Monitoring National Health Programs Checklists

1
Monitoring National Health Programs
A new approach for quick & frequent monitoring
By independent public health faculty members
March 2020

2
Background & Purpose of this exercise:
We have a group of 254 “Public Health Faculty members” from different Medical Colleges
across India, which is active on electronic media discussing important issues regarding,
National & International Public Health scenario. We had a brief discussion in this group
about issues related with monitoring of National Health Programs. These programs are
being implemented across the country, investing huge financial inputs & manpower. We
realized that monitoring of these programs to identify gaps and to introduce timely mid
course corrections needs further strengthening. The monitoring of National Health
Programs is taken up infrequently and mostly by program managers who are involved in
implementing the program which may create conflict of interest.
The independent reviews of National Health Programs by international Agencies although
considered accurate & impartial, are very few, infrequent and at times may address limited
scope of work requested to these agencies. The reviews published by news papers and
media channels are often found to be exaggerating few points to make a sensational news
and often lack the logical professional and scientific review. The large list of parameters or
indicators being presently used is considered ideal & comprehensive but often collection,
reporting & timely analysis of so many indicators poses a challenge. As a result often the
large reports of the National Health Programs may not be able to highlight timely the
action points for mid course correction.
Considering the above challenges this exercise was planned to compile checklists of
selected output indicators, which are often reported & can be compared to assess
periodically the progress of National Health Programs. Five programs were selected
for this initiative. The purpose is to use the analysis of information to plan &
implement timely mid course corrections to improve the quality & efficiency of the
programs.
I am grateful to the team of 26 faculty members as 5 Work Groups from different
Medical Colleges, across the country & Editorial Team of 10 faculty members, who
have worked hard without any honorarium for 2 months after their office hours due
to their passion for this initiative & to develop this report. I have only tried to keep our
vision focused, coordinated the process & helped in refining the checklists. Regarding any
comments, suggestions, queries & clarifications concerning the whole document, please
feel free to communicate with any member of editorial group with a copy to me. In case of
same issues as stated above, related to contents & checklist of any work group, please
feel free to write back to any member of work group with a copy to me.
Dr R K Pal
MBBS, MD (Community Medicine), MPH (University of North Carolina, U.S.A.)
Professor, Community Medicine And
Ex National Professional Officer, WHO India Country Office, New Delhi

3
Disclaimer
This is a voluntary effort by all the faculty members stated in this report, in their own
independent capacity. The work has been completed by working after office hours on
our own initiative and will, without taking any support or financial inputs in any form
from any one. The contents developed and quoted represent our own understanding
and inputs and not of any institution.
Reproducing, Quoting & Copying Contents of this Report : in
electronic or print media is permitted with the condition that due acknowledgement,
and reference is quoted. Commercial use of contents of this report including the
checklists is NOT permitted.
Acknowledgements:
The contribution of each member of all the five work groups mentioned in this report
is gratefully acknowledged. We acknowledge the valuable inputs received from all
the references & documents quoted in this report which have helped to enrich our
understanding and content of this report.
Members of Editorial Team

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Members of the Editorial Team of this Report:
Dr. Abhilash Sood
Associate Professor,
Department of Community Medicine,
Dr. Radhakrishnan Government Medical College,
Hamirpur, Himachal Pradesh.
Email: abhilashsood@yahoo.co.in
Dr. Ipsa Mohapatra
Associate Professor
Kalinga Institute of Medical Sciences, KIIT University,
Bhubaneswar, Odisha
Email: dr_ipsa@yahoo.co.in
Dr. Mitasha Singh
Assistant Professor
Department of Community Medicine
ESIC Medical College,
Faridabad Haryana
Email: Mitasha.17@gmail.com
Dr. Nilanjana Ghosh
Assistant Professor
North Bengal Medical College
West Bengal
Email: drnilanjanaghosh@rediffmail.com

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Dr. Pallavi Boro
Assistant Professor
TRIHMS, Naharlagun,
Arunachal Pradesh
Email: boropallavi@gmail.com
Dr. Paramita Sengupta
Professor and Head
Department of Community Medicine and Family Medicine
AIIMS Kalyani
West Bengal
Email: drparamita2425@gmail.com
Dr. R K Pal
Professor
ESIC Medical College
Faridabad Haryana
Email: rkpal.nhsrc@gmail.com
Dr. Shweta Goswami
Assistant Professor
Faridabad Haryana
Email: doc.shweta12@gmail.com

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Dr. Sneha Kumari
Assistant Professor
Faridabad Haryana
Email: sneharanjan811@gmail.com
Dr. Shrishti Yadav
Senior Resident
ABVIMS & Dr. RML Hospital, New Delhi
Email: dr.srishti@yahoo.in

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Introduction to contents of this Report:
S.N. Contents Page
1 The Aim of this Exercise 8
2 Short Term & Long Term Objectives 8-9
3 How to use & who may find monitoring checklists useful 10
4 Limitations of enclosed checklists 10
5 Report of Work Groups (including, Objectives, Activities & Progress of
National Health Program, References of documents reviewed &
Introduction of Work Group Members including their Public Health
Experience.
5.1 Monitoring of National Tuberculosis Eradication Program 11-16
5.2 Monitoring of Ante Natal Care & Infant Immunization 17-21
5.3 Monitoring of Malaria & Dengue 22-28
5.4 Monitoring of Ayushman Bharat Scheme 29-35
5.5 Monitoring of National Program for prevention & control of Cancer,
Diabetes, CVD & Stroke.
36-43
6 Monitoring checklists for National Health Programs stated above at
serial No. 5.1 to 5.5. (Enclosed as Excel Sheets 5.1 to 5.5)

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Aim of this Exercise:
We have tried to demonstrate a new approach through this exercise that the
interested faculty of Community Medicine / Public Health, from different Medical
Colleges/ institutes across the country can contribute in quick & frequent
monitoring of National Health Programs for mid course corrections.This approach will
also help to avoid the conflict of interest and risk of influencing the evaluators. Most of
these faculty members, have substantial experience of working in public health projects
(please see under the heading – Introduction of Members of Work Groups in following
pages) and they are also teaching and guiding the MBBS undergraduate students, interns
& Postgraduate students of community medicine / Public Health. Hence the trained
manpower is already available. This is now the challenge for Ministry of Health,
National Institutes & International Health Agencies, whether they are willing to take
up the initiative for collaboration and to support the necessary financial inputs to
utilize the opportunity.
This exercise is also aimed to encourage the faculty colleagues & post graduate
students to take this initiative forward and engage themselves in research and dissertation
in the area of monitoring of National Health Programs & Public Health Projects. The results
of such research & dissertation will help the policy makers and program managers to
improve the quality & efficiency of our national health programs.
In this exercise we are focusing only on output indicators which help us to assess the
progress of services planned under the National Health Programsfor community
members & patients. The detailed compilation & analysis of input, process, impact &
outcome indicators is being planned under long term objectives of this initiative.
Short Term objectives of this Exercise:
i. To develop checklists of monitoring indicators for services planned for
community members & patients under 5 selected National Health Programs.
ii. To select indicators which are often reported, comparatively more reliable and
are helpful in identifying the gaps in the program quality &effectiveness.
(enclosed as 5 checklists)

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Long Term objectives of this Exercise:
i. To assess the strength & feasibility of selected indicators for collecting,
compilation and analyzing the relevant statistics from health care facilities /
secondary data from relevant program managers / review articles as & when
possible . (planned as step 2 of this exercise)
ii. To suggest mid course corrections for improving quality & performance of the
program, as & when the statistics mentioned above are compiled &
analyzed. (planned as step 2 of this exercise)
This second step of the initiative depends on availability of necessary funds to
compensate the time and efforts to be contributed by volunteers, workers and Faculty
for field testing & refining of checklists, data collection, compilation & analysis,
writing, editing, printing & distribution of report. The funds will also be required for
travel to supervise the above activities and for meetings of faculty working on above
activities. Hence we will explore the possibility of financial support from Ministry of
Health, Government of India, ICMR and relevant national and international agencies
interested in such initiatives.
Regarding development of review articles and meta analysis of available documents
on selected National Programs, we may move forward as group of interested
professionals who have already initiated this activity. Hence if we find a reputed
institute or agency to support, we may consider collaboration, otherwise we may
move forward with our own effort & support.

10
How to use & Who may find the enclosed Checklists
useful:
The enclosed checklists can be used as basic indicators that can be collected and
analyzed from level of PHC up to National level to monitor the performance of 5
National Health Programs mentioned in this report.
The checklists can be used to collect the information by trained Medico Social
Workers, Undergraduate MBBS students, Post Graduate students of Community
Medicine and to be analyzed by Program Managers at District, State or National level
for progress review and improving the performance of the concerned programs.
Limitations of the checklists:
The limitations of these checklists are that theseare yet to be pretested in the field /
community, and to be further refined to retain & include the indicators for which the
statistics are often reported and found reliable & delete the ones which are usually not
reported & found unreliable, comparatively less useful or irrelevant.
These checklistsare intended for quick periodic assessment of progress of the
National Health programs, so that mid course corrections can be performed
quickly by the program managers and decision makers after proper analysis &
interpretation of the statistics collected.

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Work Group 1: National Tuberculosis Eradication
Program
Brief about RNTCP
Tuberculosis (TB) control activities are implemented in the country for more than 50
years. The National TB Programme (NTP) was launched by the Government of India
in 1962 in the form of District TB Centre model involved with BCG vaccination and
TB treatment. In 1978, BCG vaccination was shifted under the Expanded Programme
on Immunization. A joint review of NTP was done by Government of India, World
Health Organization (WHO) and the Swedish International Development Agency
(SIDA) in 1992 and some shortcomings were found in the programme such as
managerial weaknesses, inadequate funding, over-reliance on x-ray, non-standard
treatment regimens, low rates of treatment completion, and lack of systematic
information on treatment outcomes.
Around the same time in 1993, the WHO declared TB as a global emergency, devised
the directly observed treatment – short course (DOTS), and recommended to follow it
by all countries. The Government of India revitalized NTP as Revised National TB
Control Programme (RNTCP) in the same year. DOTS strategy was officially
launched as the RNTCP strategy in 1997 and by the end of 2005 the entire country
was covered under the programme.
During 2006–11, in its second phase RNTCP improved the quality and reach of
services, and worked to reach global case detection and cure targets. These targets
were achieved by 2007-08. Despite these achievements, undiagnosed and mistreated
cases continued to drive the TB epidemic. TB was the leading cause of illness and
death among persons living with HIV/AIDS and large number of multidrug resistant
TB (MDR-TB) cases was reported every year. During this period for achievement of
the long term vision of a “TB free India”, National Strategic Plan for Tuberculosis
Control 2012-2017 was documented with the goal of ‘universal access to quality TB
diagnosis and treatment for all TB patients in the community’.
Significant interventions and initiatives were taken during NSP 2012-2017 in terms
of mandatory notification of all TB cases, integration of the programme with the

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general health services (National Health Mission), expansion of diagnostic services,
programmatic management of drug resistant TB (PMDT) service expansion, single
window service for TB-HIV cases, national drug resistance surveillance and revision
of partnership guidelines.
However, to eliminate TB from India by 2025, five years ahead of the global target, a
framework to guide the activities of all stakeholders including the national and state
governments, development partners, civil society organizations, international
agencies, research institutions, private sector, and many others whose work is
relevant to TB elimination in India is formulated by RNTCP as National Strategic
Plan for Tuberculosis Elimination 2017-2025. In December 2019 the name of the
program has also been changed as National Tuberculosis Elimination Program
(NTEP).
Participants:
S.
No.
Name Role Phone
No.
Designati
on
Address E-mail Photograph
1. Dr.
Pankaja
Raghav
Group
Leader
8003996
904
Professor
and Head
AIIMS
Jodhpur
drpankajaragha
v@gmail.com

13
2. Dr.
Madhur
Verma
Group
Coordina
tor
9466445
513
Assistant
Professor
AIIMS,
Bhatinda
drmadhurverm
a@gmail.com
3. Dr.
Neelam
Anupam
a Toppo
Member 9981598
198
Professor NSCB
Medical
College,
Jabalpur
neelam.philips
2011@gmail.c
om
4. Dr.
Ritesh
Singh
Member 9836444
242
Associate
Professor
AIIMS
Kalyani
drriteshsingh@
yahoo.com
5. Dr. Rivu
Basu
Member 9830844
035
Assistant
Professor
R G Kar
Medical
College,
Kolkata
rivubasu83@g
mail.com

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Public Health Experience of Members
Dr. Pankaja Raghav is Professor and Head in the Department of Community
Medicine and Family Medicine in All India Institute of Medical Sciences
(AIIMS), Jodhpur Rajasthan. She has been involved in activities related to
prevention and control of Pneumoconiosis and TB in workers exposed to Silica
and Asbestos, Immunization of children of migrants, vaccine hesitancy to
improve immunization coverage in Rajasthan.
Dr. Madhur Verma is currently working as Assistant Professor at AIIMS
Bathinda. He completed his MD in community Medicine (2012-15) from
PGIMS Rohtak followed by Senior Residency from VMMC and Safdarjung
Hospital, New Delhi and then from PGIMER Chandigarh. He focuses on
research in Non communicable diseases. He is an Operational Research
Scholarship program awardee (2017-18) through SORT IT programme that is
jointly funded by THE UNION, MSF, WHO and DFID. He is currently
working as a co-investigator in a PGIMER-UNFPA project on family planning
issues in Rajasthan, Gujarat, PPIUCD assessment Projects in Bihar, NPCDCS
project evaluation in Haryana, Infectious disease modeling in Haryana and
Punjab.
Dr. Neelam Anupama Toppo is Professor, Community Medicine atNSCB
Medical College, Jabalpur. She has been involved with the evaluation of health
initiative of Govt of M.P. ( Jananisahyogi Yojana), immediate post placental
insertion of IUDs programme, routine immunization programme, Effective
vaccine management assessment in various states, master trainer of RCH,
malnutrition management, HIV /AIDS, IMNCI, ICD10 and ICF
Dr. Ritesh Singh is Associate Professor, Community Medicine and Family
Medicine at AIIMS Kalyani,West Bengal. He has worked as Medical officer
tuberculosis control for more than 8 years and is a National trainer of
Ayushman Bharat. He was involved in post MDA for Filariasis survey in
Nadia district. He has completed a multi-centre project of detecting Sero
prevalence of dengue in children
Dr. Rivu Basu is currently working as Assistant Professor, Community
Medicine, RG Kar Medical College, passed his MD from All India Institute of
Hygiene and Public Health in Kolkata in 2012. Since then he has been actively

15
working in the area of Public Health as a teacher, trainer, researcher and an
advocate of public health. He has been teaching UG and PG students for 8
years now of various streams. He has actively worked in the field of
Tuberculosis, Filariasis, Occupational Health and Mental Health. He has
completed 6 extramural projects among which 3 were completed as an
independent researcher. Currently, as a member of State Task Force of
Tuberculosis Control Programme, he has been an active advocate of banning
ATD in private sector and starting home based care by Family DOTS. He has
also completed his MBA in Health Care management and is pursuing his PhD
in Health Economics from Institute of Development Studies, Kolkata, working
on Behavioral Economics Modeling of causes of non-compliance to various
medications. He has been awarded as the second best paper on 14th World
Congress of Public Health, and is also the recipient of P C Senaward of Best
Paper. He has actively organized and acted resource persons of various
Capacity Building workshops on Data Sciences by R, GIS, Operations
Research and Infectious Disease Modeling.
References :
1. India TB report 2029, Central TB Division, MoHFW, Government of India
2. National Strategic Plan for Tuberculosis: 2017-25 Elimination by 2025,
MoHFW, Government of India
3. Gupta SN, Gupta N. Evaluation of revised national tuberculosis control
program, district Kangra, Himachal Pradesh, India, 2007. Lung India. 2011
;28(3):163-8.
4. Data for Action for Tuberculosis Key and Vulnerable Populations. Rapid
Assessment Report India (2018) (Available from URL:
http://stoptb.org/assets/documents/communities/CRG/TB%20Data%20Assesm
ent%20India.pdf)
5. Muniyandi M, Rao VG, Bhat J, Yadav R. Performance of Revised National
Tuberculosis Control Programme (RNTCP) in tribal areas in India. Indian J
Med Res. 2015 ;141(5):624-9.
6. Satyanarayana S, Shivashankar R, Vashist RP, Chauhan LS, Chadha SS,
Dewan PK, et al. Characteristics and programme-defined treatment outcomes
among childhood tuberculosis (TB) patients under the national TB programme
in Delhi. PLoS One. 2010 ;5(10):e13338. .

16
7. Bansal AK, Kulshrestha N, Nagaraja SB, Rade K, Choudhary A, Parmar M, et
al.. Composite indicator: new tool for monitoring RNTCP performance in
India. Int J Tuberc Lung Dis. 2014 ;18(7):840-2. .
8. Kelkar-Khambete A, Kielmann K, Pawar S, et al. India's Revised National
Tuberculosis Control Programme: looking beyond detection and cure. Int J
Tuberc Lung Dis. 2008;12(1):87–92.
9. Subbaraman R, Nathavitharana RR, Satyanarayana S, et al. The Tuberculosis
Cascade of Care in India's Public Sector: A Systematic Review and Meta-
analysis. PLoS Med. 2016;13(10):e1002149. Published 2016 Oct 25.
doi:10.1371/journal.pmed.1002149.
10.Sachdeva KS, Satyanarayana S, Dewan PK, et al. Source of previous treatment
for re-treatment TB cases registered under the National TB control Programme,
India, 2010. PLoS One. 2011;6(7):e22061. doi:10.1371/journal.pone.0022061.

17
Work Group 2: ANC and Infant immunization
Brief about the program:
Antenatal care (ANC) can be defined as the care provided by skilled health-
care professionals to pregnant women to ensure the best health conditions for
both mother and baby during pregnancy. About 67000 women in India die
every year due to pregnancy related complications and 13 lakh infants die
within one year of birth. Around 75% of neonatal deaths occur in the 1st
week
of birth and majority in first two days. The Government of India has introduced
a series of programmes since 1992 to address maternal and newborn health.
Janani Suraksha Yojana (JSY), a safe motherhood intervention under the
National Health Mission (NHM) was introduced in April, 2005. It was
implemented with the objective of reducing maternal and neonatal mortality by
promoting institutional deliveries among poor pregnant women. In 2011,
Government of India launched Janani Shishu Suraksha Karyakaram (JSSK).
The scheme is estimated to benefit more than 12 million pregnant women who
access Government health facilities for their delivery. In 2016 WHO revised
ANC model from 4 to 8 visit to maximize physician contact enabling to detect
any ante-natal complications. Provision of minimum of eight contacts under
the new ANC model are recommended to reduce perinatal mortality and
improve women’s experience of care comparing with earlier four-visit model
which lead to increased stillbirth risk and perinatal mortality.
Vaccination is one of the most cost-effective child survival interventions.
Universal Immunization Programmes have initiated the coverage of all
children by protective immunizations all over the globe. India launched the
Expanded Programme of Immunization (EPI) in 1978 with the introduction of
BCG, OPV, DPT and typhoid-paratyphoid vaccines. Vaccines have
successfully eliminated smallpox and polio from India; brought measles to an

18
all-time low; and reduced tetanus by an estimated 95% over the past 3 decades,
with at least 18 states (since 2003) validated as having eliminated maternal and
neonatal tetanus as of December 2013. Despite these improvements, an
estimated 1.3 million Indian children under the age of 5 years continue to die
each year, with India alone accounting for roughly one-fifth of the world’s total
under-five deaths. Routine childhood vaccine coverage is suboptimal and only
three-fifth of all children receive all vaccines in the schedule. There are also
inter and intra-state variations in the coverage.
Participants of Working Group:
Sr.
No.
Name Role Phone
No.
Designation Address E-mail Photograph
1. Dr.
Paramita
Sengupta
Group
Leader
98153
33725
Professor and
Head
AIIMS Kalyani
West Bengal
drparamita2425
@gmail.com
2. Dr.
Abhilash
Sood
Group
Coordi
nator
94180
76890
Associate
Professor
DRKGMC
Hamirpur
(HP)
abhilashsood@y
ahoo.co.in

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3. Dr.
Shweta
Goswami
Memb
er
88204
04084
Assistant
Professor
ESIC Medical
college,
Faridabad
doc.shweta12@
gmail.com
4. Dr. Sneha
Kumari
Memb
er,
84473
89045
Assistant
Professor
ESIC Medical
college,
Faridabad
sneharanjan811
@gmail.com
Public Health Experience of Members
Dr. Paramita Sengupta is Professor and Head in the Department of
Community Medicine and Family Medicine in All India Institute of Medical
Sciences (AIIMS), Kalyani,West Bengal. She did her MD from BJ Medical
College,Ahmedabad and MPH from Manchester Metropolitan University
Manchester,UK. She is a Fellow of both IAPSM and IPHA. She has worked
with WHO as a RRT member in Measles Rubella Campaign in Delhi and Bihar
and also as a SMO for sometime in Bhojpur,Bihar in 2019. She has been a
Principal Investigator in a number of ICMR adhoc and national multicentric
task force projects.Besides this there were projects with Monash University,
Australia. She has carried out evaluation of CHCs and PHCs for health
facilities and their infrastructure as per NRHM-IPHS standards in
Uttarakhand, supported by USAID in 2008-2009. Besides these she has written
chapters in IAPSM textbook, IGNOU module and no of indexed national and
international journals. She is in the Editorial Board of Indian Journal of
PublicHealth,Indian Journal of Community and Family Medicine and many

20
others. DrParamita has also been a Nodal Officer of the NVBDCP in Ludhiana
and National Assessor of Effective Vaccine Management.
Dr. Abhilash Sood is Associate Professor, Community Medicine, DRKGMC
Hamirpur (HP). His areas of interest include Maternal and Child Health, Health
System Administration and Public Health Management. He has been an
assessor in the Kayakalp and LaQshya programs. He is also a National Asessor
of Effective Vaccine management and has been involved in the National EVM
2019 and many state EVM assessments. He is a Master trainer in T-VACC as
well as ICD-10. He is also a state trainer of CHOs under the Ayushman Bharat
Scheme. He is a Co-Investigator in two research projects and is a reviewer for
national journals of repute.
Dr. Shweta Goswami is Assistant Professor, Community Medicine, ESIC
Medical College, Faridabad. Her areas of interest include Maternal and child
health and NCDs. She has worked as an investigator in supportive supervision
of public health care institutions for maternal and child health services under
the ambit of NRHM, Haryana. She has also worked as a research associate in a
project to promote institutional deliveries in Haryana with NRHM. She has
been a Co-Investigator in a multi-center clinical trial on Rota virus vaccine in
Kolkata.
Dr. Sneha Kumari is MBBS,DGO, MD(Gold medal), DNB Assistant
ProfessorDepartment of Community Medicine, ESIC Medical college &
Hospital, Faridabad.She has 8 years of working experience in the field of
community medicine. She got thesis research grant from RNTCP while
pursuing MD. She participated in USAID and NIDDCP program projects at
Jharkand. She has conducted 6 research projects (non-funded)at VMMC
&Safdarjung Hospital during her Senior Residency. She has also conduted 2
research projects at Hindurao Hospital. She has contributed in editing of a book
on national health program by Dr. Jugal Kishore. She is a reviewer & Assistant
Editor of various national journals. She has more than 30 research publication
and presented nearly 35 paper & posters in national and international
conferences. She has conducted various research projects related to maternal
and child health care at Jharkhand and Delhi.

21
References:
1. Paramita Sengupta. Unit 12 Indicators of RCH. Indira Gandhi National
Open University New Delhi.
2. Smitha Nayak. Questionnaire for Community – based survey on factors
influencing utilization of antenatal care service. Manipal University
Manipal.
3. Elias Legesse, Worku Deschasa. An assessment of child immu ization
coverage and its determinants in Sinana District, Southeast Ethiopia. BMC
Pediatrics 2015; 15-31
4. CDC. National Immunization Survey Immunization History Questionnaire.
Centre for Disease Control and Prevention, U.S. Department of Health and
Human Services.
5. WHO. WHO recommendations on antenatal care for a positive pregnancy
experience. Geneva; 2016
6. Paramita Sengupta, Anoop Ivan Benjamin, Puja R Myles, Bontha V Babu.
Evaluation of a community based intervention to improve routine childhood
vaccination uptake among migrants in urban slums of Ludhiana, India.
Journal of Public Health 2016; 39(4): 805-12.
7. Ashok Kumar Bhardwaj, Dinesh Kumar, Sushant Sharma, Anmol Gupta,
Vishav Chander, Abhilash Sood. Building Evidence for coverage of fully
vaccinated children of 12 – 23 months of age across districts if North India,
2015. Indian Journal of Community Medicine 2017; 42: 197-9.
8. Richa Kalia. Assessment of Knowledge and Motivation level of Accredited
Social Activist (ASHA)and Key stakeholders perspectives under NHM in
district Kangra, Himachal Pradesh, India (Dissertation). Tanda, Kangra:
Himachal Pradesh University, 2019.

22
Work Group 3 : National Programme for Prevention &
Control of Malaria & Dengue
The road map for eliminating Malaria has been put forth systematically in the
WHO Global Technical Strategy (GTS) for malaria 2016-30.1
The recommendations
of the GTS have been moulded into the Malaria control programme as per the needs
of the local conditions of a nation. Current understanding of the epidemiology of
Malaria indicates the need to adopt an approach of continuum of strategies to
eliminate Malaria by 2030 and sustain zero transmission levels beyond. In practice it
is also observed that whenever a disease transcends from the phases of major public
health concern to control levels to elimination levels, the operational definitions, cut-
off values, disease specific indicators are required to be updated to tap accurate
estimates of various phases to meet the existing requirements of the programme
through surveillance, monitoring and evaluation.
The surveillance, monitoring and evaluation of Malaria intervention activities
evolve as the disease transcends through these phases. When the disease has high
transmission rates then the programme monitoring and evaluation are mainly based
on aggregate number of the cases from the particular area indicating clustering. In
areas of moderate transmission where the disease has heterogeneous distribution it is
important to identify vulnerable population groups viz. migrants etc. As the disease
approaches elimination level the number of cases decrease; and the focuses of
“transmission hot spots” have to be identified to enable early detection of outbreaks.
Fewer cases call for developing adequate mechanisms to identify disease trends,
forecast outbreaks, early warning and early detection indicators before reaching the
stage wherein notifications of cases are eventually made (like in the case of TB
notification).

23
The current national strategy to eliminate malaria is built upon the 2014
malaria (burden) estimates which have set forth 2027 as the target year by which the
country should achieve zero transmission of malaria and should sustain its
development in eliminating malaria by 2030 and beyond globally. 2
The Annual Parasite Index wise categorisation of state creates a situation
where in the surveillance, monitoring and evaluation indicators and markers have to
be upgraded/evolved to adapt to the changes on the ground, so as to enable the
surveillance model to detect any undesirable fluctuations in the number of cases,
outbreaks and epidemics. This will also improve the response time to intervene to
contain the hotspot focus areas and further spread of cases. On reaching elimination
levels the frequency of reporting also needs to be increased from monthly to weekly
or even within 24 hours when even one or few cases detection indicates an outbreak.
In India the risk of Dengue has shown an increase after an epidemic of 1996 in
Delhi. A contingency plan in case of epidemic/outbreak exists for all states. From
2002 onwards Dengue prevention and control became a part of National vector borne
disease control programme. This included disease management, integrated vector
management and Behaviour Change Communication activity. Analysis of reports,
review, field visit and feedback are part of mid- term plan for prevention and control.

24
Members of Working Group :
S.
N.
Name Role Phone
No.
Designa
tion
1. Dr.
Malates
h Undi
Grou
p
Lead
er
+91-
95383
30505
Assista
nt
Profess
or
Dept. of
Community
Medicine,
Karwar
Institute of
Medical
Sciences,
Karwar,
Karnataka
malatesh
.u@gmai
l.com
2. Dr. Ipsa
Mohapat
ra
Grou
p
Co-
ordin
ator
+91-
98618
17092
Associa
te
Profess
or
Department
of
Community
Medicine,
Kalinga
Institute of
Medical
Sciences,
KIIT
University,
Bhubaneswar
, Odisha
dr_ipsa
@yahoo.
co.in
3. Dr.
Nilanjan
a Ghosh
Rapp
orteu
r
+91-
86170
31147
Assista
nt
Profess
or
Department
of
community
medicine
North Bengal
Medical
College
drnilanj
anaghos
h@rediff
mail.com

25
4. Dr.
Jitender
Majhi
Mem
ber
+91-
98995
33414
Assista
nt
Profess
or
Department
of
Community
Medicine &
Family
Medicine,
AIIMS
Kalyani
5. Dr.
Srishti
Yadav
Mem
ber
+91-
87502
49449
Senior
Residen
t
Department
of
Community
Medicine,
ABVIMS &
Dr. RML
Hospital,
New Delhi
dr.srishti
@yahoo.
in
6. Dr.
Paramit
a
Sengupt
a
Reso
urce
Pers
on
+91-
98153
33725
Profess
or &
HOD
Department
of
Community
Medicine &
Family
Medicine,
AIIMS
Kalyani
drparam
ita2425
@gmail.
com
Public Health Experience of Members:
Dr. Malatesh Undi is working as Assistant professor, Community Medicine,
Karwar Institute of Medical Sciences,Karwar Karnataka. He has been an
Evaluator for SNCU (Special Newborn Care Unit) Evaluation of Karnataka
state along with NNF/IAP team member which was held on Feb 2018. He is a
State surveillance team (SST) member for HIV sentinel surveillance 2015

26
(ANC) and 2017 (ANC and HRG). He is a State level trainer for Training of
Medical Officers, ICTC counselors and lab technicians of various districts
organized by KSAPS for HIV Sentinel Surveillance since 2015. He is a Master
Trainer for TOG-2016 and PMDT under RNTCP in Karnataka state since
2017. He has worked as an Independent Evaluator of Mass Drug
Administration (MDA) programme for elimination of Lymphatic Filariasis in
Bidar district, Karnataka in March 2013 and also as an Independent Evaluator
of National Anti-malaria Programme (NAMP) at Bidar district in March 2013.
He has worked as a Field investigator for the study “Scoping the Pathway to
Leadership in Health Research in India” conducted by Welcome Trust-DBT-
INCLEN India Alliance. He has been a Survey Assistant for WHO adopt a
village project- a rural rabies prevention project, sponsored by Global Alliance
for Rabies Control (GARC) and Rabies in Asia foundation (RIA)
Commonwealth Veterinary Association (CVA) and a WHO External monitor
for pulse polio immunization for Bangalore South Zone in 2013. He is a
Resource person for the training session on technique of intradermal rabies
vaccination and PEP and PrEP against human rabies for medical faculty,
nursing staffs and veterinary staff.
Dr. Ipsa Mohapatra is MBBS, PGDMCH, CCICP, MD in Community
Medicine, presently working as Associate Professor, Department of
Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar.
She has eight years of public health experience. Her research interests include
HIV/AIDS & MCH care. She was nominated as a member of District HIV-TB
Collaboration Committee Central Dist. Delhi, in the year 2010. She is also a
National Assessor for Effective Vaccine Management and a Master Trainer for
CSA & GBV Govt. of Odisha, SIHFW & UNICEF. She is a reviewer of
international & national journal, co-author of national textbook with around 30
publications in national and international peer reviewed indexed journals.
Dr. Nilanjana Ghosh is Assistant Professor, Community Medicine at North
Bengal Medical College. She is a public health specialist with experience of 6
years post PG. She has completed DNB and post graduate diploma in
epidemiology, hospital management and public health nutrition from NIHFW.
She is also trained in CCEBDM and Immunization from PHFI. She is the nodal
officer of IDSP at North Bengal Medical College. She is the Central Team

27
Member of HIV Sentinel Surveillance, AIIMS and is actively involved with
their Project MinerVa. She is working with ICMR in a multicentric project and
PI of International project in collaboration with Philips Amsterdam. She is
interested in teaching and has been co guide of few dissertations and actively
taken classes as well. She is National elected editorial board member of IJPH
and have few original articles published apart from presenting and being
awarded in national and international conference. She was invited as Guest
speaker in few Medical education conference in academic institutes of repute.
Dr. Jitender Majhi is Assistant professor, Community Medicine and Family
Medicine at AIIMS Kalyani, West Bengal. As Senior Resident at Centre for
Community Medicine, AIIMS New Delhi, he has worked as Medical Officer-
In-Charge at PHC Dayalpur, Faridabad of CRHSP Ballabgarh. As Surveillance
Medical Officer, NPHSP WHO Country Office India, he was deputed at WHO
Unit Office, District Sambhal where he has worked with the district and the
State authorities and other stakeholders like UNDP & UNICEF in
implementation and execution of Immunization Programme. As
Epidemiologist cum Assistant Professor in the Department of Community
Medicine, Dr. BSA Medical College & Hospital, Rohini Delhi, he attended
meetings as an expert with District Authorities and NPHSP-WHO for
investigation and containment of communicable disease outbreaks in North
West Delhi
Dr. Shrishti Yadav is Senior Resident, Community Medicine atABVIMS &Dr
RML Hospital New Delhi. She has 4.5 years of experience in public health,
three years during post- graduation, 6 months as tutor at ESIC medical college
and hospital, Faridabad (Haryana) and 6 months as Senior Resident at VMMC
&Safdarjung hospital, New Delhi. She is currently representing her institution
for being a part of national preparedness for 2019-nCoV at Emergency
Medical Relief Department of Ministry of Health and Family Welfare, Nirman
Bhawan. She has done community surveys and projects (including village
surveys regarding NCDs prevalence and urban field practice area of ESIC at

28
Faridabad) and epidemic investigation of Measles at Fatehpur Beri area, New
Delhi in the year 2016 under the supervision of WHO team. She has conducted
various awareness campaigns and health camps in the field practice areas of
Najafgarh. She has 5 publications in national and international journals.
Dr. Paramita Sengupta: Already mentioned above under work group 2.
References:
1. World Health Organization. Malaria surveillance, monitoring and evaluation: a
reference manual. Directorate of National Vector Borne Disease Control
Programme.
2. National Framework for Malaria Elimination in India 2016–2030. Directorate
General of Health Services Ministry of Health and Family Welfare, Govt. of
India: New Delhi, India. 2016:1-4
Further Readings:
1. Ghosh SK, Rahi M. Malaria elimination in India- The way forward. J Vector
Borne Dis 2019;56:32-40.
2. Directorate of National Vector Borne Disease Control Programme. National
Framework for Malaria Elimination in India 2016–2030. Directorate General
of Health Services Ministry of Health and Family Welfare, Government of
India: New Delhi, India. 2016
3. Malaria Surveillance, Monitoring & Evaluation: A reference manual. Geneva:
World Health Organization;2018; Available from: https://apps.who.int>handle
4. Monitoring and Evaluation of the Global Technical Strategy for Malaria 2016–
2030 and Action and Investment to defeat Malaria 2016–2030 August 2016,
Geneva, Switzerland ; Available from: https://www.who.int>mpac
5. Indicators and Calculating Coverage indicators; Available from:
https://www.measureevaluation.org
6. Pan American Health Organization. Monitoring and Evaluation Framework for
the Plan of Action for Malaria Elimination 2016-2020 Background Document
for Session 4 [Internet]. Regional Committee of WHO for the Americas; 2017
Jun; Washington, DC. Washington, DC: PAHO; 2017 [cited 2020 Jan31].
Available from:
https://www.paho.org/hq/index.php?option=com_docman&view=download&s
lug=session-4-monitoring-and-evaluation-framework-for-the-plan-of-action-
for-malaria-elimination&Itemid=270&lang=en

29
Work Group 4: Ayushman Bharat-Pradhan Mantri Jan
Arogya Yojana
Currently public spending on healthcare in India is amongst the lowest in the world
at just over1.28% of GDP (Gross Domestic Product) which is much less than that in
other Lower Income Countries. According to National Health Accounts Estimates,
Total Health Expenditure (THE) in the year 2015-2016 was estimated to be about
3.84% of the GDP. The Government Health Expenditure was 30.6% (i.e., 1.18% of
GDP) of Total Health Expenditure, which is much less than other Low Income
Countries. Over three-fourths (78%) of all health spending is from private sector
and 64.7% of the total health expenditure is by household Out-of –pocket payment.
Such out –of-pocket payments lead to disproportionate economic impact on poor.
About 18% households faced catastrophic expenditures due to health care costs and
an estimated 50 to 60 million people are pushed into poverty each year as a result of
medical-related expenditure.1
While there are several government sponsored insurance schemes existing in India
in different states, still about 80% of the population did not have any significant
health insurance coverage.2
This was due to significant gaps in those health
insurance schemes in terms of population coverage, quantum of insurance cover,
spectrum of care, pricing of packages, treatment protocols etc.3
To fill the major gaps in the existing health insurance schemes, Government of
India launched nationwide flagship scheme-Ayushman Bharat-NHPM (National
Health Protection Mission) to become the world’s largest sponsored health
insurance scheme. It is an attempt to move from sectoral and segmented approach
of health service delivery to a comprehensive need-based health care service. This
is a step towards achieving the vision of Universal Health Coverage (UHC) on
different parameters such as population coverage, In-patient coverage, diagnostics,
pharmaceuticals, Out-patient coverage, wellness and rehabilitation and aims to
reduce out-of-pocket expenditure (OOPE), and focusing on wellness of poor
families by providing medical benefits to them through improving their access to
quality healthcare.4
Under this schemes, two inter-related approaches are implemented to achieve its
desired objectives i.e., creation of Health and Wellness Centers (HWCs) by

30
transforming existing Sub-Centers and Primary Health Centers and providing
health insurance cover to poor and vulnerable families. This covers medical and
hospitalization expenses for almost all secondary care and most of tertiary care
procedures. It will provide benefit of Rs 5 lakhs per family per year covering over
10 crore families (approximately 50 crore beneficiaries) identified on the basis of
Socio-Economic Caste Census (SECC), 2011.
It envisages standard treatment guidelines, standardized package rates, updating
Registration of Hospitals in Network of Insurance (ROHINI), enrichment of
national health resource repository, IT integration and data generation and
employment generation.4
Implementation of this large health insurance scheme in the pre existing health
systems needs constant third party monitoring and quality improvement of
existing public health system. RSBY implementation in India has taught us
lessons that public health insurance schemes are not the sole responsibility of
health sector. There are many other sectors & issues involved; hence occurrence
of frauds, denial of services, increase in prices etc. keep on emerging as obstacles.
Unbiased monitoring and mid course correction is the key to successful
implementation of this program with an objective of –
To develop a checklist of monitoring indicators for services planned for
community members & patients under the programme.

31
Participants of Working Group:
S.N. Name Role Phone
No.
Design
ation
1. Dr.
Shanka
r
Reddy
Group
Leader
99635
89333
Associ
ate
Profess
or
Govt.
Medical
College
Kadapa, A.P
drshankarr
eddy1979
@gmail.co
m
2. Dr.
Gaurav
Kambo
j
Group
Co-
ordinat
or
98135
00050
Assista
nt
Profess
or
KalpanaCha
wla Govt.
Medical
College,
Karnal
(Haryana)
dr.gauravk
amboj@ya
hoo.com
3. Dr.
Sneha
Kumar
i
Membe
r
84473
89045
Assista
nt
Profess
or
ESIC
Medical
college,
Faridabad
sneharanja
n811@gm
ail.com
4. Dr. R
K Pal
Membe
r
98910
77651
Profess
or
ESIC
Medical
college,
Faridabad
rkpal.nhsr
c@gmail.c
om

32
5. Dr.
Racha
na A R
Rapport
eur
95383
38835
Assista
nt
Profess
or
Karwar
Institute of
Medical
Sciences,
Karwar,
Karnataka
rachana.m
anas@gm
ail.com
6. Dr.
Srishti
Yadav
Membe
r
87502
49449
Senior
Reside
nt
ABVIMS &
Dr RML
Hospital
New Delhi
Dr.srishti
@yahoo.in
Public Health Experience of members:
Dr. Shankar Reddy is Associate Professor, Community Medicine atGovt. Medical
CollegeKadapa, Andhra Pradesh. He has worked as MOIC in Tribal area for 3 years
in Telangana. He has also worked as District Coordinator for Aarogyashri Health
Insurance scheme for 10 months in A.P. He has been a RRT member for GOI &
WHO IN Manipur, Mizoram, Nagaland for 3 months. He is a National assessor in
Effective Vaccine management.
Dr. Gaurav kambojis Assistant professor, community Medicine atKalpanaChawla
Govt. Medical College, Karnal(Haryana). He has been an external monitor for State
Government, Haryana under various projects like RAPID (Rapid Assessment and
Program Implementation in Districts), Supportive Supervision of Public Health
Facilities across the state and BetiBachaoBetiPadhao evaluation program. He has
organised 3 workshops on Clinical Research Methodology as organising Secretary.
He passed as Elite in the Health Research Fundamentals course organized by NIE,
ICMR, Chennai and also passed the course ‘Principles and Practices of Clinical
Research’ jointly conducted by NIH, USA; ICMR; DHR; DBT; BIRAC and CDSA at
Hyderabad. He is Member Secretary of Institutional Scientific Committee at

33
KCGMC, Karnal and successfully guides ICMR-STS project in the year 2018 and
scholarship awarded to the student for completion of project report. He is working as
Deputy Medical Superintendent in a 600 bedded hospital and dealing with patients of
Ayushman Bharat on day to day basis.
Dr. Sneha Kumari Already mentioned above under work group 2.
Dr. RK Pal is Professor and Head, Community Medicine, ESIC Medical College
Faridabad. He is the Technical incharge& General Manager for
Planning,implementing & monitoring of projects in the area of immunization,disease
surveillance and control including Polio eradication,Maternal and child
health,Environmental sanitation,Disaster Management & improving management of
Health systems(in 2 states of India).These projects were funded by World Bank,
NORAD, MEMISA, USAID, DANIDA, WHO, European Union & DFID.He
Introduced Hepatitis B vaccine in India while working as National Professional
Officer with India Country Office of WHO. He has worked ads Co-Director
Executive MPH,University of North Carolina & IIHMR. He has also worked as
Dean, Hospital Administration for PG Diploma of IILM & Max Hospital, Delhi. He
has been an advisor, Public Health Planning, National Health Systems Resource
Centre, New Delhi and Chairman, Quality Unit, College of Public Health, Qassim
University, Saudi Arabia.
Dr. Rachana AR is Assistant professor, Community Medicine at Karwar Institute of
Medical Sciences, Karwar, Karnataka. She is the Principle investigator for the study
on “safety and immunogenicity of intradermal rabies vaccination in a BBMP hospital
in Bengaluru” which was a part of evaluation of pilot project on prevention and
control of rabies in India” in the year 2012-2014. She has been a State surveillance
team member for HIV sentinel surveillance 2015 (ANC) and HIV sentinel
surveillance 2017 (ANC and HRG). She was an Evaluator for SNCU Evaluation of
Karnataka along with NNF/IAP team member which was held on Feb 2018. She is a
State level trainer for Training of Medical Officers, ICTC counselors and lab
technicians of various districts organized by KSAPS for HIV Sentinel
Surveillance 2015 (ANC) and also a State level trainer in Training of Medical
Officers, ICTC counselors and lab technicians of various districts organized by
KSAPS for HIV Sentinel Surveillance 2017 (HRG). She was involved in the
Evaluation of 9th round of Mass Drug Administration (MDA)programme for
elimination of Lymphatic Filariasis in Bidar district, Karnataka in March 2013 and

34
Evaluation of National Anti-malaria Programme (NAMP) at Bidar district in
March 2013. She has been a Field investigator for the study “"Scoping the Pathway
to Leadership in Health Research in India" conducted by INCLEN, New Delhi. She
has worked as a survey assistant for WHO adopt a village project- a rural rabies
prevention project, sponsored by Global Alliance for Rabies Control (GARC) and
Rabies in Asia foundation (RIA) Commonwealth Veterinary Association (CVA). She
has worked as External monitor for pulse polio immunization for Bangalore south
zone in 2013.
Dr. Shrishti Yadav Already mentioned above under work group 3.
References:
1.National Health Systems Resource Centre (2017).National Health Accounts
Estimates for India(2014-15).New Delhi, Ministry of Health and Family Welfare,
Government of India.
2.IRDA annual report (2018-2019.Available at www.irdai.gov.in
3.PwC research-Confederation of Indian Industry. Available at www.pwc.in
4.Ayushman Bharat-National Health Protection Mission. Available at pmjay.gov.in
5. https://scroll.in/pulse/917578/only-a-strong-public-health-sector-can-ensure-fair-
prices-and-quality-care-at-private-hospitals
6. https://www.jagranjosh.com/current-affairs/pm-modi-launches-pradhan-mantri-
jan-arogya-yojana-1537704795-1
7. https://www.indiatoday.in/programme/newstrack-with-rahul-kanwal/video/chinks-
in-ayushman-bharat-scheme-exposed-no-doctor-for-the-needy-1595619-2019-09-04
8. https://www.thehindubusinessline.com/economy/a-year-on-ayushman-bharat-
faces-multiple-challenges-ahead/article29497106.ece
9.https://www.zeebiz.com/personal-finance/news-pmjay-ayushman-bharat-hospital-
packages-recast-to-curb-misuse-111413
10.https://m.economictimes.com/news/politics-and-nation/view-ayushman-bharat-a-
change-whose-time-has-come/articleshow/71303953.cms
11.https://www.ayushmanbharatyojana.in/2019/08/eligibilitycriteria.html?m=1

35
https://m.economictimes.com/small-biz/entrepreneurship/can-pm-modis-ayushman-
bharat-help-healthcare-startups-scale/articleshow/68147401.cms
12. https://www.aninews.in/news/national/general-news/cabinet-secretary-directs-all-
central-ministries-to-empanel-their-hospitals-with-ab-pmjay20191204165813/#.
XejQV2CnsQk
13. https://www.ndtv.com/india-news/after-fraud-20-000-ayushman-health-
insurance-cards-junked-in-gujarat-says-official-2158823

36
Work Group 5: National Programme for Prevention and
Control of Diabetes, CVD and Stroke (NPDCS)
Globally 40.5 million deaths occurred due to Non-Communicable Diseases
(NCDs) and constituted 71% of total deaths in 2016.1
The highest risks of dying from
NCDs were observed in Low and MiddleI Income countries (LMICs).2,3,4
As per
India State-Level Disease Burden Initiative, NCDs resulted in 6 million deaths (61%
of totals deaths) and its contribution in DALYs increased from 30% in 1990 to 55%
in 2016. NCDs are estimated to cause cumulative global economic loss of $47 trillion
USD by 2030, or about 75% of the 2010 global GDP.5
Moreover, NCDs are an
important reason for global and national health inequality.6
India is committed to sustainable Development Goals (SDGs) to reduce
premature mortality due to NCDs by 33% by 2030.7
As a follow-up to the global call
against NCD menace in form of Global Action Plan and Monitoring Framework,
government of India developed its own National NCD Monitoring Framework with
10 targets and 21 indicators to be achieved by 2025. One of the strategies to achieve
these targets was the launch of National Programme for Prevention and Control of
Diabetes, CVD and Stroke (NPDCS) by Ministry of Health & Family Welfare.
Realization of duplication of efforts in National Cancer Control Programme led to
integration of the Cancer control component in the renaming and re-launching of the
National Programme for Prevention and Control of Cancer, Diabetes, CVD and
Stroke (NPCDCS) by Ministry of Health & Family Welfare in October 2010 in 100
districts.8
NPCDCS has subsequently been integrated with National Health Mission
in 2013 to expand at national level. The programme components include: (i)
establishment /strengthening of health infrastructure; (ii) early diagnosis and
treatment; (iii) human resource development; (iv) health promotion; and (v)
monitoring, surveillance and research.

37
A National Multi sectoral Action Plan (NMAP) has been developed for the
duration of 2017-2022 with an aim of prevention and control of common NCDs
through provision of a clear direction to the nation's pursuit in this direction.9
One of
the key objectives of the NMAP is to establish sustainable surveillance, monitoring
and evaluation systems to achieve the various NCD targets committed by
Government of India under SDGs, UHCs, Global & national NCD Monitoring
Framework. Simultaneously the first National NCD Monitoring survey (2017-18) has
recently been completed to provide national level estimates on burden of priority
NCDs and their risk factors as enlisted under targets &indicators of the NMAP. The
priority NCDs are Cardiovascular Diseases (CVDs), Cancers, Diabetes Mellitus and
COPD. The priority biological risk factors are raised blood pressure (BP), raised
plasma glucose, raised BMI and dyslipidemia. Behavioural risk factors targeted are
tobacco use, alcohol use, unhealthy diet and physical inactivity.
Table number 1 delineates the 10 NCD targets enlisted under NMAP & other
related documents produced by Government of India. It should be considered while
preparing any further monitoring or evaluation indicators.
Table 1: Targets of NCD Prevention and Control in India
No Domain Indicator Target for
2020
Target
for 2025
1 Premature
mortality
from NCDs
Relative reduction in overall mortality
from cardiovascular disease cancer
diabetes or chronic respiratory disease
10%
25%
2 Alcohol use Relative reduction in alcohol use 5% 10%
3 Obesity and
diabetes
Obesity and diabetes prevalence No target Halt the
rise
4 Physical
inactivity
Relative reduction in prevalence of
raised blood pressure (BP)
10% 25%
5 Raised blood
pressure
Relative reduction in prevalence of
raised blood pressure
10% 25%
6 Salt/sodium
intake
Relative reduction in mean population
intake of salt (with an aim of less than
20% 30%

38
5gms per day)
7 Tobacco use Relative reduction in prevalence of
current tobacco use
15% 30%
8
Drug therapy
to prevent
heart attacks
and strokes
Eligible people receiving drug therapy
and counselling (including glycemic
control) to prevent heart attacks and
strokes
30% 50%
9 Essential
NCD
medicines &
basic
technologies
to treat major
NCDs
Availability and affordability of quality
safe and efficacious essential NCD
medicines including generics and basic
technologies in both public and private
facilities.
60% 80%
10 Household
indoor air
pollution
Relative reduction in household use of
solid fuels as a primary source of
energy for cooking.
25% 50%
Regulating the increasing burden of NCDs in low and middle-income countries
involves establishing adequate systems for monitoring the same and using the data
obtained to upgrade or implement control strategies.10
A recent study concluded that
India has delayed response on NCD risk factors surveillance and information of the
same are sporadic and incomplete. Relative lack of adequate risk factor data in its
entirety, inadequate coverage (geographically and demographically) and absence of a
standardized methodology are the major deficiencies which need to be overcome for
a superior and more effective NCD control in the country.10
Much of the evidence for
NCDs relates to high income countries. There is scarcity of data regarding NCD
monitoring and evaluation from LMICs (like India.
Hence developing monitoring and reporting mechanisms for NCDs outcomes
and risk factors becomes essential for creating accountability and evolve evidence
based strategy for reducing NCDs burden.

39
Members of Working Group :
S.
N.
Nam
e
Role Phone
No.
Design
ation
1. Dr.
Sanje
ev
Kum
ar
Group
Leader
942530
0968
Associa
te
Profess
or
AIIMS
Bhopal,
Madhya
Pradesh
docsanjiv@g
mail.com
2. Dr.
Palla
vi
Boro
Group
Co-
ordinat
or
965481
7069
Assista
nt
Profess
or
TRIHMS,
Naharlagun,
Arunachal
Pradesh
boropallavi
@gmail.com
3. Dr.
Soum
ya
Rappo
rteur
889565
8170
Assista
nt
Profess
or
AIIMS,
Bhathinda,
Punjab
swaroop.drs
oumya@gm
ail.com
4. Dr.
Ankit
a
Kank
aria
Memb
er
964625
9076
Assista
nt
Profess
or
AIIMS,
Bhathinda,
Punjab
kankariyaan
kita@gmail.
com

40
5. Dr.
Mitas
ha
Singh
Rappo
rteur
981085
1145
Assista
nt
Profess
or
ESI medical
college,
Faridabad
Mitasha.17
@gmail.com
Public Health Experience of Members:
Dr. Sanjeev Kumar is Associate Professor in Community Medicine at AIIMS
Bhopal, Madhya Pradesh.As National Master trainer for NPCDCS Programme
Manager Module developed by MoHFW/ AIIMS New Delhi/ WHO India, he
has been involved in training of NCD Nodal Officers/ Programme Managers of
states of MP/ Chhattisgarh/ Odisha/ Haryana/Bihar. Their team has trained 2
batches of Medical Officers MP in NCD Management as per MoHFW
MO/Staff Nurse Module with Dr. Sanjeevinvolved as course coordinator. He
was also core team member involved as course coordinator in training of more
than 25 batches of Medical Officers & Staff Nurses in NCD Management
using module developed at AIIMS Bhopal. He was the State Surveillance
Team (SST) member for IBBS conducted by NACO in 2015-16, HSS
conducted by MPSACS in 2017 under aegis of NACO. He has 13 research
publications till date. He has also conducted research in the domain of NCD
and Health Communication as Principal Investigator & Co investigator for
ICMR & other reputed organizations.
Dr. Pallavi Boro is Assistant Professor, Community Medicine at TRIHMS,
Naharlagun,Arunachal Pradesh. She has worked as in Immunization data quality
assessment in Jhansi, MP in collaboration with PHFI, Delhi. 2015. She has also
worked in Hepatitis A outbreak investigation in Delhi followed by subsequent
surveillance of the eating facilities of LokNayak Hospital in Delhi during 2015.
She was involved in the Data collection, analysis and preparation of the report of
ICMR funded project on Tuberculosis morbidity in Meghalaya in 2018. She is a
resource person in training of Medical Officers, ANMs and ASHA regarding

41
Bio Medical waste disposal in various health facilities in Shillong, Meghalaya.
2018- 19.
Dr. Soumya is Assistant Professor, Community Medicine at AIIMS Bhatinda,
Punjab. He has worked as an assessor and trainer in the Supportive Supervision
and Rapid Appraisal of Programme Implementation in District (RAPID)
programme of NRHM Haryana in various districts of Haryanain 2012-14. He is
trained in ‘Strengthening Cessation Capacity of Primary Care Physicians
(SCCOPE)’ by The Global Bridges and The London and Barts School of
Medicine and Dentistry and conducted training sessions on tobacco cessation
practices among Primary care physicians in Cuttack and Khurda districts,
Odisha 2015. He actively participated in Projects on “Patient satisfaction in
cancer care in Regional Cancer care centre, Cuttack” and “Heat wave action
plan of Odisha” during his tenure at Indian Institute of Public Health (IIPH),
PHFI Bhubaneswar 2015-16. He has conducted training sessions in INAP for
frontline health care workers and Medical officers in various districts of Odisha
2017-18. He was involved in Training of Medical Officers and ICDS department
functionaries in the “Aspirational District Programme of Odisha” in andhamal
and Bolangir districts, Odisha 2019
Dr. Ankita is Assistant Professor, Community Medicine at AIIMS Bhatinda,
Punjab. She has close to 6 years of teaching and 5 years of research experience
in public health. She had worked as a community physician, researcher and
teacher during her junior and senior residency. She was the project coordinator
for CDC-WHO funded and USAID funded project for about 2 years. She has 12
publications and was co-investigator for 2 intramural projects and 2 extramural
projects. Currently she is collaborating with UCSF, USA and LSHTM, UK for
projects on maternal and child health and diabetic retinopathy.
Dr. Mitasha Singh is Assistant Professor, Community Medicine, ESIC
Faridabad. She has worked as a Field supervisor in NHM, H.P. funded project
on immunization coverage survey and verbal autopsy of Stillbirths. She
participated actively in data collection of projects of ICMR i.e. prevalence of
autism in tribal, rural and urban areas of H.P. She had a RNTCP funded
dissertation on coexistence of TB-DM in PHI of Kangra district, Himachal
Pradesh.

42
References:
1. Bennett JE, Stevens GA, Mathers CD, Bonita R, Rehm J, Kruk ME. NCD
Countdown 2030 collaborators. NCD Countdown 2030: worldwide trends in
non-communicable disease mortality and progress towards sustainable
development goal target 3.4. Lancet. 2018;9(22):392.
2. Cesare MD, Khang YH, Asaria P, Blakely T, Cowan MJ, Farzadfar F, et al.
Non-Communicable Diseases 3 Inequalities in non-communicable diseases and
eff ective responses.
3. Ezzati M, Pearson-Stuttard J, Bennett JE, Mathers CD. Acting on non-
communicable diseases in low-and middle-income tropical countries. Nature.
2018 Jul;559(7715):507-16.
4. Niessen LW, Mohan D, Akuoku JK, Mirelman AJ, Ahmed S, Koehlmoos TP,
et al. Tackling socioeconomic inequalities and non-communicable diseases in
low-income and middle-income countries under the Sustainable Development
agenda. Lancet. 2018 May 19;391(10134):2036-46.
5. Tandon N, Anjana RM, Mohan V, Kaur T, Afshin A, Ong K, et al. The
increasing burden of diabetes and variations among the states of India: the
Global Burden of Disease Study 1990–2016. Lancet Global health. 2018
Dec;6(12):e1352-62.
6. Jamison DT, Summers LH, Alleyne G, Arrow KJ, Berkley S, Binagwaho A, et
al. Global health 2035: a world converging within a generation. Lancet. 2013
Dec;382(9908):1898-955.
7. UN General Assembly. Transforming our world: the 2030 agenda for
sustainable development. 2015. Available
fromhttps://sustainabledevelopment.un.org/post2015/transformingourworld/pu
blication. Accessed on 25-01-2020
8. Ministry of Health and Family Welfare. Government of India. National
Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular
Diseases and Stroke. 2013.Available from:
https://mohfw.gov.in/sites/default/files/Operational%20Guidelines%20of%20
NPCDCS%20%28Revised%20-%202013-17%29_1.pdf.Accessed on 25-01-
2020

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9. Ministry of Health and Family Welfare. Government of India. National
Multisectoral Action Plan for prevention and control of common non
communicable disease. 2017. Available from:
https://mohfw.gov.in/sites/default/files/National%20Multisectoral%20Action%
20Plan%20%28NMAP%29%20for%20Prevention%20and%20Control%20of
%20Common%20NCDs%20%282017-22%29_1.pdf. Accessed on 25-01-2020
10.Nethan S, Sinha D, Mehrotra R. Non communicable disease risk factors and
their trends in India. Asian Pacific journal of cancer prevention: APJCP.
2017;18(7):2005-10

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