In 2011 to reduce neonatal mortality government of India launched Home based new born care program based on Gadchirolli model of SEARCH. This presentation will tell about how the program is enrolling in our country.
under 5 mortality, most common causes for under 5 mortality, the situation in India, situation in other parts of the world and schemes by Indian government to overcome this problem
In 2011 to reduce neonatal mortality government of India launched Home based new born care program based on Gadchirolli model of SEARCH. This presentation will tell about how the program is enrolling in our country.
under 5 mortality, most common causes for under 5 mortality, the situation in India, situation in other parts of the world and schemes by Indian government to overcome this problem
IMNCI (Integrated Management of Neonatal and Childhood illness) is an integrated approach to child health that focuses on the well-being of the whole child.
IMNCI strategy is one of the main interventions under RCH-II/NRHM, that focuses on Preventive, Promotive and Curative aspects of program.
The maternal mortality rate is the number of maternal deaths in a population divided by the number of women of reproductive age. It captures the likelihood of both becoming pregnant and dying during pregnancy (including deaths up to six weeks after delivery).
The present status report includes issues of rights to survival and development, these being health, early childhood development and education. A major section is devoted to child protection since the issues to be addressed are far too many. While there is a chapter dedicated to violence against children, separate chapters deal with child sexual abuse, juvenile justice, child labour and trafficking. The last two years have seen large scale de-housing of children and their families. As an addition this time we have included a section on right to adequate housing as it is a right that cuts across survival, development and protection issues. Given that a large number of children are growing in situations of emergency – human made or natural, it was critical to address their situation separately. Even as we write this report a new disaster has struck the country. Thousands have died or been rendered homeless in Jammu & Kashmir due to the earthquake. The rights of the disabled child have always been marginalised. But since little has changed since our last report, we have addressed issues of disability in the chapters on health and education.
HAQ: Center for Child Rights
B1/2, Ground Floor,
Malviya Nagar
New Delhi - 110017
Tel: +91-26677412,26673599
Fax: +91-26674688
Website: www.haqcrc.org
Facebook Page: https://www.facebook.com/HaqCentreForChildRights
Important maternal and child health parameters to evaluate quality care for the special group. Includes MMR, IMR, SBR, PMR, NMR, PNMR, U5MR. Practical class for UG 4th sem
This slide is about India New Born Action Plan. It encloses complete detail of the plan and what are its principles and objective and how it aims to achive it
Launched by the ministry of health & family welfare, government of India, under the national health mission.
It envisages Child Health Screening and Early Intervention Services
Bottlenecks, barriers, and solutions: Results from multi-state consultations focused on reduction of childhood pneumonia and diarrhea deaths. Under-5 Malnutrition plays a great role behind deaths from Pneumonia & Diarrhoea.
IMNCI (Integrated Management of Neonatal and Childhood illness) is an integrated approach to child health that focuses on the well-being of the whole child.
IMNCI strategy is one of the main interventions under RCH-II/NRHM, that focuses on Preventive, Promotive and Curative aspects of program.
The maternal mortality rate is the number of maternal deaths in a population divided by the number of women of reproductive age. It captures the likelihood of both becoming pregnant and dying during pregnancy (including deaths up to six weeks after delivery).
The present status report includes issues of rights to survival and development, these being health, early childhood development and education. A major section is devoted to child protection since the issues to be addressed are far too many. While there is a chapter dedicated to violence against children, separate chapters deal with child sexual abuse, juvenile justice, child labour and trafficking. The last two years have seen large scale de-housing of children and their families. As an addition this time we have included a section on right to adequate housing as it is a right that cuts across survival, development and protection issues. Given that a large number of children are growing in situations of emergency – human made or natural, it was critical to address their situation separately. Even as we write this report a new disaster has struck the country. Thousands have died or been rendered homeless in Jammu & Kashmir due to the earthquake. The rights of the disabled child have always been marginalised. But since little has changed since our last report, we have addressed issues of disability in the chapters on health and education.
HAQ: Center for Child Rights
B1/2, Ground Floor,
Malviya Nagar
New Delhi - 110017
Tel: +91-26677412,26673599
Fax: +91-26674688
Website: www.haqcrc.org
Facebook Page: https://www.facebook.com/HaqCentreForChildRights
Important maternal and child health parameters to evaluate quality care for the special group. Includes MMR, IMR, SBR, PMR, NMR, PNMR, U5MR. Practical class for UG 4th sem
This slide is about India New Born Action Plan. It encloses complete detail of the plan and what are its principles and objective and how it aims to achive it
Launched by the ministry of health & family welfare, government of India, under the national health mission.
It envisages Child Health Screening and Early Intervention Services
Bottlenecks, barriers, and solutions: Results from multi-state consultations focused on reduction of childhood pneumonia and diarrhea deaths. Under-5 Malnutrition plays a great role behind deaths from Pneumonia & Diarrhoea.
Infográfico sobre as potencialidades do mundo digital aplicadas ao universo dos museus e espaços culturais. Material produzido pela equipe especializada da 360Graus, especialista em dinamização e gestão de museus e espaços culturais.
CORE Group Fall Meeting 2010. WHO/UNICEF - Joint Statement Service Delivery & Program Implications, - Winnie Mwebesa & Stella Abwao, Save the Children.
RMNCH + A MCH Program Dr Girish .B Associate Professor, CIMS, ChamarajanagarDr Girish B
RMNCH + A MCH Program Dr Girish .B Associate Professor, Department of Community Medicine, Chamarajanagar Institute of Medical Sciences (CIMS), Chamarajanagar
Neonatal Health in Nepal _ Saroj Rimal.pptxsarojrimal7
The document describes about the History, trends and programs to improves the neonatal health of nepal. It will helps to know and understand the current programs and what was done before for the health of neonates and childrens in nepal. Mostly used for Public health, Nursing and Medical students. The document is developed on 2023 so, the policies and programs after 2023 was not encorporated in this document.
Government Schemes in India are launched by the government to address the social and economic welfare of the citizens of this nation. These schemes play a crucial role in solving many health-related and socio-economic problems that beset Indian society, and thus their awareness is a must for any concerned citizen.
Can the health system sustain population explosion in indiaHarivansh Chopra
The present pandemic has taught us many lessons as far as health care delivery system is concerned in india. population growth is a neglected issue for many decades in india and it is well known that till we are able to control the growth ,all remedial action to improve health care go in vain.this presentation is highlighting the existing gaps in the provision of primary health care in india. we definitely need to increase the percentage of GDP on health as well as control the population.
Lesson learned and not learned in COVID -19 PANDEMICHarivansh Chopra
in march 2019 WHO declared covid -19 as pandemic and since than we have come long way to understand the epidemiology of covid -19. we also have learned quite a number of unpleasant/pleasant lessons in the control and management of covod -19. vaccines have been developed by a quite rapid pace across the globe and similarly vaccine hesitancy and utilisation has also been seen across the globe . this is a very simple presentation highlighting the the importance of correct knowledge and strategies to control this pandemic
Bio psycho social and spiritual dimension and chdHarivansh Chopra
This presentation is a part of webinar on prevention and reversal of chd and type 2 diabetes mellitus . in this presentation prof rahul bansal has emphasised the role of mind body connection and role of stress in causation as well its removal in prevention and reversal of chd.he has given ample evidence of use of meditation, yoga, as well as of prayers and diet in the reversal of chd
CORONARY ARTERY DISEASE is a modern epidemic in india. due to changes in living conditions and habits its prevalence is increasing day by day . in this presentation i have explained the various risk factors and innovations in diagnosis of CAD. IT is very useful for primary health care physicians and community medicine specialist
Promotion of child survival -Experiences, innovations and opportunitiesHarivansh Chopra
In this presentation, i have discussed the normal growth in children. the focus of attention must be an infant as it is the time of maximum growth and chances of growth faltering are also high. if one has to reduce underfive mortality and promote child survival than aBIGWIN APPROACH is to be followed. i have also shared few success stories of low birth weight babies attaining the target at one year of age.causes of malnutrition are also discussed and what type of opportunities are there for public health professional in the community settings.focus from under six has to be shifted to ist year of life
crying in infant is a normal phenomenon but can be troublesome when an infant cry excessively. colic is an acronym and it is important to rule out every physiological and pathological cause before making a diagnosis of colic.this presentation will help you in doing so . happy viewing.
Success stories & innovative approach for prevention of childhood malnutr...Harivansh Chopra
in this presentation i have shown few success stories of low birth weight children attaining normal weight by the end of first year by implementing an innovative BIGWIN APPROACH. Bigwin is an acronym for the best practices described aptly in this presentation.if we can shift the strategy to prevent malnutrition in children from under six to under one than we can overcome malnutrition in five years time provided if we are able to reach every pregnant women and newborn child.
This is a most basic presentation on balanced diet and RDA. Unfortunately the basic requirements are easily forgotten and right kind of nutrition education is thus not provided to population. Remembering the right requirement in vulnerable periods is of utmost important to prevent the occurrence of deficiency and its deleterious effects
Vitamin C is a water soluble vitamin and thus is not stored in the body . It is potent antioxidant and in this covid-19 arena ,there is lot of emphasis of its role in enhancing immunity. it is required daily in 40-80 mgm. This requirement can be easily fulfilled by eating food which are the rich sources of this vitamin.Hope this presentation will clear lots of myths which are prevalent like taking tablet 500-1000mgm daily
CORONARY HEART DISEASE is the modern epidemic facing the developing world. Among all the modifiable risk factors ,diet plays an important role in all of them. adequate knowledge is the first step towards behaviour change . in this presentation I have tried to impress upon food items which are beneficial as well as harmful for individuals having risk factors or disease . hope it will stimulate the viewer to understand and change the eating habits in the society.
Nutrition assessment in children- dr harivansh chopraHarivansh Chopra
Assessment of nutritional status especially in vulnerable population is important for taking prompt action. young children are the most affected proportion of the population in the world.In community settings, rapid methods of assessment are important tools to identify children suffering from both macro and micro deficiencies .This is pictorial presentation showing various methods as well as pictures of deficiencies
Nutritional deficiencies are very common in india as well as in other developing countries.both macro and micro nutrients are not eaten in adequate quantities in india due to poverty and ignorance. A number of national program are there to combat these deficiencies.But unfortunately effective implementation is lacking due to which nutritional deficiency is not being overcome in our country. Now due to covid -19 these are bound to increase
Stress is the gift of modern society which has got a lot of bearing on the mental and physical health of the people . the stress can't be eliminated in totality but can be minimised by using this simple presentation and applying it in day to day life .the answer of stress is in the word stress only.kindly view and use and share it further.
Medicine is considered as one of the best profession in the world and Doctors are still considered next to GOD because they save human life. now a days doctors in developing countries are under tremendous stress. lot of changes are happening in medical education and recently national medical commission has started a new initiative to to change the teaching learning practices medical colleges. Now the upcoming doctors are to be trained keeping in mind the necessary attributes and skills which are required to fulfil their responsibility in fitting manner in future.
This presentation is based upon my more than 3 decades of experience in medical college.
Immunization is one of the best public health intervention to reduce mortality and morbidity caused by vaccine preventable diseases. in this part i am going to describe regarding cold chain ,frequently ask questions regarding vaccines and how to manage acute and life threatening adverse reactions at most peripheral level
Immunization is one of the best public health intervention to prevent morbidity as well as mortality. it also help in prevention of malnutrition in young children.still developing countries are trying hard to make it universal. in india lot of changes have taken place in the immunization schedule and number of newer vaccines have been incorporated. still the awareness as well as acceptability is not universal . this presentation is very basic and will help students as well as teachers. we all have to join hands to make it universal
japenese encephalitis is an important vector borne disease which carries a high mortality as well as high disability. it is a preventable disease and an effective vaccine is available for it.the vaccine is an important part of universal immunization program in india. Environmental modification and control of vector will go long way in the control of this disease.
Enhancing child survival means keeping the normal child as normal as well as bringing low birth weight child to normal.this presentation describe four real stories of low birth weight children attaining normal weight by the end of first year. for this intensive child caring practices are to be implemented. in fact a BIGWIN APPROACH is applied. if this strategy is scaled up then we can make india and other developing countries free of malnutrition in five years thereby giving a big boost to child survival.videotalk can be seen at https://youtu.be/7Ey07cV2clw
Tuberculosis infection is very common in the world and the disease manifest when ever either the virulence of the organism increases or the resistance of the host goes down.it can affect any part of the body.the best method of control of tuberculosis is early diagnosis and treatment.despite international cooperation the problem of resistance in tuberculosis is increasing and great efforts are being made to tackle this problem both in diagnostic tools as well as in treatment modalities. the social factors also play a big role in the causation as well as emergence of resistance is concerned . a participatory approach is required to combat the problem.
meningococcal meningitis is a very serious and fatal disease if not treated in time. the case fatality rate can go upto 50% in untreated cases .there are many strains which are responsible for its occurrence .it tend to occur both in endemic as well as in epidemic form. a qudrivalent vaccine is available for protection. recipient of this vaccine are to be given chemo prophylaxis .recently a vaccine against type b strain has been made avialable in canada for use in routine immunization
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
1. Dr. Harivansh Chopra
Dr. Harivansh Chopra,
DCH, MD
Professor,&Head
Department of Community Medicine,
LLRM Medical College, Meerut.
NEONATAL SURVIVAL
STRATEGY &CHALLANGES
1
2. Dr. Harivansh Chopra
Conclusions
80% of the newborns can be managed at home either by
mother or with the assistance of skilled and trained workers.
Reduction in infant mortality can only be achieved by reducing
Neonatal mortality
Neonatal mortality can only be decreased by reducing the
Incidence of low birth weight children.
Empowerment of the mothers as well as provision of essential
Antenatal care are the key to success.
7 feb. 2003
6. Dr. Harivansh Chopra
DISTRIBUTION OF NEONATAL DEATHS DAY 1 TO 7
0
5
10
15
20
25
30
35
40
D 1 D 2 D 3 D 4 D 5 D 6 D 7
39.3
7.3 10.2
6.2 5.5
2.8 2.8
PERCENTAGE%
DAYS
Distribution of Neonatal Deaths Day 1-7
HBNC GUIDELINES BY MOHFW6
10. Dr. Harivansh Chopra
CAUSES FOR NEONATAL DEATHS IN INDIA
BIRTH
ASPHYXIA
20%
PRE TERM
35%
SEPSIS
15%
PNEUMONIA
16%
DIARRHOEA
2%
MALFORMATIONS
9%
OTHER
3%
BIRTH ASPHYXIA
PRE TERM
SEPSIS
PNEUMONIA
DIARRHOEA
MALFORMATIONS
OTHER
Lancet 2012
10
23. Dr. Harivansh Chopra
• HYPOTHERMIA PREVENTIONH
• PROVISIONS OF ANTENATAL, NATAL,
POSTNATAL & NEONATAL CARE
• PROMOTION OF REFERRALP
• PREVENTION OF PREMATURITY &
LOW BIRTH WEIGHT
• PROMOTION OF SMALL FAMILY
• PREVENTION OF CONGENITAL
MALFORMATIONS
P
• YES TO EXCLUSIVE
BREAST FEEDINGY
• ASPHYXIA PREVENTION
A
23
25. Dr. Harivansh Chopra
MILESTONES IN CHILD SURVIVAL AND SAFE MOTHERHOOD
PROGRAMME
2014 – INDIA NEWBORN ACTION PLAN
2013 – NATIONAL HEALTH MISSION
2013 – RMNCH + A STRATEGY
2005 – NATIONAL RURAL HEALTH MISSION
2005 – RCH II
1997 – RCH I
1992 – CHILD SURVIVAL AND SAFE MOTHERHOOD
PROGRAMME
25
26. Dr. Harivansh Chopra
JANANI SURAKSHA YOJNA
INTEGRATED MANAGEMENT OF NEONATALAND
CHILDHOOD ILLNESS
NAVJAT SHISHU SURAKSHA KARYAKARAM
JANANI SHISHU SURAKSHA KARYAKARAM
FACILITY BASED NEWBORN CARE
HOME BASED NEWBORN CARE
RASHTRIYA BAL SWASTHA KARYAKARAM
INDIA NEWBORN ACTION PLAN
26
27. Dr. Harivansh Chopra
1. Janani Suraksha Yojna
• Launched in 2005
• Objective : Safe motherhood intervention to increase
institutional delivery through demand-side financing
and conditional cash transfer
• Status: implemented in all States/UT’s
Special Focus on Low performing States
27
28. Dr. Harivansh Chopra
2. Integrated Management Of Neonatal and
Childhood illness (IMNCI)
• Launched in 2007
• Objective: Standard case management of major causes of neonatal and
childhood morbidity and mortality
• Status: operationalized in more than 500 districts
5.9 lakh health and other functionaries, including physicians, nurses,
AWWs, ASHAs trained under IMNCI.
26,800 medical officers and specialists placed at CHCs / FRUs trained
under F-IMNCI
28
29. Dr. Harivansh Chopra
3. Navjat Shishu Suraksha Karyakaram
(NSSK)
• Launched in 2009
• Objective: Basic newborn care and
resuscitation training programme
• Status: 1.3 lakh health providers trained to
date
29
30. Dr. Harivansh Chopra
4.Janani Shishu Suraksha Karyakaram
(JSSK)
• Launched in 2011
• Objective: Zero out of pocket expenditure for
maternal and infant health services through
free health care and referral transport
entitlements.
• Status: implemented in all States / UT’s
Assured service package benefits extended to
sick children upto age one.
30
31. Dr. Harivansh Chopra
5. Facility Based Newborn
(FBNC)
• Launched in 2011
• Objective: Newborn Care facilities at various levels of Public Health
Services that includes NBCCs, NBSUs, and SNCUs.
• Status: NBCCs
NBSUs
SNCUs
more than 6300 persons provided FBNC training.
online reporting system reported and scaled up in 7 states.
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32. Dr. Harivansh Chopra
6. Home Based Newborn Care (HBNC)
• Launched in 2011
• Objective: provision of essential newborn care to all newborns,
special care of preterm and LBW newborns by ASHA workers.
• Status: implemented in all States and UT’s
• Most of ASHA’s trained in newborn care
• ASHA’s visited more than 12 lakh newborn in 2013.
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33. Dr. Harivansh Chopra
7. Rashtriya Bal Swasthya Karyakaram
(RBSK)
• Launched in 2013
• Objective: Screening of children with birth defects, diseases,
deficiencies, and developmental delays.
• Status: All children 0 to 18 targeted
More than 8 crore children screened and more than 10 lakh
children identified for tertiary care in 2013.
33
34. Dr. Harivansh Chopra
8. INDIA NEWBORN ACTION PLAN
• Launched in September 2014
• Objective:
To reduce NMR to below 10 by 2030
To reduce Still Birth Rate below 10 by 2030
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37. Dr. Harivansh Chopra
Status of Health Services in U.P
Required In Position
Sub-centres 31037 20521
Primary Health
Centers
5172 3692
Community Health
Centers
1293 515
(Source: RHS Bulletin, March 2012, M/O Health & F.W., GOI)
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38. Dr. Harivansh Chopra
Seats for Pediatrics in UP…
DEGREE/DIPLOMA GOVERNMENT
INSTITUTION
PRIVATE
INSTITUTION
TOTAL
MD PEDIATRICS 53 21 74
DCH 41 04 45
TOTAL 94 25 119 38
39. Dr. Harivansh Chopra
STATISTIC INDIA UP UP %
POPULATION (in crores) 121.06 19.96 16.4%
No. of SNCUs Established 418 15 3.6%
No. of NBSUs Established 1554 92 5.9%
No. of NBCCs Established 13167 1430 10.9%
State Of India’s Newborn, 2014 by PHFI
STATUS OF INFRASTUCTURE IN INDIAAND UP
SOURCE: STATE OF INDIA’S NEWBORN, 2014 BY PHFI 39
40. Dr. Harivansh Chopra
Some useful data…
Presently working SNCUs in UP: 15
LBW babies requiring Facility Based Care is 15% of all LBW : 228480
No. of LBW babies in UP/year: 1523200
Prevalence of low birth weight : 28%
Total newborn born every year: 5440000
Crude birth rate : 27.2/1000 mid year population
Total population of UP : 19.6 crores
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41. Dr. Harivansh Chopra
Requirement is for 22.8 lakh children and we are able to provide to
only 7800 i.e. 3.4% only.
So total babies who can be given bed :
150 x 52 = 7800
Total no. of beds : 15 x 10 = 150
Then 52 babies per year can be given per bed
No. of Days Stay per bed assume to be 7
Beds per SNCUs approx 10
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42. Dr. Harivansh Chopra
• So we are able to provide Facility Based Care to only 3.4% children.
• So if we wish to reduce our IMR by reducing NMR we have to provide
services to those 96.6% children who are devoid of necessary Facility
Based Care.
• In order to combat such difficulty there is an Essential Need for
• HOME BASED NEWBORN CARE
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44. Dr. Harivansh Chopra
Impact targets
Targets Current 2017 2020 2025 2030
NMR (per
1000 live
births)
29 24 21 15 <10
SBR (per
1000 live
births)
22 19 17 13 <10
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45. Dr. Harivansh Chopra
Coverage targets
Targets Current 2017 2020 2025 2030
Safe delivery
(institutional + home
delivery by SBA (%)
76 90 95 95 95
Initiation of
breastfeeding within
one hour of birth
(%)
- 75 90 90 90
Women with
preterm labour
receiving at least one
dose of
antenatal
corticosteroids (%)
- 75 90 95 95
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46. Dr. Harivansh Chopra
Coverage targets
Targets Current 2017 2020 2025 2030
Babies born in health
facilities with birth
asphyxia
received resuscitation (%)
- 75 90 95 95
Babies received complete
schedule of home visits
under
HBNC by ASHA (%)
- 50 75 95 95
Newborn with sepsis in the
community received
Gentamicin by ANM (%)
- 50 75 75 75
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47. Dr. Harivansh Chopra
Coverage Targets
47
Target Current 2017 2020 2025 2030
Newborn
discharged from
SNCU followed
until
age one (%)
- 35 50 75 75
Newborn with low
birth weight /
Prematurity
managed
with KMC at
facility (%)
- 35 50 75 90
48. Dr. Harivansh Chopra
Neonatal Mortality is the major obstacle in reducing Infant Mortality Rate
as well as Under 5 Mortality Rate
To reduce Neonatal mortality we have to reduce incidence of Low Birth
Weight
To reduce Low Birth Weight we have to have Robust Mechanism of
provision of quality Antenatal care as well as Intranatal care
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