1st Year MSc Nursing Medical Surgical Nursing MIMS CON

1. NATIONAL HEALTH
PROGRAMME
Prepared by
Ms Theertha P Krishna
1st year Msc Nursing
MIMS CON

2. NATIONAL MENTAL HEALTH PROGRAMME

3. NATIONAL MENTAL HEALTH PROGRAMME
• The Government of India Launched the
National Mental Health Program (NMHP) in
1982, keeping in view the heavy burden of
mental illness in the community & the absolute
inadequacy of mental health care infrastructure
in the country to deal with it.

4. AIM…
1. Prevention & treatment of mental neurological
disorders & their associated disabilities.
2. Use of mental health technology to improve
general health services.
3. Application of mental health principles in total
national development to improve quality of
life.

5. OBJECTIVES…
1. To ensure availability & accessibility of minimum
mental health care for all in the foreseeable future,
particularly to the most vulnerable &
underprivileged sections of the population.
2. To encourage application of mental health
knowledge in general health care & social
development.
3. To promote community participation in the mental
health services development & to stimulate efforts
towards self-help in the community.

6. STRATEGIES…
1. Integration of mental health with primary
health care through the NMHP;
2. Provision of tertiary care institutions for
treatment of mental disorders;
3. Eradicating stigmatization of mentally ill
patients & protecting their rights through
regulatory institutions like the central mental
health authority, & state mental health
authority.

7. APPROACHES…
1. Integration of mental health care services with
the existing health services.
2. Utilization of the existing infrastructure of
health services & also deliver the minimum
mental health care services.
3. Provision of appropriate task-oriented training
to the existing health staff.
4. Linkage of mental health services with the
existing community development program

8. COMPONENTS…
I. Treatment: Multiple levels
II. Rehabilitation
III. Prevention

9. I. Treatment: Multiple levels
• A. Village & sub-center Level Multipurpose Workers
(MPW) & Health Supervisors (HS), under the
supervision of Medical Officer (MO) to be trained for:
a. Management of psychiatric emergencies.
b. Administration & supervision of maintenance treatment
for chronic psychiatric disorders.
c. Diagnosis & management of grandmal epilepsy,
especially in children.
d. Liaison with local school teachers & parents
regardingmental retardation & behavioral problems in
children.
e. Counseling problems related to alcohol & drug abuse.

10. B. MO of primary Health Center (PHC) aided by
HS, to be trained for:
a. Supervision of MPW’s performance.
b. Elementary diagnosis.
c. Treatment of functional psychosis.
d. Treatment of uncomplicated cases of psychiatric
disorders associated with physical diseases.
e. Management of uncomplicated psychosocial
problems.
f. Epidemiological surveillance of mental morbidity.

11. C. District Hospital:
• It was recognized that there should be at least one
psychiatrist attached to every district hospital as
an integral part of the district health services.
• The district hospital should have 30-50 psychiatric
beds.
• The psychiatrist in a district hospital was
envisaged to devote only a part of his time to
clinical care & a greater part in training &
supervision of non-specialist health workers.

12. D. Mental hospitals & teaching psychiatric
units: Major activities of these higher centers
of psychiatric care include:
a. Help in care of ‘difficult’ cases.
b. Teaching.
c. Specialized facilities like, occupational
therapy units, psychotherapy, counseling &
behavioral therapy.

13. II. Rehabilitation
• The components of this sub-program include
treatment of epileptics & psychotics at the
community level & development of
rehabilitation centers at both the district level
& higher referral centers.

14. III. Prevention
• The prevention component is to be
community-based, with initial focus on
prevention & control of alcohol-related
problems.
• Later on, problems like addictions, juvenile
delinquency & acute adjustment problems like
suicidal attempts are to be addressed.

15. NATIONAL GUINEAWORMERADICATION
PROGRAMME

16. GUINEAWORM ERADICATION PROGRAMME
• India is the first country in the world to
establish the National Guinea Worm
Eradication Programme in 1983-84 as a
centrally sponsored scheme on 50-50 sharing
between Centre and States with the objective
of eradicating guinea worm disease from the
country.

17. GUINEAWORM ERADICATION PROGRAMME
• The National Institute of Communicable
Diseases (NICD), Delhi worked as the nodal
agency for planning, coordination, guidance
and evaluation of NGWEP in the country.

18. THE IMPORTANT STRATEGY ADOPTED TO
ERADICATE THE GW:
1.GW case detection and continuous surveillance
through active case search operations and
regular monthly reporting
2.GW case management
3.Vector Control by the application of Tempos in
unsafe water sources eight times a year and
use of fine nylon mesh/double layered cloth
strainers by the community to filter Cyclops in
all the affected villages

19. THE IMPORTANT STRATEGY ADOPTED TO
ERADICATE THE GW:
4.Health education
5.Trained manpower development and
6.Provision and maintenance of safe drinking
water supply on priority in GW endemic
villages
7.Concurrent evaluation and operational research

20. GUINEA WORMDISEASE FREE"
• "Zero" incidence has been maintained since
August 1996 through active surveillance and
intensified field monitoring in the endemic
areas.
• In the Meeting of WHO in February 2000 the
India has been certified for the elimination of
Guinea Worm Disease and on 15th February
2001 declared India as "Guinea Worm
Disease Free".

21. YAWS ERADICATIONPROGRAMME

22. YAWS ERADICATION PROGRAMME
• Yaws is a disfiguring and debilitating non-
venereal disease. It is a highly infectious
disease transmitted by direct (person-to-
person) contact. Skin shows early lesions,
which on healing show little scarring. Disease
can be progressive involving bone and
cartilage and causing disability.

23. Clinical Features
a) Primary/ early stage: Primary sore or as a
vesicle on the knee or near the mouth. The
scabs becomes macule and later a papilloma.
b) Secondary Stage: rashes resemble a raspberry
"framboesia" develop. They fall off without
pain.
c) Tertiary or later stage: gummatous lesion near
bones and joints.

24. Treatment
• Benzathine penicillin G is the drug of choice in
a dose of 1.2 million units for all cases and
contacts, and half that dose (0.6 million units)
for children under 10 years of age. In penicillin
sensitive cases, erythromycin or tetracycline is
used in recommended doses for a period of 15
days.

25. Yaws Eradication Programme
• The programme was started in 1996-97 in
Koraput districts of Orissa then extended to
endemic states as a centrally sponsored health
scheme with the objectives of:
1. Interrupting the transmission of yaws infection
(no case) in the country; and
2. Eradication of Yaws (i.e. no sero reactivity to
RPR/VDRL in children below 5 years of age)
from the country.

26. Programme Strategy
1.Manpower development
2.Detection of cases
3.Treatment of cases and contacts
4. IEC involving multi-sectors approach

27. NATIONAL PROGRAMME FOR
CONTROL AND TREATMENT OF
OCCUPATIONAL DISEASES

28. NATIONALPROGRAMME FOR CONTROL ANDTREATMENT
OF OCCUPATIONAL DISEASES
• Ministry of Health & Family Welfare, Govt. of
India has launched a scheme entitled "National
Programme for Control & Treatment of
Occupational Diseases" in 1998-99.
• The National Institute of Occupational
Health, Ahmedabad (ICMR) has been
identified as the nodal agency for the same.

29. Following research projects has been
proposed to initiate by the Government:
1. Prevention, control and treatment of silicosis
and silico-tuberculosis in Agate Industry.
2. Occupational health problems of tobacco
harvesters and their prevention.
3. Hazardous process and chemicals, database
generation, documentation, and information
dissemination

30. Following research projects has been
proposed to initiate by the Government:
4. Capacity building to promote research,
education, training at National Institute of
Occupational Disease.
5. Health Risk Assessment and development of
intervention programme in cottage industries
with high risk of silicosis.
6. Prevention and control of Occupational Health
Hazards among salt workers in the remote
desert areas of Gujarat and Western Rajasthan.

31. Nutritional programme

32. Programme
• Vitamin A prophylaxis
• Prophylaxis against nutritional anemia
• IDD control programme
• Special nutrition programme
• Balwadi nutrition programme
• ICDS programme
• Mid-day meal programme
• Mid-day meal scheme

33. Vitamin A prophylaxis
• National programme for Control of Blindness
is to administer a single massive dose of
vitamin A containing 2,00,000 IU orally to all
preschool children in the community every 6
month.
• Programme was launched by Ministry Of
Health and Family Welfare in 1970.

34. Prophylaxis against nutritional anemia
• Programme was launched by Govt. of India.
• Distribution of iron and folic acid tablets to
pregnant women and young children (1-12yrs).
• Control of anemia though iron fortification of
common salt.

35. IDD control programme
• The National Goiter Control Programme
launched by Govt. of India in 1962, in the
conventional goiter belt in the Himalayan
region.
• Objective is to identify goiter endemic areas
to supply iodized salt in place of common salt
and to assess impact of goiter control
measures over a period of time.

36. Special nutrition programme
• Programme started in 1970 for the nutritional
benefit of children below 6 years of age,
pregnant and nursing mothers.
• Aim is to improve the nutritional status of the
target groups.

37. Special nutrition programme
• The supplementary food supplies about
300kcal and 10-12 grams protein per child per
day.
• The beneficiary mothers receive daily 500 kcal
and 25 grams of protein.
• This supplement is provided to them for about
300 days in a year.

38. Balwadi nutrition programme
• The programme was started in 1970 for the
benefit of children in the age group 3-6 years in
rural areas.
• The programme is implemented through Balwadis
which also provide pre-primary education to these
children.
• Food supplements provide 300kcal and 10 grams
protein per child per day

39. ICDS programme
• Integrated child development services(ICDS)
programme was started in 1975
• Supplementary nutrition, vitamin A prophylaxis and
iron and folic acid distribution.
• Beneficiaries : pre school children below 6 years,
and adolescent girls 11 to18 years.

40. ICDS programme
• Anganwadi Workers at village level covers a
population of 1000.
• Mahila Mandals help anganwadi workers in
providing health and nutrition services.
• Anganwadis is supervised by Mukhyasevikas.
• Field supervision by Child Development
Project Officer (CDPO).

41. Mid-day meal programme
• MDMP also known as School Lunch
Programme.
• Operation since 1961.
• Objective; to attract more children for
admission to school and retain them so that
literacy improvement of children could be
brought about.

42. Principles of MDMP
• The meal should be a supplement and not a
substitute to the home diet.
• The meal should supply at least 1/3rd of total
energy requirement and half of the protein
need.
• The cost of the meal should be reasonably low.

43. Principles of MDMP
• The meal should be such that it can be
prepared easily in schools; no complicated
cooking process should be involved.
• Locally available foods should be used; this
will reduce the cost of the meal.
• The menu should be frequently changed to
avoid monotony.

44. MODEL MENU
Foodstuff g/day/child
Cereals and millets 75
Pulses 30
Oils and fats 8
Leafy vegetables 30
Non leafy vegetables 30

45. Mid-day meal scheme
• Also known as National Programmme of
Nutritional Support to Primary Education.
• Launched in 15TH August 1995 and revised in
2004.
• Objective: being universalization of primary
education by increasing enrolment, retention
and attendance and simultaneously impacting
on nutrition of students in primary classes.

46. Beneficiaries of mid-day meal scheme
• The programme covered children of primary
stage (classes I to V) in government, local
body and government aided schools and
extended in October 2002, to cover children
studying in Education Guarantee Scheme and
Alternative and Innovative Education Centres
also.

47. •NATIONAL WATER SUPPLY
AND SANITATION
PROGRAMMME

48. • The programme was initiated in 1954 with the
object of providing safe water supply and
adequate drainage facilities for the entire urban
and rural population of the country.
• In 1972 the Accelerated Rural Water Supply
Programme was started as a supplement to the
national water supply and sanitation
programme.

49. A PROBLEMVILLAGE
• One where no source of safe water is
available within a distance of 1.6km or
where water is available at a depth of
more than 15 metres or where water
source has excess salinity, iron, fluorides
and other toxic elements or water is
exposed to the risk of cholera..

50. • The Government of India launched the
International Drinking Water Supply and
Sanitation Decade Programme in 1981.
• 100% coverage for water, both rural and urban,
80% for urban sanitation and 25% for rural
sanitation.
• The stipulated norm of water supply is40liters of
safe drinking water per capita per day and at least
one hand pump/spot source for every 250persons.

51. Swajaldhara
• Launched on 25th December 2002.
• Community led participatory programme.
• Aims at, providing safe drinking water in rural
areas, with full ownership of the community,
building awareness among the village
community on the management of drinking water
projects, including better hygiene practices and
encouraging water conservation practices along
with rainwater harvesting.

52. components
• Swajaldhara I (First Dhara) is for a gram
panchayat or a group of panchayats ( block /
tehsil level).
• Swajaldhara II (Second Dhara) has district as
the project area.
• District water and sanitation mission sanctions
Swajaldhara I.

53. MINIMUMNEED’SPROGRAMME
• The Minimum Needs Program (MNP) was
introduced in the country in the first year of the
Fifth Five Year Plan (1974–78).
• The objective of the programme is to provide
certain basic minimum needs and thereby improve
the living standards of the people.
• It is the expression of the commitment of the
government for the “social and economic
development of the community particularly the
underprivileged and undeserved population.”

54. Basic principles
a. The facilities under MNP are to be first
provided to those areas which area present
underserved so as to remove disparities
between different areas.
b. The facilities under MNP should be provided
as a package to an area through intersectoral
area projects, to have a greater impact.

55. COMPONENT OF MINIMUMNEED’S PROGRAMME
•Rural health
•Rural water supply
•Rural electrification
•Elementary education
•Adult education
•Nutrition
•Environmental improvement of Urban
slums
•Houses for landless labourers

56. 1. Rural health
• The objectives to be achieved under MNPs:
• One PHC fro 30,000 population in plains and
20,000 population in tribal and hilly areas.
• One sub centre for a population of 5000
people in the plains and fro 3000 in tribal and
hilly areas.
• One CHC (rural hospital) for a population of
one lakh.

57. 2.Rural water supply
• Water supply and sanitation is a state
responsibility under the Indian Constitution.
• State may give the responsibility to the
Panchayathi Raj Institutions(PRIs) in rural
areas.
• In the urban areas responsibility is given to the
municipalities called Urban Local
Bodies(ULB)

58. Water supply

59. 3. Rural electrification
• A village is classified as electrified if
electricity is being used within its revenue area
fro any purpose what so ever.
• The basic infrastructure such as distribution
transformer and or distribution lines is made
available in the inhabited locality within the
revenue boundary of the village including at
least one Dalit Basti as applicable.

60. 4. Elementary education
• Elementary education is also called primary
education in India.
• Primary education starts at age of 5 and ends
when he or she is 12 to 13 years old. In India
primary education starts from Class 1 or grade 1
and goes up to Class 6/7 or Grade 6/7.
• Elementary education does not include Kinder
Garden and pre schooling. So in India elementary
education or primary school is from Class 1
through Class 7.

61. 5. Adult education
• According to Houle (1996) Adult education is
the process by which men and women seek to
improve themselves or their society by
increasing their skill, knowledge or
sensitiveness .
• According to Courtney(1989) Adult education
is an intervention into the ordinary business of
life-an intervention whose immediate goal is
change in knowledge or competence.

62. 6.Nutrition
( a) To expand nutrition support to 11 million
eligible persons.
( b) To expand “special nutrition programme” to
all the ICDS projects
( c) To consolidate the mid-day meal programme
and link it to health, portable water and
sanitation.

63. 7.Environmental improvement of Urban slums
• Slum Areas Improvement and Clearance Act
1956.
• An Act to provide for the improvement and
clearance of slum areas in certain Union
territories and for the protection of tenants in
such areas from eviction.

64. 8. Houses for landless labourers
• The government's approach to rural housing has
been based on four considerations:
(1) Highly subsidized housing should be provided
for the poor
(2) The poor should use their own labour to
construct their houses
(3) Low-cost houses should use local materials and
local skills
(4) The public, the co-operative and the household
sectors should be involved in housing activity.

65. 20 POINT PROGRAMME
• In 1975 the Govt. of India initiated a special
activity- 20 point programme.
• An agenda for national action to promote
social justice and economic growth.
• On August 20,1986,programme restructured.
• Described as “the cutting edge of the plan for
the poor.”

66. objectives
• “Eradication of poverty, raising
productivity, reducing inequalities,
removing social and economic
disparities and improving the quality
of life”

67. LIST of 20 points
• Point1:Attack on rural poverty
• Point2:Strategy for rained agriculture
• Point3:Beter use of irrigation water.
• Point4:Bigger harvest.
• Point5:Enforcement of land reforms.
• Point6:Special programmes for rural labour.
• Point 7: Clean drinking water

68. • Point 8: Health for all
• Point9: Two-child norm
• Point10: Expansion of education
• Point11:Justice for SC/ST.
• Point12:Equality for women
• Point13:New opportunities for women.
• Point14: Housing for the people

69. • Point15:Improvement of slums
• Point16.New strategy for forestry.
• Point17: Protection of the environment
• Point18:Concern for the consumer.
• Point19:Energy for the villagers.
• Point20:A responsive administration

70. POINTS RELATED TO HEALTH
• Points,1,7,8,9,10,14,15 & 17
are directly or indirectly related to health.

71. LIST OF 20 POINTS-2006
• Poverty Eradication
• Power to People
• Support to Farmers
• Labour Welfare
• Food Security

72. • Housing for All
• Clean Drinking Water
• Health for All
• Education for All
• Welfare of Scheduled Castes,
• Scheduled Tribes, Minorities and OBCs

73. • Women Welfare
• Child Welfare
• Youth Development
• Improvement of Slums
• Environment Protection and Afforestation

74. • Social Security
• Rural Roads
• Energisation of Rural Area
• Development of backward Areas
• IT Enabled e-Governance

75. ROLE OF NURSE’S
• Nurses must be aware about the national health
programmes, their strategy and
implementation.
• Nurse should participate actively in such
programme while working in community.
• Nurse must know government department and
their activities noting where and whom advice
can be obtained.

76. ROLE OF NURSE’S
• Nurse should study the various government
and other forms for reports that are required
weekly, monthly/ quarterly/ yearly from CH
department.
• Find out and discuss about different social
activities and self help project in the
community, their value and effect upon the
community.

77. ROLE OF NURSE’S
• In addition the responsibility includes: Case
finding, case Holding, Follow up, referrals,
records and education.
• This role or approach in community can be
implemented by suing nursing process. Nurse
must be active participant in each and every
national health programme. As he/she is the
key person for health team he/she needs to be
alert, attentive and supporter.