The document summarizes health programs and progress in Bangladesh. It notes that Bangladesh has achieved significant reductions in under-5 and maternal mortality rates through effective interventions. Key interventions include oral rehydration therapy for diarrhea, immunizations, integrated management of childhood illness, and newborn health programs. Bangladesh has also seen major declines in malnutrition and fertility rates. Overall, Bangladesh has made major improvements in health indicators through the efforts of the government and development partners.
Epidemiology of Non Communicable Diseases (NCDs)Prabesh Ghimire
Declaration: The materials incorporated in this document have come from variety of sources and compiler bears no responsibilities for any information contained herein. The compiler acknowledges all the sources although references have not been explicitly cited for all the contents in this document.
The document discusses several key concepts in demography and health, including:
1) It introduces population dynamics and the three factors that determine population change: births, deaths, and migration.
2) It discusses measures of fertility such as the crude birth rate, general fertility rate, and total fertility rate, and explains how to calculate these rates.
3) It introduces several measures of mortality like the crude death rate, infant mortality rate, and maternal mortality ratio, and provides examples of rates in different countries.
The health system in Bangladesh is pluralistic and aims to ensure healthy lives for all citizens as outlined in its constitution and international agreements. It consists of community clinics, rural health centers, upazila health complexes, and district and specialized hospitals. However, the health workforce is unevenly distributed between urban and rural areas. National health programs target communicable diseases, family planning and maternal and child health. The government finances 26% of health spending while out-of-pocket payments account for 63.3%. Bangladesh aims to expand coverage through its health sector reform programs.
The document defines quality of life according to the World Health Organization as an individual's perception of their position in life based on their culture, goals, and health. It is affected by physical and mental health, independence, social relationships, beliefs, and environment. The document then lists six key indicators that were identified with over 83% accuracy: 1) extent of security, 2) availability of health, education, and recreation facilities, 3) diet and nutrition, 4) life expectancy, 5) infant mortality rate, and 6) access to public utilities and technology. Examples are provided for each indicator explaining how it impacts an individual's quality of life.
The document defines social determinants as the economic and social conditions that shape health, such as income, education, employment, housing, and gender. It provides examples of social determinants like income level, employment conditions, and access to healthcare services. It also notes that addressing social determinants takes a holistic approach to healthcare and challenges paradigms that perpetuate HIV stigma. Several state organizations plan to collaborate to identify how social determinants impact clients and address root causes of HIV risk through programming.
A presentation by Karen Nelson, MBA, MSW, RSW, of the Ottawa Hospital, made to social workers at their 2013 Annual Meeting. A very thorough overview with significant research supporting the link between Social Determinants of Health and healthcare outcomes.
The course offers an opportunity to develop a holistic understanding of Global health, its functions, and scope. The course attendants will learn the principles of Primary Health Care, the course is expected to help the students to understand and internalize international health and public health transition facilitating the integration of health sector with other sectors.
Ottawa charter and jakarta declarationkavita yadav
The document summarizes the Ottawa Charter and Jakarta Declaration, which are important documents in health promotion. The Ottawa Charter of 1986 established health promotion strategies like building healthy public policy, creating supportive environments, strengthening community actions, developing personal skills, and reorienting health services. The Jakarta Declaration of 1997 addressed new challenges to health promotion in an era of urbanization, chronic diseases, and globalization. It emphasized social responsibility, multisectoral partnerships, empowering communities and individuals, and securing infrastructure for health promotion.
Epidemiology of Non Communicable Diseases (NCDs)Prabesh Ghimire
Declaration: The materials incorporated in this document have come from variety of sources and compiler bears no responsibilities for any information contained herein. The compiler acknowledges all the sources although references have not been explicitly cited for all the contents in this document.
The document discusses several key concepts in demography and health, including:
1) It introduces population dynamics and the three factors that determine population change: births, deaths, and migration.
2) It discusses measures of fertility such as the crude birth rate, general fertility rate, and total fertility rate, and explains how to calculate these rates.
3) It introduces several measures of mortality like the crude death rate, infant mortality rate, and maternal mortality ratio, and provides examples of rates in different countries.
The health system in Bangladesh is pluralistic and aims to ensure healthy lives for all citizens as outlined in its constitution and international agreements. It consists of community clinics, rural health centers, upazila health complexes, and district and specialized hospitals. However, the health workforce is unevenly distributed between urban and rural areas. National health programs target communicable diseases, family planning and maternal and child health. The government finances 26% of health spending while out-of-pocket payments account for 63.3%. Bangladesh aims to expand coverage through its health sector reform programs.
The document defines quality of life according to the World Health Organization as an individual's perception of their position in life based on their culture, goals, and health. It is affected by physical and mental health, independence, social relationships, beliefs, and environment. The document then lists six key indicators that were identified with over 83% accuracy: 1) extent of security, 2) availability of health, education, and recreation facilities, 3) diet and nutrition, 4) life expectancy, 5) infant mortality rate, and 6) access to public utilities and technology. Examples are provided for each indicator explaining how it impacts an individual's quality of life.
The document defines social determinants as the economic and social conditions that shape health, such as income, education, employment, housing, and gender. It provides examples of social determinants like income level, employment conditions, and access to healthcare services. It also notes that addressing social determinants takes a holistic approach to healthcare and challenges paradigms that perpetuate HIV stigma. Several state organizations plan to collaborate to identify how social determinants impact clients and address root causes of HIV risk through programming.
A presentation by Karen Nelson, MBA, MSW, RSW, of the Ottawa Hospital, made to social workers at their 2013 Annual Meeting. A very thorough overview with significant research supporting the link between Social Determinants of Health and healthcare outcomes.
The course offers an opportunity to develop a holistic understanding of Global health, its functions, and scope. The course attendants will learn the principles of Primary Health Care, the course is expected to help the students to understand and internalize international health and public health transition facilitating the integration of health sector with other sectors.
Ottawa charter and jakarta declarationkavita yadav
The document summarizes the Ottawa Charter and Jakarta Declaration, which are important documents in health promotion. The Ottawa Charter of 1986 established health promotion strategies like building healthy public policy, creating supportive environments, strengthening community actions, developing personal skills, and reorienting health services. The Jakarta Declaration of 1997 addressed new challenges to health promotion in an era of urbanization, chronic diseases, and globalization. It emphasized social responsibility, multisectoral partnerships, empowering communities and individuals, and securing infrastructure for health promotion.
The document discusses the epidemiologic transition, which describes the transition of major causes of death from infectious diseases to chronic and degenerative diseases as populations adopt behaviors associated with economic development and improved living standards. It describes three models of transition - the classic Western model over 200 years, an accelerated model in places like Japan and Eastern Europe, and a delayed model in most low-income developing countries since WWII. The transition is accompanied by changes in mortality and morbidity patterns, as well as demographic changes as fertility declines and populations age.
Non communicable disease and risk factorsRabin Dani
The document discusses non-communicable diseases (NCDs) such as heart disease, diabetes, cancer, and chronic lung disease. It notes that NCDs cause over 70% of deaths globally and are increasing in low and middle income countries. Key risk factors for NCDs include tobacco use, alcohol consumption, unhealthy diet, physical inactivity, obesity, high blood pressure, and high blood glucose. The status of NCDs in Nepal is described, with over 50% of deaths caused by cardiovascular or respiratory disease, cancer or diabetes. World Health Organization global targets for reducing NCD deaths and risk factors by 2025 are also presented.
The health care system of Bangladesh has three levels - primary, secondary, and tertiary. The primary level consists of community clinics and union health centers. The secondary level includes district hospitals. Tertiary care is provided through large hospitals affiliated with medical colleges. In addition to government facilities, NGOs and private providers play a large role in service delivery. However, challenges remain in human and physical resource allocation across the country.
A Community Health Worker (CHW) is a frontline public health worker who is a trusted community member with an unusually close understanding of the community served. This is short presentation designed to garner support for CHWs.
This document discusses global disease burden and methods for measuring and comparing the impacts of different diseases. It introduces the Global Burden of Disease database developed by Harvard University to assess overall health loss from diseases, injuries, and risk factors using metrics like disability-adjusted life years (DALYs). DALYs consider both years of life lost due to premature mortality and years lost due to disability. The document provides examples of DALY calculations and shows data on leading causes of death and disease burden globally and in different country income levels. It discusses trends over time in life expectancy, causes of death, and population growth.
The document discusses Nepal's family planning program. The main points are:
1) Family planning is a priority in Nepal to improve health outcomes and economic development. It aims to ensure individuals can fulfill reproductive needs through informed choice of contraceptive methods.
2) The government, NGOs, and private sector provide a range of temporary and permanent family planning methods through health facilities. Community health volunteers also provide information and some methods.
3) National policies emphasize increasing access, integrating services, and engaging both males and females in planning their families to improve their quality of life.
Health promotion aims to reach optimal health through activities that increase well-being, prevent disease, and control existing disease. It involves empowering communities, policymakers, professionals, and the public to support health-promoting policies, systems, and behaviors. Approaches to health promotion include creating healthy populations by addressing needs across life stages, promoting healthy lifestyles, and developing healthy environments. Challenges to health promotion in developing countries include poverty, economic priorities focused on growth over health, low education levels, political instability, and influence of commercial interests.
The document discusses primary health care, including its conceptualization, philosophy, principles, strategies, and models. It describes the key outcomes of the 1978 Alma-Ata Conference, including its 10 declarations and 22 recommendations which established primary health care as a global health strategy focused on achieving health for all by 2000 through equitable access to comprehensive services. The document also analyzes selective and comprehensive primary health care approaches and outlines the basic components, principles, and operational aspects of primary health care delivery within national health systems.
The document outlines the major health problems in Bangladesh, which include communicable diseases like malaria, tuberculosis, and diarrhea; nutritional problems such as protein-energy malnutrition and iodine deficiency; environmental sanitation issues due to lack of safe water and proper sanitation; inadequate medical care resources distributed unevenly between urban and rural areas; overpopulation putting pressure on development resources; and social problems such as drug and alcohol abuse.
The nutrition section is responsible for Nepal's national nutrition program. Its goals are to improve nutritional status and contribute to socioeconomic development. Major issues include stunting, wasting, anemia, and vitamin deficiencies. Programs promote breastfeeding, supplementation, food fortification, and management of malnutrition. Significant progress has been made in reducing stunting, anemia, and iodine and vitamin A deficiencies. However, challenges remain to meet global nutrition targets by 2025.
About Healthcare system of Bangladesh: Health care delivery is a daunting challenge area of the Bangladesh’s healthcare systems. The Health
care system in Bangladesh falls under the control of the Ministry of Health and Family Planning. The
government is responsible for building health facilities in urban and rural areas.
The document discusses global health policies and initiatives. It outlines health policy aims like maintaining and improving population health status. It discusses key global health strategies like Health for All by 2000, the Millennium Development Goals, and Sustainable Development Goals. It provides details on initiatives like the Global Fund to Fight AIDS, Tuberculosis and Malaria, GAIN (Global Alliance for Improved Nutrition), and progress made in combating diseases like HIV/AIDS, tuberculosis, and malaria.
Non-communicable Diseases And Interventions to minimize itGaaJeen Parmal
Rise of non-communicable diseases like RTA, obesity, psychological disturbance, etc. Its impact towards the healthcare of a nation. The steps or approach that can be taken to minimize the disease.
Global burden of non communicable diseasesNayyar Kazmi
Non-communicable diseases such as cardiovascular diseases, diabetes, cancer, and respiratory diseases are on the rise globally due to rapid urbanization, industrialization, and changes to diets and lifestyles. Key risk factors fueling the increase in non-communicable diseases include tobacco use, alcohol abuse, unhealthy diets, obesity, and physical inactivity as a result of modernization and globalization trends over the past few decades. Common non-communicable diseases mentioned in the document are cardiovascular diseases, diabetes, cancer, tobacco use, alcohol and drug dependency, obesity, asthma, and mental health problems.
Indicator is a variable which gives an indication of a given situation or a reflection of that situation.
Health Indicator is a variable, susceptible to direct measurement, that reflects the state of health of persons in a community.
Indicators help to measure the extent to which the objectives and targets of a programme are being attained.
Burden of disease analysis provides a fuller assessment of population health beyond just mortality rates. It considers the impact of morbidity and estimates the effects of years lived with illness or disability. Common measures used in burden of disease analysis include disability-adjusted life years (DALYs) and quality-adjusted life years (QALYs), which combine mortality and morbidity into a single metric. Calculating DALYs and QALYs involves defining health states, assigning weights to different states, and combining estimates of life expectancy and duration of illness. Burden of disease analysis is useful for comparing population health over time and between regions, identifying major health problems, and informing health policy and resource allocation decisions.
The Ottawa Charter for Health Promotion was developed at the first International Conference on Health Promotion in 1986. It outlines five areas of action to achieve health promotion by the year 2000: build healthy public policy, create supportive environments, strengthen community actions, develop personal skills, and reorient health services toward health promotion. The Charter calls for governments, health services, and communities to work together to support policies and actions that create physical and social environments conducive to health.
This document discusses different ways of measuring health, including natural measurements like healthy days and quality-adjusted life years (QALYs) and disability-adjusted life years (DALYs). It describes how QALYs quantify both the quality and quantity of life by assigning weights between 0 and 1 to different health states. Methods for estimating these weights include rating scales, time trade-off, and standard gambling. The document also discusses instruments like the EQ-5D that are used to measure health-related quality of life and provide weights to calculate QALYs and QALY gains from interventions.
Non-communicable diseases (NCDs) such as heart disease, cancer, diabetes and respiratory diseases account for the majority of deaths worldwide. Over 38 million people die from NCDs each year, with 80% of deaths occurring in low- and middle-income countries. The main risk factors that drive NCDs are tobacco use, physical inactivity, unhealthy diets and harmful use of alcohol. In response, the WHO has created a global action plan to reduce premature NCD deaths by 25% by 2025 through targeting these key risk factors. National programs are also seeking to prevent and control NCDs through lifestyle changes, early diagnosis and management.
Bangladesh has made significant progress in health outcomes for women and children through effective interventions. The under-5 mortality rate fell from 151 per 1000 live births in 1990 to 38 per 1000 in 2017, exceeding Millennium Development Goal 4. This was achieved through programs promoting oral rehydration therapy, immunizations, integrated management of childhood illness, and newborn health interventions. Bangladesh also reduced the maternal mortality ratio by 75% and exceeded Millennium Development Goal 5. Current challenges include further reducing child injuries such as drownings, improving nutrition, and addressing emerging issues like non-communicable diseases and environmental health hazards.
The document discusses strategies to improve child survival globally and reduce child mortality. It states that nearly 10 million children die before their 5th birthday annually, mostly from preventable causes like pneumonia, diarrhea, malaria, measles and malnutrition. Over 8 in 10 of these deaths could be avoided with timely access to basic healthcare. The document then outlines several evidence-based interventions to improve child survival, including integrated management of childhood illnesses (IMCI), community case management (CCM), immunizations, and preventative measures like breastfeeding and insecticide-treated bednets. It emphasizes scaling up access to essential services, improving quality of care, increasing demand for healthcare, and supporting innovation and policies to promote child survival.
The document discusses the epidemiologic transition, which describes the transition of major causes of death from infectious diseases to chronic and degenerative diseases as populations adopt behaviors associated with economic development and improved living standards. It describes three models of transition - the classic Western model over 200 years, an accelerated model in places like Japan and Eastern Europe, and a delayed model in most low-income developing countries since WWII. The transition is accompanied by changes in mortality and morbidity patterns, as well as demographic changes as fertility declines and populations age.
Non communicable disease and risk factorsRabin Dani
The document discusses non-communicable diseases (NCDs) such as heart disease, diabetes, cancer, and chronic lung disease. It notes that NCDs cause over 70% of deaths globally and are increasing in low and middle income countries. Key risk factors for NCDs include tobacco use, alcohol consumption, unhealthy diet, physical inactivity, obesity, high blood pressure, and high blood glucose. The status of NCDs in Nepal is described, with over 50% of deaths caused by cardiovascular or respiratory disease, cancer or diabetes. World Health Organization global targets for reducing NCD deaths and risk factors by 2025 are also presented.
The health care system of Bangladesh has three levels - primary, secondary, and tertiary. The primary level consists of community clinics and union health centers. The secondary level includes district hospitals. Tertiary care is provided through large hospitals affiliated with medical colleges. In addition to government facilities, NGOs and private providers play a large role in service delivery. However, challenges remain in human and physical resource allocation across the country.
A Community Health Worker (CHW) is a frontline public health worker who is a trusted community member with an unusually close understanding of the community served. This is short presentation designed to garner support for CHWs.
This document discusses global disease burden and methods for measuring and comparing the impacts of different diseases. It introduces the Global Burden of Disease database developed by Harvard University to assess overall health loss from diseases, injuries, and risk factors using metrics like disability-adjusted life years (DALYs). DALYs consider both years of life lost due to premature mortality and years lost due to disability. The document provides examples of DALY calculations and shows data on leading causes of death and disease burden globally and in different country income levels. It discusses trends over time in life expectancy, causes of death, and population growth.
The document discusses Nepal's family planning program. The main points are:
1) Family planning is a priority in Nepal to improve health outcomes and economic development. It aims to ensure individuals can fulfill reproductive needs through informed choice of contraceptive methods.
2) The government, NGOs, and private sector provide a range of temporary and permanent family planning methods through health facilities. Community health volunteers also provide information and some methods.
3) National policies emphasize increasing access, integrating services, and engaging both males and females in planning their families to improve their quality of life.
Health promotion aims to reach optimal health through activities that increase well-being, prevent disease, and control existing disease. It involves empowering communities, policymakers, professionals, and the public to support health-promoting policies, systems, and behaviors. Approaches to health promotion include creating healthy populations by addressing needs across life stages, promoting healthy lifestyles, and developing healthy environments. Challenges to health promotion in developing countries include poverty, economic priorities focused on growth over health, low education levels, political instability, and influence of commercial interests.
The document discusses primary health care, including its conceptualization, philosophy, principles, strategies, and models. It describes the key outcomes of the 1978 Alma-Ata Conference, including its 10 declarations and 22 recommendations which established primary health care as a global health strategy focused on achieving health for all by 2000 through equitable access to comprehensive services. The document also analyzes selective and comprehensive primary health care approaches and outlines the basic components, principles, and operational aspects of primary health care delivery within national health systems.
The document outlines the major health problems in Bangladesh, which include communicable diseases like malaria, tuberculosis, and diarrhea; nutritional problems such as protein-energy malnutrition and iodine deficiency; environmental sanitation issues due to lack of safe water and proper sanitation; inadequate medical care resources distributed unevenly between urban and rural areas; overpopulation putting pressure on development resources; and social problems such as drug and alcohol abuse.
The nutrition section is responsible for Nepal's national nutrition program. Its goals are to improve nutritional status and contribute to socioeconomic development. Major issues include stunting, wasting, anemia, and vitamin deficiencies. Programs promote breastfeeding, supplementation, food fortification, and management of malnutrition. Significant progress has been made in reducing stunting, anemia, and iodine and vitamin A deficiencies. However, challenges remain to meet global nutrition targets by 2025.
About Healthcare system of Bangladesh: Health care delivery is a daunting challenge area of the Bangladesh’s healthcare systems. The Health
care system in Bangladesh falls under the control of the Ministry of Health and Family Planning. The
government is responsible for building health facilities in urban and rural areas.
The document discusses global health policies and initiatives. It outlines health policy aims like maintaining and improving population health status. It discusses key global health strategies like Health for All by 2000, the Millennium Development Goals, and Sustainable Development Goals. It provides details on initiatives like the Global Fund to Fight AIDS, Tuberculosis and Malaria, GAIN (Global Alliance for Improved Nutrition), and progress made in combating diseases like HIV/AIDS, tuberculosis, and malaria.
Non-communicable Diseases And Interventions to minimize itGaaJeen Parmal
Rise of non-communicable diseases like RTA, obesity, psychological disturbance, etc. Its impact towards the healthcare of a nation. The steps or approach that can be taken to minimize the disease.
Global burden of non communicable diseasesNayyar Kazmi
Non-communicable diseases such as cardiovascular diseases, diabetes, cancer, and respiratory diseases are on the rise globally due to rapid urbanization, industrialization, and changes to diets and lifestyles. Key risk factors fueling the increase in non-communicable diseases include tobacco use, alcohol abuse, unhealthy diets, obesity, and physical inactivity as a result of modernization and globalization trends over the past few decades. Common non-communicable diseases mentioned in the document are cardiovascular diseases, diabetes, cancer, tobacco use, alcohol and drug dependency, obesity, asthma, and mental health problems.
Indicator is a variable which gives an indication of a given situation or a reflection of that situation.
Health Indicator is a variable, susceptible to direct measurement, that reflects the state of health of persons in a community.
Indicators help to measure the extent to which the objectives and targets of a programme are being attained.
Burden of disease analysis provides a fuller assessment of population health beyond just mortality rates. It considers the impact of morbidity and estimates the effects of years lived with illness or disability. Common measures used in burden of disease analysis include disability-adjusted life years (DALYs) and quality-adjusted life years (QALYs), which combine mortality and morbidity into a single metric. Calculating DALYs and QALYs involves defining health states, assigning weights to different states, and combining estimates of life expectancy and duration of illness. Burden of disease analysis is useful for comparing population health over time and between regions, identifying major health problems, and informing health policy and resource allocation decisions.
The Ottawa Charter for Health Promotion was developed at the first International Conference on Health Promotion in 1986. It outlines five areas of action to achieve health promotion by the year 2000: build healthy public policy, create supportive environments, strengthen community actions, develop personal skills, and reorient health services toward health promotion. The Charter calls for governments, health services, and communities to work together to support policies and actions that create physical and social environments conducive to health.
This document discusses different ways of measuring health, including natural measurements like healthy days and quality-adjusted life years (QALYs) and disability-adjusted life years (DALYs). It describes how QALYs quantify both the quality and quantity of life by assigning weights between 0 and 1 to different health states. Methods for estimating these weights include rating scales, time trade-off, and standard gambling. The document also discusses instruments like the EQ-5D that are used to measure health-related quality of life and provide weights to calculate QALYs and QALY gains from interventions.
Non-communicable diseases (NCDs) such as heart disease, cancer, diabetes and respiratory diseases account for the majority of deaths worldwide. Over 38 million people die from NCDs each year, with 80% of deaths occurring in low- and middle-income countries. The main risk factors that drive NCDs are tobacco use, physical inactivity, unhealthy diets and harmful use of alcohol. In response, the WHO has created a global action plan to reduce premature NCD deaths by 25% by 2025 through targeting these key risk factors. National programs are also seeking to prevent and control NCDs through lifestyle changes, early diagnosis and management.
Bangladesh has made significant progress in health outcomes for women and children through effective interventions. The under-5 mortality rate fell from 151 per 1000 live births in 1990 to 38 per 1000 in 2017, exceeding Millennium Development Goal 4. This was achieved through programs promoting oral rehydration therapy, immunizations, integrated management of childhood illness, and newborn health interventions. Bangladesh also reduced the maternal mortality ratio by 75% and exceeded Millennium Development Goal 5. Current challenges include further reducing child injuries such as drownings, improving nutrition, and addressing emerging issues like non-communicable diseases and environmental health hazards.
The document discusses strategies to improve child survival globally and reduce child mortality. It states that nearly 10 million children die before their 5th birthday annually, mostly from preventable causes like pneumonia, diarrhea, malaria, measles and malnutrition. Over 8 in 10 of these deaths could be avoided with timely access to basic healthcare. The document then outlines several evidence-based interventions to improve child survival, including integrated management of childhood illnesses (IMCI), community case management (CCM), immunizations, and preventative measures like breastfeeding and insecticide-treated bednets. It emphasizes scaling up access to essential services, improving quality of care, increasing demand for healthcare, and supporting innovation and policies to promote child survival.
The document discusses the Reproductive and Child Health (RCH) Programme in India. Some key points:
- The RCH Programme was launched in 1997 with the objectives of reducing maternal, infant, and under-5 mortality as well as promoting adolescent health.
- The programme aimed to achieve targets such as an infant mortality rate below 60 per 1000 live births and a maternal mortality rate below 400 per 100,000 live births.
- RCH Phase 2 was launched in 2005 with a focus on achieving the Millennium Development Goals and expanding access to essential obstetric and newborn care services.
- The strategies under RCH include improving antenatal, delivery and postnatal services; increasing
The document summarizes several key health programs in India, including:
1) The Universal Immunization Programme launched in 1985 aims to vaccinate all children against six preventable diseases.
2) The Pulse Polio Immunisation Programme launched in 1995 aims to eradicate polio in India through additional oral polio vaccination drops.
3) Several new vaccines have been introduced over time, including for hepatitis B, Japanese encephalitis, and measles.
4) The National Health Mission launched in 2013 aims to strengthen rural and urban health systems and tackle communicable/non-communicable diseases.
This document provides an overview of the Reproductive, Maternal, Neonatal, Child and Adolescent Health (RMNCH+A) initiative in India. It discusses the background and goals of reducing infant mortality, maternal mortality, and fertility rates. It outlines the key interventions and coverage targets of the initiative, including increasing institutional deliveries and access to healthcare. The document also describes various components of reproductive health, maternal health, and their related programs in India such as Janani Suraksha Yojana, Village Health and Nutrition Days, and Pradhan Mantri Surakshit Matritva Abhiyan.
This document discusses the evolution of approaches to improving child health and survival over time, from early colonial public health efforts focused on single diseases, to integrated primary health care and selective primary care strategies in the late 20th century. It describes campaigns targeting specific diseases from the 1950s-1970s and the "child survival revolution" of the 1980s based on low-cost GOBI interventions of growth monitoring, oral rehydration, breastfeeding, and immunization. More integrated, health system-wide approaches emerged in the 1990s to strengthen struggling systems.
This document provides information on progress towards the UN's Sustainable Development Goals in various countries. It discusses successes in reducing poverty in China and improving health outcomes in Bangladesh. It also outlines community health initiatives in Namibia, Ecuador, and Ethiopia that have increased access to healthcare. The document then analyzes India's progress on goals related to health, noting successes in disease control but challenges around nutrition, sanitation, and inequality. It also discusses Brazil's struggles with deforestation, fires and COVID-19, and how this impacts achievement of interconnected SDGs. Successes in Timor-Leste and El Salvador integrating nutrition and economic programs are also highlighted.
Reproductive, Maternal, Newborn, Child and Adolescent Health RMNCHAKailash Nagar
This document outlines India's strategic approach to reproductive, maternal, newborn, child, and adolescent health called RMNCH+A. It was launched in 2013 to be at the heart of India's National Health Mission. The goals are to reduce infant mortality to 25 per 1000 live births, maternal mortality to 100 per 100,000 live births, and total fertility rate to 2.1 by 2017. It identifies 184 high priority districts and outlines coverage targets and interventions across the lifespan from adolescence to reproductive years. Key interventions include antenatal care, institutional deliveries, postnatal care, newborn care, child nutrition, immunization, and family planning.
This document discusses the current state of pediatric cardiac services in India. It notes that India has a high birth prevalence of congenital heart disease (CHD), with approximately 242,390 children born with CHD each year. However, the availability of advanced cardiac care is very limited, with only 9 high-volume centers performing over 500 surgeries per year. While an estimated 43,000 children are born annually with serious forms of CHD requiring treatment, only around 8,500 (20%) currently receive optimal cardiac care. The document outlines several challenges facing the improvement and expansion of pediatric cardiac services in India, including limited resources, infrastructure, and trained staff. It proposes various strategies to address these issues, such as establishing more specialized
This slide contains information regarding Maternal and Child Health Program. This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated. Thank you!
The document discusses common bacterial infections in children. The most common bacterial infections in babies are skin, ear, and throat infections, while the most common viral infections are respiratory infections such as RSV. Over 44% of child deaths under age 5 occur during the neonatal period, with approximately 2.6 million neonatal deaths worldwide in 2015. Bacterial infections and sepsis are major causes of neonatal mortality. Prevention strategies discussed include immunization of mothers and children, breastfeeding, hygiene practices like chlorhexidine cord care, and education of health professionals in neonatal resuscitation. Prudent antibiotic use and stewardship programs are important to prevent antibiotic resistance.
RMNCH+A ( REPRODUCTIVE,MATERNAL, NEWBORN, CHILD AND ADOLESCENT HEALTH) PROGRAMAnujkumaranit
Reproductive, Maternal, Newborn, Child, and Adolescent Health (RMNCH+A) is a comprehensive approach to health care that addresses the continuum of care needed at different life stages: from pre-pregnancy and pregnancy through childbirth, infancy, childhood, and adolescence. The aim of RMNCH+A is to improve health outcomes and reduce mortality and morbidity through integrated and equitable health services.
Key components include:
1. **Reproductive Health**: Ensuring access to contraception, fertility services, and safe abortion where legal.
2. **Maternal Health**: Providing antenatal care, skilled birth attendance, and postnatal care.
3. **Newborn Health**: Ensuring immediate newborn care, including resuscitation, breastfeeding support, and prevention of infections.
4. **Child Health**: Promoting immunization, nutrition, and treatment of common childhood illnesses.
5. **Adolescent Health**: Addressing health issues specific to adolescents, including sexual and reproductive health, mental health, and prevention of substance abuse.
RMNCH+A emphasizes the importance of a strong health system
The document discusses antenatal, intranatal, and postnatal care. It defines key terms like maternal mortality ratio and rate. Antenatal care includes regular checkups, tests, supplements, immunizations, and identifying high-risk pregnancies. Intranatal care aims to ensure clean delivery, monitor for complications, and care for the newborn. Key aspects of care discussed include frequency of antenatal visits, identifying danger signs, use of a partograph during delivery, and rooming-in after birth.
What's New? Update on Babies Born Too SmallCORE Group
This document discusses care for preterm and small newborn babies. It begins with an overview of prematurity as the leading cause of newborn death worldwide. It then outlines several presentations on newborn care research and programs, including continuum of care for preterm babies, management of preterm labor and delivery, newborn sepsis management, and integration of newborn care into community health platforms in Ethiopia. The document focuses on strategies to expand proven interventions for preterm birth and low birthweight babies in priority countries through collaboration with global health partners. It proposes activities like needs assessments, advocacy, and targeted technical assistance, as well as implementation research on improving care along the continuum from households to facilities.
This document discusses undernutrition in children in India and government initiatives to address it. It provides key statistics on stunting and wasting rates. The first 1000 days of life are critical for child growth and development. Interventions like ICDS services focus too little on this period. Challenges in complementary feeding for children aged 6-24 months are outlined. The Poshan Abhiyaan initiative has 4 pillars and targets to reduce stunting, undernutrition, anemia, and low birth weight. Activities under the initiative include improving nutrition, preventing diarrhea, hand washing, and focusing on the first 1000 days. Local herbs and yoga practices are mentioned as part of Ayush's role in nutrition outreach during Poshan month.
Pediatrics deals with the health of children from birth until age 18. The goals of pediatrics include reducing infant and child mortality, controlling infectious diseases, and promoting healthy lifestyles. Pediatricians diagnose and treat conditions like infections, genetic disorders, cancers, and organ diseases in children. Pediatrics differs from adult medicine in that children's bodies are still developing physiologically. National indicators like infant mortality rate are used to monitor child health. The leading causes of neonatal death in Nepal are respiratory/cardiovascular issues during birth and delivery complications. Government programs like CB-IMNCI aim to reduce under-five mortality through managing childhood illnesses at the community level.
INTEGRATED MANAGEMENT OF CHILDHOOD ILLNESSES.pptxgrace471714
This document discusses integrated management of childhood illnesses (IMCI), an approach developed by WHO and UNICEF to reduce child morbidity and mortality in developing countries. It focuses on improving health worker case management skills, strengthening health systems, and promoting family/community practices. The main causes of death in children under 5 are pneumonia, diarrhea, malaria, measles, and malnutrition. IMCI aims to classify and treat these illnesses early through integrated care. It uses charts to guide health workers through assessment, classification, treatment, counseling and follow-up. IMCI also promotes preventive measures, growth monitoring, and encourages communities to seek timely care.
James Sengwe completed an industrial attachment at Population Service International Zimbabwe (PSI/ZIM) to fulfill requirements for his BSc in Statistics. PSI/ZIM is a global health organization in Zimbabwe focused on improving health through family planning, HIV/AIDS prevention, and addressing other issues. It uses marketing strategies and partnerships with local organizations to develop sustainable health solutions. PSI/ZIM's core business areas include HIV prevention and treatment, tuberculosis screening and treatment, contraception provision, non-communicable diseases like diabetes, and malaria prevention through insecticide-treated nets and rapid testing.
South Africa faces a high burden of disease due to four colliding epidemics: HIV/AIDS, tuberculosis, non-communicable diseases, and violence and injuries. While health expenditures are relatively high, health outcomes remain poor due to issues across the healthcare system including poor clinical care quality, administrative shortcomings, and avoidable community factors. To improve health outcomes, the document recommends addressing structural and health systems bottlenecks such as improving health worker morale, expanding mid-level workers, task-shifting, strengthening community health programs, and reorienting training to focus on public health.
it is coming under the National ruler health mission. every year various guidelines are published by CENTRAL GOVERNMENT to improve the condition of children.
This document provides information about immunization and vaccine-preventable diseases. It discusses:
1. Immunization is a process that uses vaccines to stimulate immunity against infectious diseases. It has proven effective at controlling and eliminating diseases like smallpox.
2. Major vaccine-preventable diseases that kill children include measles, polio, pertussis, Hib, and pneumococcal diseases. Immunization is one of the most cost-effective health interventions.
3. The document then provides details on specific diseases like pertussis, its symptoms, complications, and treatment with antibiotics or immunization. It emphasizes the importance of clinical diagnosis and avoiding severe outcomes in infants.
The document discusses diarrhea as a leading cause of death among children under 5, providing statistics on prevalence and causes of different types of diarrhea like acute watery diarrhea, acute invasive diarrhea, and persistent diarrhea. It outlines signs and symptoms, causes, complications, and treatments for different forms of diarrhea. The document emphasizes the importance of oral rehydration therapy and continued feeding to treat diarrhea and prevent more serious outcomes like dehydration and malnutrition.
This document discusses infant feeding principles and the benefits of exclusive breastfeeding for the first 6 months. It provides information on breastmilk composition, the importance of early initiation and exclusive breastfeeding, positioning and attachment for breastfeeding, and challenges and difficulties some mothers may face. The document emphasizes that breastmilk provides ideal nutrition and protection against illness for infants and has numerous health, developmental and economic benefits for both mother and baby.
The document provides information on acute respiratory infections (ARIs) in children under 5 years old. It discusses the definition of ARIs, signs of respiratory distress, normal respiratory defense mechanisms, how ARIs spread rapidly in children, common sites of infection, etiological agents, how ARIs harm children, the relationship between ARIs and malnutrition, methods for assessing and classifying pneumonia severity according to IMCI guidelines, treatment principles including antibiotics and other supportive care, prevention strategies, and acute epiglottitis.
The document discusses Dengue fever (DF), a mosquito-borne viral disease. It provides details on the history, transmission, clinical presentation, diagnosis and treatment of DF. DF is common in tropical and sub-tropical regions and is caused by the dengue virus, which has four serotypes. While most cases are mild, infection with a second serotype increases the risk of severe dengue which can be fatal if not properly treated through fluid resuscitation. Prevention relies on controlling the mosquito vectors and avoiding mosquito bites. There is no vaccine available for all four serotypes.
- The document discusses hepatitis and acute liver failure. It notes that hepatitis viruses like hepatitis A, B, C, D, and E can cause hepatitis and affect millions worldwide, killing 1.4 million people per year. Hepatitis A is commonly the cause in children, while hepatitis B and C can lead to liver cancer and chronic liver disease.
- It provides information on the functions of the liver, defines hepatitis as inflammation of the liver that can be self-limiting or progress to fibrosis, and lists the various causes of infectious and non-infectious hepatitis. Hepatitis B in particular is described in terms of epidemiology, transmission, pathogenesis, and interpretation of hepatitis B markers.
The document discusses enteric fevers such as typhoid and paratyphoid. It notes that typhoid occurs only in humans and causes around 21 million cases and 200k deaths worldwide each year. The causative agents are Salmonella typhi and Salmonella paratyphi. Symptoms of typhoid fever typically last 4 weeks and include rose colored spots, abdominal tenderness, diarrhea, and possible complications like bleeding or perforation. Diagnosis involves blood, stool, or bone marrow cultures. Treatment is with antibiotics like ceftriaxone for 14 days. Relapse can occur in 15% of cases.
This document provides information about renal diseases. It notes that kidney disease can be a silent killer but childhood nephrotic syndrome is mostly curable and acute post-streptococcal glomerulonephritis (APSGN) mostly recovers and does not recur. It also discusses hematuria in children, age-related kidney diseases, preventing acute renal failure (ARF), and learning objectives about renal diseases.
CXR is a commonly performed imaging test that uses ionizing radiation to visualize the inside of the body. It is useful for diagnosing and treating conditions. A standard CXR involves exposing the chest to a small dose of radiation for less than half a second to produce images. It requires no special preparation and carries minimal risk when used appropriately. The CXR must be evaluated systematically by examining bones, the heart, lungs, mediastinum, diaphragm and soft tissues to identify any abnormalities.
This document discusses various B vitamins, including their sources, functions, deficiency symptoms, diagnosis, and treatment. It provides details on thiamine (B1) and its role in energy production. Deficiencies of B1 can cause beriberi, which presents as acute or chronic peripheral neuropathy. It also covers riboflavin (B2) and its role in redox reactions as part of FAD. Riboflavin deficiency can result in ariboflavinosis with mouth sores and dermatitis. The document provides recommendations to prevent deficiencies through a balanced diet and vitamin supplements when needed.
The document discusses abdominal pain, its causes, characteristics, and approaches to diagnosis. It notes that abdominal pain can arise from abdominal wall or organs and may be difficult to localize. Common causes in children include constipation, gastroenteritis, and appendicitis, though some cases require urgent evaluation. Diagnosis involves considering characteristics of the pain, physical exam, and test results. Referred pain is also discussed.
This document discusses childhood injuries and accidents in children. Some key points:
- Injuries are unintentional or intentional damage to the body from things like thermal, mechanical, electrical or chemical energy.
- 95% of childhood injuries occur in low and middle income countries. Drowning is a major killer, especially in these countries.
- Injuries account for 14% of all childhood deaths globally. Road traffic accidents, drowning, falls and burns are among the leading causes.
- Childhood injuries place a significant burden on families and healthcare systems. Many result in lifelong disabilities or even death. Prevention programs can save over 1,000 child lives per day.
This document provides information about immunization against various infectious diseases. It discusses the importance of immunization in preventing millions of deaths per year from diseases like measles, polio, diphtheria, and pertussis. The document outlines the target diseases for immunization programs in Bangladesh and other vaccines available in the country. It also discusses vaccines still in development and provides details on diseases like pertussis, diphtheria, and poliomyelitis, including causes, symptoms, treatment and complications.
This document discusses infant feeding guidelines and the benefits of breastfeeding. It provides the following key points:
1) Exclusive breastfeeding is recommended for the first 6 months as breastmilk provides ideal nutrition and protects infants from illness. Undernutrition contributes to 45% of under-5 mortality globally.
2) Breastfeeding has significant health benefits for both mother and baby, including reducing the risks of obesity, diabetes, breast and ovarian cancer. It improves cognitive development and results in economic gains.
3) Proper breastfeeding techniques such as positioning, attachment and frequent feeding are important to ensure the baby receives enough milk from the breast. Common challenges can be addressed through counseling and support.
This document provides information on diarrhea among under-5 children. It discusses the global burden of diarrhea, key facts about diarrhea including causes and prevention. Specific diarrheal pathogens like rotavirus, cholera, and giardiasis are explained. Treatment of acute watery diarrhea and dysentery are also summarized. The document emphasizes continued feeding and oral rehydration therapy in treating diarrhea.
The document discusses acute respiratory infections (ARIs) in children under 5 years old. It defines ARI and describes the signs and symptoms, including fast breathing and chest indrawing. Common causes are viruses like RSV and bacteria like Streptococcus pneumoniae. ARIs often spread rapidly in young children due to anatomical factors. They are a major cause of mortality, responsible for around 900,000 child deaths per year. Proper treatment with low-cost measures can reduce the death toll from ARIs.
This document provides an overview of Bangladesh. It begins with a brief description of Bangladesh's location and geography, noting that it is located in South Asia on the Bay of Bengal and has the world's largest delta formed by the Ganges, Brahmaputra, and Meghna rivers. It then discusses Bangladesh's population, demographics, economy, industries, exports, infrastructure, education system, healthcare successes, challenges, and potentials. The document also profiles Bangladesh's climate, landscape, biodiversity, culture, and history. It concludes by outlining some of Bangladesh's current problems including corruption, poverty, pollution, and natural disasters.
Here are the answers to the MCQs:
1. RSV is the commonest c/of bronchiolitis - True
2. ABT is usually required in B - False
3. Most B are later associated with BA - True
4. In EBF babies B is rare - True
5. Anticholingergic nebulization is beneficial in B - False
6. B is usually a killer D - False
7. SARS/MERS is caused by RSV - False
8. Antiviral Rx is beneficial in all B cases - False
1. The patient presented with fatigue, pallor, and weight loss and was found to have enlarged spleen and low blood counts consistent with visceral leishmaniasis. Biopsies revealed Leishmania donovani infection.
2. Additional findings included an ulcerated lesion on the thumb and crusty ulcers on the ankle.
3. Leishmaniasis is a neglected tropical disease spread by sandfly bites that disproportionately affects the poorest populations. It manifests as visceral, cutaneous, or mucosal disease and can cause severe disfigurement if left untreated.
1. A patient presented with weight loss, fatigue, and pallor and was found to have enlarged spleen and liver with pancytopenia. Biopsies revealed Leishmania donovani infection.
2. Leishmaniasis is transmitted by the bite of infected sandflies and presents as cutaneous, mucocutaneous, or visceral disease. Visceral leishmaniasis, known as kala-azar, is the most serious form.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
low birth weight presentation. Low birth weight (LBW) infant is defined as the one whose birth weight is less than 2500g irrespective of their gestational age. Premature birth and low birth weight(LBW) is still a serious problem in newborn. Causing high morbidity and mortality rate worldwide. The nursing care provide to low birth weight babies is crucial in promoting their overall health and development. Through careful assessment, diagnosis,, planning, and evaluation plays a vital role in ensuring these vulnerable infants receive the specialize care they need. In India every third of the infant weight less than 2500g.
Birth period, socioeconomical status, nutritional and intrauterine environment are the factors influencing low birth weight
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.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
9. Overview
• Bangladesh has made significant progress in health of women & children &
achieved MDG4 (to reduce U-5MR) & MDG5a (reduce MMR)
• U-5MR, 1990-2017, fell from 151/1000 to 32/1000 LBs. IMR from 87/1000 to
26/1000 LBs. NMR is now 18. MMR fell by 75%
• Achieved by effective interventions to prevent/treat the most common c/of child
death & with socioeconomic improvements
• ORT & Rx of ARIs, high coverage of vax., IMCI & newborn health interventions,
have been crucial for this achievements
•Malnutrition fell significantly
• Life expectancy 73.4y (>than India & Pakistan)
10. • Remarkable fall in Total Fertility Rate in the last 4 Decades
• We have reduced disparities in U-5MR between urban-rural areas
• We have reduced poverty, done more enrolment at primary schools,
attaining gender parity at primary & secondary
education, contained HIV
• Ensured U-5 children sleeping under insecticide treated bed nets,
detection & cure rate of TB
• Have made remarkable progress reducing underweight children,
improving immunization coverage & reducing communicable d.
11. Successes Stories of Bangladesh
• Success in health sector
• Nobel: Prof. Dr. Yunus
• Sir Fazle Hasan Abed
• Largest NGO
• Cricket
• Everest win
• Garments: 2nd largest
• Drug act, - export
• EPI success
• Agricultural success
• Life expectancy
• Islami banking
• Women empowerment
• Language movement
• Inventor of radio
• One YouTube founder
• FR Rahman
• Channel winner Brozen
11
12.
13. Dev. Partners
• HPNSDP (Bangladesh) Consortium, etc.
• WHO. UNICEF. World Bank. UNFPA (UN Population Fund. (formerly UN
Fund for Population Activities)
• DFID (UK. Dept. for International Dev.)
• CIDA (Canadian International Dev. Agency)
• JICA (Japan International Cooperation Agency)
• USAID (US Agency for International Dev.)
• GIZ (Deutsche Gesellschaft für Internationale Zusammenarbeit)
• Kfw (Development Bank of Germany)
• Save The Children USA, SIDA (Swedish Int’l Dev. Authority)
HPNSDP: Health, Popn. & Nutrition Sector Dev. Program (HPNSDP)
14. Millennium Development Goals (MDGs):
Signed in 2000 to achieve by/2015:
1. To halve undernourished people (achieved)
2. To achieve universal primary education
3. To promote gender equality & empower women
4. To reduce child mortality (achieved)
5. To improve maternal health (achieved)
6. To combat HIV/AIDS, malaria, & other diseases
7. To ensure environmental sustainability
8. To develop a global partnership for development
1, 4, 5, 6 are directly health related
14
15. 17 Sustainable Dev. Goals (SDGs): 25.9.15-2030
•No Poverty!
• Zero Hunger
• Good Health & Well-being
• Quality Education
• Gender Equality
• Clean Water & Sanitation
• Affordable & Clean Energy
• Decent Work & Economic Growth
• Industry, Innovation & Infrastructure
15
• Reduced Inequalities
• Sustainable Cities & Communities
• Responsible Consumption & Production
• Climate Action
• Life Below Water
• Life on Land
• Peace, Justice & Strong Institutions
• Partnerships for the Goals
17. Child Status in Bangladesh
•Child population: 40%
• MMR: 176/100,000 LB (569 in 1990)
• NMR 18/1000 LB (BA, NNS, LBW)
• IMR: 26/1000 LB (NMR plus Pn., D, Mn, IDs)
• U-5MR: 32/1000 LB (IMR plus Drowning, accidents)
• U-5 malnutrition: chr. 43%, ac. 13%
• Girls married <18y: 70%
• Child labor: 7%
17
18. Problems of our Children
High mortality
• ID, Mn., VADX, anemia, worms
• LBW (22%), prematurity
• Faulty feeding
• Accidents: (drowning, poisoning,
animal bites, fall, RTA)
• Chr. Hemolytic A
• Child labor (7%), no
schooling, drop-out
domestic violence
• Emotional deprivation
• Mutilation, begging,
child trafficking
• Slum, Street children
18
• Diarrhea is still high; ORT still low
• Safe water, sanitation, handwashing also inadequate
• VADX is potentially-lethal but preventable. Eating VA-rich
F&V & fortified oil & flour are important
19. Major Programs
• HPNSDP: Health, Popn. & Nutrition
Sector Dev. Program (HPNSDP)
• IMCI: ARI, diarrhea, etc.
• EPI: eradication of NT, polio, measles, …
• Control of TB, leprosy, Kala azar, …
• ,, Malaria
• ,, Filariasis
• ,, Nutrition deficiencies
• ,, Helminthiases
• MMR: Safe motherhood
• Neonatal care
• School health
• Adolescent health
• Injuries
• Poisoning/pollution: arsenic, air
pollution, smoking, food
poisoning/adulteration
• NCD
20. Control of diarrheas
World’s Largest research center!
• ORS
• EBF, safe CF, safe water
• Immunization
• Personal hygiene (hand washing)
• Food safety
21. Control of ARI
• EBF, no bottle, CF from family food
• Immunization
• IMCI
• Rx of pneumonia
• VA, zinc supplementation
• Standard practices: no overcrowding, good housing, clothing, hand
washing, etc.
22. National Tuberculosis Control Program (NTP)
• BD ranks 8th (prev. 5th ) in TB burden & is also a high burden country for DR TB
• <1993: TB services were mainly curative & based in 44 TB clinics, 8 sanatorium &
4 TB hospitals with case detection at 10% & cure rates at 40%. Now under
Mycobacterial D. Control (MBDC) DOTS is available in all Upazilas
• WHO Stop TB strategy targets of 70% case detection & 85% Rx success are now
achieved. It must be sustained & accelerated
• NTP is supported by NGOs
Challenges to TB control:
• Long-term Rx, Rx. failure, MDR, late Dx
• No highly sensitive easy test, new Dx tools are v. complex
DR: drug resistant
23. National Leprosy Elimination Program (NLEP)
Target: “leprosy-free BD”
• BD ranks 5th with >5000 new cases/y
• Control target of <1/10,000 is achieved in 1998
• Prevalence in 2014: 0.23/10,000
• L. in BD decreased over 15y. Now, 46% are MB, 38% female, 5.4% children
• NLEP aims to reduce disability & to increase community awareness, promote
voluntary case reporting, & minimize social stigma
MB: multibacillary
24. • NLEP is integrated into the general health services. Specialized L. staff are
retained for technical support. Health institutes are involved for training
• NLEP provides free MDT. Logistics for Rx of complications & prevention of
disability are inadequate. Expertise is difficult to sustain because of a lack
of training & capacity building because of gradual retirement of senior staff
Major challenges: to reduce incidence to 1000; to reduce Dx & Rx delays.
Leprosy still carries a fairly high stigma
MDT: multidrug treatment
25.
26. Filariasis
• 1/10 in 13 northern districts
In the capital, 4 in 100, mostly in slums
• WHO: to wipe out by 2020. 2 goals: to stop transmission & to treat cases.
National Filariasis Elimination Program since 2001: to eliminate by 2015
• Stop transmission: each person is given a 2-tablet dose albendazole 400 mg plus
diethylcarbamazine (DEC; 6 mg/kg) or albendazole (400 mg) plus ivermectin 200
mcg/kg)/y (total 5) till 2015
• To treat cases: program will focus on decreasing 2y bacterial & fungal inf. of limbs or
genitals
27. Reduction of MMR (240/100,000 LB in 2010; now 176)
ANC, TT, nutrition, hospital delivery
• Detection of preg. complications
• SBA at community level
• 24h emergency service for labor at HCs
• Full functioning referral system
SBA: skilled birth attendant. HCs: health centers
27
28. Reducing NMR (BA, NNS, LBW)
ANC, TT, maternal nutrition & Fe & B9
• Steroid for preterm labor. KMC
• Essential NB care (clean place, - catch,- cut, chorhexidine for cord, HBB)
• Prevention & Rx of NNS, birth trauma
• SCaBU at Upazila, district & 3y care hospitals
• BF in first hr (saves 1 million globally)
•EBF
BA: birth asphyxia. HBB: helping babies breathe. KMC: kangaroo mother care. SCaBU: spcl. care baby unit. NNS: neonatal
sepsis. EBF: exclusive breastfeeding 28
29. Reducing U-5 MR (+NMR, +IMR)
(IDs, Drowning, accidents)
• Reduction of NMR, IMR
•Prevent drowning and other injuries
• IMCI (ARI, D, F, Otitis, Mn, Feeding, HPVAC, EPI)
• EBF, CF (IYCF)
• Effective referral system
• New vaccine (pneumococcal, Flue,)
• More trained health workers, more resources
IMCI: integrated management of childhood illness. IYCF: infant & young child feeding. CF: complementary feeding 29
30. Drowning: >97% in L&MICs: 57% 1–2y
• Bangladesh: 45/d or 1/30min. Near D: 182/d
• Mostly in morning (68%), in ponds (69%), mom was busy (70%)
• A silent public health emergency/epidemic
• Preventable but few programs
• Children aged 1-4y, & 5-9 are at highest risk
To Prevent
• Supervision; skills: swimming, CPR, etc.
• Raising awareness
30
31. ACTIONS for injuries
• GoB: injury prevention as 1/5 priorities for Child Health
• To make homes, schools & communities safe
Home: awareness; making homes & play-areas child-friendly, swimming, proper
supervision
School: safe learning (physically safe, emotionally secure & psychologically
enabling). Safety risks, injury prevention, basic first-aid
Community: supervise children 1-5y for 4h/d, 6d/w. Supervisors are trained on
ECD, injury Px., healthy practices
After a great progress in ID; child injury must now be
addressed (drowning, RTA, burns, falls, NAI, etc.)
31
• NAI: non-accidental injuries. F&V: fruits & vegetables
32. WHO: Ending Preventable U-5MR by ’35
• ANC, nutrition & Fe+B9 in preg, SBA
• Steroid in preterm labor, KMC
• Essential NB care, cord care, Mx. of NNS
• SCANU, EBF/IYCF
•Rx of IDs
• EPI: new vax
• IMCI
• Injury & drowning prevention
• Zn & ORT, management of malnutrition
NNS: neonatal sepsis. KMC: Kangaroo Mother Care
SBA: skilled birth attendant 32
37. Arsenic (As) Contamination in BD
• <1990 surface water was mainly used for drinking, but it was severely polluted
• So the GoB, UNICEF, etc. decided to use under-ground water
• Ironically, it triggered natural As in the earth to dissolve into water
• As is colorless, tasteless & odorless, so people did not realize contamination
• It is a poison with lethal dose 125mg. It is x4 poisonous as Hg
• Toxicity is acute, sub-acute & chronic. Water contamination causes chr. toxicity
• Most As is excreted in urine, stool, skin, hair, nail & breath. Excessive As is
deposited in tissues & inhibits enzymes
All organs are affected insidiously in 6mo to 2y depending upon intake dose
38. As. Toxicity in Different Organ Systems
System Problems
Skin hyperkeratosis of palms & soles, melanosis or depigmentation,
Bowen's d. (SCC in situ), basal cell Ca. & SCC
Liver Enlargement, jaundice, cirrhosis, non-cirrhotic portal HTN
Nervous System Peripheral neuropathy, hearing loss
CVS Acrocyanosis & Raynaud's Phenomenon
Hemopoietic System Megalobastosis
Respiratory System Lung Ca
Endocrine System DM & goiter
40. PRE-CLINICAL STAGE INITIAL STAGE SECOND STAGE LAST STAGE
No clinical
manifestation
Melanosis, keratosis,
conjunctivitis,
bronchitis,
gastroenteritis
Depigmentation
(leucomelanosis),
hyperkeratosis, non-
pitting edema of legs,
peripheral neuropathy,
hepatopathy
Nephropathy,
hepatopathy,
gangrene, cancer of
skin, bladder & lung
CF of Arsenicosis in Bangladesh
• In Bangladesh, majority of patients are in initial & second stages
41. In BD, De-arsination methods are used:
• Chemical Method
• NIPSOM: based on the principle of iron coagulation with a pre-oxidation step.
Removal of As. is almost 99%
• Alum Method
• Cheap. 70% effective. 300-500g alum in cloth is put in a bucket of water for
12h. Upper 2/3rd of the water is separated using 2 layered clean cloth.
Lower third is discarded
• Ferric oxide-Manganese dioxide clay based filter columns:
attached to tube well outlet; removes significant amount of As. at a flow
rate of 90-110 mL/minute & it can filter up to 5000 L of water before
disposal
42. Control Measures by GoB
• To detect popn. at risk
• Case detection: Rx & Follow-Ups
• Alternate source of drinking water. Distribute de-arsination filters, encourage
people use alum; & digging deep tube wells
• Train staff in the health services
• Appropriate health education campaigns
• Awareness
43. Continued...
Long Term Programs
• Find out c/of As. contamination of soil water & take control measures
• Surveillance to identify, treat, FU cases & conduct water-testing activities
• Establish 10-bed As. hospitals in the affected districts with a view to provide
Rx to Pts. & also do research
• Alternative source of safe drinking water (rain water)
• Rational use of ground water
• Include media people in campaign
• To enhance awareness of the people
44. NCD Prevention & Control in BD
• 50% deaths are due to NCD
• We have the 9th highest NCD mortality: primarily CVD, stroke & DM
• Chr. d, cancer, DM, CVD, & chr. respiratory d. are increasing as the population
becomes more urbanized
• CVD: is the c/of 25.1% deaths
• Tobacco use: more among the poorest men (70%)
• HTN: 1 in 3 women & 1 in 5 men age 35 and older
• DM: Prevalence: 10%, with urban areas having a vastly higher prevalence.
Bangladesh is among top 10 countries
45. Country Activities to NCD
• BD was the first nation to ratify WHO Tobacco Control in 2004 & in March 2005
enacted Smoking & Tobacco Product Usage (Control) Act 2005
• Multiple agencies exist & some have outreach activities (DAB, National Heart
Foundation, BIRDEM). NCD management, esp. for DM is incorporated in
UHC & Community Clinics
46. Health, Popn. & Nutrition Sector Dev. Program (HPNSDP)
To reduce MMR; popn. growth rate & improve nutrition, esp. of W&C
Achievements:
• MMR, IMR & U-5MR declined
• EPI coverage increased. More children receive VA
• Popn. growth rate & total fertility rate (TFR) declined
• Life expectancy at birth is rising
• TB case detection & cure rates achieved MDG targets
• Polio eradicated. Kala azar, leprosy, filariasis virtually eliminated
• Malnutrition & micro-nutrient deficiencies reduced
• HIV prevalence very low
• Remarkable countrywide network of health care infrastructure
47. Main Challenges
• Low rate of deliveries by skilled BA
• High rates of NMR, malnutrition & micronutrient deficiencies
• Low utilization of public health facilities by the poor
• Ineffective urban PHC service delivery
• Emerging & re-emerging d. & impact of climate change
• Rise in NCD including CVD, stroke, DM, Cancer & injury
• Family Planning service: high rate of discontinuation
• Gender sensitive & equity based service delivery
• Inadequate human resources
• Quality assurance system, medical auditing, accreditation & weak legal
framework
48. UNICEF for Disabled Children
• They have many abilities, but are often excluded, mostly invisible, vulnerable.
They face many challenges
• UNICEF brings global attention to them
• Rx for disability is expensive, frustrating
• UNICEF encourages to continue Rx & send them to school as education gives
them confidence
48
51. Adolescent Health
22% of population are adolescents
63% of girls get early marriage, vs. only 3.7% of boys in the same age
31% of these girls get pregnant within a year of marriage
Lack of girls mobility - because of Reputation & Security
Lack of Adolescent Friendly Health Services/Lack of sensitivity among the
service providers
Lack of appropriate Knowledge on Sexuality & reproductive Health
In villages, there is v. limited opportunity for paid employment, especially for girls
52.
53. 1992: BRAC started Reading Centres for rural adolescent girls
Purpose: to retain literacy, a safe place to socialize
Reading books, newspaper, magazine
Playing indoor games
Performing cultural program
BRAC started Adolescent Dev Program (ADP) &
Adolescent Peer Organized Network (APON)
54.
55. Objectives of ADP:
To empower adolescents, especially girls, to participate meaningfully in
decisions affecting their lives & to be active in social change
To create & sustain a supportive environment for
adolescent girls
To reduce child marriage & dowry
Components of ADP:
1. Adolescent Centres
2. Issue based life skills course
3. Livelihood training
56.
57. Issue based Life Skills Course (APON):
• To prepare them about issues related to lives & practice in day to day life
• To enhance their capacity on different life skills
• To develop leadership skill of the adolescents
• To help the adolescents to practice their rights
The course content includes:
Social, Family & Community Issues
Sexual & Reproductive Health Issues
(20 books & 1 peer educator guide has been developed for the course.)
58. Issue based Life Skills Course: Con...
Cross-cutting issues
• Child Rights
• Negotiation skills
• Gender sensitive
• Inclusiveness
• Effective Communications
59. Livelihood Training
The livelihood training includes:
• Poultry & livestock
• Sewing & embroidery
• Photography
• Computer
• Journalism etc.
This activities are helping to reduce early marriage from the intervention areas
60. Community Participation:
The activities includes:
• Forum with mothers
• Forum with fathers
• Forum with community leaders
• There is a child marriage & dowry prevention committee, who are
working to reduce the child marriage & dowry from their community
61. Achievements:
• There are 17,000 Adolescent Leaders
under this project & most of them
are continuing their education
• The marriage age has increased by 1-2
years in the intervention areas
62. Activities Beneficiaries
Adolescent Centres (8500) 221100 Girls
APON course for girls 178225 Girls
APON course for Boys 35356 Boys
Sewing & embroidery 8000 Girls
Photography Training 723 Girls
Computer Training 1581 Girls
Journalism 145 Girls
Poultry & livestock 90 Girls
63. Lessons learnt:
• Adolescents are capable of doing a lot more provided if they are
given the opportunities
• Active participation of Community Leaders & Religious Leaders
are essential to prevent early marriage & dowry
• Livelihood program, aside from economic independence, has
been able to change the attitudes of their family & community
towards adolescent girls
64. MCQ
• Fall in NMR is parallel to IMR/U-5MR
• Kala azar is now controlled
• Leprosy is not eradicable
• To control TB case detection is most important
• BCG vax. can contribute to leprosy control
• Surface/rain water are free from arsenic