Various national health programs are currently in operation in India to improve public health. This document outlines programs related to communicable diseases, non-communicable diseases, nutrition, system strengthening, and national health policies. It also provides details on key child health programs like the Reproductive and Child Health Program, Universal Immunization Program, Integrated Child Development Services Scheme, and School Health Program. Nutritional programs like the Vitamin A Prophylaxis Program, National Program for Control of Anemia, and National Iodine Deficiency Disorders Control Program are also summarized.

2. How to achieve health
By improving host resistance to
environmental hazards
By improving environmental safety
By improving health systems designed
to increase the likelihood, efficiency &
effectiveness of the first two goals

3. Programmes for Communicable Diseases
1. National Vector Borne Diseases Control
Programme (NVBDCP)
2. Revised National Tuberculosis Control
Programme
3. National Leprosy Eradication Programme
4. National AIDS Control Programme
5. Universal Immunization Programme
6. National Guinea worm Eradication Programme
7. Yaws Control Programme
8. Integrated Disease Surveillance Programme

4. Programmes for Non Communicable
Diseases
1. National Cancer Control Program
2. National Mental Health Program
3. National Diabetes Control Program
4. National Program for Control and treatment
of Occupational Diseases
5. National Program for Control of Blindness
6. National program for control of diabetes,
cardiovascular disease and stroke
7. National program for prevention and control
of deafness

5. National Nutritional Programs
 Integrated Child Development Services Scheme
 Midday Meal Programme
 Special Nutrition Programme (SNP)
 National Nutritional Anemia Prophylaxis
Programme
 National Iodine Deficiency Disorders Control
Programme

6. Programs related to System Strengthening
/Welfare
1. National Rural Health Mission
2. Reproductive and Child Health
Programme
3. National Water supply & Sanitation
Programme
4. 20 Points Programme

7. National Health Policies
 National Health Policy 2002
 National Population Policy 2000
 National AIDS control and Prevention Policy
 National Blood Policy
 National Policy for empowerment of Women
2001
 National Charter for Children
 National Youth Policy 2001998
 National Nutrition Policy

8. Various national health programs are currently in
operation for the improvement of child health and
prevention of childhood diseases. The brief lists of
these programmes are:
 Reproductive and Child Health
Program.
 Universal Immunization Program
 Integrated Child Development Services
Scheme
 School Health Program
 Nutritional Program

10. The Reproductive and Child Health
(RCH) Programme
It was launched in October 1997. The main aim of the
programme is to reduce infant, child and maternal
mortality rates.
The main objectives of the programme in its first phase
were:
 To improve the implementation and management of
policy by using a participatory planning approach and
strengthening institutions to maximum utilization of the
project resources
 To improve quality, coverage and effectiveness of existing
Family Welfare services

11.  To gradually expand the scope and coverage of the
Family Welfare services to eventually come to a
defined package of essential RCH services.
 Progressively expand the scope and content of
existing FW services to include more elements of a
defined package of essential
 Give importance to disadvantaged areas of
districts or cities by increasing the quality and
infrastructure of Family Welfare services

12. RCH-I: had a number of successful and unsuccessful
outcomes. Base line statistics were recorded in 1998-
99 and compared to 2002-03.
 Percentage of women receiving any ANC rose by
about 12 % to reach 77.2%. But use of government
health facilities has declined.
 Use of contraceptives increased by 3.3 % to 52.0 %,
while family planning due to spacing method rose by
3.3% to 10.7 %. Use of permanent methods did not
change.
 Infant mortality came down from 71to 63 but the aim
of universal immunization was far from reach. Polio
though reduced has not met the eradication target.
 Not enough attention was paid to awareness of
diarrhoea management and Acute Respiratory
Infection danger signs hence resulting in a rise of case
incidents.

13. The child health programmes is now its
second phase: RCH-II.
Following are the aims of the programme:
 Expand services to the entire sector of Family Welfare
beyond RCH scope
 Holding States accountable by involving them in the
development of the programme
 Decentralization for better services
 Allowing states to adjust and improve programmes
features according to their direct needs.

14.  Improving monitoring and evaluation processes at the
District, state and the Central level to ensure improved
program implementation.
 Give performance based funding, by rewarding good
performers and supporting weak performers.
 Pool together financial support from external sources
 Encourage coordination and convergence, within and
outside the sector to maximize use resources as well as
infra structural facilities

15. The recommended package of services:
For the mothers:
 Tetanus Toxoid Immunization
 Prevention and treatment of anaemia
 Antenatal care and early identification of maternal
complications
 Deliveries by trained personnel
 Promotion of institutional deliveries
 Management of obstetric emergencies
 Birth spacing

16. For the children:
 Essential newborn care
 Exclusive breast feeding and weaning
 Immunization
 Appropriate management of diarrhoea
 Appropriate management of ARI
 Vitamin A prophylaxis
 Treatment of Anemia
For eligible couple:
 • Prevention of pregnancy
 • Safe abortion
Prevention and treatment of reproductive tract
infection (RTI) and sexually transmitted diseases
(STD).

17. Women of reproductive age must receive:
Counselling on
 Importance of care of girl child
 Optimal timing & spacing of birth
 Small family norms
 Use and choice of contraceptives
 Prevention of RTI / STI
Information on Availability of
 MTP Services
 IUD & sterilization services
Family Planning Services
 Condom distribution
 Oral contraceptives
 IUD

18. Universal Immunization Programme
 Sponsored by Central Government
 Funding Pattern-It is a Centrally sponsored scheme,
so the total funding is managed by the Central
Government.
 Ministry/Department- Department of Health &
Family Welfare Department
 Description-Universal immunization programme,
UIP, was launched in 1985 in a phased manner.
Immunization is one of the most cost effective
interventions for disease prevention. Traditionally,
the major thrust of immunization services has been
the reduction of infant and child mortality.

19.  Immunisaton is an important vehicle for health
promotion and therefore is a true national investment.
 Evaluated coverage by UNICEF in the last 3 years
indicates that there is a decline in coverage of all
antigens. Proportion of districts achieving 80 percent of
DPT3 coverage has also decreased.
 Districts will provide equitable, efficient and safe
immunization services to all infants and pregnant
women.

20. The aim is to achieve 100 percentages of full
immunization status by 2009 to 2010 and to
maintain it for long.
The objectives of the mission are(were):
I. Contribute to global eradication of Polio by 2007.
II. Elimination of Neonatal Tetanus, Diphtheria and
Pertussis by 2009.
III. Establish sufficient sustainable and accountable fund
flow at all levels.
IV. Ensure that there is sustained demand and reduced
social barriers to access immunization services.

21. The strategies of the programme are:
I. Reducing drop outs rate and missed opportunities.
II. Strengthen institutional training at all levels.
III. Strengthen coordination and review meeting at all
levels.
IV. Strengthening micro planning processes in all
districts and urban areas.
V. Strengthening coordination with national operational
guidelines, supervision practices and prioritizing
poorly performing districts and under served
populations.
VI. Reaching the under served by influencing behavior at
household level through BCC.

23. Integrated Child Development Services
(ICDS)
 ICDS being implemented by Ministry of Women and
Child Development is the world’s largest programme
aimed at enhancing the health, nutrition and learning
opportunities of infants, young children (O-6 years)
and their mothers.
 It is the foremost symbol of India’s commitment to its
children – India’s response to the challenge of
providing pre school education on one hand and
breaking the vicious cycle of malnutrition, mortality
and morbidity o the other.

24. The Scheme provides an integrated approach for
converging basic services through community based
workers and helpers.
The services are provided at a centre called the
‘Anganwadi’, which literally means a courtyard play
centre, a childcare centre located within the village
itself.
The package of services provided are:
❖Supplementary nutrition,
❖Immunization,
❖Health check-up
❖Referral services,
❖Pre-school non-formal education and
❖Nutrition and health education

25. It is a centrally sponsored scheme implemented
through the State Governments with 100% financial
assistance from the Central Government for all inputs
other than supplementary nutrition which the States were
to provide from their own resources.
However, from the year 2005-06, the Government
of India has decided to provide Central assistance to States
for supplementary nutrition also to the extent of 50% of
the actual expenditure incurred by States or 50% of the
cost norms, whichever is less.

26. School Health program
 School Health program is a program for school health
service under National Rural Health Mission, which has
been necessitated and launched in fulfilling the vision of
NRHM to provide effective health care to population
throughout the country.
 It also focuses on effective integration of health concerns
through decentralized management at district with
determinant of health like sanitation, hygiene, nutrition,
safe drinking water, gender and social concern.
 The School Health Programme intends to cover 12,88,750
Government and private aided schools covering around 22
Crore students all over India

27.  The School health programme is the only public sector
programme specifically focused on school age children.
 Its main focus is to address the health needs of children,
both physical and mental, and in addition, it provides for
nutrition interventions, yoga facilities and counseling.
 It responds to an increased need, increases the efficacy
of other investments in child development, ensures good
current and future health, better educational outcomes
and improves social equity and all the services are
provided for in a cost effective manner.

28. Components of School Health Program:
1. Screening, health care
and referral:
 Screening of general health, assessment of
Anaemia/Nutritional status, visual acuity, hearing
problems, dental check up, common skin conditions,
Heart defects, physical disabilities, learning disorders,
behavior problems, etc.
 Basic medicine kit will be provided to take care of
common ailments prevalent among young school going
children.
 Referral Cards for priority services at District / Sub-
District hospitals.

29. 2. Immunisation:
 As per national schedule
 Fixed day activity
 Coupled with education about the issue
3. Micronutrient (Vitamin A & IFA) management:
 Weekly supervised distribution of Iron-Folate tablets
coupled with education about the issue
 Administration of Vitamin-A in needy cases.
4. De-worming:
 As per national guidelines
 Biannually supervised schedule
 Siblings of students also to be covered

30. 5. Health Promoting Schools:
 Counseling services
 Regular practice of Yoga, Physical education, health
education
 Peer leaders as health educators.
 Adolescent health education-existing in few places
 Linkages with the out of school children
 Health clubs, Health cabinets
 First Aid room/corners or clinics.
6. Capacity building
7. Monitoring & Evaluation
8. Mid Day Meal

33. INTRODUCTION
 The various nutritional programmes are in operation
in India since 1st five year plan period.
 International agencies such as WHO, UNICEF, FAO,
CARE are assisting the Govt. in these programmes of
India to improve nutrition of the people with special
emphasis on mother & children.

34. FUNCTIONS fall in 3 categories
To eradicate major causes of malnutrition.
-Increase food production
-Provide safe drinking water
-improve environmental sanitation
-control of communicable diseases
-nutritional education to the masses
-promoting kitchen garden

35. Cont…….
Aspects specially related to women and children
-to improve the employment
opportunities for women
-provision of better health care to
parents & children
-promoting breast feeding
-weaning at right time

36. Cont…….
Special reference to pregnant & lactating
mothers
-to raise nutritional status through nutritional
education
-promoting small handicrafts scheme through
self employment

37.  Vitamin-A Prophylaxis Program.
 Prophylaxis against nutritional anemia.
 Control of iodine deficiency disorders.
 Applied nutritional program.
 Special nutrition program.
 Balwadi nutrition program.
 Midday meal program.
 Integrated child development services scheme.

38.  Launched by Ministry of Health and Family Welfare
in 1970.
 Component- control of Blindness
 Beneficiary group – preschool children 200,000 IU of
oily preparation of Vitamin A (retinol palmitate
110mg) administered orally every 6 months for every
preschool child above 1 year.

39. Cont…….
Age of the child Quantity of vitamin A
administered
At 9th month 1,00,000 IU
15th - 16th months Mega dose of 2,00,000 IU
18 - 24 months 2,00,000 IU
24 - 30 months 2,00,000 IU
30 - 36 months 2,00,000 IU

40.  1 IU is equivalent to 0.3 microgram of retinol.
 Vitamin A deficiency increases the severity of
mortality from measles and diarrhea.
 Increased infectious morbidity and mortality is
apparent even before the appearance of xerophthalmia
 Improving the vitamin A status of deficient children
aged 6 months to 6 years can dramatically reduce their
morbidity and mortality from infection

41. Cont…….
 Prompt administration of large doses of vitamin A to
children with moderate to severe measles, particularly
if they may be vitamin A deficient, can reduce
individual mortality by 50% and prevent or moderate
the severity of complications.

43. Cont……
 The programme was launched in 1970 to prevent
nutritional anemia in mothers and children.
 the expected and nursing mothers as well as acceptors
of family planning are given one tablet of iron and folic
acid containing 60 mg elementary iron which was
raised to 100 mg elementary iron, however folic acid
content remained same (0.5 mg of folic acid).

44. Cont…...
 Children in the age group of 1-5 years are given one
tablet of iron containing 20 mg elementary iron (60
mg of ferrous sulphate and 0.1 mg of folic acid) daily
for a period of 100 days.
 This programme is being taken up by Maternal and
Child Health (MCH) Division of Ministry of Health
and Family Welfare.

45. Cont…….
 Now it is part of RCH programme.
 National programmes to control and prevent anemia
have not been successful.
 Experiences from other countries in controlling
moderately-severe anemia guide to adopt long term
measures i.e. fortification of food items like milk,
cereal, sugar, salt with iron.
 Nutrition education to improve dietary intakes in
family for receiving needed macro/micro nutrients as
protein, iron and vitamins like folic acid, B,C, etc. for
hemoglobin synthesis is important.

46. Cont…….
 Nutritional Anemia Control Programme should be
comprehensive and incorporate nutrition education
through school health and ICDs infrastructure to
promote regular intake of iron/ folic acid-rich foods, to
promote intake of food which helps in absorption of
iron and folic acid and adequate intake of food.
 The technology for the control of anemia through iron
fortification of common salt has also been developed
at the NIN, Hyderabad.

48. Cont…….
 The government of India, launched the National
Goiter control programme (NGCP) in 1962.
 It aimed at replacement of ordinary salt by iodised
salt, particularly in the goiter endemic regions.
 The program of universal iodisation of edible salt was
started from first April 1986 in phases with the aim of
total salt iodisation by 1992.

49. Cont……
 IN 1992, the NGCP was renamed as national iodine
deficiency disorder control programme.
 The central government provides case grants for health
education and publicity campaign for promoting the
consumption of Iodised salt.

50. Cont……
 A national reference laboratory monitoring of IDD has
been set up at the bio-chemistry division of the
national institute of communicable disease, Delhi.
 It monitors the Iodine content of salt.

51. Cont…….
 The medical and paramedical personnel monitoring
laboratories have been established at the district level
also in many districts in allocation of Rs.75,000/-
district laboratory has been provided for this purpose.

54. SNP
 The programme was launched in the country in 1970-
71 for the benefit of children below 6 years of age,
pregnant and nursing mothers.
 Originally launched as a central programme and was
transferred to the state sector in fifth Five year plan as
part of the Minimum Needs Programme.
 AIM-
To improve the nutritional status of the target
groups.

55. Cont……
OBJECTIVES:
 To improve the nutritional status of women, pre-
school children, pregnant women and lactating
women in urban, slums, tribal areas and drought prove
rural areas
 The main activities of the program are:
-To provide supplementary nutrition
-To provide health services, including supply of
vitamin-A solution and iron and folic acid

56. Cont……..
 It provides supplementary feeding of about 300
calories and 10 grams of protein to preschool children
and about 500 calories and 25 grams of protein to
expect at and nursing mothers for six days a week.
 This programme was operated under Minimum Need
Programme.
 The programme was taken up in rural areas inhibited
predominantly by lower socio-economic groups in
tribal and urban slums.

57. Cont……..
 Fund for nutrition component of ICD programme is
taken from the SNP budget.
 This supplement is provided for 300 days in a year.

58.  This programme which was started in December
1970.
 It is under the overall charge of the Department
of Social Welfare.
 It is being promoted with the help of four
national-level voluntary organisations, namely,
the Indian Council for Child Welfare, Harijan
Sewak Sangh, Bharatiya Adamjati Sewak Sangh
and Central Social Welfare Board.
 Beneficiary group – 3 to 6 years.

59. Cont……..
 Visualizes on the provision of supplementary
nutrition to the extent of 300 calories and 15 grams
of protein during 250 days in a year for children
attending Balwadis.

60.  Started in 1975 in pursuance of the National Policy for
children.
 Strong nutritional component in this programme is in
the form of
-Supplementary nutrition
-Vitamin A prophylaxis
-Iron and folic acid distribution

61. Cont…….
Beneficiary group:
 children below 6 years
 adolescent girls
 elderly pregnant and lactating women
Services:
 Supplementary nutrition,
 immunization
 Health checkups,
 medical referral services,
 nutrition and health education to women
 non formal education.

62. Cont………
Service Delivery :
Anganwadi Workers
 Each Anganwadi unit covers a population of about
1000.
 A network of Mahila Mandals has been built up in
ICDS Project areas to help Anganwadi workers in
providing health and nutrition services.

63. Cont………
 The work of Anganwadis is supervised by
Mukhyasevikas.
 Field supervision is done by the Child Development
Project Officer(CDPO).

64. APPLIED NUTRITION PROGRAMME
 The ANP was first introduced in 1960 in Orissa and
Andhra Pradesh.
 It was extended there after to Tamilnadu in 1961 and
Uttar Pradesh in 1962, during 1973, it was extended to
all the states.
Specific objectives:
 To make people conscious of their nutritional needs
 To increase production of nutrition foods and their
consumption

65. Cont….
 To provide supplementary nutrition to vulnerable
groups through locally produced foods.
Components:
-Production of protective foods
-Training of functionaries involved in production of
these foods
-Nutrition education and demonstration

66. Cont….
Specific activities:
 Supplementary feeding
 Non-formal preschool education
 Nutrition education
 Poultry forming
 Providing better seeds and seedling
 Raising kitchen gardens

67. Cont……
Beneficiaries:
 Children between 2-6 years, pregnant and lactating
mothers.
 The children and women are given supplementary
nutrition's worth
25paise / day / child , 50paise / women/day
respectively.
 A single supplementary meals is given weekly for 25
days/year.

68. Cont…..
Evaluation:
 Studies show that ANP has not generated and
desired awareness for production and
consumption to protective food, the community
kitchens and school gardens could not function
properly. In reality the program lacked effective
supervision and has almost become defunct.

70.  Also known as School Lunch Programme.

71. Cont…..
 1st organised in 1957 in TamilNadu.
 In operation since 1961 throughout the
country.
 AIM: 1/3rd of the required food per day for
the child be furnished through this
programme.

72. Cont…….
 OBJECTIVE:
- To improve the nutritional status of children
and imparting nutritional education.
- To ensure universal primary education.
- To attract more children for admission to
schools and retain them to improve literacy rate

73. Cont……
 The feeding programme is the joint venture of
the health and educational department with aid
from UNICEF, CARE, and other agencies.
 Skimmed milk, banana, rice meals etc. are
provided.
 Cost is fixed as 12 paise per child.

74. Cont......
Principles:
 supplement, not substitute
 1/3 total energy and ½ total protein
 low cost
 easily prepared
 locally available food
 change menu frequently

75. Cont......
 It is further planned to introduce development
of vegetable gardens in schools.
 Adding subject on nutrition in the curriculum to
motivate the young minds on the concepts of
nutrition for better health.
 There are 70 million children who benefit
through this programme in India every year.

77.  Have to study the food habits
of people, their views etc.
 Needs to impart the
knowledge of importance of
good nutrition without hurting
their cultural habits.
 Needs to demonstrate
simple recipes which are
affordable and locally available.

78. Cont……
 Needs to use all media of health education.
 Needs to identify the malnourished children and
refer them appropriately to the nutrition
programme.
 Assists in nutrition rehabilitation programme.
 Takes part in research activities.