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6. HEALTH SERVICES
6.1 Health
education and promotion
In India,
though health education has been a low priority, it has been an integral part
of all national programmes. Lack of information is the major barrier to the
effective access to services. However, various efforts have been made by the
government to improve health through IEC activities. The main focus of the
IEC strategy for the Reproductive and Child Health Programme is on promoting
behavioural change rather than awareness generation and to utilize well
defined and culturally appropriate programmes for specific regions,
population segments, etc.
Special campaigns were launched for social mobilization for Pulse
Polio Immunization (PPI) Programme. Four Population Education Projects at
Schools, Universities, Adult and Technical Education level (through NCERT,
DAE, UGC, DGE&T) with UNFPA assistance remained under operation in States/UTs for integrating population issues in various
curricula for school students, youth and women, live entertainment
programmes, Family Planning counselling, HIV/STD counselling and distribution
of educational materials. The focus of IEC activities during the year was on
themes like eradication of Polio, increase in the age of marriage,
reproductive and child health, safe motherhood, women empowerment, gender
equality and male responsibility. Social mobilization for the Pulse Polio
Immunization Programme has been hailed as highly successful in the evaluation
conducted by independent agencies.
Related Links
 Health Promotion – WHO/India
Health
Promotion, NCD - WHO/SEARO
Health
Education – WHO/HQ
Health Promotion
– WHO/HQ
6.2 Maternal and child health/family
planning/adolescent health
According to NFHS-III, the proportion of pregnant women attended by
trained personnel during pregnancy (received antenatal check-up at least
three visits) was 51 percent. Deliveries attended by trained personnel were
48 percent.
According to performance statistics of family welfare programme in
India (Ministry of Health and Family Welfare, Government of India), the couples effectively protected by
various methods of family planning increased from 22.8 percent in 1980-81 to
44.1 percent in 1990-91 and further increased to 56.3 in 2005-06.
Related Links
Family
Welfare
Maternal Health Programme
Reproductive and Child Health
Family &
Community Health – WHO/India
Child Health
Adolescent
Health - WHO/SEARO
Child Health -
WHO/SEARO
Adolescent Health - WHO/HQ
Gender, Women and Health - WHO/SEARO
Maternal Health – WHO/HQ
Reproductive
Health - WHO/SEARO
Reproductive
Health - WHO/HQ
Making
Preg. safer - WHO/SEARO
Making Preg. safer - WHO/HQ
6.3 Immunization
Universal Immunization Programme against six preventable diseases,
namely, diphtheria, pertussis, childhood
tuberculosis, poliomyelitis, measles and neonatal tetanus was introduced in
the country in a phased manner in 1985, which
covered the whole of India
by 1990. Significant progress was made under the Programme in the initial
period when more than 90% coverage for all the six antigens was achieved.
Immunization programmes in India
have been successful to certain extent.
Percentage of children fully vaccinated were 4 percent (NFHS-III).
Immunization against BCG was 73 percent, DPT-3 was 64 percent, polio-3 was 70
percent and measles was 56% in 2005. (EPI fact sheet 2005)
Related Links
Immunization
and Vaccine Development – WHO/India
Routine Immunization – WHO/India
Immunization - WHO/SEARO
Immunization - WHO/HQ
National Family Health Survey – India
National Polio Surveillance Project - India
6.4 Prevention and control of locally endemic
diseases
Related Links
National
Vector Borne Disease Control Programme (NVBDCP)
Communicable Diseases -
WHO/SEARO
Communicable Diseases and
Disease Surveillance - WHO/SEARO
Communicable Diseases and Disease
Surveillance - WHO/India
Kala-Azar*
Kala-azar is endemic in 33
districts of Bihar, 11 districts of West Bengal
and three districts in Jharkhand and sporadic cases
have been reported in Uttar Pradesh.
After a reported increase in the number of cases and deaths due to kala-azar during 1989-1991, an intensive programme for
containment of kala-azar was launched in 1992.
The strategy for control of infection included interruption of
transmission through insecticidal spraying with DDT and early diagnosis and
treatment of kala-azar cases. The Central Government provides the
insecticides and anti kala-azar drugs, while the
State governments meet the expenses involved in the diagnosis and treatment
of cases and insecticide spraying operations.
Increase in drug resistance to sodium stibogluconate
has been reported in the Muzaffarpur and Darbhanga districts of Bihar. Though sand fly is usually sensitive to
DDT, pockets of insecticide resistance have been reported from Bihar.
Related Links
Kala-Azar or Visceral Leishmaniasis
Kalazar - WHO/SEARO
Dengue*
One of the most important resurgent tropical infectious diseases is
dengue. Dengue Fever and Dengue
Hemorrhagic Fever (DHF) are acute fevers caused by four antigenically
related but distinct dengue virus serotypes (DEN 1,2,3 and 4) transmitted by
the infected mosquitoes, Aedes aegypti.
Dengue is a disease of the tropics and is one of the most important
emerging diseases affecting nearly half of the world’s population. It is estimated that there are between 50
and 100 million cases of dengue fever and about 500,000 cases of DHF that
require hospitalization each year.
Periodic dengue outbreaks occur in many parts of India, in
both rural and urban areas. Mortality is usually low but may be high in case
of dengue shock syndrome and DHF.
Diagnostic tests for dengue are not readily available in most parts of
the country.
Related Links
Dengue
- India
Dengue
– WHO/India
Dengue -
WHO/SEARO
Filariasis*
Filariasis is endemic in 19
States/union territories in India. Estimates based on surveys by Filariasis Survey Units suggested that: about 454 million
people (120 million in urban areas) are living in known endemic areas; there
are 29 million filariasis cases in the country and
22 million micro-filaria carriers.
Currently, there are 206 filaria control
units, 199 filaria clinics, and 27 filaria survey units.
A total of 48 million people in urban areas are being protected through
anti-larval measures. The Indian
Council for Medical Research (ICMR) is conducting a feasibility and efficacy
study on a mass annual single dose administration of DEC and albendazole drugs for the control of filariasis. Kerala has
initiated a pilot project for monitoring and management of mosquitoes, in
three filariasis endemic districts (Kottayam, Alappuzha and Ernakulam) for the control of vector-borne diseases.
Related Links
Lymphatic Filariasis - India
Lymphatic
Filariasis - WHO/India
Lymphatic Filariasis - WHO/SEARO
Roll Back Malaria*
The Governments of malaria-endemic countries have identified malaria
as a high priority disease and there is growing political commitment to
control it. The WHO has initiated a project termed as “Roll Back Malaria”
(RBM) to coordinate global actions. RBM consists of world-wide partnership in
which all partners contribute their skills and resources to maximize the
impact of RBM on malaria control. RBM is a time-bound project of 5 years
Related Links
Malaria
- India
Malaria
- WHO/India
Malaria - WHO/SEARO
HIV/AIDS and Tuberculosis (Information presented under health related Millennium Development
Goals at Annex-2).
________________
* National Health Programmes of India by J. Kishore.
Related Links
Tuberculosis Control - India
Tuberculosis
Control - WHO/India
CDS – WHO/SEARO
CDS –
WHO/HQ
HIV - WHO/SEARO
6.5 Prevention, control and management
of common diseases and injuries
ARI
Acute Respiratory Infection is one of the most common causes of deaths
in under-5 age group contributing to around 13% of in-patient deaths in
Paediatrics ward. The proportion of deaths due to ARI in community is
probably much higher, as many children die at home and considering poor
availability of health services and high levels of ignorance.
Risk
factors for Acute Lower Respiratory Tract Infection in under-five children (Broor et al 2000) are lack of breast feeding, URI in
mother or siblings, cooking fuel other than LPG, inappropriate immunization
for age, and history of lower respiratory tract infection in the family. Treatment of ARI is very simple and can be instituted at
home itself or at Sub Centre level by ANM.
Diarrhoea
Diarrhoea is one of the most common causes of death in under-5 children
in India.
Acute diarrhoeal disease is one of the major consequences not only of water
pollution but also of the failure of proper management of sewage in both
cities and rural areas.
The best treatment for dehydration is Oral Rehydration
Therapy by Oral Rehydration Salt (ORS) solution.
WHO ORS packets are available with Anganwadi
Workers in the villages as well as with the ANM. The community is oriented to
use ORS solution and resort to other measures in case the child has
diarrhoea. (National Health Programmes of India by J.Kishore)
Malnutrition
Malnutrition is being addressed by Integrated Child Development
Services Programme implemented by Department of Women and Child Development,
Ministry of Human Resource Development.
Related Links
Nutrition
for Health and Development - WHO/Inida
TB & Respiratory Diseases - India
Nutrition - India
Ministry of Women and Child Development - India
NCD
- WHO/India 
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