Ministry of Health and Family Welfare

About Ministry

The Ministry of Health and Family Welfare is an Indian government ministry charged with health policy in India. It is also responsible for all government programs relating to family planning in India.

the Ministry of Health and Family Welfare had two Departments

Department of Health & Family Welfare

The Department of Health deals with health care, including awareness campaigns, immunisation campaigns, preventive medicine, and public health.

Bodies under the administrative control of this department are:

• • National AIDS Control Organisation (NACO) (see HIV/AIDS in India)
  • 13 National Health Programmes
  • Medical Council of India
  • Dental Council of India
  • Pharmacy Council of India
  • Indian Nursing Council etc.

Department of Family Welfare

The Department of Family Welfare (FW) is responsible for aspects relating to family welfare, especially in reproductive health, maternal health, pediatrics, information, education and communications; cooperation with NGOs and international aid groups; and rural health services. The Department of Family Welfare is responsible for:

• 18 Population Research Centres (PRCs) at six universities and six other institutions across 17 states
• National Institute of Health and Family Welfare (NIHFW), South Delhi
• International Institute for Population Sciences (IIPS), Mumbai
• Central Drug Research Institute (CDRI), Lucknow
• Indian Council of Medical Research (ICMR), New Delhi

 

 

NATIONAL HEALTH POLICY, 2017

Key Objectives

• • Progressively achieve Universal Health Coverage – by assuring availability of free, comprehensive primary health care services improved access and affordability of quality secondary and tertiary care services significant reduction in out of pocket expenditure
  • Reinforce trust in Public Health Care System –by making it predictable, efficient, patient centric, affordable and effective
  • Align the growth of private health care sector with public health goals – through Strategic purchasing by the Government to fill critical gaps in public health facilities
  • Specific Quantitative Goals and Objectives – in alignment with SDG goals

Key Highlights

• • Ensuring Adequate Investment – raising public health expenditure from 1.4% to 5% of the GDP, in a time bound manner, with 2/3rd of it towards primary healthcare.
  • Universal, easily affordable primary health care – Health cards to be provided for free diagnostics, free drugs, and free emergency services at all public hospitals.
  • Assurance based approach – The Policy advocates progressively incremental assurance-based approach.
  • Comprehensive approach – expand preventive, promotive, curative, palliative and rehabilitative services provided through the public health sector with focus on quality.
  • Focus on Preventive and Promotive Health – Perspective of health changed from cure to prevention which includes intervention from early detection of issues to prevention of chronic diseases.
  • Medical Pluralism – Plethora of options to choose from among yoga and AYUSH umbrella of remedies.
  • Better regulatory mechanism
    • 1. National Healthcare Standard Organization – to maintain adequate standard in public and private health care
      2. Medical tribunal – setting up of a separate, empowered medical tribunal for speedy resolution to address disputes /complaints regarding standards of care, prices of services, negligence and unfair practices.
      3. Standard Regulatory framework for laboratories and imaging centers, specialized emerging services, etc. to ensure quality of care.
  • Digital interventions for national health
    1. 1. National Digital Health Authority to regulate, develop & deploy digital health.
       2. Promoting tele-consultation, linking tertiary care institution with specialist consultation.
       3. National Knowledge Network (NKN) for tele-education, tele-consultation and digital library.
       4. Promotion of electronic Health Record (EHR).
  • Make in India Initiative – Policy advocates the need to incentivize local manufacturing to provide customized indigenous products for Indian population in the long run.
  • Micronutrient Deficiency – Focus on reducing micronutrient malnourishment and systematic approach to address heterogeneity in micronutrient adequacy across regions.
  • Private Sector engagement – for strategic purchase for critical gap filling and for achievement of health goals.

 

NATIONAL HEALTH MISSION (NHM)

Objectives

• • Reduction in child and maternal mortality
  • Prevention and control of communicable and non-communicable diseases, including locally endemic diseases.
  • Access to integrated comprehensive primary health care.
  • Population stabilisation, gender and demographic balance.
  • Revitalize local health traditions & mainstream AYUSH.
  • Promotion of healthy life styles.
  • Universal access to public services for food and nutrition, sanitation and hygiene and universal access to public health care services with emphasis on services addressing women’s and children’s health and universal immunisation.

Salient Features

• • It is a major instrument of financing and support to the States to strengthen public health systems and healthcare delivery. This financing to the States is based on the State’s Programme Implementation Plan (PIP).
  • 2 sub schemes under it
    1. 1. National Rural Health Mission
       2. National Urban Health Mission
  • States that show improved progress made on key Outcomes/Outputs such as IMR, MMR, Immunization, number and proportion of quality certified health facilities etc. will be able to receive additional funds as incentives.
  • 5 Key Programmatic Components
    1. 1. Reproductive Maternal Neonatal Child & Adolescent Health
       2. Communicable Diseases
       3. Non-Communicable Diseases
       4. Health Systems Strengthening including infrastructure, human resource, drugs & equipment, ambulances, ASHAs etc.
       5. Infrastructure Maintenance, to support salary of ANMs and LHVs etc.

National Rural Health Mission

• • • Launched in 2005

Objective

• • • To provide accessible, affordable, accountable and effective primary healthcare facilities, especially to the poor and vulnerable sections of the population.
    • Establishing a fully functional, community owned, decentralized health delivery system with inter-sectoral convergence at all levels,
    • Ensures simultaneous action on a wide range of determinants of health such as water, sanitation, education, nutrition, social and gender equality.
    • Coverage – for all towns and villages below the population of 50,000.

Initiatives under NRHM

• • • Accredited social health activists (ASHA)
    • Janani Suraksha Yojana
    • National Mobile medical units
    • Janani Shishu Suraksha Karyakram (JSSK)
    • Rashtriya Bal Swasthya Karyakram (RBSK)
    • Mother and child health wings (MCH wings)
    • RMNCH+A – Reproductive Maternal New-born Child and Adolescent Health.
    • Free drugs and free diagnostic service
    • District hospital and knowledge center (DHKC)
    • Mainstreaming AYUSH – revitalizing local health traditions.

National Urban Health Mission

• • • Launched in 2013

Objective

• • • To meet health care needs of the urban population with the focus on urban poor, slum dwellers, by making available to them essential primary health care services
    • Reducing their out of pocket expenses for treatment
    • Support by – Asian Development Bank (ADB)
    • Coverage – NUHM would cover all State capitals, district headquarters and cities/towns with a population of more than 50000 + 64 District Headquarter towns with population between 30,000-50,000.

Initiatives under NUHM

• • • Need based city specific urban health care system.
    • Partnership with community and local bodies and NGOs.
    • District health action plan.
    • Funding pattern will be 75:25 for all the states and 90:10 for Special Category States.
    • For Service Delivery Infrastructure it provides- Urban–Primary Health Centre, Urban Community Health Centre (U-CHC) and Referral Hospitals and Outreach services.
    • For Community Process it includes Mahila Arogya Samiti and ASHA/Link Worker.

 

AYUSHMAN BHARAT – NATIONAL HEALTH PROTECTION MISSION (AB-NHPM)

• The Prime Minister rolled out the Centre’s flagship scheme, National Health Protection Scheme (NHPS), now renamed as Pradhan Mantri Jan Arogya Abhiyan (PMJAY), under the larger Ayushman Bharat Programme.
• Centrally sponsored programme, announced in Budget 2018-19.
• It is an umbrella scheme consisting of 2 major initiatives –
  1. Health and Wellness Centre
  2. Pradhan Mantri Jan Arogya Yojana or National Health Protection Scheme (NHPS)

Health and Wellness Centre

Objective

• • • To scale up a wellness-oriented rather than illness-focused approach. Operates on the supply side.
    • 5 lakh centres will be set up to provide comprehensive preventive and primary care health care, including free essential drugs and diagnostic services.
    • Involvement of private sector through CSR and philanthropic activities.

Pradhan Mantri Jan Arogya Yojana or National Health Protection Scheme (NHPS)

• • • World’s largest Government-funded universal health insurance scheme.
    • Centrally sponsored scheme – Centre: State contribution – 60:40

Objective

• • • To ensure cost-effective healthcare for all without financial hardship.
    • Operates on the demand side.

Coverage

• • • Over 10 crore poor and vulnerable families in rural & urban
    • No cap on family size and age of members.

Identification

• • • Based on deprivation & occupational criteria in Socio-Economic Caste Census (SECC)

Insurance cover

• • • Rs 5 lakh/family/year for secondary and tertiary care hospitalization.

Implemented by

• • • National Health Agency (NHA) and State Health Agency (at state level).
    • PMJAY will subsume the on-going centrally sponsored scheme – Rashtriya Swasthya Bima Yojana (RSBY) and Senior Citizen Health Insurance Scheme (SCHIS).

Objectives

• • • To provide medical cover up to Rs 5 lakh per year per household for secondary and tertiary health care. National Health Authority (NHA) – It will be set up to manage NHPS.

Intended beneficiary

• • • It is a health insurance scheme for BPL families and workers in the unorganized sector.
    • Beneficiaries to be identified on the basis of SECC-2011

Salient Features

• • • Using JAM – It would be a cashless and Aadhaar enabled for better targeting of beneficiary
    • It will be portable across the country and a beneficiary covered under the scheme will be allowed to take cashless benefits from any public/private empanelled hospitals across the country.
    • The scheme is creating a cadre of certified frontline health service professionals called Pradhan Mantri Aarogya Mitras (PMAMs) who will be primary point of facilitation for the beneficiaries to avail treatment at the hospital and thus, act as a support system to streamline health service delivery.
    • Along with NHPS Ayushman Bharat programme has another component viz, Health and Wellness Centre.
    • Health and Wellness Centre were envisioned under National Health Policy, 2017. Under this 1.5 lakh centres will bring health care system closer to the homes of people. These centres will provide comprehensive health care, including for non-communicable diseases and maternal and child health services.
    • National Health Protection Scheme (Pradhan Mantri Jan Arogya Yojana) – covers over 10 crore poor and vulnerable families (approximately 50 crore beneficiaries selected on the basis of SECC data) providing coverage upto 5 lakh rupees per family per year for secondary and tertiary care hospitalization.

Key Benefits

• • • Holistic Health Coverage – Includes interventions to address health holistically, at secondary and tertiary levels. All pre-existing diseases covered. Pre-hospitalisation and transport expenses also covered.
    • Reduction of Out of Pocket (OOP) expenditure -The unmet needs of deprived section of the society. which remained hidden due to lack of financial resources will be catered
    • Poor & Vulnerable Population covered- This flagship scheme is likely to benefit more than 37% of the population, meaning that nearly all the poor and vulnerable families will be covered.
    • Cashless & paperless access to service – In partnership with NITI Aayog, a robust, modular, scalable and interoperable IT platform will be made operational which will entail a paperless, cashless transaction.
    • Executed through Empanelled Hospitals- The beneficiaries can avail benefits in both public and empanelled private facilities. Hospitals cannot deny treatment.
    • Coordination with states – Ayushman Bharat National Health Protection Mission Council (AB-NHPMC) has been set up at apex level, Chaired by Union Health and Family Welfare Minister, for giving policy directions and fostering coordination between Centre and States.
    • Ensures portability of benefits across the country.
    • Improved quality of life – Will lead to timely treatments, improvements in health outcomes, patient satisfaction, improvement in productivity & efficiency, job creation -+ improvement in quality of life.
    • Pradhan Mantri Aarogya Mitra (PMAM) – a cadre of certified frontline health service professionals who will be primary point of facilitation for the beneficiaries to avail treatment at the hospital.

 

PRADHAN MANTRI SWASTHYA SURAKSHA YOJANA (PMSSY)

Central Sector Scheme, started in 2003

Objectives

• • To correct regional imbalances in the availability of affordable/reliable tertiary healthcare services
  • To augment facilities for quality medical education in the country

Salient Features

• • It has two components
    • Setting up of AIIMS like institutions
    • Up-gradation of existing Government medical college institutions.

 

RASHTRIYA AROGYA NIDHI (RAN)

• It is a National Illness assistance Fund by Ministry of Health and Family Welfare

Objectives

• • To provide financial assistance to patients, living below poverty line, who are suffering from major life threatening diseases to receive medical treatment at any of the 13 super specialty institutes or Government hospitals.

Intended beneficiary

• • Patients, living below poverty line who are suffering from major life-threatening diseases.

Salient Features

• • RAN has been registered under the Societies Registration Act 1860.
  • The financial assistance is not given directly to patients but released in the form of ‘one time grant’ to the Medical Superintendent of the Hospital in which the treatment has been/is being received.
  • Assistance admissible for treatment in Government Hospital only.
  • It is operationalized through 4 windows – revolving fund, direct financial assistance, State Illness Assistance Fund and Health Minister’s Cancer Patient Fund.
  • States are required to create their own State Illness Assistance fund.
  • Scheme for financial assistance for patients suffering from specified rare diseases has also been included under RAN.

 

KAYAKALP AWARDS

Objectives

• • To promote cleanliness, hygiene and infection control practices in public health facilities -Under Swachh Bharat Abhiyaan.
  • Awards and commendation certificates are given to public healthcare facilities that show exemplary performance meeting standards of protocols of cleanliness, hygiene and infection control.

 

SWACHH SWASTH SARVATRA

• Launched by – Union Health Ministry in collaboration with Ministry of Drinking Water and Sanitation and Human Resource Development.

Objectives

• • To strengthen community health centres in blocks across the country to enable them to achieve higher levels of cleanliness and hygiene.
  • Its objective is to build on and leverage achievements of two complementary programmes – Swachh Bharat Mission (SBM)

 

SCHEMES RELATED TO MOTHER & CHILD HEALTH

 

JANANI SURAKSHA YOJANA

• A Centrally sponsored scheme under National Health Mission (NHM)

Objectives

• • Reducing maternal and infant mortality by promoting institutional delivery among pregnant women.

Intended beneficiary

• • Pregnant woman
  • New born babies (neonates)

Eligibility

• • Low Performing States – All pregnant women in states that have low institutional delivery rates namely, UP, Uttarakhand, Bihar, Jharkhand, MP, Chhattisgarh, Assam, Rajasthan, Odisha, and J&K.
  • High Performing States – pregnant women from BPL, SC/ST category only

Salient Features

• • Eligible pregnant women are entitled for cash assistance irrespective of the age of mother and number of children for giving birth in a government or accredited private health facility.
  • BPL pregnant women, who prefer to deliver at home, are entitled to a cash assistance of Rs. 500 per delivery regardless of the age of pregnant women and number of children.
  • Focuses on poor pregnant woman in all states with a special dispensation for low performing states.
  • Performance based incentives to women health volunteers known as ASHA (accredited social health activist) for promoting institutional delivery among pregnant women.
  • A small cash assistance is also given for home deliveries.

 

INDIA NEWBORN ACTION PLAN (INAP)

• Launched in 2014

Objectives

• • To make concerted efforts towards attainment of the goals of “Single Digit Neonatal Mortality Rate” and “Single Digit Stillbirth Rate”, by 2030.

Salient Features

• • Based on six pillars:
    • Preconception and antenatal care
    • Care during labour and child birth
    • Immediate newborn care
    • Care of healthy newborn
    • Care of small and sick newborn
    • Care beyond newborn survival.

 

JANANI SHISHU SURAKSHA KARYAKRAM

Centrally sponsored scheme, started in 2011

Objectives

• • To mitigate the problem of out of pocket expenses which prevents institutional attendance of pregnant women.
  • To provide better health facilities for pregnant women and sick neonates.

Intended beneficiary

• • Pregnant women who access Government health facilities for their delivery.

Eligibility

• • Pregnant women in both rural & urban areas.

Salient Features

• • Zero expense deliveries – Pregnant women delivering at public health institutions will be provided with –
    • 1. Free drugs, diagnostics, blood transfusion
      2. Free diet up to 3 days for normal delivery and 7 days for c-section in public institutions
      3. Free transport from home to institution
      4. Similar entitlements are available for all sick infants (up to 30 days after birth)
      5. (entitlement based approach)
  • Free transport from home to institution.
  • It supplements the cash assistance given to a pregnant woman under Janani Suraksha Yojana (JSY). It has no component for cash assistance within itself.

 

PRADHAN MANTRI SURAKSHIT MATRITVA ABHIYAAN (PMSMA)

Objectives

• • Reduce maternal and infant mortality rates through safe pregnancies and safe deliveries.

Intended beneficiary

• • All Pregnant Women who are in the 2nd & 3rd Trimesters of pregnancy.

Salient Features

• • To provide fixed-day assured, comprehensive and quality antenatal care universally to all pregnant women on the 9th of every month free of cost.
  • One of the critical components of the Abhiyan is identification and follow-up of high risk pregnancies.
  • Private sector doctors would support the initiatives of government.
  • This scheme is available for both rural and urban areas.

Strategy

• • PMSMA guarantees a minimum package of ANC services to pregnant women at designated government health facilities, including diagnostics and counselling services, as part of the Reproductive Maternal Neonatal Child and Adolescent Health (RMNCH+A) Strategy.
  • ANC checkup services would be provided with voluntary support from private sector doctors to supplement the efforts of the government sector.

Measures under PMSMA

• • Ensuring at least one antenatal checkup for all pregnant women in their 2nd/ 3rd trimester by a physician/specialist.
  • Identification of high risk pregnancies based on obstetric/ medical history and existing clinical conditions (like Pregnancy induced hypertension, Gestational Diabetes etc.)
  • Issuing of Mother and Child Protection Cards (MCP) with a sticker indicating the condition and risk factor of the pregnant women
    • 1. Green Sticker- for women with no risk factor detected
      2. Red Sticker – for women with high risk pregnancy
  • Special emphasis on early diagnosis & appropriate management of women with malnutrition (for e.g. Anemia) by providing them with medicines such as IFA supplements, calcium supplements etc.
  • Special focus on adolescent and early pregnancies as these pregnancies need extra and specialized care
  • A National Portal for PMSMA and a Mobile application have been developed to facilitate the engagement of private/ voluntary sector.
  • Under this, ‘1Pledgefor9’ campaign was launched to create awareness about the importance of antenatal care.

 

LAQSHYA- LABOUR ROOM QUALITY IMPROVEMENT INITIATIVE

• It a Safe Delivery Mobile Application (m-health tool) for health workers who manage normal and complicated deliveries in the peripheral areas.

Objectives

• • To improve quality of care in labour room and maternity Operation Theatre (OT).
  • Reduce preventable maternal and new-born mortality, morbidity and stillbirths associated with the care around delivery in Labour room and Maternity OT and ensure respectful maternity care.

Salient Features

• • This initiative will be implemented in Government Medical Colleges (MCs) besides District Hospitals (DHs), and high delivery load Sub- District Hospitals (SDHs) and Community Health Centres (CHCs).
  • The initiative plans to conduct quality certification of labour rooms and also incentivize facilities achieving the targets outlined.

 

MOTHER’S ABSOLUTE AFFECTION (MAA) PROGRAMME

• Launched in August 2016

Objectives

• • It is a nation-wide programme to promote breastfeeding and counselling related to it to prevent malnutrition at early stages.

Salient Features

• • Community awareness generation
  • Strengthening inter personal communication through ASHA.
  • Skilled support for breastfeeding at delivery points in public health facilities.
  • Monitoring and award/recognition for various lactating mothers.

 

VATSALYA – MAATRI AMRIT KOSH

• It is a National Human Milk Bank and Lactation Counselling Centre.
• Opened at – Lady Hardinge Medical College, New Delhi
• Established in collaboration with the Norwegian government, Oslo University and Norway India Partnership Initiative (NIPI)

Function

• • It will collect, pasteurize, test and safely store milk donated by lactating mothers and make it available for infants in need.
  • It will protect, promote and support breastfeeding of mothers by providing lactation support to mothers through dedicated lactation counsellors
  • It will act as the teaching, training and demonstration site for other milk banks.

 

RASHTRIYA BAL SWASTHYA KARYAKRAM (RBSK)

Launched in 2013 & subsumes the existing school health programme.

Objectives

• • It aims at early identification and early intervention for children to cover 4 ‘D’s viz. Defects at birth, Deficiencies, Diseases, Development delays including disability.
  • Zero cost treatment and medical support.

Intended beneficiary

• • The services aim to cover all children of 0-6 years of age group in rural areas and urban slums, in addition to older children up to 18 years of age enrolled in classes 1st to 12th in Government and Government-aided schools.

Salient Features

• • Part of (child health screening and early intervention services under NRHM) – reproductive and child health initiatives
  • Children diagnosed with illnesses shall receive follow up including surgeries at tertiary level, free-of-cost under NRHM.
  • Child Health Screening and Early Intervention Services under RBSK envisages to cover 30 selected health conditions for Screening, early detection and free management.
  • Child screening under RBSK is at two levels community level and facility level.

 

RASHTRIYA KISHORE SWASTHA KARYAKRAM (RKSK)

• Launched in 2014

Objectives

• • To cater and address health and development needs of the country’s adolescents.

Intended beneficiary

• • Adolescents in age groups 10-14 years and 15-19 years

Coverage

• • Universal coverage i.e. males and females in school and out of school, in urban and rural, married and unmarried and vulnerable and under- served

Salient Features

• • Comprehensive programme focusing on Sexual Reproductive Health, Nutrition, Injuries and violence (including gender based violence), Non-Communicable Diseases, Mental Health and Substance Misuse with a promotive and preventive approach.
  • Students are screened in schools and then referred to health facilities for early detection of diseases, particularly the non-communicable diseases (NCDs).
  • Six thematic areas of RKSK namely
    • 1. nutrition,
      2. sexual reproductive health,
      3. substance misuse,
      4. non -communicable diseases,
      5. mental health,
      6. injuries and violence.
  • It introduces community-based interventions through peer educators (Saathiyas).
  • Saathiya resource kit – to help peer educators, especially in villages, discuss sensitive issues and answer teenage queries in their community in an informed manner.
  • To guide the implementation of this programme, MOHFW in collaboration with UN Population Fund (UNFPA) has developed a National Adolescent Health Strategy.

Major initiatives under RKSK

• • Adolescent Friendly Health Clinics
  • Weekly Iron Folic Acid Supplementation (WIFS) Programme
  • Menstrual Hygiene Scheme – For adolescent girls in the rural areas
  • Peer Education Programme: 4 peer educators (Saathiyas) – 2 males + 2 females.
  • Saathiya Salah App and toll free Saathiya Helpline

Menstrual Hygiene Scheme (MHS)

• • • Being implemented by Health Ministry as part of Rashtriya Kishor Swasthya Karyakram.
    • It provides subsidized sanitary napkins among adolescent girls residing primarily in rural areas.
    • Aim – to reach 15 million girls aged 10 to 19 and in 152 districts across 20 states.

 

MISSION PARIVAR VIKAS

Objectives

• • To accelerate access to high quality family planning choices based on information, reliable service and supplies within a right based framework.
  • To reach the replacement level fertility goals of 2.1 by 2025.

Target areas

• • will focus on 145 high fertility districts in 7 states with high TFR (>3) that constitute 28% of the country’s population, 30% of maternal deaths, and 50% of infant deaths (Uttar Pradesh, Bihar, Rajasthan, Madhya Pradesh, Chhattisgarh, Jharkhand and Assam)

Salient Features

• • Focus on improving access to contraceptives through delivering assured services, dovetailing with new promotional schemes, ensuring commodity security, building capacity (service providers), creating an enabling environment along with close monitoring and implementation.
  • 5 pronged approach –
    • 1. Delivering assured services – for eg. injectable contraceptives Antara, Condom boxes, Social marketing, convergence with RMNCH+A strategy (a life cycle approach to Reproductive Maternal, Newborn, Child and Adolescent health – ‘Continuum of Care’)
      2. Implementing new promotional schemes – Nayi Pahel (an FP kit for “newly weds”), Saas­Bahu Sammelan, ‘SAARTHI-Awareness on wheels’ (to disseminate family planning strategies), consumer friendly website
      3. Commodity security – Family Planning Logistics Management Information System (FPLMIS) to track supplies & consumption
      4. Capacity building – training nurses/Mos, ASHAs
      5. Creating enabling environment – inter-sectoral convergence and advocacy at national, state, district, & block level
  • The Ministry of Health and Family Welfare also launched two new contraceptives under the mission -Antara and Chaya to strengthen the population control measures in the country.
  • Antara is an injectable contraceptive MPA (Medroxyprogesterone acetate), while Chaya is non­steroidal, non-hormonal oral contraceptive
  • It will also distribute a kit (Nayi Pahal) containing products of family planning and personal hygiene among newly-wed couples.
  • It will increase sterilization services, roll out injectable contraceptive at sub centre level and generate awareness about condoms and pills.

 

SCHEMES RELATED TO IMMUNIZATION

 

UNIVERSAL IMMUNIZATION PROGRAMME

Objectives

• • Provide free of cost vaccines to all children across the country to protect them against 12 Vaccine Preventable Diseases (VPDs).
  • Rapidly increase immunization coverage
  • Establish a reliable cold chain system to the health facility level
  • Achieve self-sufficiency in vaccine production
  • Strengthen and maintain robust surveillance system for Vaccine Preventable Diseases (VPDs) and Adverse Events Following Immunization (AEFI);
  • Introduce and expand the use of new and underutilized vaccines and technology in UIP.

Salient Features

• • 100 Percent Funded by the central government.
  • Under UIP, Government of India is providing vaccination free of cost against 12 vaccine preventable diseases i.e.
    • 1. Diphtheria, Pertussis, Tetanus, Polio
      2. Measles (measles-rubella (MR) vaccine – single vaccine for dual protection against measles and rubella)
      3. severe form of Childhood Tuberculosis, Hepatitis B.
      4. Meningitis & Pneumonia caused by Hemophilus Influenza type B across the country; (Pneumococcal Conjugate Vaccine (PCV) was recently launched against pneumonia and meningitis.)
      5. Rubella, Japanese Encephalitis and Rotavirus diarrhoea → These 3 only in selected states.

 

MISSION INDRADHANUSH

• Implemented since: 2015 (launched in 2014)

Objectives

• • To ensure full immunization to more than 90%.
  • The ultimate goal is to ensure full immunization with all available vaccines for children up to two years and pregnant women.

Need

• • The rate of increase in immunization coverage had slowed down under Universal Immunization Programme (UIP).
  • Thus, Mission lndradhanush launched to rapidly increase the full immunization coverage to 90% by 2020.

Intended beneficiary

• • Children who are partially vaccinated or unvaccinated and pregnant women who have been left uncovered under the routine immunisation programme.

Salient Features

• • All vaccines are available free of cost under ‘universal immunization programme’
  • 7 vaccine preventable diseases which include diphtheria, whooping cough, tetanus, polio, tuberculosis, measles and hepatitis b.
  • “Catch-up” campaign mode aims to cover all the children who have been left out or missed out for immunization.
  • First phase of mission has identified and targeted 201 high focus districts in the country that have the highest number of partially immunized and unimmunized children.
  • Technical support to be given by WHO, UNICEF, Rotary International etc.
  • In addition to this, vaccines for Japanese Encephalitis, Haemophilus influenza type B, inactivated polio vaccine, Rotavirus vaccine and Measles Rubella vaccine are also being provided in selected states.

 

INTENSIFIED MISSION INDRADHANUSH

• Launched in October 2017, to cover low performing areas in the selected districts and urban areas.

Need for IMI

• • Finding gaps in immunization in urban areas, the Ministry of Health launched Intensified Mission lndradhanush (IMI) in, 2017, to achieve full immunization coverage.
  • It is an aggressive action plan to cover all left outs and drop outs in select districts and urban areas.

Objective

• • To reach every child below the age of 2 years, and pregnant women still uncovered under the routine immunization programme.

Target

• • To achieve more than 90% immunization coverage by December, 2018 (instead of 2020)

Focus areas

• • Areas with vacant sub centres – ANM not posted or absent for more than 3 months
  • Unserved/low coverage pockets in sub-centre or urban areas
  • Villages/areas with three or more consecutive missed routine immunization sessions

Salient Features

• • Special attention will be given to unserved/low coverage pockets in sub-centre and urban slums with migratory population.
  • It is one of 12 best practices from around the world to be featured in a special issue of the British Medical Journal.
  • The focus is also on the urban settlements and cities identified under National Urban Health Mission (NUHM).

High risk areas

• • Urban slums with migratory population
  • Nomadic sites (brick kilns, construction sites, other migrant settlements-fisherman villages, riverine areas with shifting populations, underserved and hard-to-reach populations-forested and tribal populations, hilly areas, etc.)
  • Areas with low routine immunization coverage identified through measles outbreaks, cases of diphtheria and neonatal tetanus in the last two years.

Key implementation strategy

• • Inter-ministerial coordination – convergence with other ministries/departments like Women and Child Development, Panchayati Raj, Urban Development, Youth Affairs, etc.
  • Convergence of ground level workers – like ASHA, ANMs, Anganwadi workers, Zila preraks under NULM.
  • Action based review mechanism – Reviewed by the Cabinet Secretary at the National level and under a special initiative ‘Proactive Governance and Timely Implementation (PRAGATI).
  • Intensive monitoring and accountability framework.

 

ELECTRONIC VACCINE INTELLIGENCE NETWORK (EVIN)

Objectives

• • To address widespread inequities in vaccine coverage by supporting state governments in overcoming constraints of
    • 1. infrastructure,
      2. monitoring and human resources

Salient Features

• • It aims to support the Government of India’s Universal Immunization Programme.
  • It is an indigenously developed technology system in India that provides realtime information on vaccine stocks and flows, and storage temperatures across all cold chain points; right down to vaccine storage points in state, district and health centres, using mobile and web-based dashboards.
  • In partnership with the Ministry of Health and Family Welfare, UNDP is currently rolling out EVIN in 12 states.

 

INTENSIFIED DIARRHOEA CONTROL FORTNIGHT (IDCF)

Observed during July-August every year since 2014.

Objectives

• • To combat diarrheal mortality in children with the ultimate aim of zero child deaths due to childhood diarrhea.
  • Aims to create mass awareness about the most effective and low-cost diarrhoea treatment- a combination of Oral Rehydration Salt (ORS) solution and Zinc tablets.

Salient Features

Strategy

• • It involves three action framework –
  • Mobilize: health personnel, State Governments and other stakeholders (NGOs).
  • Prioritize investment: Government and International organisation.
  • Create mass awareness: ORS and Zinc therapy demonstration will be conducted at state, district and village levels.
  • The IDCF strategy is three folds –
    • 1. Improved availability and use of ORS and Zinc at Households
      2. Facility level strengthening to manage cases of dehydration
      3. Enhanced advocacy and communication on prevention and control of diarrhoea through IEC campaign.

 

NATIONAL DEWORMING INITIATIVE

• Programme launched in 2015 to combat Soil Transmitted Helminth (STH) infections.
• National Deworming Day – organised twice in a year, except in the states of Rajasthan and Madhya Pradesh where deworming is carried out once in a year (prevalence< 20%)

Objectives

• • To prioritize investment in control of soil transmitted helminthes (STH)

Intended beneficiary

• • All pre-school and school-age children (enrolled and non-enrolled) between the ages of 1-19 years

Coverage

• • covers all the children from 1-19 years of age

Salient Features

• • Children are provided deworming tablet Albendazole in schools and Anganwadis
  • Organizing health promotion activities related to Water, Sanitation and Hygiene (WASH)
  • Implemented through combined efforts of Department of School Education and Literacy under Ministry of Human Resource and Development, Ministry of Women and Child Development and Ministry of Drinking Water and Sanitation.
  • It will be implemented through the schools and Aanganwadi centres.
  • It will create mass awareness about the most effective and low-cost STH treatment administering Albendazole tablets.
  • Behaviour change practices in terms of cleanliness, hygiene, use of toilets, wearing shoes/chappals, washing hands.
  • National Centre for Diseases Control is the nodal agency to conduct STH mapping.
  • It is a single fixed-day approach to treating intestinal worm infections in all children aged 1- 19 years observed every year on February 10 and August 10.

 

NATIONAL VIRAL HEPATITIS CONTROL PROGRAM

Objectives

• • To reduce morbidity and mortality due to viral hepatitis.

Salient Features

• • Establish National program management unit at the Centre which will act as the hepatitis cell within the National Health Mission.
  • Establish State program management unit which will also be the state coordination unit in the first year and will act as the hepatitis cell within existing state health governance structure i.e. state health society.
  • Upgrade and strengthen the existing laboratories in the state to perform the requisite diagnostic functions for testing of viral hepatitis. Free drugs and diagnosis for Hepatitis B and C will be provided under the programme.
  • Establish 665 testing centres in the public sector that can offer access to quality assured testing and diagnosis of hepatitis over 3 years.
  • Establish at least 100 treatment sites in the public sector that can offer access to quality assured management of Viral Hepatitis with focus on treatment of Hepatitis C over 3 years. It aims to treat a minimum of 3 lakh hepatitis C cases over a period of three years.
  • Recently, Ministry of Health and Family Welfare launched National Action Plan for Viral Hepatitis.

 

SCHEMES RELATED TO IT INITIATIVES FOR HEALTH

 

INTEGRATED DISEASES SURVEILLANCE PROGRAM (IDSP)

• IDSP was set up by Ministry of Health and Family Welfare, in November 2004, with World Bank’s
• It was undertaken to meet the World Health Organization (WHO) Guidelines for South East Asian countries on disease surveillance to track the outbreak of diseases and its potential trans-boundary threats.

Objectives

• • The key objective is to strengthen/maintain decentralized laboratory based IT enabled disease surveillance system for epidemic prone diseases to monitor disease trends and to detect and respond to outbreaks in early rising phase through trained Rapid Response Team (RRTs).

Salient Features

• • It seeks to set up a Central Disease Surveillance Unit and a State Surveillance Unit in each State where data is collected and analyzed
  • An early warning system has been put into place in order to take timely preventive steps.
  • Under IDSP data is collected on epidemic prone diseases on weekly basis.
  • Whenever there is a rising trend of illnesses in any area, it is investigated by the Rapid Response Teams (RRT) to diagnose and control the outbreak.
  • The program covers both communicable as well as non-communicable diseases and there is focus on inter sectoral co-ordination for zoonotic diseases.
  • IDSP as a segment of IHIP (Integrated Health Information Platform) intends to receive person-level data from health facilities across all States and Union Territories on all health events.

Restructuring of IDSP

• • IDSP has now been restructured/upgraded and the new IDSP Portal has been included as a segment of Integrated Health Information Platform (IHIP).

Benefits of Restructured IDSP under IHIP

• • Helps capture real-time or daily data (rather than weekly)
  • Allows switch from paper based collection to on line collection of data.
  • Captures disaggregate person level data at all levels, on all health events.
  • Monitors more than 33+ health conditions (earlier just 13)
  • Ensures integration with all ongoing surveillance programs.
  • Provides analysis on mobile and electronic

 

INTEGRATED HEALTH INFORMATION PLATFORM (IHIP)

• The IHIP is a web-enabled electronic information system that integrates data from various “registries” to provide near real-time information on health surveillance from all across India, for decision-makers to take action.

Objectives

• • To enable the creation of standards compliant Electronic Health Records (EH Rs) of the citizens on a pan-India basis.
  • The EHRs aims to build a comprehensive Health Information Exchange (HIE) as part of this centralized accessible platform.

Salient Features

• • Real time data reporting (along through mobile application); accessible at all levels (from villages, states and central level)
  • Advanced data modelling & analytical tools. It can interpret geographic correlations of persons with their socioeconomic and demographics attributes.
  • GIS enabled Graphical representation of data into integrated dashboard Role & hierarchy-based feedback & alert mechanisms
  • Geo-tagging of reporting health facilities
  • Scope for data integration with other health programs
  • Conduct public health surveillance in the context of One Health (human health + animal health + environment)

 

OTHER IT INITIATIVES

SCHEMES RELATED TO HIV/AIDS RELATED INITIATIVES

NATIONAL STRATEGIC PLAN ON HIV/AIDS & SEXUALLY TRANSMITTED INFECTIONS (STI), 2017-24

The National Strategic Plan (2017-24) was developed by National AIDS Control Organization (NACO)

Objectives

• • It aims to strive, along with partners:
    • To ‘fast track’ efforts to achieve an ‘AIDS free India’ by 2030 (in line with SDG goal 3)
    • To pave a roadmap for achieving the target of 90:90:90.

Salient Features

90-90-90 Target

• • Adopted by UNAIDS
  • An ambitious treatment target to help end the AIDS epidemic by 2030
  • By 2020 –
    • 90% of all people living with HIV will know their HIV status.
    • 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy.
    • 90% of all people receiving antiretroviral therapy will have viral suppression.

Goal

• • “3 Zeros” – Achieving zero new infections, zero AIDS related deaths and zero discrimination
  • Fast Track Targets
    • (by 2020)
      1. 1. 75% reduction in New HIV Infections
         2. 90-90-90
         3. Elimination of Mother to Child Transmission of HIV & Syphilis
         4. Elimination of Stigma & Discrimination
    • (by 2024)
      1. 1. 80% reduction in New HIV infections
         2. Extending from 90:90:90 strategy to 95:95:95 strategy

 

NATIONAL AIDS CONTROL PROGRAM (NACP)

• Launched in 1992, as a comprehensive programme for prevention and control of HIV/AIDS in India.

Objectives

• • for prevention and control of HIV/AIDS in India.

Salient Features

• • NACP based on three pillars -Prevention, Care-counselling and Treatment
  • Implemented by – National AIDS Control Organization (NACO), a division of Ministry of Health & Family Welfare Currently in the fourth phase (since 2012) of NACP, with following objectives –
  • 50% reduction in new infections (2007 Baseline of NACP III)
  • Provision of comprehensive care and support to people living with HIV

 

National AIDS Control Programme-IV (NACP-IV)

Objectives

• • • Reduce new infections by 50% (2007 Baseline of NACP III)
    • Provide comprehensive care and support to all persons living with HIV/AIDS and treatment services for all those who require it.

Salient Features

• • • It aims to accelerate the process of reversal and further strengthen the epidemic response in India through a cautious and well-defined integration process over the next five years.
    • It was aimed at zero infection, zero stigma and zero death.
    • Recently Cabinet approved continuation of NACP-IV beyond 12th Five Year Plan for a period of three years from 2017 to 2020.
    • NACP-IV Components –
      • 1. Intensifying & Consolidating Prevention services with a focus on High-Risk Group (HRG) and vulnerable populations.
        2. Expanding IEC services for –
           • 1. general population and
             2. high risk groups with a focus on behaviour change & demand generation.
      • Comprehensive Care, Support, Treatment.
      • Building capacities at National, State, District and facility levels
      • Strategic Information Management Systems

 

PROJECT SUNRISE

Objectives

• • Aims at –
    • Prevention of AIDS, especially among people injecting drugs, in the 8 North-Eastern states
    • Diagnose 90% of such drug addicts with HIV & put them under treatment by 2020
    • Bringing the people living with HIV/AIDS into the national mainstream and create more awareness about the disease in these NE states

Salient Features

• • Implemented in addition to the existing projects of the National AIDS Control Organization (NACO) funded under the Centre for Disease Control and will be implemented in coordination with state AIDS control organisations and non-government organisations (NGOs).
  • Implemented by Family Health International 360.
  • Sponsored by US based Centre for Disease Centre

 

HIV/AIDS PREVENTION AND CONTROL ACT, 2017

Objectives

• • It aims to end the epidemic by 2030 in accordance with the Sustainable Development Goals set by the United Nations.

Salient Features

• • The Act mandates that no one should be tested for HIV as a pre-requisite for securing a job, accessing health care or education.
  • A person living with AIDS cannot be treated unfairly at employment, educational establishments, renting a property, standing for public or private office or providing healthcare and insurance services
  • It prohibits publishing of information or advocating of feelings of hatred against HIV positive persons by anybody.
  • It prohibits HIV testing or medical treatment without informed consent.
  • An HIV positive person will be required to disclose his/her HIV status only if required by a court order.
  • There are also penal provisions for discrimination and breach of confidentiality.
  • The Act requires appointment of ombudsman by each state government to inquire into the complaints related to the violation of the Act and the provision of health care services.
  • Every HIV infected or affected person below the age of 18 years has the right to reside in a shared household and enjoy the facilities of the household
  • Cases relating to HIV positive persons shall be disposed off by the court on a priority basis. The proceedings to be conducted by suppressing the identity of the person and in camera.
  • Every person in the care and custody of the State shall have right to HIV prevention, testing, treatment and counselling services.

 

OTHER HIV/AIDS INITIATIVES

SOME OTHER INITIATIVES BY MINISTRY