The document summarizes several key government programs in India aimed at improving child health. The Integrated Child Development Services Programme provides supplementary nutrition, immunizations, health checkups, and preschool education. Other programs discussed include the Universal Immunization Programme, Vitamin A supplementation, iron deficiency programs, and initiatives to address malnutrition, newborn health, child health, and adolescent health such as Rashtriya Bal Swasthya Karyakram and Rashtriya Kishor Swasthya Karyakram. The government's goal is to improve health outcomes and reach all people through these various child health initiatives.

1. GOVERNMENT PROGRAMMES
FOR CHILDREN
Dr Jishnu.K.R
PGT-I
Dept of Pediatrics
Moderator- Dr.Surya Kumar Namdeo
Asso. Professor
Dept of Pediatrics

2. Aim of National Health
Programmes
• Improve health of country
• Healthy mother = Healthy child
• Better pregnancy care
• Better newborn care
• Eliminate vaccine preventable diseases
• Target malnutrition
• Education
• Healthy adolescents
• Population control

4. Integrated Child Devolpment Services
Programme
• Started in 1975
• Beneficiaries-
1. Preschool children
2. Adoloscent girls 11 to 18
years
3. Pregnant and lactating
mothers
• Services:-

5. OBJECTIVES OF ICDS
 To improve the nutritional health status (0-6yrs)
 To lay foundation for proper psychological, physical and social
development
 To reduce the malnutrition and school drop out.
 To achieve an effective coordination of policy and
implementation among various departments.
 To enhance the capacity of mother and nutritional needs of
children through proper nutrition and health education.

6. 1.SUPPLEMENTARY NUTRITION
A)Each child 6months to 6yrs – 500 kcal, 12- 15 grams
of protein.
B)severly malnourished child 6months to 6yrs – 800kcal,
and 20-25 grams proteins.
C)Each pregnant and nursing women- 600 kcal and 18-20
grams of proteins.
 This supplementary nutrition is given for 300 days in year.
 Weight of children is checked every monthly.

7. 2.NUTRITION AND HEALTH EDUCATION
Nutrition and health education is given to all women in
age group 15-45 yrs.
Priority is given to nursing and expectant mother.

8. 3)IMMUNIZATION
Immunization against 6 vaccine preventable diseases is
been done.
Expectant mothers are immunized against tetanus.

9. 4)HEALTH CHECKUP
a)Antenatal care of expectant mothers .
b)Postnatal care of nursing mother and care of newborn.
c)Care of children under 6 yrs of age.

10. 5)NON FORMAL PRE SCHOOL EDUCATION
•Children of 3 to 5 years are imparted non formal and pre
school education in an Anganwadi.

11. Vitamin A Prophylaxis programme
• It was launched by Ministry of health and family
welfare(1970).
• Single massive dose of an oily preparation of vitamin A
containing 200000IU orally to all preschool children(1
year to 5 years)
• Half that dose 100000IU to children between 6 months
and 1 year of age in the community .

12. National Iron Plus Initiative (NIPI)
• Launched in March 2018

13. Iodine Deficiency Disorders Programme
• Essential components-
 Use of iodized salt in place of common salt
• Objectives:-
 Surveys to assess the magnitude of IDD in districts.
 Supply of iodized salt in place of common salt
 Resurveys to assess iodine deficiency disorder and
impact of iodized salt after every 5 years in districts
 Lab monitoring of iodized salt and urinary iodine
excretion
 Health education and publicity

14. UNIVERSAL IMMUNIZATION PROGRAMME
• Expanded Program of Immunization - Launched in
1974
• Prevention and control of six killer diseases of children,
namely tuberculosis, diphtheria, pertussis, tetanus,
poliomyelitis and measles.
• Government of India launched EPI in1978

15. • On 19 November 1985, GOI renamed EPI program, as
‘Universal Immunization Program’ dedicated to the
memory of Late Prime Minister Mrs Indira Gandhi.
• UIP has two vital components:
 immunization of pregnant women against tetanus,
 immunization of children in their first year of life against
the six EPI target diseases

16. Immunisation milestones in INDIA
1.1978- Expanded programme of Immunisation-
BCG,DPT,OPV,Typhoid(urban areas)
2.1983- TT Vaccine for pregnant women
3.1985- Universal Immunisation programme- Measles added, Typhoid
removed
4.1990- Vit A Suplplementation
5.1995- Polio National Immunisation Days
6.1997-VVM introduced on vaccines in UIP
7.2002-Hep B introduced as pilot in 33 districts and cities of 10 states
8.2005- National Rural Health Mission launched
9.2006-JE Vaccine introduced after campaigns in endemic districts
10.2007-2008- Hep B expanded to all districts in 10 states
11.2011- Hep B universalized and hemophilus influenza type b
introduced as pentavalent in 2 states
12.2013- Pentavalent expanded to 9 states, second dose of JE
introduced

17. 13.2014- India and South East Asia Region certified Polio-Free
14.2015- India validated for maternal and neonatal tetanus elimination,
Pentavalent Expanded to all states, IPV introduced
15.2016- Rotavirus vaccine introduced in 4 states in phase1, tOPV to
bOPV switch, switch to fractional IPV
16.2017- MR Vaccine introduced, PCV introduced.

18. MISSION INDRADHANUSH
• The Government of India launched Mission Indradhanushon 25th
December 2014,
• It covers children who are either unvaccinated or partially vaccinated
against seven vaccine preventable diseases, i.e., diphtheria, whooping
cough, tetanus, polio, tuberculosis, measles and hepatitis B.
• The goal is to vaccinate all under-fivesby the year 2020.

20. • Government of India introduced “Intensified Mission
Indradhanush (IMI)” on October 2017
• Targetof more than 90% coverage by december 2018.
• IMI focus on children up to 2 years of age and pregnant
women who have missed out on routine immunization.
• IntensifiedMissionIndradhanushImmunizationdrivewill
be spread over 7 working days starting from 7th of
every month.
• These7daysdo notincludeholidays,Sundaysand the
routineimmunizationdaysplannedinthatweek.

21. NEW VACCINES
• In April 2016, India introduced the use of fractional
dose IPV (fIPV)
• On 5 Feb 2017, The Ministry of Health and Family
Welfare launched Measles Rubella (MR) vaccination
campaign in the country.
• In March 2016, the Rotavirusvaccine was first
introduced .
• On 13 May 2017, Union Minister for Health and
Family Welfare, announced the introduction of
pneumococcal conjugate vaccine (PCV) in the UIP

22. RMNCH+A
Major Milestones so far are :
1992 – Child Survival And Safe Motherhood Program (CSSM)
1997 – RCH I
1997 – RCH II
2005 – National Rural Health Mission 2013 – RMNCH + A Strategy
2013 – National Health Mission
2014 – India New Born Action Plan (INAP)

23. • Recent New Initiatives :
 Rashtriya Bal Swasthya Karyakram (RBSK)
 Rashtriya Kishore Swasthya Karyakram (RKSK)

25. • AIM:-
• Reach the maximum number of people in the remotest
corners of the country through
• ▸Continuum of services
• ▸Constant Innovations
• ▸Routine monitoring

26. Newborn Health
1. Early Breast Feeding and Exclusive Breast Feeding
• Early Initiation of Breast Feeding (<1hr)
• Exclusive Breast feeding for 6 months (among 6–9
monthschildren)

27. 2. HOME BASED NEWBORN CARE(HBNC)
•The major objective of HBNC is to decrease neonatal
mortality and morbidity through:-
1.The provision of essential newborn care to all newborns
and the prevention of complications.
2.Early detection and special care of preterm and low birth
weight newborn.
3.Early identification of illness in the newborn and provision
of appropriate care and referral.
4.Support the family for adoption of healthy practices and
build confidence and skills of the mother to safeguard her
health and that of the newborn.

28. 3.FACILITY BASED NEWBORN CARE
• Sick children are screened at the peripheries and
referred to health facilities.
Health Facility All newborns at
birth
Sick newborn
PHC/Subcentre Newborn care corner
in labor rooms
Prompt referral
CHC Newborn care corner
in operation theatre
Newborn stabilization
unit(NBSU)
District Hospital Newborn care corner
in operation theatre
Special newborn care
unit(SNCU)

29. Newborn Care Corner(NBCC)
• Space within the delivery room in any health facility
where immediate care is provided to all newborns at
birth.
• This area is mandatory for all health facilities where
deliveries are conducted.

30. Newborn Stabilization Unit(NBSU)
• Facility within or in close proximity of the maternity ward
where sick and low birth weight newborns can be cared
for during short periods.
• Requires space for 4 bedded unit and two beds in
postnatal ward for rooming in.

31. Special Newborn Care Unit(SNCU)
• Neonatal unit in the vicinity of labor room which is to
provide special care(all care except assisted ventilation
and major surgery) for sick newborns.
• Any facility with more than 3000 deliveries per year
should have an SNCU.
• Minimum number of beds for an SNCU in district hospital
is 12.

32. Child Health
1. Complementary feeding, Iron Folic Acid supplementation
and focus on nutrition
2. Diarrhoea management at community level using ORS
and Zinc
3. Managment of Pneumonia
4. Full immunisation coverage

33. 5. Rashtriya Bal Swasthya Karyakram(RBSK)
• Launched in February 2013
• Screening of children for 4D's:-
 Birth Defects
 Devolopmental delays
 Deficiencies
 Diseases

35. Adolescent Health
1. Address teenage pregnancy and increase contraceptive
prevalence in adolescents
2. Adolescent nutrition and folic acid supplementation

36. 3.Adolescent friendly health services
 Services at sub centre level will be provided byANM
 Adolescent Information and Counseling Centre will be made
functional by MO and ANM at PHC on weekly basis.
 At CHC, DH/SDH/ and Medical College, Adolescent HealthClinics will
provide services on a daily basis
 Special focus will be given to establishing linkages with Integrated
Counseling and Testing Centres (ICTCs) and making appropriate referrals
for HIV testing and RTI/STI management

37. • 4. Information and counselling on health
issues
 School will serve as platform to educate and counsel adolescents on
behaviour risk modification
 Under Child Health Screening and Early Intervention Services,
screening for diabetes and other non-communicable diseases is
proposed
 Service providers (teachers, AWW ANMs ) will be trained to screen for
anxiety, stress, depression, suicidal tendencies and refer them to
appropriate facility management of mental health disorders

38. 5.Menstrual hygeine
 This scheme promotes better health and hygiene among adolescent
girls
 Sanitary napkins are provided under NRHM’s brand ‘Free days’.
 These napkins are being sold to adolescent girls byASHAs.

39. Rashtriya Kishor Swasthya Karyakram
(RKSK)
• Launched on 7th January, 2014
• Key principle :-
 Adolescent participation and leadership
 Equity and inclusion
 Gender Equity
 Strategic partnerships with other sectors and stakeholders

40. • Objectives:-

41. IMNCI(Integrated managment of neonatal and
childhood illness)
• Introduction:-
 10 million children/year die in devoloping countries due to
acute respiratory infections, diarrhea, measles, malaria,
malnutrition
 1990-WHO+UNICEF +other agencies- (IMCI)
 India adopted as (IMNCI).

43. • IMNCI strategy is integrated case management of following
conditions in age group upto 2 months:-
 Local bacterial infection
 Jaundice
 Diarrhoea
 Feeding problem or low weight for age

44. • IMNCI strategy is integrated case management of
following conditions in age group 2 months to 5 years:-
 Diarrhoea
 Pneumonia
 Malnutrition
 Ear infection
 Malaria
 Anemia
 Measles

46. •The strategy includes three main components:
Improving case management skills of health-care staff
Improving overall health systems
Improving family and community health practices.

47. • Elements of case management process:-
• Assess - Child by checking for
danger signs by history and examination.
• Classify - Child's illness by color coded triage system.
• Identify - Specific treatments.
• Treatments- Instructions of oral drugs, feeding & fluids.
• Counsel - Mother about breast feeding & about her own health as
well as to follow further instructions on further child care.
• Follow up care - Reassess the child for new problems.

48. • Clinical Strategy:-
 Methods for assessing signs that indicate severe disease
 Assessing child's nutrition,immunization and feeding
 Teaching parents how to care for a child at home
 Counselling parents to solve feeding problems
 Advising parents to solve feeding problems.
 Advising parents about when to return to health facility.

49. F-IMNCI
• Integration of the facility based care package with IMNCI
package.
• Focuses on providing appropriate inpatient management
of:-
 Asphyxia
 Sepsis
 Low birth weight
 Pneumonia
 Diarrhoea
 Malaria
 Meningitis
 SAM

50. Advantages of the Integrated System
• Speeds up the urgent treatment and treatment seeking
practices.
• Prompt recognition of serious condition, hence prompt
referral.
• Involves parents in effective care of baby at home.
• Partial Success of Individual disease control
programme.

51. India Newborn Action Plan(INAP)
• Launched in June 2014
• Outlines targeted strategy for accelerating the reduction
of preventable newborn deaths and stillbirths in the
country.
• Goal :-
 Single Digit Neonatal Mortality Rate by 2030
 Single Digit Stillbirth Rate by 2030

52. • Six pillars of intervention packages:-
1. Preconception and antenatal care
2. Care during labour and childbirth
3. Immediate newborn care
4. Care of small and sick newborn
5. Care beyond newborn survival

53. • Interventions categorized as:-
1. Essential- to be implemented universally
2. Situational- implementation depend on epidemiological
context
3. Advanced- implemetation based on health-system
capacity of the state/district.

54. SOCIAL AWARENESS AND ACTION TO
NEUTRALISE PNEUMONIA SUCCESSFULLY
(SAANS)

55. • Launched in Nov 17 2019.
• Aims:
 To reduce child mortality due to pneumonia, which
contributes to around 15% of deaths of children under
the age of five annually.
 To mobilise people to protect children from pneumonia,
and train health personnel and other stakeholders to
provide prioritised treatment to control the disease.

56. • Key features of the programme:
 A child suffering from pneumonia will be treated with a pre-referral
dose of antibiotic amoxicillin by ASHA.
 Pulse Oximeter (device to monitor oxygen saturation) will be used at
the Health and Wellness Centre and if required, the child can be
treated by the use of oxygen cylinders.
 A mass awareness campaign will be launched about the effective
solutions for pneumonia prevention like breastfeeding, age-
appropriate complementary feeding and immunization etc.

57. THANK YOU