The document outlines the National Viral Hepatitis Control Program (NVHCP) in India. The objectives of the NVHCP are to [1] enhance awareness of hepatitis, [2] provide early diagnosis and management of viral hepatitis at all healthcare levels, and [3] strengthen infrastructure and human resources for comprehensive hepatitis services. The program will implement strategies like immunization, harm reduction, and infection control to prevent hepatitis and establish treatment centers to diagnose and treat hepatitis cases.
India being a developing country with growing population has been traditionally vulnerable to natural and man made disasters.
Development cannot be sustainable unless disaster mitigation is built into developmental process.
Disaster could be a nature calamity, outbreak of disease, bioterrorism, etc.
New Delhi, Feb 23. The health ministry has proposed a bill that seeks to empower state and local authorities to take appropriate actions to tackle public health emergencies like epidemics and bio-terrorism.
India being a developing country with growing population has been traditionally vulnerable to natural and man made disasters.
Development cannot be sustainable unless disaster mitigation is built into developmental process.
Disaster could be a nature calamity, outbreak of disease, bioterrorism, etc.
New Delhi, Feb 23. The health ministry has proposed a bill that seeks to empower state and local authorities to take appropriate actions to tackle public health emergencies like epidemics and bio-terrorism.
After the successful NSP 2017-2025,Goi is lauching NSP 2017-2025 for elimination of TB on 24th march( World TB day ) 2017. Module is on MOHFW site but i have try to keep it brief,hope its ll be useful specially for academic and administrative purposes.
After the successful NSP 2017-2025,Goi is lauching NSP 2017-2025 for elimination of TB on 24th march( World TB day ) 2017. Module is on MOHFW site but i have try to keep it brief,hope its ll be useful specially for academic and administrative purposes.
JHIAPSMCON 2024 ; Presentation on Need for big data in tribal healthEx WHO/USAID
Need for Big Data in Tribal Health with examples of big data , their correct format, need for trained skill personnel , need for right software etc . It also shows how much potential is being missed upon and talks about the need to have detailed ABDM everywhere .
Early diagnosis and treatment of Lymphatic filariasis , its need , challenges , and ways to integrate in current strategy in our march towards elimination in 2030. The ppt. also has has brief data from 2021 for State of Jharkhand and concerned District , some pics designed by myself and info on newer diagnostic modalitites
Struggling with intense fears that disrupt your life? At Renew Life Hypnosis, we offer specialized hypnosis to overcome fear. Phobias are exaggerated fears, often stemming from past traumas or learned behaviors. Hypnotherapy addresses these deep-seated fears by accessing the subconscious mind, helping you change your reactions to phobic triggers. Our expert therapists guide you into a state of deep relaxation, allowing you to transform your responses and reduce anxiety. Experience increased confidence and freedom from phobias with our personalized approach. Ready to live a fear-free life? Visit us at Renew Life Hypnosis..
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
We understand the unique challenges pickleball players face and are committed to helping you stay healthy and active. In this presentation, we’ll explore the three most common pickleball injuries and provide strategies for prevention and treatment.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
2. CONTENTS
1. EPIDEMIOLOGY.
2. INTRODUCTION TO THE PROGRAM.
3. AIM & OBJECTIVES.
4. PROGRAMME STRATEGIES.
5. PROGRAMME COMPONENTS.
6. IMPLEMENTATION STRUCTURE.
7. PREVENTION OF VIRAL HEPATITIS.
8. MONITORING, SURVEILLANCE, SUPERVISION AND EVALUATION.
9. TOTAL NO SLIDES: 38
8/2/2019
NVHCP 2
3. Introduction
Viral hepatitis is a global public health problem of epidemic
proportions that caused 1.34 million deaths in 2015 a number
comparable to deaths caused by tuberculosis and higher than
those caused by HIV.
Infection can be caused by the five known hepatitis viruses – A,
B, C, D and E (HAV, HBV, HCV, HDV and HEV).
HEPATITIS B AND C are responsible for 96% of overall hepatitis
mortality.
8/2/2019
NVHCP 3
4. National Viral Hepatitis Control Program
(NVHCP)
prevention and control of viral hepatitis-
• free of charge screening,
• diagnosis,
• treatment &
• counselling services to all,
(specially to people belonging to high-risk groups).
6. Global
It is estimated that 325 million people worldwide are living with
chronic HBV or HCV infection.
Approximately,1.75 million people were estimated to be newly
infected with HCV in 2015, increasing the total number of people
living with Hepatitis C to 71 million.
Hepatitis A Virus (HAV) infections caused approximately 11,000
deaths in 2015.
It is estimated that Hepatitis E caused 44,000 deaths in 2015.
*Source: WHO Global Hepatitis Report. 2017.
8/2/2019
NVHCP 5
7. India
HAV is responsible for 10-30% of acute hepatitis and 5-15% of acute liver failure.
HEV accounts for 10-40% of acute hepatitis and 15-45% of acute liver failure.
Hepatitis B surface Antigen (HBsAg) positivity in the general population ranges
from 1.1% to 12.2%, with an average prevalence of 3-4%.
Approximately 40 million people are chronically infected with Hepatitis B and 6-12
million people with Hepatitis C.
Chronic HBV infection accounts for 40% of Hepato-cellular Carcinoma (HCC) and
20-30% cases of cirrhosis in India.
Chronic HCV infection accounts for 12-32% of HCC and 12-20% of cirrhosis.
8/2/2019
NVHCP 6
8.
9. INTRODUCTION TO THE PROGRAM
India is committed to progressively move towards elimination of viral hepatitis B
and C and control other virus induced hepatitis.
This is in line with our global commitment towards achieving Sustainable
development goal (SDG) goal 3; target 3.3 which aims to “BY 2030, END THE
EPIDEMICS OF AIDS, TUBERCULOSIS, MALARIA AND NEGLECTED TROPICAL
DISEASES AND COMBAT HEPATITIS, WATER BORNE DISEASES AND OTHER
COMMUNICABLE DISEASES”.
Government of India is a signatory to the resolution 69.22 endorsed in the WHO
Global Health Sector Strategy on Viral Hepatitis 2016-2021 at 69th WHA towards
ending viral hepatitis by 2030.
•
8/2/2019
NVHCP 7
10. Aim
Combat hepatitis and achieve country wide elimination of
Hepatitis C by 2030.
Achieve significant reduction in the infected population,
morbidity and mortality associated with Hepatitis B and C viz.
Cirrhosis and Hepatocellular carcinoma.
Reduce the risk morbidity and mortality due to Hepatitis A and E.
8/2/2019
NVHCP 8
11. OBJECTIVES
Enhance community awareness on hepatitis and lay stress on
preventive measures among general population especially high-
risk groups and in hotspots.
Provide early diagnosis and management of viral hepatitis at all
levels of healthcare.
Develop standard diagnostic and treatment protocols for
management of viral hepatitis and its complications.
8/2/2019
NVHCP 9
12. Strengthen the existing infrastructure facilities, build capacities of
existing human resource and raise additional human resources,
where required, for providing comprehensive services for
management of viral hepatitis and its complications in all districts of
the country.
Develop linkages with the existing National programmes towards
awareness, prevention, diagnosis and treatment for viral hepatitis.
Develop a web-based “VIRAL HEPATITIS INFORMATION AND
MANAGEMENT SYSTEM” to maintain a registry of persons affected
with viral hepatitis and its sequelae.
8/2/2019
NVHCP
10
13. PROGRAMME STRATEGIES
Preventive and promotive interventions with focus on awareness generation,
safe injection and socio cultural practices, sanitation and hygiene, safe
drinking water supply, infection control and immunization.
Co-ordination and collaboration with different Ministries and departments,
NACP for safety of blood and blood products and with IDSP and NACP for
surveillance.
Increasing access and promoting diagnosis and providing treatment support
for patients of viral hepatitis.
Building capacities at national, state, district and sub district levels up to
PHC and Health and Wellness center in a phased manner.
8/2/2019
NVHCP 11
14. PROGRAMME COMPONENTS
1. Preventive component.
2. Diagnosis and Treatment.
3. Monitoring and Evaluation, Surveillance and Research.
4. Training and capacity Building.
8/2/2019
NVHCP 12
17. IMPLEMENTATION STRUCTURE AT NATIONAL,
STATE AND DISTRICT LEVEL
The program will have two key prongs:
1. Program management.
2. Servicedelivery component.
8/2/2019
NVHCP 15
18. 1.PROGRAM MANAGEMENT
The initiative will be coordinated by the units at the centre and the
states:
National Viral Hepatitis management unit(NVHMU)
State Viral Hepatitis management unit(SVHMU)
District Viral Hepatitis management unit (DVHMU)
8/2/2019
NVHCP 16
21. 2.SERVICE DELIVERY
Synergies with the existing programs and relevant ministries of
Government of India.
New Interventions- Diagnosis and Management of Viral Hepatitis
with focus on treatment of Hepatitis B&C.
8/2/2019
NVHCP 18
23. 1. Universal Immunization Program
Strengthen routine immunization services to achieve and sustain
the desired coverage of the timely birth dose followed by three
doses of hepatitis B vaccine.
Coordinate with the Universal Immunization Programme for
mandatory immunization of all healthcare workers.
Schedule recommends hepatitis B birth dose to all infants within
24 hours, followed by three doses at 6, 10 and 14 weeks to
complete the schedule.
8/2/2019
NVHCP 20
24. India’s target for Hepatitis B immunization
S.No. Country Targets (to be provided by UIP) Baseline
(2016-
17)
2019-20
1 Coverage of Birth Dose of Hepatitis B ( All deliveries) 60% 90%
2 Coverage with three doses of Hepatitis B vaccine in
infants (B3).
75% 95%
3 Routine Hepatitis B vaccination among health-care
workers
N/A Will be made
Available
8/2/2019
NVHCP 21
25. 2.National AIDS Control Program (NACP)
The NVHMU will coordinate with NACP for surveillance
of hepatitis in key populations, establishing linkages.
For testing and care for hepatitis C infected PLHIV and
vaccination of the vulnerable population.
The SVHMU will coordinate in a similar manner with the state
machinery for executing the same.
8/2/2019
NVHCP
22
26. 3.Safety of blood and blood products
To review and strengthen national policies and practices on blood
safety those promote rational use of blood and blood products, and
move towards 100% VOLUNTARY BLOOD DONATION.
Setting up a mechanism for follow up of individuals detected positive
on screening, their counselling, confirmatory testing and linkages to
care and support services for viral hepatitis.
Strengthen systems for surveillance, hemo-vigilance and monitoring
of the incidence and prevalence of viral hepatitis infections in blood
donors, and monitor the risk of post-transfusion hepatitis.
8/2/2019
NVHCP
23
27. Establish mechanisms for counselling of HBsAg& anti-HCV
reactive blood donors for referral and follow-up to confirm the
presence of infection by confirmatory tests & provide treatment
for Hepatitis B and C where necessary.
Developing/updating training modules with SACS, State Blood
Transfusion Council and blood cells on safety of blood and blood
products with special focus on prevention of Viral Hepatitis
through transfusion of blood and blood products and linkages for
those screened positive.
8/2/2019
NVHCP
24
28. 4.Harm reduction in key populations
• Targeted Interventions in key population include female sex
workers (FSW), men who have sex with men (MSM), transgender
(TG)& people who inject drugs (PWID), while bridge populations
include migrants & truckers.
• Provide a package of prevention services.
• Needle syringe exchange program and opioid substitution therapy
are provided for prevention of HIV among PWID.
8/2/2019
NVHCP
25
29. 5.Injection safety and infection control
By 2020, 100% of all injections are administered with safety engineered devices.
NVHMU and SVHMU will integrate with the national and state regulatory bodies to
strengthen the infection prevention and control practices in healthcare settings.
Coordinate with the Pradhan Mantri National Dialysis Program for making special
emphasis on the component of injection safety and infection control in their
program module.
Coordinate with the regulatory body towards effective roll-out of re-use
prevention (RUP) syringes, addressing prescriber practices and community
preference.
Coordinate with the Ministry of Environment & Forestry and pollution control
board for capacity building for effective implementation of the bio-medical waste
management rules.
8/2/2019
NVHCP
26
30. 6.Integrated Disease
Surveillance Programme
The NVHMU, SVHMU and DVHMU will integrate with the IDSP
.
To provide technical support for outbreak investigation and
reporting and monitoring of outbreaks of viral hepatitis, specially
hepatitis A and E.
Assisting in rapid response team activities during outbreaks.
Ensure linkages with the laboratory and treatment facilities of
those affected in the outbreak with the disease.
To involve all structures up to PHC level.
8/2/2019
NVHCP
27
31. DIAGNOSIS AND MANAGEMENT OF VIRAL
HEPATITIS
A. Laboratory services: Laboratory services are necessary for
screening, confirmation and monitoring the response and
outcomes of treatment.
B. Treatment services: Designated treatment sites that are
located within an existing health facility, such as district
hospitals and state medical colleges will utilize the current
health care system.
8/2/2019
NVHCP 28
32. LABORATORIES SERVICES
Laboratory services are necessary for screening, confirmation
and monitoring the response and outcomes of treatment.
To facilitate the same, the program will strengthen the state,
district, and sub district level laboratories in a phased manner.
8/2/2019
NVHCP 29
34. TREATMENT SITES
The services under the hepatitis treatment initiative will be delivered through
the designated treatment sites that are located within an existing health
facility, such as district hospitals and state medical colleges.
Model Hepatitis Treatment centres (MTC) will act as places for referral and
mentoring of the other treatment centres (TC).
The Hepatitis Treatment centre can be located in the district hospital or co-
located with the sentinel sites.
The diagnosis and treatment centers will have the capacity to differentiate
whether the patient has advanced liver disease or not.
8/2/2019
NVHCP 31
35. Level Screening Confirmation Treatment of
uncomplicated
cases
Treatment of
Complicated
case
Health and
Wellness
centers
Introduced in
phased manner
PHC Yes
CHC Yes Yes In phased
manner after
assessing
capacity
District Hospital Yes Yes Yes
Medical
Colleges and
specialised
centers ( MTC)
Yes Yes Yes Yes
8/2/2019
NVHCP 32
36. TRAINING
Training and capacity building are crucial in delivery of quality health
care.
Develop standardized training manuals and online training modules for
health care providers and undertake their capacity building using
conventional and other platforms.
To identify centers over 3 years who could take the task of mentoring
the human resource from the centers that are linked to them.
These centers could also support the program in undertaking research
and secondary data analysis to inform policy.
8/2/2019
NVHCP 33
37. MONITORING, SURVEILLANCE, SUPERVISION AND
EVALUATION
• Surveillance :
Systematic collection, collation, analysis, and interpretation of output
and outcome-specific data for the planning, implementation, evaluation,
and improvement of programme.
The objective is to develop and implement evidence-based effective
interventions.
• Monitoring :
Monitoring of programme of all interventions at all levels will be the key
to ensure the quality of services in the stipulated timeframe, with active
involvement of programme management structure.
8/2/2019
NVHCP 34
38. • Evaluation :
Impact evaluation of the programmatic component of the viral
hepatitis provides important feedback to the programme.
Efficient evaluation mechanism can potentially identify key gaps
and guide the programme to improve overall performance in
synergistic areas, including water and sanitation, safety of blood
and blood products and injection safety etc.
• Data management :
Computerized data management system under the ‘‘INTEGRATED
INITIATIVE FOR PREVENTION AND CONTROL OF VIRAL
HEPATITIS’’ would facilitate automated data transfer.
8/2/2019
NVHCP 35
39. RECORD KEEPING
A technical group will advise on development of the flow charts and
mechanisms to address the collection and flow of information from
ground level to national level in pre designed formats.
Monitoring of the progress for the existing components for
Immunization, Blood Safety and Drinking Water and Sanitation shall
be done through the existing program and their recording and
reporting system.
Proper recordkeeping of client results is vital for providing quality
service, tackling the medico-legal issues, and operational research.
As per the guidelines, all documents must be stored for at least 5
years or as per state/ institutional guidelines whichever is longer.
8/2/2019
NVHCP 36
40. AWARENESS GENERATION
Increasing awareness among
communication channels will
general population.
be used (like mass
Various
media,
advertisements, radio jingles, posters, TV spots etc).
Behavior change communication strategies for vulnerable groups.
Continued focus on demand generation of services including
hepatitis B birth dose and safe injections and testing for
hepatitis.
Increasing treatment literacy and adherence to treatment.
8/2/2019
NVHCP 37
41. DISTRICT ROLES
• These laboratories would be co- located with the Treatment Centres at the district
hospitals. The capacities of these labs will be strengthened in a phased manner. The
state laboratories will train the district laboratories in carrying out serological testing
for viral hepatitis (immuno-assays/rapid Tests). These laboratories will perform the
testing and would be linked to other treatment centres in the district, sub-district
levels in the region.
• Roles and Responsibilities
• Sample collection and serological testing under the NVHCP Molecular testing where
feasible.
• Sample transportation for molecular testing, where necessary