College, Cuttack
§ Tripura- Agartala
Medical College, Agartala
§ Madhya Pradesh- Gandhi
Medical College, Bhopal
§ Bihar- Patna Medical
College, Patna
These
centres will provide tertiary level of care for referred cases, undertake
training programmes and research in the field of Geriatrics. Each of these
Medical College will have a Department of Geriatrics with 30 beds and OPD
facilities including academic and research wing. These institutes will ensure
initiation of 2 PG seats for MD in Geriatric Medicine. Support will be provided
for –
- Construction/renovation/extension
of the existing building and furniture of department of Geriatrics.
- Machinery
and Equipment
- Video
Conferencing Unit
- Drugs
and consumables
- Research
Activities
- Human
Resources (Contractual)
- Training
to faculty members of medical colleges and doctors from district hospitals
District Hospital
Identified District
hospital will be strengthened /upgraded for management of the elderly. It will
have 10 bedded Geriatric Ward and run a Geriatric OPD on a daily basis for care
of the elderly. There will be a dedicated Physiotherapy Unit in all the
District Hospitals with bed strength of 100 and above. Support will be provided
for –
·
Construction/renovation/extension
of the existing building and furniture of Geriatric Ward and OPD
·
Machinery
and Equipment
·
Drugs
and consumables
·
Training
of doctors and staff from CHCs and PHCs
·
Public
Awareness and IEC
·
Human
Resource
·
Transport
of referred/serious patients
·
Home
based care for bed ridden cases
- Miscellaneous
cost for communication
- TA/DA,
POL, Contingency
Sub-District:
Geriatric Clinics will be set up in all CHCs and
PHCs of the selected districts. Aids and appliances required by elderly will be
made available. It is proposed to provide support for home-based care for
rehabilitative services at the door step of such elderly patients. In case of
emergency, transport and referral services will be provided to the elderly
persons. Annual check-up of all the elderly at village level will be organized
by PHC/CHC.
A.
Community
Health Centres (CHCs):
Geriatric clinic will be held twice a week at CHCs. A
Rehabilitation Worker will be employed on contract for Physiotherapy and medical
rehabilitation services for the elderly. CHC will also be supported with
certain appliances and aids for the elderly. Domiciliary visits for bed-ridden
elderly and counseling to family members for home based care of such patients
will made by the rehabilitation worker. Financial support will be provided for
-
·
Machinery
and Equipment
·
Training
& IEC
·
Transport
of referred cases
·
Home
based care for bed ridden elderly & counselling
·
Transport
and referral services
·
Consumables
B. Primary Health Centres
(PHCs):
PHC
Medical Officer will be in-charge for coordination, implementation &
promoting health care of the elderly. A weekly geriatric clinic will be held at
PHC level by trained Medical Officer. Financial assistance will be provided for
–
·
Machinery and
Equipment
·
Training
& IEC
·
Home
based care for bed ridden cases
·
Transport
of referred cases
·
Consumables,
etc.
Sub Centres (SCs)
The
ANM / Male Health Workers will be trained for health care of the elderly. Support will be given for certain appliances and aids
for the elderly. Home based care will be facilitated for bed ridden cases.
Support will be provided for
·
Aids
and Appliances
·
Transport
of referred cases
·
IEC
activities
·
Consumables
etc.
It is proposed that the remuneration of contractual
manpower proposed in the programme will be at par with the HRD under NRHM or
posts in other NCD Programmes with a 5% annual increment.
National Centre of Aging (NCA)
The proposal for National Centre for Aging could not
be considered during 11th Plan. It is proposed to support
development of two National Institute of Aging one in New Delhi and another in
Chennai attached to AIIMS and Madras Medical College respectively.
(i)
Human
Resource Development: MD in Geriatric Medicine is already a MCI approved
course. Medical colleges to be covered under the scheme of Regional Geriatric
Centre will have provision for 2 PG seats in Geriatric Medicine. Apart from
this, a 6 month certificate course in geriatric medicine will be developed for
training of in service candidates in these colleges. Every medical college will
train 6 candidates at a time and there will be 2 session each year.
(ii)
Research:
Research areas will be identified on priority which will include clinical,
programmatic and operational research. Grants made available to Regional
Geriatric Centres will be used for this purpose.
(iii)
Technical
advice will be provided by an Expert Group under the Chairpersonship of DGHs.
The members will be experts in the field of geriatric from across the country
and includes representatives of Dte.GHS and the Ministry of H&FW.
Achievements
so far during the year 2015-16
·
As
on date 104 districts of 24 States/UTs have been covered under this programme.
Amount to the tune of Rs. 17544.71 lakhs has been released for this purpose
upto financial year 2014-15. No separate allocation of funds has been made for
National Programme for Health Care of the Elderly (NPHCE), during 2015-16.
NPHCE is the part of NCD flexible pool under the National Health Mission for
which total allocation at BE stage for 2015-16 is Rs. 527.36 crores.
·
Approval
of the Hon’ble HFM and Hon’ble Finance Minister has been obtained to continue
and expand the tertiary level activities of NPHCE
· Guidelines relating to
establishment of 02 National Centres of Ageing (NCAs) are being finalized in
consultation with all stakeholders and also the administrative approval has
been issued to All India Institute of Medical Sciences (AIIMS), New Delhi and
Madras Medical College (MMC) Chennai, for setting up of National Centres of
Ageing.
·
Guidelines
relating to Regional Geriatric Centres and District level activities of NPHCE
are also being finalized.
·
04
Regional Review Meetings for East, North East, South and North Zone, have been
held with various States and UTs to review implementation of NPHCE in
States/UTs.
·
A
Review Meeting has been held to assess the physical and financial progress in
respect of the 8 RGCs under NPHCE.
·
MoU
with International Institute for Population Sciences (IIPS), Mumbai, for
implementation of Longitudinal Ageing Study in India (LASI) was signed.
Longitudinal Ageing Study in India (LASI) project is to be conducted by
International Institute for Population Sciences (Deemed University), Mumbai
under tertiary level activities for the National Programme for Health Care of
the Elderly (NPHCE). The main objectives of the study are to provide comprehensive
evidence based on health and well-being of the elderly population in India.
LASI is designed to cover four major subjects and policy domain of adult and
older population of India i.e. Health, Health Care & Health Financing,
Social Factors and Economic Situation.
Expected
Outcomes (till 31st March, 2017)
·
20
institutions with capacity to produce 40 postgraduates (MD) in Geriatric
Medicine per year
·
Additional
6400 beds in District Hospitals and 600 beds in Medical Colleges for the
Elderly
·
Geriatric
Clinics in the OPD and Physiotherapy units in the District Hospitals and about
32000 Geriatric Clinics in CHCs/PHCs
·
Free
aids and appliances to elderly population at Sub-Centres
·
Improvement
in life expectancy and better quality of life of the elderly population
13. National Programme for
Prevention and Control of Fluorosis
The Government
of India initiated the National Programme for Prevention and Control of
Fluorosis (NPPCF) in 2008-09 with an aim to prevent and control
fluorosis in the country. So far, the programme has been expanded to cover 111
districts in 18 States in a phased manner.
Objectives of
NPPCF:
- To collect,
assess and use the baseline survey data of fluorosis of Ministry of
Drinking Water and Sanitation for starting the project;
- Comprehensive
management of fluorosis in the selected areas;
- Capacity
building for prevention, diagnosis and management of fluorosis cases.
Strategy
of NPPCF:
·
surveillance
of fluorosis in the community;
·
capacity
building (human resource) in the form of training and manpower support;
·
establishment
of diagnostic facilities in the medical hospitals;
·
management
of fluorosis cases including treatment surgery, rehabilitation
·
health
education for prevention and control of fluorosis cases.
Activities:
- Community
Diagnosis of Fluorosis village/block/cluster wise.
- Facility
mapping from prevention, health promotion, diagnostic facilities,
reconstructive surgery and medical rehabilitation point of view – village/block/district
wise.
- Gap
analysis in facilities and organization of physical and financial support
for bridging the gaps, as per strategies listed above.
(a) Diagnosis of individual cases
and providing its management.
(b) Public health intervention on
the basis of community diagnosis.
·
Behaviour
change by IEC.
·
Training
Assistance provided to States:
Strengthening manpower in
endemic district:
Consultant
Laboratory Technician
Field Investigators (3) for six months
•
Purchase
of equipment for lab including an Ionmeter
•
Training
at various levels
•
Health
Education and Publicity
• Treatment including
reconstructive surgery and rehabilitation
Funds for New districts-Rs. 45 lakhs with
breakup as follows:
(Rs. in lakhs)
|
S. No
|
Activities
|
12th
Plan
|
|
1.
|
Salary
of one consultant / per month and Salary of 3 Field Investigators for 6
months including travel & contingencies
|
9.00
|
|
2.
|
District Laboratory
Equipments (Non-recurring)
|
10.00
|
|
3.
|
Recurring
expenditure for laboratory diagnosis facilities including salary of
Laboratory Technician / per month
|
3.50
|
|
4.
|
Training of medical
and para-medical districts level
|
3.00
|
|
5.
|
One Coordination
Meeting at district level
|
1.00
|
|
6.
|
Medical management
of fluorosis cases including treatment, surgery, rehabilitation
|
15.50
|
|
7.
|
Health Education and
publicity
|
3.00
|
|
T
O T A L
|
45.00
|
For continuing districts-Rs. 20 lakhs
Budget
Allocation:
For 12th Five Year Plan budget is Rs. 135 crores
For 2013-14 - Rs. 10.00 crore
For 2014-15 - Rs. 3.73 crore
For 2015-16 - Rs.2.26 crore.
Two training of
trainers (TOT’s) were held at National Institute of Nutrition, Hyderabad to
train about 50 persons (State Nodal Officers, District Nodal Officer and
District Consultant NPPCF). A joint strategy for IEC is being developed by
Ministry of Health & Family Welfare and Ministry of Drinking Water and
Sanitation for Fluoride and Arsenic affected areas. To achieve this, joint
meetings were held between Hon’ble Ministers and Secretaries of Ministry of
Health & F.W. and M/o Drinking Water and Sanitation followed by a Video
Conference of Secretaries of the two Ministries with the State Secretaries of
the two departments on 13 May, 2015. List of 50 districts across 11 States
have been identified for Joint IEC campaign with Ministry of Drinking Water and
Sanitation. A review meeting with the State Nodal Officers, NPPCF of all
affected States was held at New Delhi on 6th November 2015 along
with the Regional Directors (H&FW) of concerned States.
Review of NPPCF in Prakasam and
Guntur districts of Andhra Pradesh was undertaken. Further, 3 districts in
West Bengal (Nadia, Murshidabad, South 24 Praganas) affected by arsenic were
also visited by Senior Officer of the Directorate.
14. Oral Health Programme
India has a high prevalence of
oral diseases and it is well established that oral diseases are a public health
problem and have a great impact on systemic health. Poor oral health can cause
poor aesthetics, affects mastication adversely, causes agonizing pain and can
lead to loss of productivity due to loss of man-hours.
As per the data from Dental
Council of India, there are approximately 1, 52,679 registered dentists for the
population of about 121 million. Though India is producing a large number of
dental graduates, most of the rural areas in the country do not have service
providers for common oral diseases and hence about 72.6% of the rural
population remains neglected. Apart from this fact, the issue of accessibility
(reaching to the health services) also exists, as it becomes a costly affair
for the rural population to seek oral health related treatment. Promotion of
healthy lifestyles with respect to oral health needs to be considered. World
Health Assembly in 2005 included Oral Health with other non-communicable
diseases (NCDs) for health promotion & disease prevention strategies.
Objectives:-
a) Improvement in the determinants
of oral health e.g. healthy diet, oral hygiene improvement etc and to reduce
disparity in oral health accessibility in rural & urban population.
b)
Reduce
morbidity from oral diseases by strengthening oral health services at Sub
district/district hospital to start with.
c)
Integrate
oral health promotion and preventive services with general health care system
and other sectors that influence oral health; namely various National Health
Programmes (National Tobacco Control Program, School Health Programme, National
Program for Prevention & Control of Fluorosis, National Program for
Prevention & Control of CVD, Diabetes & Stroke etc) education, social
welfare, women and child development, etc.
d)
Promotion of
Public Private Partnerships (PPP) for achieving public health goals
National Oral Health Programme
Taking into account the oral
health situation in the country, Government of India has initiated a National
Oral Health Programme to provide integrated, comprehensive oral health care in
the existing health care facilities with the following objectives:
a.
To improve the determinants of oral health
b.
To reduce morbidity from oral diseases
c.
To integrate oral health promotion and preventive services with general health
care system
d.To
encourage Promotion of Public Private Partnerships (PPP) model for achieving
better oral health.
In order to achieve above listed
objectives, Government of India has decided to assist the State Governments in
initiating provision of dental care along with other ongoing health programmes
implemented at various levels of the primary health care system. Funding has
been made available through the State PIPs for establishment of a dental unit
[at district level or below]
This dental unit equipped with
necessary trained manpower, equipments including dental chair and support for
consumables would be provided to the states through the NOHP. These units,
according to the level of saturation of state’s own dental units, may be
established at district hospitals or in the health facilities below the level
of district hospitals.
Manpower
Manpower, if required, [such as a
Dental Surgeon, a Dental Hygienist & a Dental Assistant] may be appointed
on contractual basis.
Equipment
Equipments for the dental unit
such as dental chair, x-ray machine and other supportive instruments may also
be procured by the State Government.
Consumables
The sanctioned funds can be used
for procurement of consumables required for the unit. The National Oral Health
Cell will also help in imparting training to the Oral health manpower as well
as general health manpower for better integrated approach to better oral
health. In order to increase the level of awareness, the Government of India
will help preparation of prototype Information, Education and Communication
(IEC) materials/Behavior Change Communication (BCC) materials for dissemination
of information.
-
The
National Oral Health Cell will also help in imparting training to the Oral
health manpower as well as general health manpower for better integrated
approach to better oral health.
-
In
order to increase the level of awareness, the Government of India will help
preparation of prototype Information, Education and Communication (IEC)
materials/Behavior Change Communication (BCC) materials for dissemination of
information.
-
Public
Private Partnership model may also be utilized with the private dental colleges;
various dental associations and community based organizations to promote
community based oral health awareness and service delivery, wherever feasible.
-
The
National Oral Health Cell (NOHC) will be monitoring the implementation and
progress of the programme from time to time through established mechanisms.
-
The
National Oral Health Programme (NOHP) was started as a National Programme in FY
2014-15. The program constitutes two separate activities i.e (i) Activities up
to district level which is under the umbrella of NHM (ii) Tertiary level
activities for IEC, training and research activities.
NHM
Components:- NOHP
supports the Health Facilities [District level and below] of the states to
improve the dental care infrastructure and manpower for an efficient oral
health care delivery to the rural population.
·
Manpower
support [Dentist, Dental Hygienist, Dental Assistant]
·
Equipments
including dental Chair
·
Consumables
for dental procedures
Progress
FY 2014-15:-
As on
31st March 2015, funds to the tune of Rs 1.72 Crore have been released to 9
States [Himachal Pradesh, Mizoram, Jammu & Kashmir, Madhya Pradesh, Rajasthan,Sikkim,Gujarat,Nagaland,
Arunachal Pradesh]. NOHP has been able to support the States/UTs to start new
or augment the existing dental care units in the public health facilities at
District/Sub district level. In the process 18health facilities have received
support fully/partially to strengthen the oral health care service for the
community.
Progress
FY 2015-16:-
NPCC meeting for all states/UTs have been conducted and the proposals of 28
states/UTs have been considered for support through the program. A total
approval of Rs12.8 Crore has been recommended to NHM finance for releases to
support activities under NOHP. Till date approvals to the tune of Rs 12.51
Crore has been communicated to 27 states/UTs by NHM division for supporing
NOHP.
15. Indian Council of
Medical Research ICMR
Department
of Health Research (DHR) through Indian Council of Medical Research (ICMR),
aims at bringing modern health technologies to people by encouraging
innovations related to diagnostics, treatment methods as well as prevention-vaccines,
translating the innovations into products/ processes by facilitating
evaluation/testing in synergy with other departments and introducing these
innovations into public health service through health systems research.
Infrastructure Development–Establishment of new
research facilities
Establishment
of Multi-Disciplinary Research Units
Total
62 Multi-Disciplinary Research Units (MRU) in different Medical Colleges have
been approved and funds were released to 48 Medical Colleges in 25 States/UTs
in Government Medical Colleges with the aim to strengthen health infrastructure
at the periphery and create an environment of research in medical colleges.
Establishment
of Model Rural Health Research Units
Model
Rural Health Research Units (MRHRU) is being set up in 5 States to take new
technologies from lab to field for benefit of the society.
Establishing
a Network of Laboratories for managing epidemics & natural calamities
-
A
Network of viral diagnostic and research laboratories is being rolled out to
build capacity for handling outbreaks, managing epidemics & natural
calamities across the length and width of the country. Work has been initiated
for 5 Regional, 11 state level and 35 Medical College Level labs.
-
These
labs will be connected to Asia’s first BSL IV laboratory at NIV, Pune to deal
with most dangerous lethal infections like hemorrhagic fevers, agents of
bioterrorism, etc.
Establishment
of new Centres in un-served and Deficit Health Research Areas
-
Centre
on vaccine preventable diseases
-
ICMR
Field Unit at Keylong in Lahaul & Spiti areas of Himachal Pradesh
-
Samrat
Ashok Tropical Disease Research Centre at RMRI, Patna with a 200 bedded
hospital for research on tropical diseases is ready.
-
Establishment
of National Animal Resource Facility for Biomedical Research, Hyderabad: The
Institution will be the first of its kind for quality laboratory animals for
basic and applied biomedical research in the Country. The Cabinet has approved
the proposal.
Reaching
to the people
-
Tribal
Health Research Forum: A Network of 16 ICMR Institutes. Research programme on
hypertension, nutrition and TB started with a goal of improving health of
tribal and other marginalized communities.
-
Vector
Borne Diseases Science Forum: Multi-centric programmes on malaria, filariasis,
JE/AES initiated. Ambitious public-private partnership for malaria elimination
in Jabalpur to be initiated. New triple drug therapy project with NVBDCP to
support filariasis elimination. Indigenous production of Insecticide
impregnated papers for insecticide resistance developed by VCRC, Puducherry.
Legislation:
Regulatory Issues
-
Assisted
Reproductive Technologies (Regulation) Bill: To accreditate, supervise and regulate
the services of Assisted Reproductive Technologies clinics and banks in the
Country (to regulate medical, social, ethical and legal aspects of surrogacy),
a draft Assisted Reproductive Technology (Regulation) Bill has been developed
and is at advance stage of enactment.
-
Establishment
of Medical/Health Technology Assessment Board for Technology Choice: To develop
guidelines and provide guidance for introduction of cost-effective
technologies/strategies for public health.
Translational
Research-Support to Govt. Initiatives of Make in India Campaign
ICMR
is working on various indigenously developed medical technologies/devices/kits
etc which are cost effective and applicable in primary health care system.
Following major technologies have been developed and launched.
Affordable
Indigenous Technologies launched recently
-
Vaccine
for Japanese Encephalitis (JE)
-
Test
for molecular diagnosis of Thallassemia
-
Magnivisualizer
for cervical cancer screening
-
Strips
and detection system(s) for Diabetes
-
New
test for detection of pathogenic bacteria in food and Technologies for Vitamin
A and Ferritin estimations
-
Development
of PCR based diagnosis procedure for visceral leishmaniasis from Urine samples-
(Non-invasive method)
-
Novel
noninvasive method for diagnosis of visceral leishmaniasis by rK39 testing of
sputum samples
Technologies Ready for Launch
-
Diagnostic
kit for lung fluke disease (paragonimiasis)
-
Kits
for leptospirosis – prevalent in Karnataka, Gujarat, Tamil Nadu and several
other states.
-
Kit
for diagnosis of chlamydial infection prevalent in women.
-
Kits
for hormone assays: for various sex hormones useful for reproductive health
problems
-
Cooling
jacket for persons exposed to hot atmosphere
Research
Highlights from ICMR
-
Established
National Anti Microbial Resistance Surveillance Network
-
Established
National Hospital Based Rotavirus Surveillance Network
-
Research
cum Intervention project on AES/JE
-
ICMR-INDIAB,
an epidemiological study on diabetes was completed in 5 states.
-
Management
of Acute Coronary Event Registries: Structured data capture of acute coronary
syndromes is the first step in improvement of quality of treatment. The
feasibility study was undertaken under in 13 public and private hospitals
across India and recruited 1515 confirmed ACS patients ≥ 18 years.
-
A
Centre for Advanced Research for Innovations in Mental Health and
Neurosciences: Manpower
-
Development
and Translational Research at NIMHANS, Bangalore has been initiated.
-
A
stroke registry was set up in rural and urban population of Bangalore and
Ludhiana.
-
DHR/ICMR
guideliens for diagnosis and treatment of rickettsial infections in the
country.
-
TF
study launched towards establishment of National Institute of Zoonosis at
Nagpur.
Dealing
with Sickle Cell Anemia and G6 PD Deficiency
-
Satellite
Centre of NIIH at Chandrapur Maharashtra has started working on screening and
management of sickle cell diseases.
-
Providing
mobile phones to sickle cell disease families has given a tremendous response
and by giving necessary medical advises helped to reduce morbidity and
mortality.
-
Genetic
Counseling has helped the 19 tribal couples at risk having Sickle Cell babies
opting for prenatal diagnosis to avoid birth of affected child.
-
Prenatal
diagnosis for preventing the birth of babies with severe genetic disorders like
haemoglobinopathies, haemophilia, severe immuno-deficiencies, anemia was
offered to more than 100 families.
-
G6Pd
deficiency was found to be problem among the tribals of Gujarat, Madhya Pradesh
and Chattisgarh and irrational use of anti-malarial drugs are matter of
concern.
Other
Blood Disorders
-
Established
the molecular diagnostic facility laboratory at Agartala Medical College,
Tripura which has helped in diagnosis of different haemoglobin abnormalities
and enzymopathies to the population of Tripura
-
Complementation
groups in Indian Fanconi anemia (FA) patients are discovered as 30% patients of
FA remain undiagnosed molecularly.
-
Registry
for rare blood groups like Bombay Phenotype is available. ,Work on rare donor
registry is initiated.
-
Techniques
for non-invasive foetal RhB typing are being established.
M-Health/E-Health
-
Development
of MoSQuIT - A mobile based diseases surveillance system for malaria using
mobile platform developed by Regional Medical Research Centre (RMRC), Dibrugarh
in collaboration with CDAC, Pune and deployed in Tengaghat PHC of Assam with 10
sub-centres.
-
Mobile
Edutainment for TB prevention, curative TB Management, Entertainment (TB
related mobile games).
-
Development
of Cancer Web Portal for cancer awareness among the public developed by ICPO,
Noida.
-
Learning
Progarmme in Health Research: NIE-NPTEL (National Programme on Technology
Enhanced Learning) planning to launch various courses in Health Research
including areas of bio-ethics, good clinical lab practices, Research Methods,
etc.
-
Partograph:
Plotting of partograph during labour using software has been developed in collaboration
with IIT Delhi. This can be used by peripheral health workers to monitor
progress of labour, send electronic message to referral centres for seeking
advice or information; and it can also be used as a self-learning tool or
teaching aid. Field validation of the software is ongoing.
Important
Databases/ Knowledge bases
Tuberculosis
(Developed by NIRTH, Chennai)
A.
TBDRUGS
-Database of Drugs for Tuberculosis
B.
DDRTB-
Database for Drug Resistant Tuberculosis
Nutrition
(Developed by NIN, Hyderabad)
A.
Food
and Nutrition Database
B. Diet Calculator with
recipes and Recommended dietary Guidelines
C.
National
Food Borne Disease Surveillance Portal
Addressing
Impact of Climate Change on Human Health and Promoting use of Space Technology
tools like Remote Sensing/GIS in Diseases mapping/early warning
-
Development
of Japanese Encephalitis (JE) Early Warning system for Upper Assam
-
Determined
Climate suitability for Cholera using weather parameters
-
Map
for filariasis in 3 blocks of Orissa
-
Impact
of deforestation on malaria vectors in Sonitpur, Assam
-
Mapping
of village level ecological risk of malaria
-
Mapping
of dengue mosquito breeding in Delhi
-
Niche
modeling of Kala-azar vector
-
Up-scaling
of Models for predicting filariaisis (LYMFASIM and GERM).
-
Communication
about nutrition in rural areas through Space Technology
-
Early
warning System for outbreaks of malaria and dengue using satellite data
(vegetation index/Temperature Condition Index)
Human
Resource Development in the area of Health Research: Support to Skill India
-
To
attract young graduates, both from medical and allied disciplines to research,
ICMR has tried to create a variety of programs as mentioned below
-
ICMR-Junior
Research Fellowship, Senior Research Fellowships, Post-Doctoral Fellowship
-
Short
Term Studentship (STS) Program
-
Fellowships
for training abroad in identified areas (6 to 12 months)
-
Fellowships
to women candidate having break in career
International
Cooperation in Health Research
-
Ongoing
partnerships in Health Research (under 7 MOUs) with various international
organizations/agencies during last one year.
-
Total
28 exchange visits of Scientists were arranged for various international
collaborative programmes/projects.
-
MOU
signed with National Institute for Health and Care Excellence (NICE), UK
-
International
Research Co-operation – Seventy Seven projects approved by Health Ministry’s
Screening Committee
-
Total
12 Scientist and 6 Senior Scientists were selected for ICMR International
Fellowship during 2015-16.
Key
Challenges
The
ICMR is committed to the vision of Govt. of India in addressing the current
health challenges of persistent and new communicable diseases, increasing
non-communicable diseases, emerging infections, climate change related problems
with triple burden due to trauma and disabilities and need for more focused
efforts on marginalized and vulnerable population. ICMR has identified
following challenges for future Research:
-
Strengthen
efforts to eliminate diseases like filariasis, leishmaniasis, and leprosy.
-
Control/management
of malaria, dengue/ chikungunya /lung fluke and HIV
-
Support
in developing vaccines for cholera, typhoid, chikungunya, Japanese Encephalitis
(JE), tuberculosis (TB) etc.
-
Strengthening
the National Anti-Microbial Resistance Surveillance Network (AMRSN)
-
Twin
problems of under nutrition and increasing percentage of childhood obesity,
micronutrient deficiencies, toxicity due to arsenic and fluoride, pesticides
etc.
-
Adequate
availability of drugs and devices at affordable prices.
Other
Initiatives of the ICMR/Success Stories
-
In
a bid to promote inter-department collaboration a DHR/ICMR and MHRD joint
Workshop on Medical Devices was held in Sep 2014 and an Exhibition was hosted
at Rashtrapati Bhavan in March 2015. Forty Six innovative technologies of
public health significance were displayed in the Exhibition. Researchers from
various ICMR, IITs, IIM (A), DBT, DST, DeitY, DRDO, ISRO, Ministry of textile
and industry, ASSOCHAM, FICCI and PHD Chamber of commerce participated in these
events. Report of the workshop is available on website.
-
Management
of Acute Coronary Event Registries: Structured data capture of acute coronary
syndromes is the first step in improvement of quality of treatment.The feasibility
study was undertaken under in 13 public and private hospitals across India and
recruited 1515 confirmed ACS patients ≥ 18 years. A web based secure
electronic data capture and management system was developed to expedite data
collection from dispersed sites. MACE registry Feasibility study showed that establishment of
multicentric hospital based registry of ACS through a web based system in India
is feasible. Pilot Study is ongoing. The study will enroll 10,000
patients admitted in public and private hospitals. The 12 participating nodal
registries will each take up sub-registries with and without PCI facility.We
feel that as the system matures and gets greater acceptability among
caregivers, the data may help in not only standardizing 'Best Practices' but
also rating institutions. The registry has a great potential for evolving low
cost methods of ACS care across institutions with varying infrastructure and
capacities.
-
A
stroke registry was set up in rural and urban population of Bangalore and
Ludhiana. The study was completed in this year. A model for urban and rural
stroke registries has been developed.
-
Report
of Jai Vigyan study on Rheumatic Fever and Rheumatic Heart Disease has been
placed on website. The study observed (i) Prevalence of RHD in 5-14-year-old
students ranged from 0.2 to 2.2/1000 (median 2) (ii).Secondary prevention of
RHD is possible through registry approach is possible (iii) Heterogeneity of
Group A Streptococcus strains isolated from different parts of the country was
observed, making development of vaccine using N terminal of M protein of GAS
isolates difficult. Translation Research: Upscaled to Punjab State’s “School
Rheumatic and Congenital Heart Disease Control Program” in 2008 and is still
continuing in the state.
-
A
comprehensive clinical and neuropsychological test battery for use in the
Indian context for patients with Vascular Cognitive Impairment has been
developed. Validation exercises for this tool have been undertaken this year.
The tool will help in detection of mild cognitive impairments.
-
A
multi centric study on Prevalence of Hearing Impairment has been initiated
covering six major regions of India viz North, South, East West, Central and
North-East. The study will assess prevalence of mild, moderate and severe hearing
loss in the community.
-
Neuro-Muscular
Disorder is a disease which has no treatment and very poor prognosis.Tthere is
no clue as to why it happens. Therefore, ICMR has finalized projects to
look into the Genotypes underlying Duchenne Muscular Dystrophy phenotypes
besides A comprehensive clinical assessment, genetic testing and rehabilitation
.Projects will be undertaken on–DMD/BMD and SMA studies as well as
Project On Limb Girdle Muscular Dystrophy
-
Preparation
and dissemination of SOPs - published the complete set of study protocols and
SOPS in a high impact peer-reviewed journal that is also available as an open
access resource (Balakrishnan et al. 2015). This study has generated one of
the largest datasets of direct household level 24-hr PM2.5 measurements in India.
-
The
exposure-response relationships from the Adult Respiratory health fill a
critical gap in the national and global literature for potential effects of air
pollution on young, non-smoking populations.
-
Birth
and adult cohorts have been created and maintained to examine health effects
from air pollution exposures at one site in Tamil Nadu.
-
The
large base of exposure information generated in the study has allowed the
development of exposure models that could be based on information on household,
land use or demographic variables that are more easily collected.
-
Evidence
from this study could pave the way to include reduction of air pollution
exposures in intervention efforts. This could for e.g. include behavioral
changes to reduce exposures from household solid fuels during pregnancy and for
young children, shifts to cleaner sources of household energy in rural
households currently dependent on solid fuels and improvements in urban air
quality management programs.
-
The
First Report of Development of an Atlas of Cancer in Punjab State for the years
2012-2013 completed. The First report for the combined years 2012 and 2013 for
districts and centres gives an idea of the prevailing patterns of cancer by district
in Punjab State. Under this project, a cost-effective design and plan using
advances in modern electronic information technology, was conceived, to collate
and process relevant data on cancer.
-
The
Patterns of Care and Survival Studies in Cancer Breast, Cervix and Head &
Neck Cancers for the year 2006-2008 is under publication. The main findings
are:
-
In
locally advanced cervical cancer significant survival benefit was observed when
treated with a combination of radiation with cisplatin than radiation alone
-
The
same observation was seen in patients with locally advanced cancers of the oro
and hypo-pharynx.
-
In
cancer of the breast a high proportion of early stage patients had mastectomy
with poorer survival compared to breast conserving surgery which is the usual
practice.
-
Development
of Software Applications Programme with specific modules is a primary mandate
of the NCDIR and as part of Translational Research is a major activity of the
centre. An overview of the applications is given immediately after this
section.
-
The
report of North East Cancer Atlas (other than areas where PBCRs exist) has been
prepared.
-
Population
Based Cancer Registry at Patiala –The data for 2011-2012 has been finalised. Data has
been published by PBCR Patiala in form of a report.
-
Review
– PBCRs:
As per the PBCR Review system formulated by NCDIR, with the purpose of
improvement in various issues of PBCR i.e. coverage, timely data submission,
data quality etc. A detailed study of each registry has been carried out and a
document has been prepared.
-
To
verify the completeness of data obtained through Punjab cancer atlas we have
conducted a cross-sectional survey of almost 1, 00,000 individuals (around
25000 families) in four districts of Malwa region in Punjab. Those are, Muksar,
Batinda, Mansa, and Barnala. During the same study we have planned to get the
estimate of magnitude of other three NCDs, i.e., diabetes, CVD, and stroke.
-
Making
cancer a Notifiable Disease - Karnataka State: Government of Karnataka vide
notification No. HFW 189 CGM 2015 dated 25.07.2015 has made cancer a Notifiable
Disease in Karnataka State.
-
Radiotherapy
Module with Discharge summary: An intranet software module for Radiotherapy (RT)
department, based on the RT chart used by JIPMER, Regional Cancer Centre,
Puducherry has been developed by NCDIR-NCRP, Bangalore. Once data has been
captured with this module, the related data on HBCR and POCSS will be uploaded
to NCRP-NCDIR website. So the registry staff can retrieve the case from their
HBCR login and fill the remaining information. This module has the provisions
to generate the hard copy of the RT chart and also the discharge summary which
will be given to the patient at the time of completion of treatment.
Software Development at NCDIR
-
Hospital
Based Cancer Registry (HBCR) – Pattern of Care and Survival Studies (POCSS) Data
Entry
-
HBCR-HIV
Data Entry
-
Onset
Young Diabetes Registry data entry software.
-
Independent
modules:
Pathology Data Entry with outputs/reports; Radiotherapy Data Entry; Surgical
Oncology Data Entry; Medical Oncology Data Entry
-
E-Monitoring: Online Data status
for RCCs and budget estimation; Online Data Status - HBCRs, POCSS, Pathology,
Radiotherapy etc.; Online registration for independent modules; Core Form
stock; HBCR File Maintenance; QC Management ; Data Entry Operators daily data
entry count
-
Ongoing
Software development :
Dynamic data entry, JIPMER RT Module
-
Population
Based Cancer Registry
-
PBCRDM
2.1.1: New version of PBCRDM 2.1
-
Data
Entry Programme (www.pbcrindia.org):
-
Dynamic
table generation (www.pbcrindia.org):
-
Book
Report Generator:
Other software development
-
Stroke
Registry:
-
Punjab
Cancer Atlas Survey
Admin Softwares
-
File
Movement for Administrative Department
-
Annual
Maintenance Contract(AMC) Management
-
Application
for Biometrics Attendance Report Generation
Occupational Health
Biomass fuel use and adverse neonatal/perinatal
outcome
-
The
study observed that low birth weight, lesser head circumference, neonatal
death, less developed genitalia and need to stay at nursery was more frequent
with mothers using biomass fuel when compared with other fuel users.
-
Significantly
increased risk of ‘low birth and ‘need of newborn to stay in neonatal care
unit’ in the form of calculated odds ratio was observed in biomass fuel users.
-
Coal
and wood were major source for VOCs and particulates exposure during cooking
followed by kerosene and LPG.
Health hazards of workers in ceramic industries and
iron foundries
-
Sleeplessness,
muscle cramps and fatigue, excessive feeling of thirst, heavy sweating,
elevated body temperature and headaches were main responses of workers during
their daily work schedule.
-
General
systemic health complaints as reported were musculoskeletal discomforts,
digestive discomforts, respiratory discomforts, cardiovascular discomforts and
visual discomforts.
-
Among
ceramic workers, pain in lower extremities and upper extremities was reported
due to awkward posture of work for long hours and manual material handling.
Among iron foundry workers, workers reported of lower back pain followed by
knee pain and legs pain.
Seroprevalence of human brucellosis among
veterinarians
-
Human
brucellosis was found positive in 13.15% of the subjects using traditional RBPT
screening test.
-
Recent
or acute infection was found positive by IgM ELISA in 15.52% cases and possible
chronic infections was observed in 19.47% which is diagnosed based upon IgG
antibodies titre and gives >90% accuracy of the result.
Long-Term Exposure to Lead and Musculoskeletal
Disorders
-
Blood
lead level among lead exposed workers was associated with odds of
musculoskeletal morbidities. The Hb%, serum calcium, magnesium and handgrip in
both hands were lower in workers with musculoskeletal disorders.
-
Highly
sensitive C-reactive protein, an inflammatory marker was significantly
increased in lead exposed workers having MSD compare to non-symptomatic
subjects.
-
Workers
having MSD has shown decreased muscle strength in both hands as compared to
non-symptomatic workers.
Coal miners and Health effects
-
The
common respiratory complaints observed among coal miner was cough in 29 (6.6%)
workers of which only 17 (3.9%) had productive cough.
-
Breathlessness
and haemoptysis was reported by only 11 (2.5%) and 3 (0.7%) coal miners
respectively. The other symptoms observed among coal miners were tiredness
(3.4%), backache (6.6%) and difficulty in hearing (5.2%).
-
Similarly
in the resident groups only 7 (2.5%) reported cough of which 4 (1.4%) had
productive cough.
Utility of Personal Cooling Garment for use in
Outdoor Hot Environment
-
Study
suggests that PCG provided a practical and economical way of alleviating the
discomfort and physiological effects of heat stress when environmental control is
not practical.
-
Developed
PCG device was demonstrated at: (1) Rashtrapati Bhawan, New Delhi on 11 Mar
2015, (2) Vibrant Gujarat Exhibition from 7-13 January 2015, and (3) PCG
technology transfer to Industrial partner Soothe Healthcare Pvt. Limite, Noida.
Other Initiatives:-
-
Interdepartmental
Collaborations between ICMR Institutes and IIMs IITs are being targeted through
signing of MOUs. The aim is to undertake collaborative innovative translation
research projects in the areas of public health.
-
School
based interventions for prevention of CAD and affordable technologies for
neurological disorders are being planned.
-
A
Centre for Advanced Research for Innovations in Mental Health and
Neurosciences: Manpower Development and Translational Research at NIMHANS,
Bangalore has been initiated.
Medicinal Plants
-
In
continuation of the series Reviews on Indian Medicinal Plants three
volumes (Vols. 14-16) covering monographs on 680 Medicinal Plants species with
botanical names (L-M) are in the press.
-
-
Quality
Standards on 35 Medicinal Plants were developed and monographs published as
Vol. 13 of the series Quality Standards of Indian Medicinal Plants.
-
-
A
MoU between ICMR and Pharmacopoeal Commission of Indian Medicine (PCIM),
Ministry of Ayush was signed on 10.4.15 under which 120 PRS generated through
extramural projects of ICMR were transferred to PCIM along with all spectral
data for characterization and Quality Assurance of Ayurveda, Siddha & Unani
Drugs (ASU) drugs. This will lead to wider acceptance of Traditional Medicines
in India and abroad, as quality assurance is the key issue. Volume 4 of the
Phytochemical Reference Standards (PRS) of Selected Indian Plants is being
finalized.
-
Two
Task force meetings were convened on Diabetes and its complications as well as
stress induced sleep disorders to review the research leads available and
identifying the research gaps, and develop a strategy in National perspective
towards positioning of the drug considering the disease burden, market size,
USP (unique selling point) and sustainability of the product with low risk and
high gain by involving industrial representatives, clinicians and Ayurvedic
experts etc.
-
A
compendium on the safety aspects of important Indian Medicinal Plants is being
compiled.
-
Regular
updating of the website developed exclusively on the divisions activities which
is hyperlinked with the Councils main website. This website gives abridged
digitized version of the publications brought out by the Division.
-
Retrieval
and dissemination of information.
-
Human
resource development. A three days’ Workshop-cum-training program sponsored by
ICMR on Standardization of Medicinal Plants and their Products was organized at
Shoolini University of Biotechnology and Management Sciences, Solan, Himachal
Pradesh from March 22-24, 2015.
-
|
-
|
-
|
-
This
program aimed to update the professionals working in the industry and academia
on latest developments in the technologies, methodologies and regulatory
requirements for Medicinal Plants and herbal products.
International Health
Joint Working Group (JWG) and Joint Steering
Committee (JSC) Meetings
Following JWG/JSC meetings under various MoUs and
Joint Statements have been held:
-
ICMR-MRC
working level meeting at New Delhi on 23rd April, 2015 (through
videoconference)
-
Indo-US
Joint Steering Committee on Diabetes at New Delhi on 29th April, 2015 (through
videoconference)
-
1st
JWG meeting between India and Indonesia at Nirman Bhawan, New Delhi (under
bilateral prog. Of MOH&FW).
The International Workshops/ meetings held under
Bilateral/multilateral programmes
-
SAFHeR
Foundation workshop in Clinical & Laboratory Medicine Research on 9-12th
Feb., 2015 at NIOP, New Delhi.
-
India-ASEAN
workshop on Malaria Research held on 11th – 15th May, 2015 at NIMR, New Delhi
under DST coordinated
programme.
The following MoUs have been signed during this
period:
-
Memorandum
of Understanding between ICMR and University of Sydney, Australia for collaboration
in Health Research signed in Jan./March, 2015
-
Memorandum
of Intent between ICMR & FORTE, Sweden was signed on 2nd June, 2015 in
Stockholm.
-
Letter
of Intent between ICMR, DBT & the National Institute of Allergy &
Infectious Diseases, National Institute of Health, USA for collaboration on
Anti-Microbial Resistance Research was signed on 25th June, 2015 in MoH&FW,
New Delhi.
-
Memorandum
of Understanding between ICMR and the Centers for Disease Control and
Prevention, USA on collaboration in Environmental and Occupational Health &
Injury Prevention and Control was signed on 25th June, 2015 at MoH&FW, New
Delhi.
-
Memorandum
of Understanding among National Cancer Institute (NCI) of AIIMS, MoH&FW,
Govt. of Republic of India, ICMR and the Department of Biotechnology, Ministry
of Science & Technology, Govt. of Republic of India and the National Cancer
Institute of the National Institute of Health, Govt. of the United State of
America (USA) for Cooperation on Cancer Research, Prevention, Control and Management
was signed on 25th June, 2015 at MoH&FW, New Delhi.
-
MoU
between ICMR and Drugs for Neglected Diseases Initiative (DNDi), Switzerland
was signed on 15th October, 2015 at New Delhi.
-
Memorandum
of Understanding between Medical Research Council, UK & ICMR was signed on
10th November, 2015 at New Delhi.
-
GoI
approvals obtained for ICMR-NHMRC, Australia; LSHTM, UK (Ready to be signed).
-
Pending
ICMR MoUs for GoI clearances – Indo-US, MCH; ICER, USA; ICAV, Canada; BMGF,
USA.
Exchange Visits
A total of 28 exchange visits of scientists /
officials to and from India were arranged during the period under reference for
various international collaborative programmes / projects.
Health Ministry’s Screening Committee (HMSC)
The research projects involving foreign assistance
and/or collaboration in biomedical/health research are submitted by the Indian
investigators to ICMR for approval of Govt. of India through Health Ministry’s
Screening Committee (HMSC) and the International Health Division of ICMR acts
as the Secretariat for HMSC. The projects are peer reviewed by the concerned
Technical Divisions at ICMR and then placed before the HMSC for consideration
and decision. During the period, seven meetings of Health Ministry’s Screening
Committee were organized, wherein 104 projects were considered and out of
which 75 projects were approved for international collaboration / assistance
with agencies from USA, Canada, UK, New Zealand, Australia, Norway EU and
several other foundations and foreign universities. Out of which, seven
projects are co-funded by ICMR.
International Fellowship Programme
-
Selection
Committee Meeting of ICMR-International Fellowships for Indian Biomedical
Scientists for 2015-16 was held on 30th June, 2015 wherein 12 Young Scientists
& 6 Senior Scientists have been selected and will avail training during
2015-16 of which 3 senior fellows & 3 young fellows have left for availing
ICMR International Fellowship for 2015-16.
-
Reports
of 10 Young & 4 Senior Scientists who availed fellowship during 2014-15
have been uploaded on ICMR website.
-
The
Selection Committee Meeting of ICMR International Fellowship from Developing
Countries was held on 13th April, 2015 of which Mr. Mohammed Soloman Ali, Jimma
University, Ethiopia was selected for ICMR International Fellowship at NIRT,
Chennai for a period of 6 months.
-
In
this connection, the approvals from MOH, MEA and MHA have been obtained by
ICMR.
Transfer of biological material for commercial
purposes
-
Announcement
made for submission of applications for transfer of human biological material
for commercial purposes and/or research and development of commercial products
with deadlines 30th April, 2015 and 31st July, 2015 were made.
-
236
cases were considered and 162 approved by the Committee in its three meetings
held on 25th Feb., 2015, 26th May, 2015 and 26th Aug., 2015.
-
Call
for applications with next deadline of 31st January, 2016 will be uploaded on
ICMR website.
Biological and Toxin Weapons Convention related work
-
ICMR
is part of an Inter-Ministerial Committee which advises the Disarmament and
International Security Affairs (DISA) Division of Ministry of External Affairs,
GOI for the negotiations on the Biological and Toxin Weapons Convention during
various consultations.
-
The
activities related to Biological Weapons Convention in coordination with
Ministry of External Affairs, GoI are coordinated. (The activity was handed
over to the Div. of International Health in March, 2011).
-
On
request from the DISA, Division of Ministry of External Affairs, GoI;
representative of ICMR participates (as part of the Indian delegation led by
MEA, GoI), in the annual meetings of State Parties to the Biological Weapons
Convention (BWC) held in Geneva for discussions/inputs on items such as
cooperation and assistance, with a particular focus on strengthening
cooperation and assistance; review of developments in the field of science and
technology related to the Convention; strengthening national implementation and
how to enable fuller participation in the Confidence Building Measures (CBMs).
Joint Call for Proposals
Call for proposals under ICMR/BMBF (Germany)
uploaded on ICMR website on 15th Oct. 2015 with a deadline to submit the
proposal till 6th January, 2016.
Other initiatives
-
Satellite
Centre of NIIH at Chandrapur Maharashtra has started working on screening and
management of sickle cell diseases.
-
G6Pd
deficiency was found to be problem among the tribals of Gujarat, Madhya Pradesh
and Chhattisgarh and irrational use of anti-malarial drugs are matter of
concern.
-
Providing
mobile phones to sickle cell disease families has given a tremendous response
and by giving necessary medical advises helped to reduce morbidity and
mortality.
-
Genetic
Counselling has helped the 19 tribal couples at risk having Sickle Cell babies
opting for prenatal diagnosis to avoid birth of affected child.
-
Prenatal
diagnosis for preventing the birth of babies with severe genetic disorders like
haemoglobinopathies, haemophilia, severe immuno-deficiencies, anemia was
offered to more than 100 families.
-
Established
the molecular diagnostic facility laboratory at Agartala Medical College,
Tripura which has helped in diagnosis of different haemoglobin abnormalities
and enzymopathies to the population of Tripura
-
Complementation
groups in Indian Fanconi anemia (FA) patients are discovered as 30% patients of
FA remain undiagnosed molecularly.
-
20
Blood Bank Officers and Technicians from all over the country have been trained
in Blood Banking procedures. Recently training was also given to Blood Bank
Offices and Technicians from North East States of India.
-
Registry
for rare blood groups like Bombay Phenotype is available; work on rare donor
registry is initiated.
-
Techniques
for non-invasive foetal RhB typing are being established.
-
Revitalization
of Traditional Medicine:
Regional Medical Research Centre, Belgaum with the mandate to work on
Traditional Systems of Medicine, initiated its activities on documentation,
conservation and scientific evaluation of traditional ethnomedicinal practices.
The leads were identified for chronic conditions like arthritis and diabetes
and are being taken up for clinical studies. The Centre is aiming towards
Centre of Excellence in non-codified traditional systems of medicine and also
National Institute of Traditional Medicine. The efforts in this direction are
being made to achieve the target by taking up the robust observational studies
to create evidence for the age old system of traditional healing, by scientific
evaluation of the claims for their safety and efficacy and through validation
by clinical trials.
-
Social
& Behavioural Research: ICMR has initiated 16 new projects in different
aspects of Gender & Health and social-behavioural aspects. A new joint
initiative of ICMR-ICSSR has been taken and through a call for proposals in the
designated identified priority areas, about 250 proposals have been received:
These studies have looked into social and behavioural aspects of health of
people including women/gender issues and marginalized groups and Dalits and
youths and would suggest intervention/policy measures for effective delivery
and better utilization of services. This would lead to better health of people
of the country.
-
Dengue
awareness campaign at Community college of Madurai Institute of Social Sciences
(MISS), Madurai:
Madurai Institute of Social Sciences (MISS) is one among the leading academic
college under Madurai Kamaraj University. A team of Scientists from CRME,
Madurai visited MISS on 4th November 2015 to create awareness on dengue
prevention. A total of 40 students participated in this programme. They were
taught about the current situation of dengue in various parts of our country
including in this part of region and their major role to play with the
community. The programme was inaugurated by the Community college Principal and
Dr. T. Mariappan delivered the training to the students. The class room
training held on 4th November 2015 at community college (MISS) with more
specifically on vector mosquitoes Aedes aegypti and Ae. albopictus and its role
on transmission of dengue and source of breeding habitats and its control
measures with emphasis on source reduction measures. They were provided with
IEC materials to talk to the people in various villages in and around Madurai
to reduce dengue incidence. Dr. T. Mariappan was accompanied with technical
staff of CRME Mr. V. Murugesan and K. Moorthi along with the required training
materials.
****
MV