DK Taneja’s Health Policies & Programmes in India Bratati Banerjee
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fm1DK Taneja's Health Policies and Programmes in Indiafm2
fm3DK Taneja's Health Policies and Programmes in India
Dr. Bratati Banerjee DPH DNB MNAMS FIPHA FIAPSM PG Diploma in Hospital and Health Management Certificate in Epidemiology of Non-Communicable Diseases (WHO Fellow) Professor Department of Community Medicine Maulana Azad Medical College New Delhi–110002
fm4
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DK Taneja's Health Policies and Programmes in India
Fifteenth Edition: 2017
9789386322722
fm5Contributors
Dr. Sandip Kumar Ray MD FIPHA
Dr. Sanjay K. Rai MD FIPHA
Dr. Sarmila Mallik DGO MD (Cal)
Dr. Pragya Sharma MD MBA (Health Care Services)
Dr. I.A. Swati MD
Dr. Abhik Sinha MD MIPHA
Dr. Amit B. Karad MPH (FE) DNB (FE)
Dr. Rupsa Banerjee MD
fm7Preface to the Fifteenth Edition
DK Taneja's Health Policies and Programmes in India is a great asset for medical students, teachers of Community Medicine, and Medical Officers in health services. For the tenth edition, I, along with some of our colleagues, was assigned the task of revising some chapters and I was happy to be a part of the book, which was of great benefit to me during my student days.
It is my honor and immense pleasure to have been endowed with the responsibility of bringing out new editions of this book, starting from the eleventh edition, with valued guidance from Dr. D.K. Taneja, Ex-Director Professor, Department of Community Medicine, Maulana Azad Medical College, New Delhi, and also with the help of my expert colleagues, who have kindly consented to revise some chapters. I have put in my best efforts for this work and I sincerely hope I have been able to keep up the high standard that the previous editions of this esteemed book have maintained all along. I am highly grateful to Dr. D.K. Taneja for giving me this great privilege.
I am highly obliged to Dr. Suneela Garg, Director Professor and Head, Department of Community Medicine, Maulana Azad Medical College, New Delhi for her valued guidance and constant encouragement to undertake and complete various assignments. I am extremely grateful to Dr. G.K. Ingle, Director Professor, Department of Community Medicine, Maulana Azad Medical College for his constant guidance, encouragement and support in all my work, including his valued guidance in editing this book. My sincere thanks to my daughter Dr. Rupsa Banerjee, Senior Resident, Department of Community Medicine, Vardhaman Mahavir Medical College, New Delhi for her contribution in completing this book.
I would also like to extend my sincere thanks to Mr. D.R. Sharma, Doctors Publications for publishing and popularizing fourteen editions of this book.
The uniqueness of this book lies in the fact that it always keeps pace with the changing scenario. It is very precisely and timely updated, with new editions incorporating the latest changes in magnitude of the problems and strategies implemented to control them. In this edition too, all data have been updated and recent references have been given. Changes in the programmes have been included, findings of various review committees incorporated, and some chapters have been extensively revised. A chapter on ‘National Programme on Prevention and Control of Burn Injuries’ has been added.
Following certification of polio-free status, the challenge for India now is to remain polio-free until the global eradication of all circulating wild polioviruses, by carefully implementing the polio endgame strategy, which involves gradual risk-free withdrawal of oral polio vaccine during the post-eradication period. The details of this including switch from tOPV to bOPV and introduction of IPV have been discussed in this edition.fm8
Certain changes in various programmes, e.g. the recent revision in treatment of TB under RNTCP; National Framework for Malaria Elimination 2016–2030; new schemes under RMNCH+A, like Mother's Absolute Affection Initiative, Pradhan Mantri Surakshit Matritva Abhiyan, etc. have been widely covered in this edition.
As we know from our experience and feedback from students and colleagues, a concise book giving important information is most useful. Therefore, to keep the size of this book handy, many issues could be discussed only briefly. However, all pertinent websites have been cited and referenced, which the interested readers can visit for detailed information.
I hope, as in the past, this edition too will meet the expectations of medical students, teachers of Community Medicine, Medical Officers in health services and postgraduate students in Community Medicine. I request my seniors, colleagues and all readers to give their views and suggestions to improve the book even further.
Dr. Bratati Banerjee
fm9Preface to the First Edition
DK Taneja's Health Policies and Programmes in India
Implementation of National Health Programmes is one of the most important tasks required to be performed by a basic doctor. He is also to function within the ambit of National Health Policy and other related policies. Therefore, he should have an overall idea of these policies as well as sound understanding of the areas directly concerning him. For the smooth implementation of the National Health Programmes, the basic doctor should have the requisite knowledge and skills for each of these programmes.
This book provides the key features of National Health, Population and Nutrition Policy. In each of the programmes, magnitude of the problem, objectives, strategy, organizational structure, managerial and technical information required for the implementation of these programmes have been described. The status of implementation and evaluations have also been briefly given.
Every attempt has been made to provide authentic and latest information, and references for this have been given at the end of this book.
It is hoped that this work will be useful for the medical students, doctors, trainers of medical and paramedical personnel and those concerned with the delivery of community health services.
As with any work, there is always a scope for further improvement. For this, I request the readers to send their views and suggestions.
Dr. D.K. Tanejafm10
fm11Acknowledgments
Dr. G.K. Ingle, Director Professor 8 Head
Department of Community Medicine
Maulana Azad Medical College, New Delhi-110002
Dr. C.S. Pandav, Professor and Head
Centre for Community Medicine
All India Institute of Medical Sciences, New Delhi-110029
Dr. Madhumita Dobe, Director Professor and Head
Department of Health Education
All India Institute of Hygiene 8 Public Health, Kolkata-700098
Prof. F.U. Ahmed, Director
Integral Institute of Medical Sciences 8 Research 8 Dean Faculty of Medical Sciences, Integral University, Lucknow-226026, Uttar Pradesh
Dr. M.K. Sudarshan, Professor and Head
Rajiv Gandhi Institute of Public Health 8 Centre for Disease Control, Bengaluru-560041, Karnataka
Dr. V.K. Srivastava, Former Director
Integral Institute of Medical Sciences 8 Research 8 Dean Faculty of Medical Sciences, Integral University, Lucknow-226026, Uttar Pradesh
Dr. U.C. Sarma, Vice Chancellor
University of Health sciences, Government of Assam
Dr. A.C. Baishya, Director
Regional Resource Centre for North-Eastern States, Guwahati-781022, Assam
Dr. J. Ravi Kumar, Professor of Community Medicine
Siddhartha Medical College, Vijayawada-520008, Andhra Pradesh
Dr. S.K. Jain, Joint Director 8 Head
Division of Helminthology 8 Parasitology
National Centre for Disease Control, New Delhi-110054
Dr. A.K. Khera, DC (CH) 8 Immunisation
Ministry of Health 8 Family Welfare, Government of India.
Dr. Sudhakar Arya, Associate Professor
Sharda Group of Hospitals and Institutions, Greater Noida, Uttar Pradesh
Dr. Amal Kumar Sinha Roy, Assistant Professor
Department of Community Medicine
Medical College, Kolkata-700073, West Bengalfm12
Dr. Dipanweeta Routray, Assistant Professor
Department of Community Medicine
Government Medical College, Cuttack-753007, Odisha
Dr. Sandip Sanyal, Assistant Professor
Department of Community Medicine
KPC Medical College, Kolkata-700032, West Bengal
Dr. Jyoti Joshi Jain, Senior Advisor
Immunisation Technical Support Unit
Ministry of Health 8 Family Welfare, Government of India
All the contributors—All the undergraduate as well as postgraduate students and teachers of Community Medicine from various medical colleges of the country and officers in the health services in different states.
I would like to thank Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President), Ms Chetna Malhotra Vohra (Associate Director–Content Strategy), Ms Geetanjali Singh (Deputy Manager–Production), and the production team of Jaypee Brothers Medical Publishers, New Delhi, India for their continuous work and commitment to this project.
Dr. Bratati Banerjee
fm13Acronyms ABER
Annual Blood Examination Rate
ACD
Active Case Detection
ACT-AL
Artemisinin Combination Therapy-Artemether Lumefantrine
ACT-SP
Artemisinin Combination Therapy-Artesunate Sulphadoxine Pyrimethanine
AD Syringe
Auto-Disable Syringe
AEFI
Adverse Events Following Immunisation
AES
Acute Encephalitis Syndrome
AFB
Acid Fast Bacillus
AFP
Acute Flaccid Paralysis
AIDS
Acquired Immunodeficiency Syndrome
ANC
Antenatal Clinic/Care
ANM
Auxiliary Nurse Midwife
APH
Antepartum Hemorrhage
API
Annual Parasite Incidence
ARSH
Adolescent Reproductive and Sexual Health
ART
Antiretroviral Therapy
ARV
Antirabies Vaccine
ARWSP
Accelerated Rural Water Supply Programme
ASHA
Accredited Social Health Activist
ATT
Antitubercular Treatment
AWW
Anganwadi Worker
AYUSH
Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy
BCC
Behavior Change Communication
BDO
Block Development Officer
BMI
Body Mass Index
BOPV
Bivalent Oral Polio Vaccine (Types 1 8 3)
BPL
Below Poverty Line
C 8 DST
Culture 8 Drug Susceptibility Testing
CBHI
Central Bureau of Health Intelligence
CBNAAT
Cartridge Based Nucleic Acid Amplification Test
CBO
Community-Based Organization
CDHO
Chief District Health Officer
CDPO
Child Development Project Officer
CHC
Community Health Centre
CMB
Conditional Maternity Benefit Scheme
CMO
Chief Medical Officerfm14
CNAA
Community Needs Assessment Approach
CNAMA
Community Needs Assessment and Monitoring Approach
COTPA
Cigarettes and Other Tobacco Products Act
CRM
Common Review Mission
CSR
Cataract Surgery Rate
CSSM
Child Survival 8 Safe Motherhood
CSU
Central Surveillance Unit
CVDs
Cardiovascular Diseases
CXR
Chest X-ray
C–SBAs
Community-Skilled Birth Attendants
DALYs
Disability-Adjusted Life Years
DANIDA
Danish International Development Agency
DBCS
District Blindness Control Society
DDC
Drug Distribution Centre
DDK
Disposable Delivery Kit
DDP
Desert Development Programme
DDWS
Department of Drinking Water Supply
DEC
Diethylcarbamazine
DF
Dengue Fever
DFID
Department for International Development (It is an UK Government's Department)
DGHS
Director General of Health Services
DHF
Dengue Hemorrhagic Fever
DHS
District Health Society
DLHS
District Level Household Survey
DMC
Designated Microscopy Centre
DMFT
Decayed, Missing and Filled Teeth
DOTS
Directly Observed Treatment Short-Course
DPAP
Drought Prone Area Programme
DPMU
District Programme Management Unit
DR-TB
Drug-Resistant Tuberculosis
DSRC
Designated STI/RTI Clinic
DSS
Dengue Shock Syndrome
DSU
District Surveillance Unit
DTC
District Tuberculosis Centre
EAG
Empowered Action Group
EGS
Employment Guarantee Scheme
ELISA
Enzyme-Linked Immunosorbent Assay
EmOC
Emergency Obstetric Care
EPI
Expanded Programme on Immunisation
EQAS
External Quality Assurance Scheme
FCTC
Framework Convention on Tobacco Control
FMG
Financial Management Groupfm15
FRU
First Referral Unit
FSWs
Female Sex Workers
FTD
Fever Treatment Depot
FTKs
Field Test Kits
GATS
Global Adult Tobacco Survey
GDMO
General Duty Medical Officer
GDP
Gross Domestic Product
GFATM
Global Fund for AIDS, Tuberculosis and Malaria
GIPA
Greater Involvement of People Living with HIV/AIDS
GIS
Geographical Information System
GOI
Government of India
GP
Gram Panchayat
GPI
Gender Parity Index
GWEP
Guinea Worm Eradication Programme
HBV
Hepatitis B Virus
HCV
Hepatitis C Virus
HEPA
High-Efficiency Particulate Air
HIV
Human Immunodeficiency Virus
HLA
Human Leukocyte Antigen
HMIS
Health Management Information System
HPS
High-Performing State
HRG
High-Risk Group
HW (M8F)
Health Worker (Male 8 Female)
IARC
International Agency for Research on Cancer
IAY
Indira Awas Yojana
ICDS
Integrated Child Development Services
ICMR
Indian Council of Medical Research
ICTC
Integrated Counselling 8 Testing Centre
IDD
Iodine Deficiency Disorders
IDSP
Integrated Disease Surveillance Programme
IDU
Injectable Drug User
IEAG
India Expert Advisory Group
IEC
Information, Education 8 Communication
IFA
Iron-Folic Acid
IGMSY
Indira Gandhi Matritva Sahayog Yojana
IGNDPS
Indira Gandhi National Disability Pension Scheme
IGNOAPS
Indira Gandhi National Old Age Pension Scheme
IGNWPS
Indira Gandhi National Widow Pension Scheme
ILR
Ice-Lined Refrigerator
IMCI
Integrated Management of Childhood Illness
IMCP
Intensified Malaria Control Project
IMNCI
Integrated Management of Neonatal and Childhood Illness
IMR
Infant Mortality Ratefm16
IOL
Intraocular Lens
IPHS
Indian Public Health Standards
IPPI
Intensive Pulse Polio Immunisation
IPV
Injectable Polio Vaccine
IRL
Intermediate Reference Laboratory
IRS
Indoor Residual Spray
ISM8H
Indian Systems of Medicine 8 Homeopathy
ISRO
Indian Space Research Organisation
ISTC
International Standards for Tuberculosis Care
ITN
Insecticide-Treated Net
IUCD
Intrauterine Contraceptive Device
IVM
Integrated Vector Management
IWDP
Integrated Wasteland Development Programme
IYCF
Infant and Young Child Feeding
JALMA
Japanese Leprosy Mission for Asia
JE
Japanese Encephalitis
JNNURM
Jawaharlal Nehru National Urban Renewal Mission
JSSK
Janani Shishu Suraksha Karyakram
JSY
Janani Suraksha Yojna
KSY
Kishori Shakti Yojana
LAM
Lactational Amenorrhea Method
LHV
Lady Health Visitor
LLIN
Long-Lasting Insecticide Net
LPA
Line Probe Assay
LPCD
Litres Per Capita Per Day
LPS
Low-Performing State
LT
Laboratory Technician
LWS
Link Worker Scheme
MB
Multi Bacillary Leprosy
MCH
Maternal and Child Health
MCR
Micro-Cellular Rubber Footwear
MCTS
Mother and Child Tracking Scheme
MDA
Mass Drug Administration
MDGs
Millennium Development Goals
MDR-TB
Multidrug-Resistant Tuberculosis
MDT
Multidrug Treatment
MGNREGS
Mahatma Gandhi National Rural Employment Guarantee Scheme
MLEC
Modified Leprosy Elimination Campaign
MMR
Maternal Mortality Rate
MoH8FW
Ministry of Health 8 Family Welfare
MOPV1
Monovalent Oral Polio Vaccine (Type 1)
MOTC
Medical Officer (Tuberculosis Control)
MPN
Maximum Probable Numberfm17
MPO
Modified Plan of Operation
MPW (F8M)
Multi-Purpose Worker (Female 8 Male)
MSM
Men having Sex with Men
MTB
Mycobacterium Tuberculosis
MTP
Medical Termination of Pregnancy
NABH
National Accreditation Board for Hospitals
NACO
National AIDS Control Organisation
NCDC
National Centre for Disease Control
NCDs
Non Communicable Diseases
NCRP
National Cancer Registry Programme
NDDTC
National Drug Dependence Treatment Centre
NER
Net Enrolment Ratio
NFBS
National Family Benefit Scheme
NFFWP
National Food For Work Programme
NFHS
National Family Health Survey
NGO
Non-governmental Organisation
NHP
National Health Policy
NHSRC
National Health System Resource Centre
NIC
National Informatics Centre
NIDDCP
National Iodine Deficiency Disorders Control Programme
NIDS
National Immunisation Days
NIN
National Institute of Nutrition
NIRT
National Institute for Research in Tuberculosis
NITRD
National Institute of Tuberculosis 8 Respiratory Diseases
NLEP
National Leprosy Elimination Programme
NMBS
National Maternity Benefit Scheme
NMEP
National Malaria Eradication Programme
NMHP
National Mental Health Programme
NNMB
National Nutrition Monitoring Bureau
NP-NSPE
National Programme for Nutritional Support to Primary Education
NPAG
Nutrition Programme for Adolescent Girls
NPCDCS
National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke
NPHCE
National Programme for Health Care of Elderly
NPP
National Population Policy
NPSP
National Polio Surveillance Project
NRDWP
National Rural Drinking Water Programme
NREGA
National Rural Employment Guarantee Act
NRHM
National Rural Health Mission
NRLM
National Rural Livelihood Mission
NSAP
National Social Assistance Programme
NSSO
National Sample Survey Organisation
NTCP
National Tobacco Control Programmefm18
NTI
National Tuberculosis Institute
NTWG
National Technical Working Group
NUHM
National Urban Health Mission
NVBDCP
National Vector Borne Disease Control Programme
OCPs
Oral Contraceptive Pills
OPD
Out Patient Department
OPV
Oral Polio Vaccine
ORS
Oral Rehydration Solution/Salt
PB
Paucibacillary Leprosy
PCD
Passive Case Detection
PCR
Polymerase Chain Reaction
PDS
Public Distribution System
PEP
Post-Exposure Prophylaxis
PFA
Prevention of Food Adulteration
PHC
Primary Health Centre
PIP
Programme Implementation Plan
PKDL
Post Kala-Azar Dermal Leishmaniasis
PLHIV
Patients Living with HIV
PLWHA
People Living with HIV AIDS
PMDT
Programmatic Management of Drug Resistant TB
PMSU
Programme Management Support Unit
PPH
Postpartum Hemorrhage
PPP
Public-Private Partnership/Purchasing Power Parity/Preferred Private Provider
PPTCT
Prevention of Parent to Child Transmission
PRIs
Panchayati Raj Institutions
PUO
Pyrexia of Unknown Origin
RCH
Reproductive and Child Health
RCS
Reconstructive Surgery
RDT
Rapid Diagnostic Test
RFFIT
Rapid Fluorescent Focus Inhibition Test
RGI
Registrar General of India
RGSEAG
Rajiv Gandhi Scheme for Empowerment of Adolescent Girls
RHS
Rapid Household Survey
RIF
Rifampicin
RIG
Rabies Immunoglobulin
RMNCH+A
Reproductive, Maternal, Newborn, Child and Adolescent Health
RNTCP
Revised National Tuberculosis Control Programme
RPR
Rapid Plasma Reagin
RRT
Rapid Response Team
RTI
Right to Information
RTIs
Reproductive Tract Infections
SACS
State AIDS Control Societyfm19
SAPEL
Special Action Project for Elimination of Leprosy
SC/ST
Scheduled Castes/Scheduled Tribes
SCC
Short-course Chemotherapy
SCM
Syndromic Case Management
SC
Sub-centre
SDM
Standard Days Method
SGRY
Sampoorna Gramin Rozgar Yojana
SGSY
Swaranajayanti Gram Swarozgar Yojana
SHGs
Self-Help Groups
SHS
Secondhand Smoke
SHS
State Health Society
SIAs
Supplemental Immunization Activities
SJSRY
Swarana Jayanti Shahri Rozgar Yojana
SMO
Senior Medical Officer/Surveillance Medical Officer
SNIDS
Sub-National Immunisation Days
SOP
Standard Operational Procedures
SPR
Slide Positivity Rate
SP
Sulfadoxine-Pyrimethamine
SRA
Simple Rapid Assay
SRS
Sample Registration Scheme/System
SSA
Sarva Shiksha Abhiyan
SSU
State Surveillance Unit
STDs
Sexually Transmitted Diseases
STIs
Sexually Transmitted Infections
STLS
Senior Tuberculosis Laboratory Supervisor
STS
Senior Treatment Supervisor
TBA
Traditional Birth Attendant
TCC
Tobacco Cessation Centres/Tertiary Care Centres
TFA
Target-Free Approach
TFR
Total Fertility Rate
TI
Targeted Intervention
TOPV
Trivalent Oral Polio Vaccine
TPDS
Targeted Public Distribution System
TPHA
Treponema Pallidum Hemagglutination Assay
TRIPS
Trade-related Aspects of Intellectual Property Rights
TSC
Total Sanitation Campaign
TU
Tuberculosis Unit
UIP
Universal Immunisation Programme
ULV
Ultra-low Volume
UMS
Urban Malaria Scheme
USAID
United States Agency for International Development
UT
Union Territory
VBD
Vector-borne Diseasefm20
VCTC
Voluntary Counselling and Testing Centre
VDPV
Vaccine-Derived Polio Virus
VDRL
Venereal Disease Research Laboratory
VHW
Village Health Worker
VL
Visceral Leishmaniasis
VVM
Vaccine Vial Monitor
VWSC
Village Water and Sanitation Committee
WHO
World Health Organization
WPV
Wild Polio Virus
XDR–TB
Extensively Drug-Resistant Tuberculosis
YEP
Yaws Eradication Programme