Social and preventive Pharmacy UNIT 4.pptx

1. Dr. Kumbhare Manoj Ramesh
Professor
S.M.B.T. College of Pharmacy
Nashik-422403
Social and preventive Pharmacy Unit 4
Social and preventive Pharmacy Unit 4

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•Introduction
•Government of India adopted the Reproductive, Maternal, New-born, Child
and Adolescent Health (RMNCH+A) framework in 2013, It essentially aims to
address the major causes of mortality and morbidity among women and
children.This framework also helps to understand the delays in accessing and
utilizing health care services
•Based on the framework, comprehensive care is provided to women and
children through five pillars or thematic areas of reproductive, maternal,
neonatal, child, and adolescent health.The programmes and strategies
developed by various divisions are guided by central tenets of equity,
universal care, entitlement, and accountability to provide ‘continuum of care’
ensuring equal focus on various life stages.

3. •Ministry of l-lealth & Family Welfare, Government of lndia
has launched a new iniiiative namely- SUMAlV- Surakshit
Matritva Aashwasan" with an aim to provide assured,
dignified, respectful and Quality healthcare at no cost and
zero tolerance for denial of services for every woman and
newborn visiting the public health facility in order to end all
preventable maternal and newborn deaths and morbidities
and provide,a positive birthing experience.The expected
outcome of this new initiative is "Zero Prevenlable
Maternal and Newborn Deaths and high qualily of
maternity care delivered with dignity and respect"

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GOAL
INDICATOR
ALL INDIA STATUS
(Source of data)
NHM Goal
(2017)
Maternal
Mortality
Ratio
(MMR)
254 (SRS
2004-06)
212 (SRS
2007-09)
178 (SRS
2010-12)
167 (SRS
2011-13)
130 (SRS
2014-16)
100
Following this strategy, the Maternal Health Division strives to provide
quality services to pregnant women and their newborns through
various interventions and programmes, building capacity of health
personnel and routine health systems strengthening activities
MMR: India’s MMR at 130 (SRS 2014-16) has improved
significantly from 167(SRS 2011-13);

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According to the latest figure released by Registrar General of India - Sample Registration System
(RGI-SRS)Maternal Mortality Ratio (MMR) for the period 2014-16 is 130maternal deaths per
100,000 live births. With this, India has achieved the Millennium Development Goal (MDG) 5 i.e.
India have achieved a reduction in MMR by three quarters between 1990 to 2015. The target was
to achieve 139 maternal deaths per 100,000 live births. The table displays the trend in MMR over
the years. The average decline in MMR between 2007-09 and 2011-13 had been 11.3 points per
year, i.e. compound rate of annual decline was5.8% whereas average compound rate of decline is
8% between 2011-13 and 2014-16.
Maternal Death Surveillance and Response(MDSR): The process of maternal death review
(MDSR) has been implemented & institutionalized by all the States since 2017. Guidelines and
tools for conducting community based MDSR and Facility based MDSR have been provided to the
States. The States are reporting deaths along with its analysis for causes of death.Maternal near
miss review is also being conducted at premier institutions.

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RCH portal / MCTS Portal: Name BasedTracking of PregnantWomen and Children
has been initiated by Government of India as a policy decision to track every
pregnant woman , infant & child upto 5years of age by name for provision of timely
ANC, Institutional Delivery, and PNC along-with immunization & other related
services.
MCP Card: Ministry of Health & Family Welfare and Ministry ofWomen and Child
Development (MOWCD) has been launched as a tool for documenting and
monitoring services for antenatal, intranatal and postnatal care to pregnant women,
immunization and growth monitoring of infants.

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•National Programme for Family Planning
•India was the first country in the world to have launched a National Programme for
Family Planning in 1952. Over the decades, the programme has undergone
transformation in terms of policy and actual programme implementation and
currently being repositioned to not only achieve population stabilization goals but
also promote reproductive health and reduce maternal, infant & child mortality and
morbidity. Under the programme public health sector provides various family
planning services at various levels of health system.
• “Mission PariwarVikas”
•For improved access to contraceptives and family planning services in high fertility
districts spreading over seven high focus states, the Ministry of Health and Family
Welfare launched “Mission Pariwar Vikas”in 2016. Special focus has been given to 146
high fertility Districts of Bihar, Uttar Pradesh, Assam, Chhattisgarh, Madhya
Pradesh, Rajasthan & Jharkhand, with an aim to ensure availability of contraceptive
methods at all the levels of Health Systems.

8. • Goal - Its overall goal is to reduce India's overall fertility rate to 2.1 by the year 2025
• Objective -The key strategic focus of this initiative is on improving access to
contraceptives through delivering assured services, ensuring commodity security
and accelerating access to high quality family planning services.
• Key strategies include –
• · Providing more choices through newly introduced contraceptives: Injectable
Contraceptive, MPA (Medroxyprogesterone acetate) under Antara program and
Chaya (earlier marketed as Saheli) will be made freely available to all government
hospitals.
• · Emphasis on Spacing methods like IUCD
• · Revitalizing Postpartum Family Planning including PPIUCD in order to
capitalize on the opportunity provided by increased institutional deliveries.
Appointment of counsellors at high institutional delivery facilities is a key activity.
• · Strengthening community-based distribution of contraceptives by involving
ASHAs and Focused IEC/ BCC efforts for enhancing demand and creating
awareness on family planning

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• · Availability of Fixed Day Static Services at all facilities.
• · Emphasis on minilap tubectomy services because of its logistical simplicity and requirement of only
MBBS doctors and not post graduate gynecologists/ surgeons.
• · A rational human resource development plan for IUCD, minilap and NSV be chalked up to empower
the facilities (DH, CHC, PHC, SHC) with at least one provider each for each of the services and Sub
Center’s with ANMs trained in IUD insertion
• · Ensuring quality care in Family Planning services by establishingQuality Assurance Committees at
state and district levels Plan for accreditation of more private/ NGO facilities to increase the provider base
for family planning services under PPP.
• · Increasing male participation and promoting Non-scalpel vasectomy.
• · Demand generation activities in the form of display of posters, billboards and other audio and video
materials in the various facilities be planned and budgeted.
• · Strong PoliticalWill andAdvocacy at the highest level, especially in states with high fertility rates.

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• HumDo
• The National Family Planning Programme, through Hum Do (/humdo.nhp.gov.in/ ) aims to provide
eligible couples with information and guidance on family planning methods and services available,
to ensure individuals and couples lead a healthy, happy and prosperous life.
• Know more about
• Mission ParivarVikas
• Hum Do
• NATIONALTOBACCO CONTROL PROGRAMME (NTCP)
• NationalTobacco Control Programme (NTCP)
• Government of India launched the NationalTobaccoControl Programme (NTCP) in the year 2007-
08 during the 11th Five-Year-Plan, with the aim to (i) create awareness about the harmful effects of
tobacco consumption, (ii) reduce the production and supply of tobacco products, (iii) ensure
effective implementation of the provisions under “The Cigarettes and OtherTobacco Products
(Prohibition of Advertisement and Regulation ofTrade and Commerce, Production, Supply and
Distribution)Act, 2003” (COTPA) (iv) help the people quit tobacco use, and (v) facilitate
implementation of strategies for prevention and control of tobacco advocated byWHO Framework
Convention ofTobaccoControl .
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• During the 11th FiveYear Plan, NTCP was implemented in 21 states covering 42 districts.To carry
forward the momentum generated by the NTCP during the 11th FiveYear Plan and baseline data
generated through the GlobalAdultTobacco Survey (GATS) India 2009-2010, indicating high level of
prevalence of tobacco use, it was upscaled in the 12th FiveYear Plan with a goal to reduce the
prevalence of tobacco use by 5% by the end of the 12th FYP. As per the second round of GATS, the
number of tobacco users has reduced by about 81 lakh (8.1 million).
• The main thrust areas for the NTCP are as under:
• Training of health and social workers, NGOs, school teachers, and enforcement officers;
• Information, education, and communication (IEC) activities;
• School programmes;
• Monitoring of tobacco control laws;
• Coordination with Panchayati Raj Institutions for village level activities;
• Setting-up and strengthening of cessation facilities including provision of pharmacological treatment
facilities at district level.

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NTCP is implemented through a three-tier structure, i.e. (i) National Tobacco
Control Cell (NTCC) at Central level (ii) State Tobacco Control Cell (STCC) at State
level & (iii) District Tobacco Control Cell (DTCC) at District level. There is also a
provision of setting up Tobacco Cessation Services at District level.
NTCP has resulted in provision of dedicated funds and manpower for
implementation of the Programme. State/District Tobacco Control components viz.
STCC and DTCC Plan have been subsumed in the Flexi-pool for Non-
Communicable Disease (NCDs) under National Health Mission (NHM) for effective
implementation since 12th Five Year Plan.
Currently, the Programme is being implemented in all 36 States/Union Territories
covering around 612 districts across the country.
For downloading State-wise list with Districts under NTCP,

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• NationalTobacco Control Cell (NTCC)
• The NationalTobacco ControlCell (NTCC) at the Ministry of Health and FamilyWelfare (MoHFW) is
responsible for overall policy formulation, planning, implementation, monitoring and evaluation of
the different activities envisaged under the NationalTobaccoControl Programme (NTCP).The
NationalCell functions under the direct guidance and supervision of the programme in-charge from
the MoHFW i.e. Joint Secretary.The technical assistance is provided by the identified officers in the
Directorate General of Health Services.
• The programme broadly envisages;
• National level:
• Public awareness/mass media campaigns for awareness building and behavioural change
• Establishment of tobacco product testing laboratories. National level:
• Mainstreaming research and training on alternative crops and livelihood with other nodal Ministries.
• Monitoring and evaluation including surveillance
• Integrating NTCP as a part of health-care delivery mechanism under the National Health Mission
framework.

14. • State Level:
• Dedicated StateTobacco Control Cells for effective implementation and monitoring of tobacco control initiatives. The ley
activities include;
• State Level Advocacy Workshop
• Training ofTrainers Programme for staff appointed at DTCC under NTCP.
• Refresher training of the DTCC staff.
• Training on tobacco cessation for Health care providers.
• Law enforcers training / sensitization Programme
• District Level:
• Dedicated DistrictTobacco Control Cells for effective implementation and monitoring of tobacco control initiatives. The key
activities include;
• Training of Key stakeholders: health and social workers, NGOs, school teachers, enforcement officers etc.
• Information, Education and Communication (IEC) activities.
• School Programmes.
• Monitoring tobacco control laws.
• Setting-up and strengthening of cessation facilities including provision of pharmacological treatment facilities at the district
level.
• Co-ordination with Panchayati Raj Institutions for inculcating concept of tobacco control at the grassroots.
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15. NATIONAL ANTI-MALARIA PROGRAMME (NAMP)
The National Malaria Control Programme was implemented in the State from 1953 to 1958.With the success
achieved the programme was converted in to eradication programme from 1958.
However, due to various reasons, there was increase in the Malaria cases, during the period 1964 to 1975.
Therefore, a modified plan of operation was introduced in the year 1977.This has resulted in the reduction of
malaria cases till 1986, after which the cases have again in- creased. During 1995, there was epidemic inThane,
Nasik and Mumbai, following this, Govt. of India appointed an expert committee for taking corrective measures.
"Malaria Action Plan 1995" recommended by the Expert Committee is being implemented in the State.
The programme is monitored by the Joint Director Of Health Services (Malaria), located at Pune.
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OBJECTIVES:
To reduce period of sickness and to prevent deaths due to Malaria
To maintain industrial and agricultural progress
To retain the achievements gained so far
ACTIVITIES:
Establishing District Malaria Control Societies
Fever treatment depot
Malaria voluntary link worker scheme
PADA worker scheme
Insecticide spraying (selective)
Early case Detection and PromptTreatment (EDPT)
Identification of high risk areas
Biological measures - Guppy fishes
Insecticide impregnated mosquito nets
Chemo prophylaxis - Preventive treatment for pregnant mothers
Anti-Malaria Campaign
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World Bank assisted Enhanced Malaria Control Project
In the State, 14 tribal districts and Navi MumbaiCorporation are identified for implementation of the project. District Malaria Control Societies have been established.
Components
Early Detection and PromptTreatment. (EDPT)
SelectiveVector Control.
Residual Insecticide Spray in selected villages.
Anti Larval Measures
Personal protection methods.
Under the scheme 1,77,646 mosquito nets impregnated with insecticide have been distributed in 28 villages.
The pregnant mothers are given prophylactic treatment for Malaria in the high risk area.
Training to Health Personnel.
Inputs ego vehicles, equipments and diagnostic kits.
Anti Malaria Campaign:
Since last five years, the month of June is celebrated for Anti Malaria campaign.This is to involve the community in the Anti Malaria measures.
Following messages are given:
Examination of blood in every case of fever is necessary.
In case of malaria, radical treatment is must.
Clean environment will prevent mosquito-breeding places.
Use of mosquito net for personal protection
Cooperate healthWorkers in the spraying activity
Malaria with headache, vomiting, unconsciousness indicates serious symptoms, contact hospital immediately.
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National programme for the health care for the elderly
Social Health Programme
Introduction
Social health is more than just the prevention of mental illness and social
problems. Being socially healthy means increased degree of happiness
including sense of belonging and concern for others.
As we grow, social ties start building their place in our lives. We become a part
of different communities around us like, school, college, office etc.These
positive relations help us build a support system making us healthier. Social
health might seem ignorable and difficult to address yet it stands as one of
the pillars of health.
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Definitions
As social health is one of the dimensions of health, thus we must know what is health.
Health- a state of complete physical, mental and social well-being and not merely the absence
of disease or infirmity (WHO).
Well-being-The well-being stands for absence of negative conditions and feelings and if not
the total absence then presence of more positive aspects than negative ones.
Social well-being- It is the ability of the people to be free from want of basic necessities and to
coexist peacefully in communities with opportunities for advancement or well-being stands for
absence of negative conditions and feelings and if not the total absence then presence of more
positive feelings than negative ones.
Social health: a state of well-being
Social health is a positive dimension of health which is included in the constitutional definition
of health ofWHO. It is an individual’s ability to handle and act based on different social
conditions.
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Need of social health
Having healthy relation involves good communication, empathy, and care for family, friends and
colleagues. Being self-centered, violent and alone have ill effects on health causing stress and depression
which are a threat to self and others. Social isolation and social exclusion, both are causes of poor
chances of survival with a decreased degree of quality of life, depression and increased risk for chronic
diseases.These in turn can lead to poor physical and mental health. Hence, the social health can be
considered as cause behind the cause.
Determinants of social health
The factors like unequal distribution of various health-damaging conditions eg. economy, goods and
services, access to education, communities etc. determine the social health of a person. In turn, poor and
unequal distribution of these conditions are a result of poor social policies and programs which have a
determining effect on the living conditions of an individual’s life. perWHO, people have dramatically
different life spans depending on places where they are born. In Japan people tend to live > 80 years, in
Brazil, 72 years; India, 63 years; and in one of African countries, the life span is less than 50 years. In turn,
Thus, there must exist a balance between social and economic development for overall health of a
country.
Dimensions of social health
According to Corey Lee M. Keyes, there are 5 dimensions of social health and well- being i.e social
integration, social contribution, social coherence, social actualization and social acceptance.
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Strategies to improve social health
Make connections
 Develop new hobbies by joining groups of reading, drawing, writing, yoga etc.
 Learn new skills like art, dance, cooking, swimming etc.
 Volunteer at schools or events outside.
 Travel and meet new people.
Get active
 Participate in debates and discussions.
 Join an exercise group or start new outdoor activities with friends.
 Help parents in household chores.
Build healthy relations
 Share your feeling with parents or friends.
 Ask for help in need.
 Listen to others without being judgmental.
 Compromise and work on agreements.
 Avoid conflicts and anger.

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WHO India Country Cooperation Strategy 2019–2023: A Time of
Transition
‘The WHO India Country Cooperation Strategy 2019–2023: A Time of
Transition’ has been jointly developed by the Ministry of Health and
Family Welfare (MoH&FW) of the Government of India (GoI) and the
WHO Country Office for India. The Country Cooperation Strategy
(CCS), provides a strategic roadmap for WHO to work with the GoI
towards achieving its health sector goals, improving the health of its
population and bringing in transformative changes in the health
sector.

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Office of the WHO Representative in India
Office address: Office of the WHO Representative to
India
537, A Wing, Nirman Bhawan
Maulana Azad Road
New Delhi 110011, India Telephone number: +91-11-
66564800 Email: wrindia@who.int