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I've extracted all 12 pages. Here's a full, clear explanation of the document:
PSM Health Programmes of India - Complete Explanation
This is a study notes document for Preventive & Social Medicine (PSM), covering major National Health Programmes of India. It has 12 pages covering 9 key programmes. Here's a breakdown of each:
1. National Vector Borne Disease Control Programme (NVBDCP) - Page 2
This programme controls diseases spread by mosquitoes, ticks, and other vectors.
Historical evolution:
- 1953 - National Malaria Control Program started
- 1958 - Shifted to eradication goal
- 1977 - Modified Plan of Operations
- 1997 - Enhanced Malaria Control Project (focused on tribal areas with high burden)
- 1998 - Roll Back Malaria (WHO-funded)
- 2004 - NVBDCP formed, combining all vector-borne disease control
Key indicators:
- API (Annual Parasite Incidence) - < 1 case/1000 population is the target
- ABER (Annual Blood Examination Rate) - should be > 10%
- API > 2 = high burden area
Goals: Eliminate Kala Azar and Lymphatic Filariasis; Control dengue mortality
Strategies:
- Disease Management - Early diagnosis & treatment, referral strengthening
- Integrated Vector Management (IVM):
- Anti-larval measures: larvivorous fish (Gambusia, Lebistes), chemicals (Paris Green, Temephos/Abate), Bacillus thuringiensis
- Anti-adult measures
- Personal protection
- Supportive: BCC (Behavioural Change Communication), intersectoral convergence, public-private partnerships
2. National AIDS Control Programme (NACP) - Page 3
Background: Started 1992; now in Phase VI (2021-2026) - "Targeted and Sustainable Response"
Implemented by: NACO (National AIDS Control Organisation) under Ministry of Health & Family Welfare
NACP VI Goals (95-95-95 targets):
- 95% of PLHIV know their HIV status
- 95% of those who know their status are on ART
- 95% on treatment have viral suppression
- Reduce new infections to < 2% (general) and < 10% (key populations)
- < 10% experience stigma or gender-based inequity
Treatment:
- Free ART through government facilities
- First-line regimen: TLD (Tenofovir + Lamivudine + Dolutegravir)
- Care & Support Centres (CSCs), Link ART Centres, Counselling services
Prevention: HIV testing services, PPTCT (Prevention of Parent-to-Child Transmission), Targeted Interventions (for FSW, MSM, PWID, Transgender persons, Migrants), Condom promotion, IEC
Organisational structure: NACO → SACS (State) → DAPCU (District) → ICTC/ART/CSC centres
3. National Tuberculosis Elimination Programme (NTEP) - Pages 4 & 5
Goal: End TB by 2025 (Elimination Strategy)
- Reduce mortality by 90% and incidence by 80%
National Strategic Plan (2017-2025): Detect - Treat - Prevent - Build
Case Detection types:
- Active (community screening in high-risk groups)
- Intensified (screening in clinics for diabetics, PLHIV, COVID, malignancies)
- Passive (clinic-based reporting)
Drug Resistance Classification:
| Type | Definition |
|---|---|
| Mono-Resistant | Resistant to 1 drug |
| Multi Drug Resistant (MDR) | Resistant to both Rifampicin + Isoniazid |
| Pre-XDR | MDR + any fluoroquinolone |
| XDR (Extensively Drug Resistant) | MDR + fluoroquinolone + Group A drug |
Key Drug Groups:
- Group A: Levofloxacin/Moxifloxacin, Bedaquiline, Linezolid
- Group B: Clofazimine, Cycloserine
- Group C: Ethambutol, Delamanid, Pyrazinamide, others
Treatment Monitoring: CBC, LFT (for Pyrazinamide/Isoniazid hepatotoxicity), Renal function, TSH (Ethionamide causes hypothyroidism), ECG (Bedaquiline)
4. National Leprosy Eradication Programme (NLEP) - Page 6
Tagline: "Leprosy can be cured - Early detection + Complete treatment + Zero disability"
Objectives:
- Prevalence rate < 1 case/10,000 population
- Annual new case detection rate < 10 cases/lakh population
- Grade II disability < 1% among new cases
- Zero disabilities among new child cases
Awareness: SPARSH initiative with mascot "Sapna" (a cured leprosy case, village school girl)
Prophylaxis: Single dose Rifampicin given to close contacts
- Age-based dosing: ≥15 years = 600 mg; 10-14 years = 450 mg; 5-9 years = 300 mg; < 5 years (> 20 kg) = 10-15 mg/kg
Treatment (MDT Regimen):
- Paucibacillary (PB): Rifampicin + Dapsone for 6 months
- Multibacillary (MB): Rifampicin + Dapsone + Clofazimine for 12 months
ASBULS: ASHA-Based Surveillance of Leprosy - door-to-door; incentive ₹250 (case without disability) / ₹200 (with disability)
5. National Mental Health Programme (NMHP) - Page 7
Launched: 1982 under Ministry of Health & Family Welfare
Vision: Accessible, affordable, quality mental health care for all
Mental morbidity in India: 18-20 per 1000 population
Major mental illnesses: Psychosis, Endogenous depression, Mania, Schizophrenia
Objectives: Make mental health care available to all, promote community participation, increase mental health professionals, integrate mental health into general health care
IQ Classification (Wechsler's Scale):
- 50-70: Mild retardation
- 35-49: Moderate retardation
Key component: District Mental Health Programme (DMHP) - integration at district level through health centres and medical colleges
Barriers to Mental Health Care: Stigma, lack of awareness, shortage of professionals, financial constraints, cultural myths
6. Reproductive, Maternal, Neonatal, Child & Adolescent Health (RMNCH+A) - Pages 8 & 9
India's MMR: 97 per 100,000 live births (SRS 2018-20), declining from 130 in 2014-16
SDG Target: Global MMR < 70 per 100,000 live births by 2030
Major causes of maternal death: Haemorrhage, Hypertensive disorders, Sepsis, Abortion complications, Obstructed labour
High burden states: UP, Bihar, MP, Rajasthan, Chhattisgarh, Assam
Key Schemes:
- JSY (Janani Suraksha Yojana) - Cash assistance for institutional delivery
- JSSK (Janani Shishu Suraksha Karyakram) - Free delivery, drugs, diagnostics, transport
- PMSMA (Pradhan Mantri Suraksha Matritva Abhiyan) - Free ANC check-up on 9th of every month
- LaQshya - Labour Room Quality Improvement Initiative
First Referral Units (FRU): Must have blood storage, C-section facility, newborn care; minimum 20-30 beds
Maternal Mortality Types (WHO):
- Direct Obstetric Death - from obstetric complications
- Indirect Obstetric Death - from pre-existing disease aggravated by pregnancy
- Incidental Death - accidental cause (e.g., road accident)
- Late Maternal Death - death 42 days to 1 year after pregnancy termination
7. National Programme for Prevention & Control of NCDs (NP-NCDs) - Page 10
Earlier name: NPCDCS (2010) - covering Cancer, Diabetes, CVD, Stroke; now expanded to NP-NCDs under NHM (now PM-Samagra Swasthya Mission)
Best level of NCD prevention: Primordial prevention
WHO Global Action Plan targets (by 2025):
- 30% reduction in tobacco use
- 25% reduction in raised blood pressure
- 10% reduction in physical inactivity
- 30% reduction in salt/sodium intake
- No increase in diabetes/obesity
MPOWER (Tobacco Control):
- Monitor tobacco use
- Protect people from tobacco smoke
- Offer cessation help
- Warn about dangers
- Enforce advertising bans
- Raise taxes on tobacco
Newer diseases added to NP-NCDs: COPD, CKD, Non-alcoholic fatty liver, Non-ST elevation MI, RHD
STEPS Approach (WHO): Questionnaire (sociodemographic) → Physical measurements (anthropometry) → Biochemical (lab investigations)
8. National Polio Eradication Programme (NPEP) / Polio Endgame Strategy - Page 11
Launched: 1995 | India declared Polio-free: 27 March 2014
Polio Endgame Strategy (2019-2026):
- Goal 1: Permanently interrupt Wild Poliovirus (WPV) transmission (endemic countries: Afghanistan & Pakistan)
- Goal 2: Stop Circulating Vaccine-Derived Poliovirus (cVDPV)
- Goal 3: Certification of eradication
Vaccine Switch:
- Before 2016: tOPV (Trivalent OPV)
- 2016: Switched to bOPV (Bivalent OPV) - because Type 2 WPV was eradicated
- Future: Replace bOPV with IPV entirely
IPV (Inactivated Polio Vaccine): Prevents VAPP (Vaccine-Associated Paralytic Polio) and cVDPV
AFP Surveillance (Acute Flaccid Paralysis):
- Target: Children < 15 years
- AFP Reporting Rate target: > 1 case/100,000 children/year
- Stool adequacy rate: > 80%
- 2 stool samples, 24 hours apart, within 14 days of paralysis onset
- Follow-up at 60 days
Mop-Up Strategy: Door-to-door vaccination in 2-3 rounds, 4-6 weeks apart, in areas with limited transmission
9. Child & Adolescent Health Initiatives - Page 12
Key Programmes:
- NSSK (Navjat Shishu Suraksha Karyakram) - 2 days training to healthcare workers on newborn care & resuscitation
- RBSK (Rashtriya Bal Swasthya Karyakram) - Screening for 4Ds in 0-18 years: Diseases, Defects, Deficiencies, Developmental delays. 32 conditions screened
- HBNC (Home-Based Newborn Care) - Provided by ASHA workers
- IMNCI - Integrated Management of Neonatal & Childhood illnesses
- ICDS - Integrated Child Development Services
Menstrual Hygiene Scheme (MHS):
- Target: Adolescent girls (10-19 years) in rural areas
- Sanitary pads at subsidized rate: ₹6 for pack of 6
- ASHA workers distribute and receive ₹1 incentive per pack sold
AFHC / ARSH (Adolescent Friendly Health Clinics):
- Weekly Iron Folic Acid Supplementation: 60 mg iron + 500 mcg folic acid
- RTI/STI services, menstrual hygiene promotion
Summary Table
| Programme | Key Target/Goal |
|---|---|
| NVBDCP | Control malaria, dengue, filariasis, kala-azar |
| NACP (Phase VI) | 95-95-95 HIV targets; end AIDS by 2030 |
| NTEP | Eliminate TB by 2025 |
| NLEP | < 1 case/10,000 population |
| NMHP | Accessible mental health care for all |
| RMNCH+A | MMR < 70/100,000 (SDG by 2030) |
| NP-NCDs | Reduce premature NCD mortality |
| NPEP | Maintain polio-free status; endgame strategy |
| Child/Adolescent Health | Screen 4Ds in 0-18 years; ASHA-based delivery |
This document is clearly intended for MBBS/MD exam preparation in PSM, with quick-reference charts, abbreviations, and high-yield facts formatted for efficient revision.
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