National Health Programs

Dr Narendra K Chaudhary
MD Ped, FNB (Ped Hem Onc)
Associate Professor,
Department of Pediatrics
AIIMS Bhopal
National Health Programmes
brief overview
Year Program Remarks
1978 Expanded Program of Immunisation
1985 Universal Immunisation Program 6 diseases (TB, Polio, Diphtheria, Pertussis, Tetanus,
Measles)
1992 Child Survival and Safe Motherhood Child survival (immunization, control of diarrheal diseases,
(CSSM) respiratory infections, vitamin A supplementation, essential
NB care) and
Maternal health ( antenatal care, deliveries in institution,
emergency obstetrics care)
1997 Reproductive and Child Health Program = CSSM + Family Planning
(RCH)
2005 RCH phase II
2013 RMNCH+A Strategy
2014 Mission Indradhanush UIP + Hepatitis B
RMNCH+A
• Reproductive, Maternal, Newborn, Child and Adolescent Health
• Under NHM;
• Ministry: MoH & FW
• Year: 2013
• Rationale: Health of Adolescent girl impacts pregnancy, health of
pregnant women impacts health of NB/child.
• Adolescent
• Pregnancy and Childbirth
• Newborn and Childcare
• Through the reproductive years
ICDS Scheme
• Integrated Child development Services Scheme
• Launched: 2nd October 1975
• Ministry: Ministry of Women and Child development (GOI)
• Beneficiaries: Children (0-6 years), pregnant women and lactating
mothers.
THE ICDS TEAM:
• Anganwadi Workers, Anganwadi Helpers, Supervisors,
• Auxiliary Nurse Midwife (ANM),
• Accredited Social Health Activist (ASHA)
• Child Development Project Officers (CDPOs) and
• District Program Officers (DPOs).
Objectives of the Scheme are:
• to improve nutritional and health status of children (0-6 years);
• to lay foundation for proper psychological, physical and social
development of the child;
• to reduce the incidence of mortality, morbidity, malnutrition and
school dropout;
• to achieve effective co-ordination of policy and implementation
amongst the various departments to promote child development; and
• to enhance the capability of the mother to look after the normal health
and nutritional needs of the child through proper nutrition and health
education.
Services under ICDS
• The ICDS Scheme offers a package of six services, viz.
• Supplementary Nutrition
• Pre-school non-formal education
• Nutrition & health education
• Immunization
• Health check-up and
• Referral services
• Last three under MoH&FW
The delivery of services to Services Target Group Service provided by
the beneficiaries is as  Children below 6 years,
follows: Anganwadi Worker and
(i) Supplementary Nutrition Pregnant & Lactating Mothers
Anganwadi Helper [MWCD]
(P&LM)

Children below 6 years,

Pregnant & Lactating Mothers ANM/MO
(ii) Immunization*
(P&LM) [Health system, MHFW]
 

Children below 6 years,

ANM/MO/AWW
Pregnant & Lactating Mothers
(iii) Health Check-up* [Health system, MHFW]
(P&LM)
 
 

Children below 6 years,

Pregnant & Lactating Mothers AWW/ANM/MO
(iv) Referral Services
(P&LM) [Health system, MHFW]
 

AWW
(v) Pre-School Education Children 3-6 years
[MWCD]
AWW/ANM/MO
(vi) Nutrition & Health Education Women (15-45 years) [Health system, MHFW &
MWCD]
Revised Nutritional Norms in ICDS (since February, 2009)

Beneficiaries Calories  Protein (g)

Children
500 12-15
(6 months to 72 months)
Severely malnourished
Children (SAM) 800 20-25
(6 months- 72 months)
Pregnant women and lactating
600 18-20
mothers
RBSK
• Under MoH&FW
• Rashtriya Bal Swasthya Karyakram (RBSK): birth to 18 years to cover 4
‘D’s viz. (30 conditions)
• Defects at birth,
• Deficiencies,
• Diseases,
• Development delays including disability
• AIM: to improve quality of life
• Objectives: early detection and management of 4Ds
• Target group
• Screening
• At community level: through mobile health team
• At Anganwadi center (for 0-6 years child): at least twice a year
• At government schools (for 6-18 years): at least once a year
• Facility level: at public health facilities like PHCs / CHCs/ DH, by
Medical Officers, Staff Nurses & ANMs
RKSK
• There are 253 million adolescents in the age group 10-19 years in India i.e 21.2%
of total population
• This age group comprises of individuals in a transient phase of life requiring
nutrition, education, counseling and guidance to ensure their development into
healthy adults
• They are susceptible to several preventable and treatable health problems,
• early & unintended pregnancy,
• unsafe sex leading to STI/HIV/AIDS,
• nutritional disorders like malnutrition, anemia & overweight,
• alcohol, tobacco and drug abuse,
• mental health concerns,
• injuries &violence.
• Emphasis on adolescent reproductive and sexual health will aid in
• delaying age at marriage,
• reducing incidence of teenage pregnancy,
• meeting unmet contraception need,
• reducing the maternal mortality,
• reducing STI incidence and reducing HIV prevalence.
• Launched in 7th January 2014
Objectives
• Improve Nutrition
• Improve Sexual and Reproductive Health
• Enhance Mental Health
• Prevent Injuries and violence
• Prevent substance misuse
Themes of RKSK
Nutrition:
• To reduce prevalence of IDA among adolescents girls and boys

Sexual and Reproductive Health

• To improve knowledge, attitudes, and behaviour in relation to SRH
• To reduce teenage pregnancies
• To improve birth preparedness and complication readiness among
adolescents
Mental Health
• To address mental health concerns of adolescents

Preventing Injuries and Violence (Including GenderBased Violence)

• To promote favorable attitudes against injuries and violence, including GBV
among adolescents

Substance Misuse
• To raise awareness on adverse effects and consequences of substance
misuse
Non-Communicable Diseases
• To promote behavior change for prevention of NCDs, hypertension, stroke,
cardio-vascular diseases and diabetes
JSSK
• Janani Shishu Suraksha Karyakram
• Launched: June 2011
• to eliminate out-of-pocket expenses for both pregnant women and
sick infants.
• Essential care is provided to the mother and her neonate within 48
hours.
Mission Indradhanush
• Launched: December 2014, MoH&FW, GoI
• Despite EPI(now UIP) in service since 1978 vaccination coverage was
only 65%, 2013-14
• Goal of Mission Indradhanush:
• To strengthen UIP
• Focus on low immunization coverage and hard to reach areas
• 90% immunisation coverage
• Target groups:
• children upto two years of age and
• pregnant women
•Intensified Mission Indradhanush (IMI): 8th October 2017.
•Aim:
• to reach each and every child up to two years of age and all those pregnant
women who have been left uncovered under the routine immunisation
programme/UIP
• to ensure full immunisation to more than 90% by December 2018
•12 vaccine preventable diseases
• BCG, OPV, DPT, Hep B
• IMI 2.0:
• from December 2019-March 2020.
• 90% immunization coverage by 2022

• IMI 3.0:
• 22 Feb 2021
• 250 districts/urban areas across 29 States/UTs
• Focus: children and pregnant women who have missed their vaccine doses
during the COVID-19 pandemic
References
• https://nhm.gov.in/images/pdf/RMNCH+A/RMNCH+A_Strategy.pdf
• https://nhm.gov.in/images/pdf/programmes/RBSK/Operational_Guid
elines/Operational%20Guidelines_RBSK.pdf
• http://nhm.gov.in/images/pdf/programmes/RKSK/RKSK_Strategy_Ha
ndbook.pdf
• http://nhm.gov.in/images/pdf/programmes/jssk/guidelines/guideline
s_for_jssk.pdf
• https://nhm.gov.in/New_Updates_2018/NHM_Components/Immuniz
ation/Guildelines_for_immunization/Mission_Indradhanush_Guidelin
es.pdf
Thank You for your attention