1.Program for Organ Transplant:
- Government of India has launched National Organ Transplant Programme for carrying out the activities as per Transplantation of Human Organs and Tissues Act, 1994 training of manpower and promotion of organ donation from deceased persons.
- Under the said programme, an apex level organization, National Organ and Tissue Transplant Organization (NOTTO) has been set-up at Safdarjung Hospital, New Delhi for National networking, National Registry, to provide an online system for procurement and distribution of Organs & Tissues and to promote Deceased Organ and Tissue Donation.
- Government has taken various steps to simplify organ donation law/rules and procedures such as Website of National Organ & Tissue Transplant Organisation (www.notto.nic.in) provides updated information and online facility for registering pledges for organ donation.
- A 24×7 call centre with toll free helpline number (1800114770) has been established for providing information on organ donation and coordinating matters relating to retrieval and allocation of organs recovered from cadaver donors.
- National Organ and Tissue Donation and Transplant Registry (NOTTR) have been launched. NOTTO has launched National Registry for maintaining National Waiting list of patients who require organs/ tissue.
- Policy and criteria for organ allocation in case of Kidney, Liver, Heart & Lung and Cornea have been approved.
- Standard Operating Procedures for various vital organs has been approved and uploaded on NOTTO website.
2.Ayushman Bharat – National Health Protection Mission:
The Union Cabinet has approved the National Health Protection Scheme that was announced in the Union Budget 2018-19.
- In-patient hospitalization expenditure in India has increased nearly 300% during last ten years. (NSSO 2015).
- More than 80% of the expenditure are met by out of pocket (OOP).
- Rural households primarily depended on their ‘household income / savings’ (68%) and on ‘borrowings’ (25%), the urban households relied much more on their ‘income / saving’ (75%) for financing expenditure on hospitalizations, and on ‘(18%) borrowings. (NSSO 2015).
- AB-NHPM will have major impact on reduction of Out of Pocket (OOP) expenditure on ground of: Increased benefit cover to nearly 40% of the population, (the poorest & the vulnerable), Covering almost all secondary and many tertiary hospitalizations. (except a negative list), Coverage of 5 lakh for each family, (no restriction of family size)
- RSBY (Rashtriya Swasthya Bima Yojana) was launched in the year 2008 by the Ministry of Labour and Employment and provides cashless health insurance scheme with benefit coverage of Rs. 30.000/- per annum on a family floater basis (for 5 members), for Below Poverty Line (BPL) families, and 11 other defined categories of unorganized workers.
- To integrate RSBY into the health system and make it a part of the comprehensive health care vision of Government of India, RSBY was transferred to the Ministry of Health and Family Welfare (MoHFW) w.e.f 01.04.2015.
- The Union Cabinet has approved launch of Ayushman Bharat-National Health Protection Mission (AB-NHPM).
- The scheme has the benefit cover of Rs. 5 lakh per family per year. The target beneficiaries of the proposed scheme will be more than 10 crore families belonging to poor and vulnerable population based on SECC database.
- Benefits of the scheme are 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 beneficiaries can avail benefits in both public and empanelled private facilities.
- All public hospitals in the States implementing AB-NHPM, will be deemed empanelled for the Scheme.
- As for private hospitals, they will be empanelled online based on defined criteria.
- At the national level to manage, an Ayushman Bharat National Health Protection Mission Agency (AB-NHPMA) would be put in place. States/ UTs would be advised to implement the scheme by a dedicated entity called State Health Agency (SHA).
- The Government has also recently announced two major initiatives as part of Ayushman Bharat for a New India-2022 programme.
- This is aimed at making path breaking interventions to address health holistically, in primary, secondary and tertiary care systems, covering both prevention and health promotion.
The initiatives are as follows:
- Health and Wellness Centre.
- National Health Protection Scheme.
3.Health – National Health Programmes:
The National AIDS Control Programme:
- It was launched in 1992 and it is being implemented as a comprehensive programme for prevention and control of HIV/ AIDS in India.
- Over time, the focus has shifted from raising awareness to behaviour change, from a national response to a more decentralized response and to increasing involvement of NGOs and networks of People living with HIV (PLHIV).
- The NACP I started in 1992 was implemented with an objective of slowing down the spread of HIV infections so as to reduce morbidity, mortality and impact of AIDS in the country.
- In November 1999, the second National AIDS Control Project (NACP II) was launched to reduce the spread of HIV infection in India, and to increase India’s capacity to respond to HIV/AIDS on a long-term basis.
- NACP III was launched in July 2007 with the goal of Halting and Reversing the Epidemic over its five-year period.
- NACP IV, launched in 2012, 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.
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.
New Initiatives under NACP IV:
- Establishment and scale up of interventions for Transgenders (TGs) by bringing in community participation and focused strategies to address their vulnerabilities
Employer-Led Model for addressing vulnerabilities among migrant labour e. Female Condom Programme.
- Scale up of Multi-Drug Regimen for Prevention of Parent to Child Transmission (PPTCT) in keeping with international protocols.
- Social protection for marginalised populations through mainstreaming and earmarking budgets for HIV among concerned government departments
- Establishment of Metro Blood Banks and Plasma Fractionation Centre Launch of Third Line ART and scale up of first and second Line ART, Demand promotion strategies specially using mid-media, e.g., National Folk Media Campaign & Red Ribbon Express and buses (in convergence with the National Health Mission).
4.Revised National Tuberculosis Control Programme:
- The National TB Control Programme was started in 1962 with the aim to detect cases earliest and treat them.
- In the district, the programme is implemented through the district Tuberculosis Centre (DTC) and the Primary Health Institutions.
- The District Tuberculosis Programme (DTP) is supported by the state level organization for the coordination and supervision of the programme.
- The Revised National Tuberculosis Control Programme (RNTCP), based on the DOTS strategy, began as a pilot project in 1993 and was launched as a national programme in 1997 but rapid RNTCP expansion began in late 1998.
- The Revised National Tuberculosis Control Programme has initiated early and firm steps to its declared objective of Universal access to early quality diagnosis and quality TB care for all TB patients’.
5.National Leprosy Eradication Programme:
- The National Leprosy Eradication Programme is a centrally sponsored Health Scheme of the Ministry of Health and Family Welfare, Govt. of India.
- The Programme is headed by the Deputy Director of Health Services (Leprosy) under the administrative control of the Directorate General Health Services Govt. of India.
- While the NLEP strategies and plans are formulated centrally, the programme is implemented by the States/UTs.
- The Programmes also supported as Partners by the World Health Organization, The International Federation of Anti-leprosy Associations (ILEP) and few other Non-Govt. Organizations.
- Early detection through active surveillance by the trained health workers;
- Regular treatment of cases by providing Multi-Drug Therapy (MDT) at fixed in or centres a nearby village of moderate to low endemic areas/district;
- Intensified health education and public awareness campaigns to remove social stigma attached to the disease.
- Appropriate medical rehabilitation and leprosy ulcer care services.
Strategies for Leprosy elimination in India:
- Decentralized integrated leprosy services through General Health Care system.
Early detection & complete treatment of new leprosy cases.
- Carrying out house hold contact survey in detection of Multibacillary (MB) & child cases.
Early diagnosis & prompt MDT, through routine and special efforts
- Involvement of Accredited Social Health Activists (ASHAs) in the detection & complete treatment of Leprosy cases for leprosy work.
6.National Mental Health Programme:
- Psychiatric symptoms are common in general population in both sides of the globe.
- These symptoms – worry, tiredness, and sleepless nights affect more than half of the adults at some time, while as many as one person in seven experiences some form of diagnosable neurotic disorder.
Burden of Disease:
- The World Bank report (1993) revealed that the Disability Adjusted Life Year (DALY) loss due to neuro-psychiatric disorder is much higher than diarrhoea, malaria, worm infestations and tuberculosis if taken individually. According to the estimates daily loss due to mental disorders are expected to represent 15% of the global burden of diseases by 2020.
- The Government of India has launched the National Mental Health Programme (NMHP) in 1982, keeping in view the heavy burden of mental illness in the community, and the absolute inadequacy of mental health care infrastructure in the country to deal with it.
NMHP has 3 components:
• Treatment of Mentally ill
• Prevention and promotion of positive mental health.
• To ensure availability and accessibility of minimum mental health care for all in the foreseeable future, particularly to the most vulnerable and underprivileged sections of population.
• To encourage application of mental health knowledge in general health care and in social development.
• To promote community participation in the mental health services development and to stimulate efforts towards self-help in the community.
• Integration mental health with primary health care through the NMHP
• Provision of tertiary care institutions for treatment of mental disorders
• Eradicating stigmatization of mentally ill patients and protecting their rights through regulatory institutions like the Central Mental Health Authority, and State Mental health Authority.
Agencies like World Bank and WHO have been contacted to support various components of the programme. Funds are provided by the Govt. of India to the state governments and the nodal institutes to meet the expenditure on staff, equipments, vehicles, medicine, stationary, contingencies, training, etc. for initial 5 years and thereafter they should manage themselves.
Govt. of India has constituted central Mental Health Authority to oversee the implementation of the Mental Health Act 1986. It provides for creation of state Mental Health Authority also to carry out the said functions.
The National Human Rights Commission also monitors the conditions in the mental hospitals along with the government of India and the states are currently acting on the recommendation of the joint studies conducted to ensure quality in delivery of mental care.
7.NATIONAL AYUSH MISSION (NAM):
- The Union Cabinet chaired by Prime Minister Shri Narendra Modi has approved the continuation of Centrally Sponsored Scheme of National Ayush Mission (NAM) from 01.04.2017 to 31.03.2020 with an outlay of Rs. 2400 crore over the 3 year period.
The Mission was launched in September, 2014.
Features of the scheme:
- The National AYUSH Mission intends to build on India’s unmatched heritage represented by its ancient systems of medicine like Ayurveda, Sidhha, Unani & Homeopathy (ASU&H) which are a treasure house of knowledge for preventive and promotive healthcare.
- The positive features of the Indian systems of medicine namely their diversity and flexibility; accessibility; affordability, a broad acceptance by a large section of the general public; comparatively lesser cost and growing economic value, have great potential to make them providers of healthcare that the large sections of our people need.
The following are the expected outcomes of the schemes:
- Better access to AYUSH healthcare services through increased number of healthcare facilities offering AYUSH services and better availability of medicines and trained manpower.
- Improvement in AYUSH education through well-equipped enhanced number of AYUSH Educational institutions.
- Improved availability of quality AYUSH drugs by increased number of quality pharmacies and Drug Testing Laboratories coupled with stringent enforcement mechanism.
- Increased awareness and acceptance of the Yoga & Naturopathy as promotive and preventive health-care systems.
- To meet the increasing domestic demand of herbal raw-materials and also to promote export.