National diarroheal control programme in nepal , presented and prepared this information was taken on 2076/77 and will be valid untill the next update of NDHS comes out, this is useful for bachleor level, community Health Nursing
The document summarizes Nepal's family planning program. The main objectives are to improve health outcomes for mothers and children by increasing access to quality family planning services, especially for rural and marginalized groups. Key activities include providing various contraceptive methods through both institutions and mobile clinics. While contraceptive use and access have increased over time, challenges remain such as high unmet need and an overreliance on emergency contraception and abortion. Recommendations focus on strengthening access to long-acting reversible contraceptives and services for adolescents.
The document provides information on Nepal's national immunization program, including its goals, objectives, strategies, and key activities. The program aims to reduce child mortality from vaccine-preventable diseases by achieving and maintaining at least 90% vaccine coverage nationwide. It coordinates immunization services delivered through government health facilities, private providers, and NGOs. Milestones include introducing new vaccines and achieving the eradication of polio and elimination of maternal and neonatal tetanus.
Integrated Disease Surveillance Project (IDSP) was launched by Hon’ble Union Minister of Health & Family Welfare in November 2004 for a period upto March 2010. The project was restructured and extended up to March 2012. The project continues in the 12th Plan with domestic budget as Integrated Disease Surveillance Programme under NHM for all States with Budgetary allocation of 640 Cr.
A Central Surveillance Unit (CSU) at Delhi, State Surveillance Units (SSU) at all State/UT head quarters and District Surveillance Units (DSU) at all Districts in the country have been established.
Objectives:
To strengthen/maintain decentralized laboratory based IT enabled disease surveillance system for epidemic prone diseases to monitor disease trends and to detect and respond to outbreaks in early rising phase through trained Rapid Response Team (RRTs)
Programme Components:
Integration and decentralization of surveillance activities through establishment of surveillance units at Centre, State and District level.
Human Resource Development – Training of State Surveillance Officers, District Surveillance Officers, Rapid Response Team and other Medical and Paramedical staff on principles of disease surveillance.
Use of Information Communication Technology for collection, collation, compilation, analysis and dissemination of data.
Strengthening of public health laboratories.
National Vector Borne Disease Control Programme (NVBDCP)Vivek Varat
This document provides information about India's National Vector Borne Disease Control Programme (NVBDCP). The key points are:
1. NVBDCP aims to prevent and control malaria and other vector-borne diseases like dengue, Japanese encephalitis, kala-azar through strategies like early detection and treatment of cases, vector control measures and community participation.
2. Malaria control is a major focus, with strategies including prompt treatment, vector control through indoor residual spraying and larviciding, use of insecticide-treated bed nets, and environmental management.
3. The programme aims to reduce malaria morbidity and mortality in India and achieve an annual parasite index of less than 1 per 1000 population by 2017.
This document summarizes the child health program in Nepal. It discusses the main medical causes of infant mortality and morbidity, including low birth weight, respiratory infections, diarrhea, and malnutrition. It then outlines Nepal's national immunization program, which aims to increase vaccination coverage and prevent diseases like polio, measles, and tetanus. The program is guided by national health strategies and goals to reduce child mortality and morbidity from vaccine-preventable illnesses. Key activities discussed include vaccinator training, polio campaigns, and integrated disease surveillance.
The CB-IMNCI program in Nepal aims to improve newborn and child survival through integrated management of neonatal and childhood illnesses in communities. It was established in 2015 by merging the CB-IMCI and CB-NCP programs. The CB-IMNCI program trains frontline health workers and volunteers to provide essential newborn care, manage childhood illnesses like pneumonia and diarrhea, and make timely referrals. It aims to reduce under-five mortality and neonatal mortality by expanding services to 90% of the population by 2020. Monitoring indicators include institutional delivery rates, newborn care practices, and treatment of childhood illnesses.
The document summarizes Nepal's family planning program. The main objectives are to improve health outcomes for mothers and children by increasing access to quality family planning services, especially for rural and marginalized groups. Key activities include providing various contraceptive methods through both institutions and mobile clinics. While contraceptive use and access have increased over time, challenges remain such as high unmet need and an overreliance on emergency contraception and abortion. Recommendations focus on strengthening access to long-acting reversible contraceptives and services for adolescents.
The document provides information on Nepal's national immunization program, including its goals, objectives, strategies, and key activities. The program aims to reduce child mortality from vaccine-preventable diseases by achieving and maintaining at least 90% vaccine coverage nationwide. It coordinates immunization services delivered through government health facilities, private providers, and NGOs. Milestones include introducing new vaccines and achieving the eradication of polio and elimination of maternal and neonatal tetanus.
Integrated Disease Surveillance Project (IDSP) was launched by Hon’ble Union Minister of Health & Family Welfare in November 2004 for a period upto March 2010. The project was restructured and extended up to March 2012. The project continues in the 12th Plan with domestic budget as Integrated Disease Surveillance Programme under NHM for all States with Budgetary allocation of 640 Cr.
A Central Surveillance Unit (CSU) at Delhi, State Surveillance Units (SSU) at all State/UT head quarters and District Surveillance Units (DSU) at all Districts in the country have been established.
Objectives:
To strengthen/maintain decentralized laboratory based IT enabled disease surveillance system for epidemic prone diseases to monitor disease trends and to detect and respond to outbreaks in early rising phase through trained Rapid Response Team (RRTs)
Programme Components:
Integration and decentralization of surveillance activities through establishment of surveillance units at Centre, State and District level.
Human Resource Development – Training of State Surveillance Officers, District Surveillance Officers, Rapid Response Team and other Medical and Paramedical staff on principles of disease surveillance.
Use of Information Communication Technology for collection, collation, compilation, analysis and dissemination of data.
Strengthening of public health laboratories.
National Vector Borne Disease Control Programme (NVBDCP)Vivek Varat
This document provides information about India's National Vector Borne Disease Control Programme (NVBDCP). The key points are:
1. NVBDCP aims to prevent and control malaria and other vector-borne diseases like dengue, Japanese encephalitis, kala-azar through strategies like early detection and treatment of cases, vector control measures and community participation.
2. Malaria control is a major focus, with strategies including prompt treatment, vector control through indoor residual spraying and larviciding, use of insecticide-treated bed nets, and environmental management.
3. The programme aims to reduce malaria morbidity and mortality in India and achieve an annual parasite index of less than 1 per 1000 population by 2017.
This document summarizes the child health program in Nepal. It discusses the main medical causes of infant mortality and morbidity, including low birth weight, respiratory infections, diarrhea, and malnutrition. It then outlines Nepal's national immunization program, which aims to increase vaccination coverage and prevent diseases like polio, measles, and tetanus. The program is guided by national health strategies and goals to reduce child mortality and morbidity from vaccine-preventable illnesses. Key activities discussed include vaccinator training, polio campaigns, and integrated disease surveillance.
The CB-IMNCI program in Nepal aims to improve newborn and child survival through integrated management of neonatal and childhood illnesses in communities. It was established in 2015 by merging the CB-IMCI and CB-NCP programs. The CB-IMNCI program trains frontline health workers and volunteers to provide essential newborn care, manage childhood illnesses like pneumonia and diarrhea, and make timely referrals. It aims to reduce under-five mortality and neonatal mortality by expanding services to 90% of the population by 2020. Monitoring indicators include institutional delivery rates, newborn care practices, and treatment of childhood illnesses.
Swot analysis of safe motherhood program of Nepalsirjana Tiwari
The document provides an overview of Nepal's Safe Motherhood and Newborn Health Program, including its goals, strategies, activities and management. Some key points:
- The program aims to reduce maternal and neonatal morbidity and mortality through preventative activities and addressing factors that cause death during pregnancy, childbirth and postpartum.
- Major strategies include promoting birth preparedness, the Aama program to promote antenatal checkups and institutional delivery, and expanding emergency obstetric services.
- Key activities include distribution of birth preparedness packages, rural ultrasound programs, expansion of birthing centers and emergency obstetric care sites, and training of skilled birth attendants.
- The program is managed through planning
RMNCH+A approach has been launched in 2013 and it essentially looks to address the major causes of mortality among women and children as well as the delays in accessing and utilizing health care and services. The RMNCH+A strategic approach has been developed to provide an understanding of ‘continuum of care’ to ensure equal focus on various life stages.
The RMNCH+A appropriately directs the States to focus their efforts on the most vulnerable population and disadvantaged groups in the country. It also emphasizes on the need to reinforce efforts in those poor performing districts that have already been identified as the high focus districts.
National Program for Prevention and Control of Cancer, Diabetes, CVD and Stro...Vivek Varat
Government of India initiated a National Programme for Prevention and Control of Cancers, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) during 2010-11 after integrating the National Cancer Control Programme (NCCP) with (NPDCS).
Dr. Immanuel Joshua outlines key priorities and goals for ending tuberculosis (TB) globally and in India by 2025. The goals include reducing TB deaths and incidence rates by 90% and 80% respectively compared to 2015, and achieving zero catastrophic expenditures due to TB. Treatment duration and costs vary depending on whether TB is drug-sensitive or drug-resistant. India has committed to ending TB five years ahead of the global 2030 goal through its TB Free India campaign launched in 2018.
This document discusses Mission Indradhanush, an Indian government health initiative launched in 2014 to increase vaccination coverage. It aims to fully vaccinate all unvaccinated and partially vaccinated children under 2 years old and pregnant women by 2020. The mission focuses on conducting vaccination drives in 201 high-priority districts and expanding the vaccines provided to include additional diseases. It emphasizes planning, training, communication, and establishing accountability at the national, state, district and local levels to improve vaccination rates from 65% to at least 90%. The first phase saw success in conducting sessions and vaccinating millions of individuals in six districts. Current efforts are focusing vaccination drives in specific high-risk areas like slums.
FCHVs are trusted members of the community who have promoted positive behaviors related to safe motherhood, child health, family planning and other various health related areas. This slide covers a comprehensive ideas regarding the FCHVs, their functions, roles and status in Nepal.
NVBDCP National Vector Borne Disease Control ProgramMihir Rupani
The document discusses guidelines for the National Vector Borne Disease Control Program (NVBDCP) in India. The NVBDCP is an integrated program that aims to prevent and control six vector-borne diseases - malaria, dengue, chikungunya, Japanese encephalitis, kala-azar, and filariasis. It outlines strategies like surveillance, diagnosis, treatment, vector control, capacity building, and inter-sectoral collaboration. Specific guidelines for malaria control include microscopy-based diagnosis, use of rapid test kits, indoor residual spraying, larviciding, epidemic preparedness, and training of health workers.
The National Health Policy of 1991 in Nepal had the objective of extending primary health care services to rural populations. It outlined 14 areas to achieve this, including preventive services like immunization and MCH, promotive services like health education, curative services through a referral system, strengthening primary health care, and developing human resources. However, a critical review found it lacked clear strategies for equity, collaboration, and community participation. While it targeted rural areas, there was no strategy for marginalized groups' access. Collaboration and referral mechanisms were also not clearly defined. Community participation was mentioned but ignored beneficiaries' involvement in services.
Behavior change communication (BCC) is a strategic process that uses communication to promote positive health behaviors and outcomes. It involves formative research, communication planning, implementation, and evaluation. BCC develops tailored messages through various channels to promote individual and community behavior change. The process aims to move people through stages from unaware to sustained behavior change. BCC can be effective at individual, community and national levels by increasing knowledge, skills, and positive attitudes. Some limitations include a focus on materials over conduct and limited local capacity. BCC plays an important role in addressing issues like HIV/AIDS by increasing awareness, stimulating dialogue, advocating for policy changes, and promoting prevention and care services.
Unit 4 - District Health Services Management Part 1 pdfDipesh Tikhatri
The document provides information on district health services management in Nepal. It discusses the background and organization of District Health Offices (DHOs), their roles and responsibilities, programs managed, staffing patterns, and job descriptions for key positions like the Chief of DHO, Public Health Chief, and Public Health Officer. The functions of DHOs have now been transitioned to new Health Offices under provincial health directorates.
The document provides background information on Nepal's health system. Some key points:
- Nepal is transitioning to a federal democratic republic after a period of political instability and has set a goal to graduate from least developed country status by 2022.
- It faces challenges of poverty, inequality, and a high burden of disease. The health system provides services through a three-tier structure at the federal, provincial, and local levels.
- Financing comes from various sources including government spending which allocates a portion of its budget to health but this share has declined in recent years despite overall spending increases. Out-of-pocket costs remain high.
Adolescent sexual and reproductive health (ASRH) in Nepal Public Health
1) The document outlines Nepal's Adolescent Sexual and Reproductive Health (ASRH) strategy, which aims to promote the health of adolescents aged 10-19.
2) Key achievements include expanding ASRH services to 75 of 77 districts, establishing 6 ASRH clinical training sites, and training over 1,700 health workers.
3) Challenges include high rates of early marriage, low contraceptive use among adolescents, and a need for more trained staff and resources for the ASRH program.
This document summarizes the key components of a diarrhoeal disease control program. It discusses the importance of oral rehydration therapy and zinc supplementation for treatment. It also emphasizes preventative strategies like improved sanitation, health education, immunization, and fly control. The long-term goals include better maternal and child health practices to reduce malnutrition and the risk of diarrhoeal diseases. The program aims to reduce mortality and morbidity from diarrhoeal diseases through both clinical management of cases and preventative public health measures.
India is the highest TB burden country in the world & accounts for nearly 1/5th (20 per cent) of global burden of tuberculosis, 2/3rd of cases in SEAR. Every year approximately 1.8 million persons develop tuberculosis, of which about 0.8 million are new smear positive highly'- infectious cases.Annual risk of becoming infected with TB is 1.5 % and once infected there is 10 % life-time risk of developing TB disease
National Vector Borne Disease Control Programme (NVBDCP)Kailash Nagar
The National Vector Borne Disease Control Program (NVBDCP) was launched in 2003-04 by merging several existing programs to prevent and control major vector-borne diseases like malaria, dengue, Japanese encephalitis, kala-azar, and filariasis. The NVBDCP aims to reduce mortality from these diseases and eliminate kala-azar and lymphatic filariasis through strategies like early diagnosis and treatment, integrated vector management, behavior change communication, and capacity building. Malaria control specifically focuses on maintaining surveillance and treating cases, as well as integrated vector control through indoor residual spraying and larval source reduction.
Female Community Health Volunteer Programme in Nepal Public Health
The Female Community Health Volunteer (FCHV) Programme was initiated in Nepal in 1988 to promote public health at the community level. There are currently over 51,000 FCHVs working across Nepal. FCHVs receive basic training and are supplied medicine kits to provide services such as distributing family planning devices, treating pneumonia, and educating communities on health issues. They play a major role in reducing maternal and child mortality. In the fiscal year 2075/76, FCHVs supported home deliveries and provided nutrition services to mothers and children. While FCHVs have achieved improvements in health indicators, issues like low utilization of funds and decreasing work performance need to be addressed.
National health programs and policies for prevention and control of ncds in n...Pawan Dhami
This document summarizes several national health programs and policies in Nepal related to the prevention and control of non-communicable diseases (NCDs). It outlines policies such as the Integrated NCD Prevention and Control Policy, the Multi-Sectoral Action Plan for NCD Prevention and Control (2014-2020), and the National Policy and Plan for NCD Prevention and Control (2013-2017). It also discusses the Health Education, Information and Communication Program and policies within the Second Long Term Health Plan, Nepal Health Sector Strategy, and other documents. The document analyzes some of the systematic challenges facing NCD prevention in Nepal, such as limited funding for primary prevention and a lack of coordination between sectors.
National heath and family welfare programmePinki Barman
The document discusses several national health programs launched by the Government of India to control communicable diseases, improve environmental sanitation and nutrition, and strengthen rural health. It summarizes the objectives, strategies and achievements of programs related to malaria control, filaria control, leprosy eradication, tuberculosis control, AIDS control and other initiatives focused on child and maternal health, eye care, nutrition, and mental healthcare. The National Health Mission is also summarized as the overarching framework that subsumes prior rural and urban health missions with the goal of strengthening health systems across the country.
The document discusses India's various national health programs. It begins with an introduction to national health programs and measures to effectively implement them. It then provides details on specific programs, including their objectives, strategies, and activities. These programs address issues such as communicable diseases, environmental sanitation, population control, and more. Intersectoral coordination and the roles of non-governmental agencies are also discussed.
Swot analysis of safe motherhood program of Nepalsirjana Tiwari
The document provides an overview of Nepal's Safe Motherhood and Newborn Health Program, including its goals, strategies, activities and management. Some key points:
- The program aims to reduce maternal and neonatal morbidity and mortality through preventative activities and addressing factors that cause death during pregnancy, childbirth and postpartum.
- Major strategies include promoting birth preparedness, the Aama program to promote antenatal checkups and institutional delivery, and expanding emergency obstetric services.
- Key activities include distribution of birth preparedness packages, rural ultrasound programs, expansion of birthing centers and emergency obstetric care sites, and training of skilled birth attendants.
- The program is managed through planning
RMNCH+A approach has been launched in 2013 and it essentially looks to address the major causes of mortality among women and children as well as the delays in accessing and utilizing health care and services. The RMNCH+A strategic approach has been developed to provide an understanding of ‘continuum of care’ to ensure equal focus on various life stages.
The RMNCH+A appropriately directs the States to focus their efforts on the most vulnerable population and disadvantaged groups in the country. It also emphasizes on the need to reinforce efforts in those poor performing districts that have already been identified as the high focus districts.
National Program for Prevention and Control of Cancer, Diabetes, CVD and Stro...Vivek Varat
Government of India initiated a National Programme for Prevention and Control of Cancers, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS) during 2010-11 after integrating the National Cancer Control Programme (NCCP) with (NPDCS).
Dr. Immanuel Joshua outlines key priorities and goals for ending tuberculosis (TB) globally and in India by 2025. The goals include reducing TB deaths and incidence rates by 90% and 80% respectively compared to 2015, and achieving zero catastrophic expenditures due to TB. Treatment duration and costs vary depending on whether TB is drug-sensitive or drug-resistant. India has committed to ending TB five years ahead of the global 2030 goal through its TB Free India campaign launched in 2018.
This document discusses Mission Indradhanush, an Indian government health initiative launched in 2014 to increase vaccination coverage. It aims to fully vaccinate all unvaccinated and partially vaccinated children under 2 years old and pregnant women by 2020. The mission focuses on conducting vaccination drives in 201 high-priority districts and expanding the vaccines provided to include additional diseases. It emphasizes planning, training, communication, and establishing accountability at the national, state, district and local levels to improve vaccination rates from 65% to at least 90%. The first phase saw success in conducting sessions and vaccinating millions of individuals in six districts. Current efforts are focusing vaccination drives in specific high-risk areas like slums.
FCHVs are trusted members of the community who have promoted positive behaviors related to safe motherhood, child health, family planning and other various health related areas. This slide covers a comprehensive ideas regarding the FCHVs, their functions, roles and status in Nepal.
NVBDCP National Vector Borne Disease Control ProgramMihir Rupani
The document discusses guidelines for the National Vector Borne Disease Control Program (NVBDCP) in India. The NVBDCP is an integrated program that aims to prevent and control six vector-borne diseases - malaria, dengue, chikungunya, Japanese encephalitis, kala-azar, and filariasis. It outlines strategies like surveillance, diagnosis, treatment, vector control, capacity building, and inter-sectoral collaboration. Specific guidelines for malaria control include microscopy-based diagnosis, use of rapid test kits, indoor residual spraying, larviciding, epidemic preparedness, and training of health workers.
The National Health Policy of 1991 in Nepal had the objective of extending primary health care services to rural populations. It outlined 14 areas to achieve this, including preventive services like immunization and MCH, promotive services like health education, curative services through a referral system, strengthening primary health care, and developing human resources. However, a critical review found it lacked clear strategies for equity, collaboration, and community participation. While it targeted rural areas, there was no strategy for marginalized groups' access. Collaboration and referral mechanisms were also not clearly defined. Community participation was mentioned but ignored beneficiaries' involvement in services.
Behavior change communication (BCC) is a strategic process that uses communication to promote positive health behaviors and outcomes. It involves formative research, communication planning, implementation, and evaluation. BCC develops tailored messages through various channels to promote individual and community behavior change. The process aims to move people through stages from unaware to sustained behavior change. BCC can be effective at individual, community and national levels by increasing knowledge, skills, and positive attitudes. Some limitations include a focus on materials over conduct and limited local capacity. BCC plays an important role in addressing issues like HIV/AIDS by increasing awareness, stimulating dialogue, advocating for policy changes, and promoting prevention and care services.
Unit 4 - District Health Services Management Part 1 pdfDipesh Tikhatri
The document provides information on district health services management in Nepal. It discusses the background and organization of District Health Offices (DHOs), their roles and responsibilities, programs managed, staffing patterns, and job descriptions for key positions like the Chief of DHO, Public Health Chief, and Public Health Officer. The functions of DHOs have now been transitioned to new Health Offices under provincial health directorates.
The document provides background information on Nepal's health system. Some key points:
- Nepal is transitioning to a federal democratic republic after a period of political instability and has set a goal to graduate from least developed country status by 2022.
- It faces challenges of poverty, inequality, and a high burden of disease. The health system provides services through a three-tier structure at the federal, provincial, and local levels.
- Financing comes from various sources including government spending which allocates a portion of its budget to health but this share has declined in recent years despite overall spending increases. Out-of-pocket costs remain high.
Adolescent sexual and reproductive health (ASRH) in Nepal Public Health
1) The document outlines Nepal's Adolescent Sexual and Reproductive Health (ASRH) strategy, which aims to promote the health of adolescents aged 10-19.
2) Key achievements include expanding ASRH services to 75 of 77 districts, establishing 6 ASRH clinical training sites, and training over 1,700 health workers.
3) Challenges include high rates of early marriage, low contraceptive use among adolescents, and a need for more trained staff and resources for the ASRH program.
This document summarizes the key components of a diarrhoeal disease control program. It discusses the importance of oral rehydration therapy and zinc supplementation for treatment. It also emphasizes preventative strategies like improved sanitation, health education, immunization, and fly control. The long-term goals include better maternal and child health practices to reduce malnutrition and the risk of diarrhoeal diseases. The program aims to reduce mortality and morbidity from diarrhoeal diseases through both clinical management of cases and preventative public health measures.
India is the highest TB burden country in the world & accounts for nearly 1/5th (20 per cent) of global burden of tuberculosis, 2/3rd of cases in SEAR. Every year approximately 1.8 million persons develop tuberculosis, of which about 0.8 million are new smear positive highly'- infectious cases.Annual risk of becoming infected with TB is 1.5 % and once infected there is 10 % life-time risk of developing TB disease
National Vector Borne Disease Control Programme (NVBDCP)Kailash Nagar
The National Vector Borne Disease Control Program (NVBDCP) was launched in 2003-04 by merging several existing programs to prevent and control major vector-borne diseases like malaria, dengue, Japanese encephalitis, kala-azar, and filariasis. The NVBDCP aims to reduce mortality from these diseases and eliminate kala-azar and lymphatic filariasis through strategies like early diagnosis and treatment, integrated vector management, behavior change communication, and capacity building. Malaria control specifically focuses on maintaining surveillance and treating cases, as well as integrated vector control through indoor residual spraying and larval source reduction.
Female Community Health Volunteer Programme in Nepal Public Health
The Female Community Health Volunteer (FCHV) Programme was initiated in Nepal in 1988 to promote public health at the community level. There are currently over 51,000 FCHVs working across Nepal. FCHVs receive basic training and are supplied medicine kits to provide services such as distributing family planning devices, treating pneumonia, and educating communities on health issues. They play a major role in reducing maternal and child mortality. In the fiscal year 2075/76, FCHVs supported home deliveries and provided nutrition services to mothers and children. While FCHVs have achieved improvements in health indicators, issues like low utilization of funds and decreasing work performance need to be addressed.
National health programs and policies for prevention and control of ncds in n...Pawan Dhami
This document summarizes several national health programs and policies in Nepal related to the prevention and control of non-communicable diseases (NCDs). It outlines policies such as the Integrated NCD Prevention and Control Policy, the Multi-Sectoral Action Plan for NCD Prevention and Control (2014-2020), and the National Policy and Plan for NCD Prevention and Control (2013-2017). It also discusses the Health Education, Information and Communication Program and policies within the Second Long Term Health Plan, Nepal Health Sector Strategy, and other documents. The document analyzes some of the systematic challenges facing NCD prevention in Nepal, such as limited funding for primary prevention and a lack of coordination between sectors.
National heath and family welfare programmePinki Barman
The document discusses several national health programs launched by the Government of India to control communicable diseases, improve environmental sanitation and nutrition, and strengthen rural health. It summarizes the objectives, strategies and achievements of programs related to malaria control, filaria control, leprosy eradication, tuberculosis control, AIDS control and other initiatives focused on child and maternal health, eye care, nutrition, and mental healthcare. The National Health Mission is also summarized as the overarching framework that subsumes prior rural and urban health missions with the goal of strengthening health systems across the country.
The document discusses India's various national health programs. It begins with an introduction to national health programs and measures to effectively implement them. It then provides details on specific programs, including their objectives, strategies, and activities. These programs address issues such as communicable diseases, environmental sanitation, population control, and more. Intersectoral coordination and the roles of non-governmental agencies are also discussed.
This document outlines several national health programs in India related to communicable disease control and maternal and child health. It provides details on objectives, strategies and activities for programs focused on malaria eradication, filaria control, kala-azar control, Japanese encephalitis prevention, dengue prevention and control, tuberculosis control, diarrheal disease control, school health, and maternal and child health. The programs aim to prevent and treat diseases, improve environmental sanitation and nutrition, and involve health education and community participation.
14. Dr.chaitanya, progress and achievements of public health programs in indiaChaitanya Pendyala
The document summarizes several public health programs and achievements in India, including programs to control vector-borne diseases like malaria and dengue, tuberculosis control through the Revised National TB Control Programme, the National Iodine Deficiency Disorders Control Programme, the National Leprosy Eradication Programme, and others. It provides details on the objectives, strategies, and achievements of these various national public health programs.
Children are vulnerable to malnutrition and infectious diseases that can often be prevented or treated. The document discusses global and national statistics on infant mortality rates and the leading causes of child death. It outlines India's national child health programs since the 1950s that aim to reduce infant and child mortality rates by focusing on interventions like immunization, diarrhea treatment, and prenatal care. Key initiatives include the Universal Immunization Program, Child Survival and Safe Motherhood Program, Reproductive and Child Health Program, and strategies to provide vitamin A supplementation and manage neonatal and childhood illnesses. The goal is to achieve significant reductions in infant, neonatal, and child mortality rates.
National health and family welfare programs in India aim to improve population health. There are many national health programs that focus on controlling communicable diseases, improving sanitation, and controlling population growth. These programs are implemented through intersectoral coordination between government agencies and non-governmental organizations. National health programs address issues like vector-borne diseases, malaria, filariasis, tuberculosis, HIV/AIDS, blindness, nutrition deficiencies, and more. Effectiveness of programs relies on factors like quality of services, appropriate training, resource availability, and increasing public awareness. Non-governmental organizations play an important role in supporting these programs through activities like research, education, and direct service provision.
National health and family welfare programs in India aim to improve public health. There are many national health programs that focus on controlling communicable diseases, improving sanitation, and controlling population growth. These programs are implemented through intersectoral coordination between government agencies and non-governmental organizations. National health programs address issues like vector-borne diseases, malaria, filariasis, tuberculosis, HIV/AIDS, blindness, nutrition deficiencies, and more. Effectiveness of programs relies on factors such as improving service quality, resources, training, and generating public awareness. Non-governmental organizations also play important roles in supporting national health programs through activities like research, education, and community services.
The document presents information on India's National Health Policies from 1983 to 2017. It discusses the goals and strategies of policies from 1983, 2002, and 2017. The key goals of policies included access to primary care for all, reducing mortality and disease prevalence, and achieving universal health coverage. The policies aimed to improve health infrastructure, personnel training, and integrate different medical systems to make progress toward health for all.
This document provides a summary of the primary health care system in Nepal. It discusses the background and principles of primary health care in Nepal since adopting the Alma Ata Declaration in 1978. It then summarizes the progress made in key primary health care indicators from 1980 to 2005 across several components, including health education, nutrition, maternal and child health, immunizations, control of endemic diseases, treatment of common illnesses, essential drugs, water and sanitation. Overall, it shows improvements across many health indicators and the strengthening of primary health care services nationwide over the past few decades in Nepal.
The document summarizes the history and current status of child health programs in India. Major programs introduced include the Family Planning Programme in 1951. Other key programs and initiatives discussed include the Universal Immunization Programme launched in 1985, the Integrated Child Development Services program, and the more recent Reproductive and Child Health Program and National Rural Health Mission. The document outlines the goals and strategies of various initiatives aimed at reducing infant mortality, neonatal mortality, and improving maternal and child health in India.
The document discusses several national health programs in India related to child health and welfare. It outlines programs focused on maternal and child care like MCH, ICDS, CSSM, and RCH. It also summarizes programs for communicable diseases such as immunization, ARI, tuberculosis, and vector-borne diseases. The National Rural Health Mission aims to reduce IMR and MMR and provide universal access to primary healthcare. It promotes community involvement through village health committees.
Various national health programs are currently in operation in India to improve public health. This document outlines programs related to communicable diseases, non-communicable diseases, nutrition, system strengthening, and national health policies. It also provides details on key child health programs like the Reproductive and Child Health Program, Universal Immunization Program, Integrated Child Development Services Scheme, and School Health Program. Nutritional programs like the Vitamin A Prophylaxis Program, National Program for Control of Anemia, and National Iodine Deficiency Disorders Control Program are also summarized.
This document outlines several national health policies and objectives in India, including the National Health Policy, National Policy on AYUSH, and National Population Policy. It provides definitions of policy and health policy. The objectives of the policies are to improve health status and outcomes, increase access to primary healthcare services, and strengthen the health system. Some specific goals mentioned are reducing mortality rates, increasing utilization of public health facilities, expanding health infrastructure and the community health workforce.
Nepal has made progress in reducing child malnutrition but still faces challenges in meeting global targets. Key national nutrition programs include growth monitoring of children under 2, promoting appropriate infant and young child feeding practices, managing acute malnutrition, operating nutrition rehabilitation homes, and controlling micronutrient deficiencies through iron supplementation, iodized salt consumption, and vitamin A distribution. Moving forward, Nepal aims to further scale up these programs through multi-sector collaboration to fully tackle malnutrition.
Food and Waterborne Diseases (FWBDs) cabriga.pptxJ.L CABRIGA
The document describes the Food and Waterborne Disease Prevention and Control Program in the Philippines. The program aims to reduce the burden of food and waterborne diseases through surveillance, diagnosis, treatment, health promotion, and interagency collaboration. It targets populations experiencing diseases like diarrhea, typhoid, hepatitis A, and rotavirus. The program has various components, partner institutions, policies and strategies to prevent and control food and waterborne illnesses.
The National Immunization Programme (NIP) in Nepal aims to reduce child mortality from vaccine-preventable diseases. Launched in 1977, it has met goals like MDG 4 on child mortality reduction. The NIP delivers vaccines through health clinics and outreach sessions nationwide. Its goals are to achieve and maintain at least 90% vaccination coverage nationally and end diseases like polio, which Nepal was declared free of in 2010. The NIP targets children under 1 for vaccines like BCG, DPT and measles, and also provides tetanus vaccines for pregnant women. It conducts over 16,000 immunization sessions monthly across the country.
The document summarizes the key points of India's National Health Policy of 2017. The policy aims to improve health access, quality and affordability for all citizens. It outlines goals such as increasing public health spending, strengthening primary care, controlling diseases like TB and HIV, and addressing issues like malnutrition, non-communicable diseases, and maternal and child health. The policy emphasizes preventive healthcare, coordinated efforts across sectors, and targeted approaches to improve health outcomes equitably.
The India Newborn Action Plan (INAP) aims to reduce preventable newborn deaths and stillbirths in India. Its two goals are to achieve a neonatal mortality rate (NMR) and stillbirth rate (SBR) of less than 10 by 2030. It outlines six intervention pillars including care during pregnancy, childbirth, the postnatal period and beyond. The plan emphasizes improving services for maternal and newborn care across various levels of India's health system through strategies like the Home Based Newborn Care program and strengthening special newborn care units. Successful implementation of INAP requires active participation and commitment from India's states to achieve its vision by 2030.
The National Sexually Transmitted Diseases Control Programme was started in 1946 in India to focus on treating STDs and reducing the social stigma around them. In 1992, it was merged with the National AIDS Control Programme due to the emergence of the HIV epidemic. The combined programme aims to prevent STD and HIV transmission through education and promoting safer sexual behaviors. It provides standardized treatment and counseling services for STDs through over 1160 clinics located in public health facilities across India.
NATIONAL AIDS CONTROL PROGRAMME(NACP) PPT BY KRITIKA.pptxKritikaDhawan9
Acquired immunodeficiency syndrome (AIDS) is a chronic , potentially life, threating condition caused by the human immunodeficiency virus(HIV), a human retrovirus . By, damaging your immune system , HIV interferes with your body's ability to fight infection and disease.
HIV uses the machinery of the CD4 cells to multiply and spread throughout the body .
Similar to Fulll chapter of national diarroheal control programme in nepal (20)
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
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TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
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Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Integrating Ayurveda into Parkinson’s Management: A Holistic Approach
Fulll chapter of national diarroheal control programme in nepal
1. BY - M O N I K A R I JA L
N I S H A AC H A RYA
N I S H M A C H AU D H A RY
PA D M A R A I
PA B I T R A G U R U N G
Control of diarrheal disease in
Nepal
1
2. DIFINITION
Diarrhoea is defined as passing of liquid or watery
stools usually at least 3 times in a 24 hours period.
However,it is the recent change in consistency of
stools rather than the number of stools that is more
important.
2
3. TYPES
Acute watery diarrhoea:
Which lasts several hours to days.
The main danger is dehydration, weight loss also
occurs if feeding is not continued.
The pathogens usually cause acute diarrhoea is
V.cholerae,or E.coli as well as Rotavirus
3
4. Cont..
Acute bloody diarrhoea:
Which is also called dysentry.
The main dangers are damage of intestinal
mucosa, sepsis, and malnutrition , other
complication including dehydration, may also
occur.
Most common cause is Shigella.
4
5. Cont..
Persistent diarrhoea:
Which lasts 14 days or longer.
The main danger is malnutrition and serious non-
intestinal infection,dehydration may also occur.
Persons with other illness, such as AIDS, are more
likely to develop persistent diarrhoea.
5
6. Cont…
Diarrhoea with severe malnutrition:
The main dangers are severe systemic infection,
dehydration, heart failure,and vitamin and mineral
deficiency
6
8. Disease Diarrhea of control programme
Started by W.H.O in the year 1978.
After the 1985/86 oral rehydration programme
,the DDCP has shifted its focus on strengthening
case management of diarrhea under 5yrs
childeren.
Research on the causes prevention and treatment
of disease is also being incorporated in this
programme. from 1992-1993 the programme has
become a part of child survival 7 safe
motherhood programme.(CSSM).
8
9. Cont…
CSSM programme is became part ofRCH
(reproductive & childhealth)
programme in 1997.
In RCH programme ,policy of IMCI was
adopted
Since 2003 –DDCP included in IMCI which
includes….
- Neonates of 0-7 days
- Incorporating national guidelines in
diarrhoea, ARI, Malaria, Anaemia, Vit A,
supplementation 7 immunizations
9
10. In nepal
Nepal recorded high under-five mortality averaging about
170 annual deaths per 1000 in the early 1980s, and on
2009 reports 61 per 1000.
WHO-supported programmes for the control of
diarrhoeal diseases and respiratory infections started
during the 1980s and reduced child mortality.
A community-based national programme to control
diarrhoeal diseases was launched in 1982
10
11. Strategies for Tenth Five Year Plan
4.8 Train all levels of health workers including
VHWs/MCHWs/FCHVs/community leaders;
4.9 Orient community opinion leaders, VDC members,
faith healers;
4.10 Supply Oral Rehydration Solution to all health
institutions;
4.11 Supply Oral Rehydration Solution to all FCHVs;
11
12. Strategies for Tenth Five Year Plan
4.12 Develop health education materials (including
development and printing of IEC materials) to be used by
mothers, FCHVs, and through channels of radio and TV
communication;
4.13 Promote supervision and monitoring at all levels;
and
4.14 Promote “Knowledge, Attitude and Practice” (KAP)
on CDD among health workers, mothers and FCHVs
12
14. BACKGROUND
Diarrhoeal diseases as one of the major public
health problems among children under five years
of age in Nepal .
NCDDP has been accorded high priority status by
Government of Nepal and is an integral part of
primary health care .
Improvement in diarrhea case management has
been used as primary strategy for the reduction
of mortality due to diarrhoea among children
under five years of age .
14
15. CONTD………
Standard diarrhea case management will be
provided in the health institutions by
establishing Oral Rehydration Therapy (ORT)
corners in Hospital , PHCC , Health posts and
Sub health posts throughtout the country.
All health facilities and Community health
volunteers will serve as the primary health
providers in the treatment of Diarrhoea with
oral Rhydration Solutions (ORS).
15
16. OBJECTIVES
To reduce mortality and morbidity due to diarrhea and
dehydration.
TARGETS
To reduce the under five mortality rate due to diarrhea
by 50% by 2007/2008.
To reduce the under five morbidity rate due to
diarrhea by 20%.
16
17. CONTD………..
To increase the accessibility of oral Rehydration
solution (ORS ) to 100% of the target population.
To raise public awareness regarding the correct
preparation and use of ORS in the treatment of
diarrhea by 20% .
To increase the proportion of caretakers that
provides ORT for children with diarrhea to 40% .
17
19. STRATEGIES
Establish functioning ORT corners in each health
facility in order to educate mothers / caretakers
to demonstrate proper ORS preparation and to
treat children suffering from diarrhoea .
Increase access to oral rehydration solution
packets and Zinc tablets through FCHV , SHP , HP
,PHCC ,Hospitals & commercial outlets .
Raise public awareness .
19
20. CONTD…………..
Promote specific preventive measures through
communication and information activities .
Involve community health workers ( VHW and
MCHW ) including the volunteers ( FCHV ) , District
Development Committee ( DDC ) and VDV members ,
local NGOs and local decision makers .
Apply an integrated child health package including
the CDD , EPI ,Nutrition , Acute Respiratory
Infection (ARI) and Malaria programme
management at all health facilities .
20
22. SPECIFIC STRATEGIES
Train all levels of health workers including
VHW / MCHW /FCHV / Community leaders .
Orient community opinion leaders , VDC
members , faith healers .
Supply ORS to all health institutions and FCHVs
.
Supply Zinc tablets to all health institutions
and FCHV of Zinc programme implemented
districts .
22
23. CONTD……….
Develop and print health education materials
to be used by mothers , FCHVs and broadcast
through mass media .
Promote supervision & monitoring at all levels .
23
24. ACTIVITIES CARRIED OUT IN FY 2062/63
(2005/2006)
Planning
District-level planning and orientation was conducted for
District Health Officers (DHOs), Public Health Officers
(PHOs), and other health personnel including DDC
members and local decision makers in Sankhuwasabha,
Sindhuli, Udayapur, Gorkha, Parbat, Kapilvastu, Surkhet
and Jumla districts.
24
25. ACTIVITIES CARRIED OUT IN FY 2062/63
(2005/2006)
Supply of ORS
2,500,000 sachets ORS purchased and distributed to
the districts.
Communication and Training Materials
Revised and finalized training materials and printed
through WHO and GoN.
Transportation
Supply of IEC materials regarding CDD to districts as
requested.
25
26. ACTIVITIES CARRIED OUT IN FY 2062/63
(2005/2006)
Monitoring and Supervision
Supervision from center and region to districts
accomplished
Supervision from district to PHCC, HP/SHP as per
schedule done
Epidemic Control
Financial support to all districts provided where epidemic
occurred
26
27. Achievements of 2062/2063
Oral Rehydration Solution supply to the districts from FY
2060/61 to 2062/63.
The CDD program provided ten packets of ORS to each
FCHV according to the CDD National Policy.
Those ten packets were replenished whenever FCHVs
used all on treatment of diarrhea in under-five children.
During the FY 2060/61, 2061/62 and 2062/63 the target
vs. achievement was 100 percent.
27
28. Cont…
At the national level during FY 2062/63, incidence of
diarrhea decreased slightly, (204 per 1,000) compared to
FY 2060/61 and 2061/62.
At regional level also diarrhea incidence has decreased in
all regions in FY 2062/63 in comparison to FY 2060/61
and 2061/62
28
29. Achievements
The 377 770 diarrhoea episodes reported in a total
under-five population of 1, 798 ,668 in districts with
interventions represented 0.21 episodes per child per
year.
In the 42 districts without interventions, the 3,03, 049
episodes reported in a total under-five population of
1 ,873 ,982 represented 0.16 episodes per child per year .
29
30. Cont…
In districts with interventions the proportion of diarrhoea
episodes with some dehydration (110 956/377 770,
29.4%) was significantly lower than in districts without
interventions.
The proportion of diarrhoea episodes with severe
dehydration was lower in districts that received
interventions(3108/377 770, 0.8%) than in those without
interventions (4465/303 049, 1.5%).
30
31. Cont…
Between 2004 and 2007 more districts were included in
the programme. during this period the proportions of
diarrhoeal episodes with some dehydration or severe
dehydration nationwide,
The national case fatality rates for acute diarrhoea,
showed a significant trend towards a decrease.
31
32. IMCI
IMCI strategy was developed by WHO in
collaboration with UNICEF , Government Nepal
decided to introduce it in June 1995 in Nepal.
It is a curative, preventive and promotive
strategy aimed at reducing the death, severity of
illness and disability which contributes to
improve growth and development of under
5children.
32
33. CONT……
Nepal is almost the first two countries in SEARO
region to start IMICI(another country being
Indonesia) It was initially implemented in
mahottari and nawalparasi districts.
By the year 2066, it is implemented in all districts,
since then training started from health
facility(HP/SHP) to the community
level(VHW/MCHW and FCHV).
33
34. CBIMCI
The community based ARI and CDD(CBAC)
program was merged in to IMCI in 1999 and was
named the CBIMCI.
New born care component included in CB-IMCI
IN 2004 and name given as CB-NCP.
Integrated package of CBIMCI and CBNCP was
implemented as IMNCI from2071/72
34
35. VISION
Contribute to survival, health growth and
development of under five years children of
Nepal.
Sustain the achievement of MDG4 beyond
2015.
35
36. GOAL
To reduce morbidity and mortality among
children under- five due to pneumonia,
diarrhea, malnutrition, measles and malaria.
36
37. TARGET
To reduce neonatal mortality from the current rate of
33/1,000 live births to 17/1,000 live births by 2015.
To reduce neonatal morbidity among infants less than 2
months of age.
37
38. OBJECTIVES
Reduce frequency and severity of illness and
death related to ARI, Diarrhoea, Malnutrition,
Measles and Malaria.
Contribute to improved growth and
development.
38
39. STATEGIES
The following strategy have been adopted by
CB-IMCI program.
1.Improving knowledge and case management
skill of health service providers.
2.Improving overall health systems.
3.Improving family and community practices.
39
40. Major Activities regarding Diarrhea
Management of Diarrheal Diseases
Diarrhea is still a leading killer disease in Nepal. CB‐IMCI
program intensely focuses on
management of diarrheal diseases among the under‐five
year’s children. Standard diarrhea case
management with Oral Rehydration Therapy (ORT,
continued feeding and Zinc tablet have been
40
41. Cont..
providing in the health institutions. All health facilities
and community health volunteers have been
serving as the primary health service providers in the
treatment of diarrhoea with low osmolar oral
41
42. Cont….
Rehydration Solutions (ORS) and Zinc supplementation.
The targets of important components of the CB‐IMCI
program were achieved by 100 percent in
three consecutive fiscal years (Annex 1.1).
42
43. Zinc Supplementation
Zinc tablet in the treatment of diarrhea was introduced in
FY 2062/63 as a pilot program in two
districts of Nepal (Rautahat and Parbat). The scaling up of
the program was completed in 2066/67.
43
44. Achievements
Diarrhoea
IMCI program has imparted positive impact on the skills
and knowledge of health workers, enabling
Them for better identification, classification and
treatment of diarrhoeal diseases. Health workers
classify diarrhoeal cases as 'No Dehydration', 'Some
Dehydration', 'Severe Dehydration' and Dysentry
2
44
45. Cont..
according to the treatment protocol of CB‐IMCI.
The reported number of total new diarrhoeal cases
(health facility plus community) and classification
a total of 1,809,205 diarrhoeal cases were reported.
The national incidence of diarrhoea per 1,000 under‐five
years' children has increased slightly from 500/1000 in FY
2067/68 to 528/1,000 in 2068/69,
45
46. Cont..
At the national level cases of 'Severe Dehydration' has
decreased slightly to 0.2 percent in FY 2068/69 from 0.4
of FY 2066/67 and 2067/68. Severe dehydration has
decreased considerably in all the regions except WDR.
In FY 2068/69 the diarrhoeal deaths increased by 2
percent from that of number 44 of FY 2067/68.
However, it is still 51 percent lower than that of FY
2066/67.
2
46
47. Treatment of diarrhoeal diseases, FY2066/67 to
2068/69
Indicators Year National level
Total Cases (HF +
Community Level)
2066/67 2,034,892
2067/68 1,735,844
2068/69 1,809,205
Zinc + ORS 2066/67 970,598 (47.7)
2067/68 1,524,871 (87.8)
2068/69 1,594,044 (88.9)
Treated with IV Fluid 2066/67 6,650 (0.3)
2067/68 6,027 (0.3)
2068/69 9,116 (0.5)
Note: Numbers in parenthesis are percentages. Source:
HMIS
47
48. CASE MANAGEMENT PROCESS
1.Assess the child or young infant
2.Classify conditions and identify treatment
actions according to colour- coded treatment
charts where;
Pink Red; urgent referral
Yellow ; treatment at outpatient facility
48
49. CASE MANAGEMENT PROCESS
Green ; home management
3.Identify treatment
4.Treat the child or refer
5. Counsel the mother
6.Give follow-up care
49
50. DIARRHEAL DISEASES
Defination ;
Diarrhoea is defined as the
passage of loose , liquid or watery stool
more than three times in 24hours.
TYPES OF DIARRHOEA
1.Acute diarrhea
2.Chronic diarrhea
50
51. CONT…..
1.ACUTE DIARRHOEA;
Acute diarrhea as an
attack of sudden onset, which usually last 3-7
days, may last up to 10-14 days.
About 10% of acute diarrheal episode become
chronic persistent diarrhea.
51
52. CONT……………
2.Chronic diarrhea;
If diarrhea last for more
than 2 weeks and may vary from day to day ,
is termed as chronic diarrhea.
It is usually associated with malabsorption
syndrome , chronic inflammatory bowel
disease and food allergies.
52
55. CB-IMNCI
CB-IMNCI is an integration of CB-IMCI and CB-NCP
Programs as per the decision of MoH on 2071/6/28
(October 14, 2014).
This integrated package of child‐survival intervention
addresses the major problems of sick newborn such as
birth asphyxia, bacterial infection, jaundice, hypothermia,
low birthweight, counseling of breastfeeding.
It also maintains its aim to address major childhood
illnesses like Pneumonia, Diarrhoea, Malaria, Measles
and Malnutrition among under 5 year’s children in a
holistic way.
55
56. Facility-Based Integrated Management of Childhood
and Neonatal Illnesses
The Facility-Based Integrated Management of Neonatal
and Childhood Illnesses(FB-IMNCI)package has been
designed specially to address childhood cases referred
from peripheral level health institutions to higher
institutions.
This package addresses the major causes of childhood
illnesses including Emergency Triage
and Treatment (ETAT) and thematic approach to common
childhood illnesses towards diagnosis and
treatment especially newborn care, cough, diarrhoea,
fever, malnutrition and anemia.
56
59. Targets
Reduction of Under-five mortality rate (per 1,000 live
births) to 28 by 2020
Reduction of Neonatal mortality rate (per 1,000 live
births) to 17.5 by 2020
59
60. Objectives
To reduce neonatal morbidity and mortality by promoting
essential newborn care services
To reduce neonatal morbidity and mortality by managing
major cause to fullness
To reduce morbidity and mortality by managing major
causes of illness among under 5 years children
60
61. Strategies
Quality of care through system strengthening and referral
services for specialized care
Ensure universal access to health care services for new
born and young infant
Capacity building of frontline health workers and
volunteers
Increase service utilization through demand generation
activities
Promote decentralized and evidence-based planning and
programming
61
62. Major interventions
• Newborn SpecificInterventions
o Promotion of birth preparedness plan
o Promotion of essential new born care practices and
postnatal care to mothers and newborns
o Identification and management of non‐breathing babies
at birth
o Identification and management of pre termand low
birth weight babies
o Management of sepsis among young infants (0‐59days)
including diarrhoea
62
63. Cont…
• Child SpecificInterventions
Case management of children aged between2 ‐59 months for
5 major childhood killer
diseases
(Pneumonia,Diarrhoea,Malnutrition,MeaslesandMalaria)
• Cross-CuttingInterventions
Behaviour change communications for healthy pregnancy,
safe delivery and promote personal
hygiene and sanitation
Improved knowledge related to Immunization and Nutrition
and care of sick children
Improved interpersonal communication skills of HWs and
FCHVs
63
64. Major Achievements
Classification of diarrhoeal cases by province 2074/75
CB-IMNCI program has created enabling environment to
health workers for better identification,
classification and treatment of diarrhoeal diseases.
As per CB-IMNCI national protocol, diarrhoea has been
classified into three categories: ‘No Dehydration’, ‘Some
Dehydration’, and ‘Severe Dehydration’.
64
65. In FY 2074/75, a total of 1,148,238diarrhoeal cases
were reported outof which about one third (33%)were
reported from health facilities and ORC and rest two
third (67%) by FCHV.
Among registered cases in Health Facilities and
PHC/ORC more thanthree fourth (83%) were classified
as having no dehydration, about one fifth (16.7%) some
dehydration.
Severe dehydration remained below 1% across all
provinces and in national level.
65
66. Cont..
incidence of diarrhoea per thousand under age 5 children
was 385 in FY2074/75, being highest at Karnali (709)
followed by Sudur Pachhim (648).
Similar trend was seen in the previous fiscal year. Further,
the lowest incidence was in province 3 (262).
66
67. Cont..
Total diarrhoeal death in health facility and PHC/ORC was
47 which increased by 42% than the last fiscal year.
Case fatality rate across all the provinces was below 1 per
thousand.
67
68. Treatment of diarrhoea cases by province (FY
2074/75)
In FY 2074/75, the proportion of diarrhoeal cases treated
with ORS and Zinc as per IMNCI national protocol at
national level was 95.2% which was slightly higher than
that of previous year (92.14%).
Highest proportion was seen in Sudur Pachhim (98.82%)
and lowest in province 1 (89.76%).
68
71. ROLES OF FCHVS IN MANAGEMENT OF DIARRHEAL
DISEASE
1. Educator :-
Provide community based education on prevention of
diarrheal disease
Educate mothers on use of ORS during diarrhea
Increase awareness on diarrheal disease and its impact
71
72. 2. MOTIVATOR :-
Motivates on increasing family and community
participation in prevention and management of
diarrheal disease
Motivates use of local health care services during
episodes of diarrhea
72
73. 3. Facilitator:-
Provide ORS packet and zinc supplement where ever
needed
4. Change agent :-
Demonstrates healthy behavior by mothers , community
people to manage diarrheal disease and follow up to see
the changed behavior
73
74. Roles of Family Health Nurse
1. Health educator :-
Provide education on how to prepare ORS and when to
visit to hospital
Assess the child and educate the family on management
protocol by CBIMNCI and inform on importance of
treating diarrhea
Provide education related to personal hygiene , balance
diet , hand washing etc
74
75. 2. PLANNER:-
Pre planning is necessary for timely control and managing
diarrhea
She assess the client affected with diarrhea and their
source of infection i.e. drainage system, latrine, personal
habit cultural aspect etc
Encourages use of local resources available .
75
76. COMMUNITY HEALTH NURSE IN PRIMARY HEALTH
CARE SETTING
1. Health care provider :-
Physical examination for sign of dehydration and its
severity and symptoms of diarrhea
Assess the intake of fluids and dietary pattern
Provide intravenous therapy as per protocol
She also emphasizes on diarrheal disease prevention ,
health promotion and maintenance and rehabilitation
76
77. 2. Motivator :-
She can motivate the people for intake of balanced diet
She can motivate people for a healthier way of life by
increasing interest to adopt healthy life style
Motivates community people to promote and maintain
their own health
77
78. 3. Counselor:-
She provides counseling service on use of safe water , use
of latrines and importance of hand washing
4. co-ordinator :-
A PHC nurse can use inter-sectoral and multi-sectoral co-
operation for maintenance of positive health habits and
health awareness
78
79. 5. EVALUATOR :-
She can evaluate the effectiveness of education ,
treatment therapy and health habits adopt by the society
She can plan follow up visits and identify the obstacles to
determine further plan in managing diarrheal disease
79
80. Evaluator cont..
Evaluates the effectiveness of nursing care seeking
assistance and knowledge as necessary
Contributes to support , direction and teaching or training
of professionals in management of diarrhea
80
81. 6. Facilitator :-
She can help bring new health
policies and facilities given by
government ( act as channel or
bridge)
81
82. Role of public health nurse
1. Management :-
Undertakes a comprehensive and accurate nursing
assessment of client with diarrhea using suitable
assessment tool
Contributes in care planning involving the community in
which clients are affected and ensures delivery of
health policies , plan at proper area
82
83. 2. Professional responsibility:-
Respect cultural aspect of client and ensure the same by
others while practicing nursing
Maintain infection control principle
Attends regular clinical supervision
Evaluate environmental safety, hazard identification and
risk assessment related to diarrheal disease
83
84. 3. inter-professional health care and quality
improvement
Collaborates and coordinates care with other health
professionals to ensure a delivery of quality service
concerned with diarrhea
Attends relevant community meetings and forums
Maintain and documents information necessary for
continuity of care and recovery from diarrhea
84
85. At central level
Collect epidemiological data from whole national level
Formulating drafts , policies and forwarding them to
ministry of Health.
Executing the formulated plans and policies regarding
Diarrhea , its management, sources and interventions.
85
87. References
Source :_ control of diarrhoeal disease,Nepali R., (2011) ,
from webocreation
Source :- Community-based interventions for diarrhoeal
diseases and acute respiratory infections in Nepal,
Bulletin of the World Health Organization 2010 by
Ghimire M.
DOHS annual report 2068/2069
Dohs annual report 2074/75
Dohs annual report 2067/68
Dohs annual report2066/2067
87