a brief descriptions and information regarding major health problemsin India.This content will help to the B.sc Nursing 4 th year students as per syllabus in community health nursing

1. Wel come

3. The government of India has been making efforts
through a galaxy of programs and initiatives over
the years to improve the health situation of the
Nation. The first National Health Policy was
drafted in 1983, followed by one in 2003 and
subsequently in 2015.

5. COMMUNICABLE DISEASES
NON-COMMUNICABLE DISEASES
NUTRITIONAL PROBLEMS
ENVIRONMENTAL SANITATION
POPULATION PROBLEMS
MEDICAL CARE PROBLEMS

8. 21.98 per cent population lives in high transmission
(> 1 case /1000 population ) of malaria areas
67 per cent in low transmission (0-1 case /1000
population) of malaria areas .

9. The incidence of malaria cases
between 1.3 and 1.6 million per year for
the past five years (2007 to 2011).
In 2013-2014, there were 0.8 million
reported cases and 379 deaths occurred
due to malaria in our country

10. AREAS MALARIA CASES
RURAL 50%
URBAN 80%

11. • Role of geospatial technology in identifying natural habitat of malaria
vectors in South Andaman, India.
• Shankar S , Agrawal DK; Narshimulu.
• OBJECTIVES:
• The present investigation appraises the role of geospatial
technologies in identifying the natural habitat of malaria
vectors.
• RESULTS
• the study result shows that in identification of the potential
natural habitat map of malaria vector surrounding the areas
of Tushnabad,
• CONCLUSION
• The study concluded that application of geospatial
technologies plays an important role in identifying the
natural habitat of malaria vector.

13. •India is the highest TB burden country in the
world .
•Number of incident cases that occur each
year .
•2.1 million new cases annually and 0.64
million cases new smear positive of which
0.32 million cases died due to TB.

14. BURDEN OF TB IN INDIA ( 2015)
ESTIMATED CASES OF
TB
RATE
INCIDENCE
176 (PER 100,000
POPULATIOON )
PREVALENCE 28 LAKHS /YEAR
MORTALITY 2.7 LAKHS /YEAR

15. • ABSTRACT
• Risk Factors for DOTS Treatment Default Among New HIV-TB
Co -infected Patients in Nalgonda ,Telangana (State): A Case
Control Study.
• Reddy Satti , Kondagunta N
AIM AND OBJECTIVES:
• To assess the influence of patient related factors for DOTS Treatment
Default among HIV-TB Co-infected cases.
RESULTS:
• The mean age was 36.5 ± 9 years; the majority (23.3%) of patients
defaulted during the second month of treatment. Significant risk
factors associated with defaulting included unskilled occupation
CONCLUSION:
• The study concluded that outcome of anti-tuberculosis treatment
(ATT), and the factors associated which will help in planning and
interventions to improve adherence to DOTS treatment.

17. •The second most common cause of death in Indian
population.
•Diarrheal disease is responsible for one in every ten
child deaths during the first five years of life.
•In India 8 per cent of deaths in under-5 years of
age group .
•In 2013 about 10.7 million cases with 1535 deaths
were reported in India .

18. ABSTRACT
• Prevalence, risk factors and treatment practices
in diarrhoeal diseases in south India.
Joseph N, Hariharan j ,Joseph N,
OBJECTIVES:
• This study was done to determine the risk factors, management
practices and awareness about diarrhoea.
RESULTS
• One hundred and sixteen (69.5 %) participants were not aware
of any sign or symptom of dehydration other than loose stools.
Majority of the participants 138 (82.6 %) preferred home
remedies as the initial management of diarrhoea
CONCLUSION:
• Public education program on proper feeding and management
practices is required to address the various issues identified
and for containment of diarrhoea cases in future.

20. In India, in 2013 ,31.7 million cases
of ARI were reported.
During 2013 about 3,278 people died and
4 lakh deaths occured annually due to
pneumonia.
There are some 2,597 deaths due to
pneumonia among children 1- 59
months.

21. ABSTRACT :
Acute lower respiratory infections due to respiratory syncytial virus in
young children: a systematic review and meta-analysis.
S chandran ,Campbell H.
AIM:
To estimate the incidence and mortality from episodes of acute lower
respiratory infection (ALRI) due to RSV ( respiratory syncytial
virus) in children younger than 5 years in 2005.
RESULTS
• An estimated 33.8 (95% CI 19.3-46.2) million new episodes of RSV-associated
ALRI occurred worldwide in children younger than 5 years (22% of ALRI
episodes), with at least 3.4 (2.8-4.3) million episodes representing severe RSV-
associated ALRI necessitating hospital admission.
CONCLUSION
• Mortality data suggested that RSV is an important cause of death
in childhood from ALRI, after pneumococcal pneumonia and
Haemophilus influenzae type b.

23. BURDEN OF LEPROSY IN INDIA
( 2013-14)
ESTIMATED CASES RATE (%)
PREVALENCE 0.68 PER 10,000 POULATION
INCIDENCE
1.27 LAKH CASES PER YEAR
NUMBER OF MULTIBACILLARY
LEPROSY
51.48 %
NUMBER OF NEW FEMALE CASES 36.91%
NUMBER OF NEW CASES AMONG
CHILDREN
9.49%
NUMBER OF NEW CASES WITH
GRADE -2 DISABILITIES
4.14%

24. Community-based needs assessment of leprosy
patients in, Karnataka, India.
• Gautham MS, Dayananda M, Gopinath D,
OBJECTIVES:
• To assess the medical, disability prevention and
rehabilitation and psychosocial needs of leprosy patients.
RESULTS:
• 259 registered leprosy-affected people were studied. 26% of
subjects had presented by voluntary reporting. The mean
detection delay was 8.25 months 66.8% of the study subjects
had received regular treatment.
CONCLUSION
• There is a need to reorient health care staff regarding leprosy
management and It is recommended that the district heath system
should conceptualize and implement an evidence-based field level
disability care and prevention programme with community-based
rehabilitation approach.

26. An estimated 600 million people
are at risk of infection in 250
Endemic districts across 20 States
and Union Territories of India.
Morbidity survey of filaria cases
in the states /UTs revealed 8 lakh
cases of lymphoedema and 4 lakh
cases of hydrocele.

27. • Experiences of a Community-Based Lymphedema
Management Program for Lymphatic Filariasis in Odisha
State, India
• Little K, Prakash A, Fox LM.
RESULTS:
• Globally 68 million people are infected with
lymphatic filariasis (LF), 17 million of whom have lymphedema.
This study explores the effects of a lymphedema management
program in Odisha State, India on morbidity and psychosocial
effects associated with lymphedema.
CONCLUSION
• There is a continued need for gender-specific psychosocial support
groups to address issues particular to men and women as well as a
continued need for improved economic opportunities for LF-
affected patients. There is an urgent need to scale up LF-related
morbidity management programs to reduce the suffering of people
affected by LF.

29. India has the third highest number of
people living with HIV in the world with 2.1
million infected cases.
HIV prevalence is estimated at 88.2 per
cent for the year 2012
0.32 % among males and 0.22 % in
females.
.

30. 0.35
0.99
2.59 2.67
4.43
7.14
8.82
0
1
2
3
4
5
6
7
8
9
10
HIV PREVALENCE FOR DIFFERENT RISK GROUPS
HIV PREVALENCE FOR
DIFFERENT RISK GROUPS

31. • High HIV burden among people who inject drugs in 15 Indian
cities.
• Srikrishnan AK, Agrawal A, Iqbal
BACKGROUND:
• Injecting drug use has historically been the principal driver of the HIV
epidemic in the northeast states of India. However, recent data indicate
growing numbers of people who inject drugs (PWIDs) in north and
central Indian cities.
RESULTS
• Participants reported high rates of needle/syringe sharing.
The median estimated HIV prevalence and incidence were
18.1% and 2.9 per 100 Personsrespectively.
CONCLUSIONS:
• The burden of HIV infection is high among PWIDs in India, and may
be increasing in cities where injecting drug use is emerging. Women
who inject drugs were at substantially higher risk for HIV than men - a
situation that may be mediated by dual injection-related and sexual
risks.

34. India has the highest number of diabetic cases in
the world. Over 77 million people in India have pre-
diabetes and an estimated 50 million have diabetics
The International Diabetes Federation estimates that
there are about 40 million diabetics in the country.
India has a high prevalence of diabetes mellitus and
the numbers are expected to increase from 50.8
million in 2010 to 87.0 million by 2030.

35. .
• A review of the epidemiology of diabetes in rural India
Misra A, Anand K.
OBJECTIVE:
• To describe the extent of problem of diabetes in rural India based
on review of available literature and examine the secular trends
over a period of 15 years i.e. from 1994 to 2009.
RESULTS
• The rate of increase was high in males (3.33 per 1000 per
year) as compared to females (0.88 per 1000 per year).
CONCLUSION:
• The prevalence of diabetes is rising in rural India. There is
a large pool of subjects with high risk of conversion to
overt diabetes. Population-level and individual-level
measures are needed to combat this increasing burden
of diabetes.

37. India reports about one million new
cases of cancer for every year.
Eight million cancer-related deaths in
2012 nearly 700,000 were in India.
Cancer is the second most common
disease in India responsible for
maximum mortality with about 0.3
million deaths per year

38. INCIDENCE OF CANCER CASES
The estimated incidence cases of
cancer in the country from
1,086,783 in 2013 to 11,17,269 in
2014.

39. INDIA MALE FEMALE TOTAL
NUMBER OF NEW
CANCER CASES
( THOUSANDS )
477.5 537.5 1014.9
NUMBER OF
CANCER DEATHS
( THOUSANDS )
356.7 326.1 682.8
ESTIMATED CANCER CASES STATISTIC IN INDIA

40. • Family caregivers' burden: A hospital based study in
2010 among cancer patients from Delhi.
• Chabra P, Bhatia MS.
• AIMS:
• To assess burden and to determine the predictors
of burden on family caregivers of cancer patients.
• RESULTS:
• The study population consisted of 90 (45%)
males and 110 (55%) female caregivers aged 18-
65 years. 113 (56.5%) caregivers reported mild to
moderate burden.
• CONCLUSION:
• All levels of health-staff in cancer hospitals in
developing countries should be sensitized to the
various burdens faced by family caregivers.

42. The 30 million HEART patients in the India .
URBAN
AREAS
16 MILLION
RURAL
AREAS
14 MILLION

43. Prevalence of heart failure in India due to coronary
heart disease, hypertension, obesity, diabetes and
rheumatic heart disease ranges from anywhere between
1.3 to 4.6 million.
The prevalence of CVD is reported to be 2-3 times
higher in the urban population as compared to the rural
population.

44. PREVALENCE
DISEASES URBAN RURAL
CORONARY
HEART DISEASE
64.37% 25.27%
ISCHAEMIC
HEART DISEASE
96.7% 27.1%
RHEUMATIC
HEART DISEASE
37.5% 25%

45. .
• Premature coronary artery disease in North India:an
angiography study of patients
• Tewari S1, Kapoor A, Singh U, Agarwal A,
AIM
To find out the differences in clinical-biochemical and angiographic profile of
young patients versus older patients with angiographically proven
atherosclerotic coronary artery disease.
RESULTS:
• Group I consisted of patients with above 55 years .Group II consisted of
patients between 41-55 years and Group III consisted of patients with < 40
years. The myocardial infarction was more frequently present in groups II and
III.
CONCLUSION:
• Significant differences were observed in the clinical, biochemical
and angiographic profile of young patients with coronary artery
disease as compared to elderly patients.

47. The 37 million blind people globally, about 15
million are in India
Cataract is the most common cause of
preventable blindness in India.
About 35,000 corneas are collected annually
nationwide, the annual demand is over 150,000

48. • Population-Based Assessment of Unilateral Visual Impairment in the
South Indian State of Andhra Pradesh: Rapid Assessment of Visual
Impairment (RAVI) Project.
• Shekhar K, Khanna RC, Rao GN
AIM:
• To assess the prevalence and causes of unilateral visual
impairment (VI) in the South Indian state of Andhra Pradesh.
RESULTS:
• In total, 7378 individuals (94.6%) were examined. After
excluding 918 individuals with VI in the better eye, data were
analyzed for the remaining 6460 individuals.
CONCLUSIONS:
• Unilateral VI is common in the South Indian state of Andhra
Pradesh. As most of this VI can be addressed with interventions
such as cataract surgery and spectacles, service models need to be
streamlined to address this need.

49. NUTRITIONAL PROBLEMS

51. •Vitamin D deficiency is the most under-
diagnosed and under-treated deficiency
in the world.
•Nearly 60-80% Indian population is
deficient in Vitamin D.
•Prevalence of Vitamin A Deficiency 40-
45% among Preschool Children in Rural
Areas.

52. • Vitamin-D Deficiency Is Associated with Gallbladder
Stasis Among Pregnant Women
• Dutta U, Aggarwal N,
AIM:
• Vitamin-D deficiency (VDD) is associated with GB stasis,
which improves on supplementation.
RESULTS
Median serum vitamin-D in 304 women was 7.9 ng ml(-1)
(IQR 5.7, 12). VDD afflicted 92 % of them. Women with VDD more
often had GB stasis (20 % vs 0 %; p = 0.015) and had lower GBEF
[53.7 ± 17 % vs 59 ± 10 %; p = 0.026] compared to those with normal
vitamin-D.
CONCLUSION:
• Vitamin D deficiency is highly prevalent among pregnant Indian
women. It is associated with GB stasis The risk factors are responsible
for VDD were reduced sun exposure, inadequate dietary intake and
urban lifestyle.

54. Calcium deficiency and calcium
deficiency-induced osteoporosis
among elderly. one of the most
common causes of bone diseases and
deformities.
Twenty per cent girls in the age-
group of 14-17 years in India suffer
from calcium deficiency.

55. calcium deficiency in development of nutritional rickets in
Indian children: a case control study.
Aggarwal V, Sharma B, Singh S
• OBJECTIVE:
• The aim was to study the role of calcium and vitamin
D deficiency in causation of nutritional rickets in young
Indian children
• RESULTS:
• Mean intake of calcium and proportion of calcium from
dairy sources were significantly lower in cases vs. controls.
• CONCLUSION:
• Rickets develops when low dietary calcium intake coexists
with a low or borderline vitamin D nutrition status.

57. According to NFHS 22% recorded
were LBW
On average, 28% children's are
born with LBW in india.
LBW in urban areas 19% and
rural areas 23%

58. • Morbidity status of low birth weight babies in rural areas of
Assam: A prospective longitudinal study.
• Borah M1, Franklin k.
AIM:
• This study was carried out in rural areas of Assam to assess the
morbidity pattern of LBW babies during their first 6 months of
life and to compare them with normal birth weight (NBW)
counterparts.
RESULTS:
• More than two thirds of LBW babies (77%) were suffering from
moderate or severe under-nutrition during the follow up.
CONCLUSION:
• The study revealed that during the follow up, incidence of
morbidities were higher among the LBW babies compared to
NBW babies. It was also observed that ARI was the
predominant morbidity in the LBW infants during first 6
months of age.

60. •80% of Indian children have mild –
moderate PEM.
•Incidence of PEM in pre-school age
children is 1-2%.
•Prevalence of underweight children
increased from 11.9% to 37.5%.

61. • Community-based management of severe
acute malnutrition in India: new evidence from Bihar.
Kumari K1, Mathew P1, Mishra KN1.
OBJECTIVE:
• In this report, we describe the characteristics and outcomes of
8274 children treated between February 2009 and September
2011.
RESULTS:
• 4401 children admitted under the new criteria, 36 children
(0.8%) died, 2526 children (57.4%) were discharged as cured,
and 1591 children (36.2%) defaulted.
CONCLUSION:
India has achieved low mortality and high cure rates in non
defaulting children. The new admission criteria lower the
threshold for severity with the result that more children are
included who are at lower risk of death

62. NUTRITIONAL

63. The prevalence of nutritional anemia in India is
relatively higher than that of other developing
countries, affecting nearly 50% of the population.
About 55% adolescent girls are suffering with
anemia in India
The prevalence of anaemia is 65-75%.

64. Anemia in severe acute malnutrition.
• Thakur N1, Chandra J2, Singh V
OBJECTIVES:
• The aim of the present study was to determine the prevalence
and type of anemia and to evaluate the possible etiologies for
severe anemia, in these children.
• RESULTS:
• Included in the study were 131 cases of SAM. The age group varied
between 6 and to 59 mo. Of patients with SAM, 67.3% had severe
anemia; 13.8% had moderate anemia.
• CONCLUSION:
• A high incidence of severe anemia in SAM with a large proportion
(25%) requiring blood transfusion is a pointer toward nutritional
anemia being a very common co morbidity of SAM requiring hospital
admission. anemia closely followed microcytic anemia,
supplementation with vitamin B12 in addition to iron and folic acid
would be recommended.

65. IODINE DEFICIENCY DISORDERS

66. Iodine Deficiency Disorders of the 321
districts across all the states and Union
Territories of India.
260 are endemic with IDD and the prevalence
is more than 10%.
An estimated 71 million people are reported to
be suffering from IDD.

67. • Status of iodine deficiency disorder in Uttarakhand
state, India.
Pandey RM, Jain V,
OBJECTIVE:
• To assess the status of iodine deficiency among school
children (6-12 years).
RESULTS:
• The Total Goiter Rate (TGR) was found to be 13.2%. The
proportion of children with Urinary Iodine Excretion level
<20, 20-49, 50-99, 100-199 and ≥200 μg/l was found to be
nil, 38.5 percent, respectively.
CONCLUSION:
• The study population had mild degree of public health
problem of iodine deficiency.

69. Fluorosis is an important public health
problem in 24 countries, including India.
Fifteen states in India are endemic for
fluorosis
 62 million people in India suffer from
dental, skeletal and non-skeletal fluorosis
including six million children below the
age of 14 years.

70. Fluoride Content of Bottled Drinking Water in Chennai,
Tamilnadu.
Somasundaram S, Ravi K,
AIM:
The aim of this study is to determine the fluoride concentration in
top 10 bottled waters in Chennai and to check the accuracy of their
labelling.
RESULTS:
• the study had less than optimal fluoride content and there is a
significant variation in fluoride concentration of each brand
and among different batches of same brand bottled waters. The
range of fluoride level in tested samples was between 0.27 to
0.59. Only one brand's label had information regarding the
fluoride content.
CONCLUSION:
• Standardization of fluoride levels in bottled waters and
labelling of fluoride content should become mandator.

71. Population problems

72. •India is the second populest country in the world.
•Over population has its share of ill-effects including
 Rising unemployment,
 Inappropriate utilization of available manpower,
 Inadequate infrastructure
 Resource scarcity,
 Drop in production
 Rising costs .

73. ENVIRONMENTAL SANITATION

74. Increased urbanization & industrialization leads to hazards to
human health , air, water, & food chain.
400 million people defecate in open and 44% mothers dispose
their children’s faeces in open.
India accounts for 60% of global and 50% of its own population
open defecation.
About 48% children in India suffer from some degree of
malnutrition.
There is an increased female school dropout rate in the
adolescent age due to lack of toilet facilities.
Only 25% have drinking water on their premise. Sixty seven per
cent Indian households do not treat drinking water though it
may be chemically and bacterially contaminated.

75. • Water and sanitation hygiene knowledge, attitude, and practices among
household members living in rural setting of India.
• Prasad S, Joshi A.
OBJECTVES
• To objectively highlight these issues, we studied the knowledge,
attitude, and practices-related to drinking water and sanitation
facilities among the rural population of Chennai, India.
RESULTS:
• Forty-five percent of the participants were not following any
methods of water treatment and among them half of the
participants felt that water available to them was clean and did
not require any additional treatment. Twenty-five percent of the
participants surveyed did not have access to toilets inside their
household.
CONCLUSION:
• There is a need for intervention to educate individuals about
drinking water treatment methods, sanitation, and hand washing
practices.

76. MEDICAL CARE PROBLEMS

77. Lack of infrastructure for setting up of primary health care facilities
Many slums are not having even a single primary health care facility.
Lack of community level organizations/slum level organizations and
lack of adequate support to them.
Inequitable distribution of health facilities.
Lack of a fully functional and well defined public outreach system .
Low levels of financing
Declining support for various healthcare demands of the people

78. ABOUT W.H.O IN INDIA

79. •World Health Organization (WHO) is the United
Nations’ specialized agency for Health.
•The World Health Organization is responsible for
providing leadership on global health matters,
shaping the health research agenda, setting norms
and standards, providing technical support to
countries and monitoring and assessing health
trends.

80. The WHO Country Cooperation
Strategy – India (2012-2017) has
been jointly developed by the
Ministry of Health and Family
Welfare of the Government of India.

81. COUNTRY COOPERATION STRATEGY (CCS) 2012-2017
the CCS has identified three strategic priorities and the focus
areas under each priority.
PRIORITY 1
SUPPORTING AN IMPROVED ROLE OF THE GOVERNMENT OF
INDIA IN GLOBAL HEALTH.
PRIORITY 2
PROMOTING ACCESS TO AND UTILIZATION OF AFFORDABLE,
EFFICIENTLY NETWORKE AND SUSTAINABLE QUALITY
SERVICES BY THE ENTIRE POPULATION
PRIORITY 3
HELPING TO CONFRONT THE NEW EPIDEMIOLOGICAL
REALITY OF INDIA

82. ROLE OF A NURSE
• The nurse designs health education contents
according to the health needs & problems,
according to the beneficiary & according to the
context.
• The nurse undertakes necessary precautionary
measures, primordial prevention strategies,
specific preventive measures to promote the
health of the community.

83. •Devise necessary surveillance
measures, control measures, control
measures to check the disease load in
the community.
•Involve mass media & relevant other
personnel in preventing preventable
diseases.

84. PROMOTE FOOD SUPPLY
&
NUTRITION.

85. PROVISION OF SAFE WATER
&
SANITATION.

86. PREVENTION & CONTROL
OF
LOCALLY ENDEMIC DISEASES

87. Thank you