Achievements/ Initiatives of the Ministry during May 2014- April 2015

1. Mission Indradhanush

The Ministry of Health & Family Welfare has launched “Mission Indradhanush”, depicting seven colours of the rainbow, to fully immunise more than 89 lakh children who are either unvaccinated or partially vaccinated; those that have not been covered during the rounds of routine immunisation for various reasons. They will be fully immunised against seven life-threatening but vaccine preventable diseases which include diphtheria, whooping cough, tetanus, polio, tuberculosis, measles and hepatitis-B. In addition, vaccination against Japanese Encephalitis and Haemophilus influenza type B will be provided in selected districts/states of the country. Pregnant women will also be immunised against tetanus.

The first round of the first phase started from 7 April 2015-World health Day- in 201 high focus districts in 28 states and carried for more than a week. This will be followed by three rounds ofmore than a week in the months of April, May June and July 2015, starting from 7th of each month. The 201 high focus districts account for nearly 50% of all unvaccinated or partially vaccinated children in the country. Of these, 82 districts are in just four states of UP, Bihar, Madhya Pradesh and Rajasthan and account for nearly 25% of all unvaccinated or partially vaccinated children of the country.

Within the districts, the Mission will focus on 4,00,000 high risk settlements identified as pockets with low coverage due to geographic, demographic, ethnic and other operational challenges. These include nomads and migrant labour working on roads, construction sites, riverbed mining areas, brick kilns, and those living in remote and inaccessible geographical areas and urban slums, and the underserved and hard to reach populations dwelling in forested and tribal areas.

Total of 297 districts will be targeted in the second phase to commence from September 2015.

Achievements in the first round of first phase (7-16 April 2015)

• 2.1 lakh sessions held
• 54.4 lakh antigens administered
  
• 5.8 lakh pregnant women immunised
  
• 2.5 lakh pregnant women fully immunised
  
• 20.8 lakh children immunised
  
• 55% of these are from Uttar Pradesh
  
• For approx. 20%, this was their first contact
  
• Approx. 24% belong of <2 years of age
  
• 4.7 lakh children fully immunised
  
• The preparation and learning during the implementation of the first round have led to health systems strengthening in terms of drawing up detailed micro plans; designing sturdy framework for stringent monitoring and evaluation of the immunisation rounds in the states(more than 3600 state and central level monitors have been deputed); training of nearly 9 lakh frontline workers; identification and analysis of limiting factors in different states leading to creating effective structures to mitigate them.
  
• The children immunized under Mission Indradhanushare in addition to the children who are immunized under the Universal ImmunisationProgramme.
  

2. India Newborn Action Plan (INAP)
India loses about 7.5 lakh newborns (<28 days)every year primarily due to prematurity, sepsis and asphyxia.
The India Newborn Action Plan (INAP)was launched in September2014 to end all preventable newborn deaths and still birthsto a single-digit by 2030. The present neonatal mortality rate is 28 per thousand live births.

Salient features:

• ANMs can now administer a pre-referral dose of antenatal corticosteroid (Injection Dexamethasone) to pregnant women going into preterm labourand pre-referral dose of Injection Gentamicin and Syrup Amoxicillin to newborns for prevention of Sepsis and Prematurity in young infants (up to 2 months of age)at the sub-centers.
• Under the ‘Life Cycle’ approach, attention is paid to health of adolescents in addition to care of the mothers during pregnancy, at the time of and after delivery.
  
• ‘Kangaroo mother care’ for strengthening of care for preterm newborn and for sick newborn.Nearly half a million newborn can be saved every year with promotion of Kangaroo Mother Care.
  
• Ensuring injection Vitamin K to all newborn children at the time of birth at the facility. This will prevent death due to bleeding disorders.
  

3. National Deworming Day

Worms adversely affect crores of children in the 1-19 year age group across the country. Soil Transmitted Helminths (STH) are a significant public health concern in the country. According to WHO estimates, 24.1 crore children in the age group 1-14 year (68% of the total cohort) are at risk of parasitic intestinal worm infections that impair physical growth and cognitive development.

The Ministry observed the first National Deworming Day on 10 February 2015, followed with mop-up activities till 14 February 2015. It was implemented in 277 districts covering 11 States/UTsacross 4.7 lakh schools and 3.67 anganwadicenters.

Against a target of 10.31 crore children in the 1-19 year group, about 8.98 crore children received deworming tablets.While the average national coverage was more than 85%, it touched 95% in places such as Dadra and Nagar Haveli. The Ministry trained 9.49 lakh frontline functionaries, school teachers and principalsto accomplish the target.

4. Maternal and Neonatal Tetanus Eliminated (MNTE) from the country

Total of 32 States/UTs have been validated for Maternal and Neonatal Tetanus Elimination (MNTE) and the formal communication from WHO has been received. For the remaining four states of Nagaland, Meghalaya, Dadra & Nagar Haveli, and Jammu & Kashmir, field visits have been conducted by the joint team of WHO and UNICEF and the parameters for MNTE validation were found to be satisfactory. However, the formal communication from WHO is expected in two months.

This has been possible through systems strengthening including improvement of institutional delivery which is also a proxy indicator for clean delivery and clean cord care practices and by strengthening Routine Immunization.Strategies to improve clean delivery have been included in the innovative JananiSurakshaYojana (JSY) and JananiShishuSurakshaKaryakaram (JSSK).

Maternal and Neonatal Tetanus Elimination (MNTE) is defined as less than one neonatal tetanus case per thousand live births per year in every district. In 1989, global deaths from Neonatal Tetanus (NT) were estimated at 7.87 lakh per year of which India contributed approximately 2 lakh deaths.

5. Decision to introduce new vaccines

In a bid to protect the children from more vaccine preventable diseases, new vaccines are proposed to be introduced as part of India’s Universal Immunisation Programme (UIP). Introduction of these vaccines will be done in a phased manner over a period of time, depending upon the field level assessments and preparedness. In addition, it has been decided to introduce an adult vaccine against Japanese Encephalitis (JE) in the high burden districts.

The new vaccines are:

a. Inactivated Polio Vaccine (IPV)

India is Polio free but to maintain this status, the Injectable Polio Vaccine will be introduced in October 2015. This will benefit 2.7 crore children every year.
b. Adult Japanese Encephalitis (JE) vaccine

20 high burden districts have been identified in Assam, Uttar Pradesh and West Bengal for adult JE vaccination in the age-group of 15-65 years. This will cut down deaths and morbidity due to Japanese Encephalitis in adults as well.

c. Rotavirus vaccine

Rotavirus is the leading cause of severe diarrhoea among infants and young children in the world. Each year India loses approximately 2 lakh children to diarrhoea out of which 1 lakh deaths are caused by Rotavirus. Rotavirus vaccine implemented to full scale would save approximately 1 lakh lives every year.
d. Measles Rubella vaccine

• Measles Rubella vaccine eliminates measles and controls Rubella in the country. The vaccine will help to reduce incidence of Congenital Rubella Syndrome. As on date, approximately 25,000 cases of CRS are estimated each year and if the child survives, this adds to the disabilities in the country.
• MR vaccination campaign will be carried out after appropriate planning and will cover 45 crore children.
  

6. Intensified Diarrhoea Control Fortnight

The Fortnight was observed during July-August, 2014. It was later extended to one month with the ultimate aim of ‘zero child deaths due to childhood diarrhoea’. During the fortnight, health workers visited the households of under-five children, conducted community level awareness generation activities and distributed ORS packets to the families with children under 5 years of age. School children and mothers were sensitised in addition to demonstration of ORS preparation in the schools and communities.

Approximately 2 crore ORS packets were distributed to families having children up to 5 years of age. This will help in reducing mortality and morbidity due to Diarrhoea in the country.

7. Integrated Action Plan for Pneumonia and Diarrhoea (IAPPD)

The IAPPD was launched in four states with highest child mortality (UP, MP, Bihar and Rajasthan) to address the two biggest killers of children- pneumonia and diarrhoea.Each year we lose approximately 5 lakh under-5 children to Dairrhoea and Pneumonia.

8. National Leprosy Eradication Programme

• Approximately 1.15 lakh leprosy cases detected in 2014-15 (till date).
• As many as 2483 reconstructive surgeries conducted.
  
• Intensive Case Detection Drive (ICDD) carried out in high endemic blocks as a special activity.
  
• Leprosy fortnight was observed from 30 Jan to 14 Feb 2015 for active case detection.
  

9. Screening for cancer

• More than 17000 visitors were screened for common non-communicable diseases (NCDs) such as Diabetes, Hypertension etc., at the mass screening and awareness programme “SwasthyaChetnaevamJansahyogAndolan” conducted at five RamleelaMaidans and Durga Puja procession at Delhi. The massive awareness campaign sensitised people regarding healthy diet, regular exercise, and healthy habits.
• More than 60,000 persons were screened for all major NCDs including cancer at the health camps put up at the Trade Fair at PragatiMaidanin November 2014.
  

10. Kala-Azar Elimination by 2015

Action Plan for elimination of Kala Azar by 2015launched in UP, Bihar, West Bengal and Jharkhand. This will benefit approximately 116.57 million population in the four states.Free diet and financial support of Rs. 500/- (one time) towards wage loss to the patient during treatment and Rs. 2000/- (one time) for treatment of post Kala-azar Dermal Leishmaniasis (PKDL) case will be provided under the Plan.

The Action Plan includes active search, new drug regimen, coordinated Indoor Residual Spray (IRS) etc. First round of Indoor Residual Spray with DDT insecticide started in 33 districts of Bihar, 4 of Jharkhand and 11 in West Bengal.In addition, new non-invasive diagnostic kit has also been launched.

11. National Family Health Survey (NFHS)

The fourth round of National Family Health Survey (NFHS-4) was launched during 2014 to provide benchmark estimates of certain health and nutritional parameters including reproductive and child health. Clinical, anthropometric and biochemical (CAB) tests have also been included in this nation-wide survey. Blood-sugar and hypertension have been added for the first time in NFHS. Most of the important indicators of the erstwhile District Level Household Survey (DLHS) and Annual Health Survey (AHS) have been included in NFHS. DLHS and AHS are accordingly being discontinued.

The NFHS-4 will provide district level estimates for the first time, besides national and state level estimates as in the past.

12. Drug resistant survey for 13 TB drugs launched

The Health Ministry launched the biggest ever drug resistant survey in the world for 13 TB drugs in September 2014. The results are expected in a year’s time. The nationwide drug resistance survey (DRS) will provide the Revised National TB Control Programme (RNTCP) with a better estimate on the burden of Multi-Drug Resistant Tuberculosis in the community. As part of the survey, the samples will be subjected to susceptibility testing for 13 anti-TB drugs (5 first line drugs and 8 second line drugs).

In addition, under the Revised National TB Control Programme there has been rapid expansion of diagnostic facilities including highly sensitive molecular test at 119 facilities across various states for diagnosis of Multi-Drug Resistance TB and TB among HIV and pediatric patients. The baseline second line Drug Susceptibility Testing has been initiated in six states- Gujarat, Tamil Nadu, Kerala, Maharashtra, Karnataka and New Delhi.

13. National AIDS Control Programme

• 58.67 lakh blood units collected across the country; 84% of this was through voluntary blood donation.
• 66 new Targeted Interventions have been established taking the total to 1,818 that provide HIV prevention services to female sex workers, injecting drug users, migrants, truckers, etc.
  
• National Helpline launched to facilitate easy dissemination of information related to HIV/AIDS to general public in all Indian languages.
  
• National Strategic plan for Elimination of Parent to Child transmission of syphilis launched on 25 February 2015.
  
• Computerized Inventory Management System launched to strengthen the supply chain management system of Anti-Retroviral Drugs, enhance efficient use of the drugs and minimize wastages across the country.
  

14. New AIIMS
Work has been expedited on the 6 new AIIMS at Raipur, Bhopal, Patna, Bhubaneshwar, Rishikesh and Jodhpur. During the last one year, the hospital work has begun and all the 6 new AIIMS are providing high-end clinical care besides the MBBS teaching activities.

In addition, 9 new AIIMS one each at Andhra Pradesh, Maharashtra, West Bengal, Uttar Pradesh, Jammu &Kashmir, Punjab, Tamil Nadu, Himachal Pradesh and Assam are proposed to be set up.Pre-investment activities have been completed for AIIMS at Andhra Pradesh,West Bengal and Maharashtra. Site inspection has been completed in Assam and Tamil Nadu whereas that for Uttar Pradesh, Punjab and Himachal Pradesh will be completed soon.

The new AIIMS will-

• have state-of-the-art medical facilities
• provide superior tertiary health care facilities to people to different regions of the country
  
• correct regional imbalance
  
• enhance capacity in medical education, research and clinical care in the underserved areas of the country
  

15. Upgradation of existing Medical Collegesto Super Specialty Blocks

Under the PradhanMantriSwasthyaSurakshaYojana (PMSSY) upgradationscheme, Government Medical Colleges (GMCs) will be upgraded to Super Specialty Blocks.In addition to 58 GMCs which were taken up in first three phases of PMSSY, 12 more GMCs in 8 States have been announced for upgradation. In case of 39 GMCs selected in Phase-III of PMSSY, gap analysis in respect of all has been completed. Detailed Projected Reports in respect of 31 GMCs have been received.

Upgradation of governmentmedical colleges to Super Specialty Blocks will create new facilities at the colleges. The tertiary care institutions will serve as composite centres for continued professional education, treatment, patient care and multi-skilling of health workers.This will improve existing health care infrastructure in different States benefiting people from these regions.

Total funds of Rs.1454.793 crorehave been released for upgradation of GMCs under Phase-I and II of PMSSY.

16. Upgradation of district/referral hospitals to Medical Colleges

• 58 district hospitals will be upgraded to medical colleges in the under-served areas of the country, which do not have any state-owned or private medical college.
• MoUs with all 20 states/UTs have been signed.
  
• 22 proposals have been approved and Rs. 128.53 crorehas been released to the states.
  

17. North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong

• Expansion of nursing college and hostel at a cost of Rs.68 crore has been approved and conveyed to the Institute to take further action.
• Setting up of Undergraduate Medical College and hostel and a Regional Cancer Centre at an estimated cost of Rs.474 crore also approved.
  

18. Funds provided to Tertiary Cancer Care Facilities

Under the scheme for enhancing the Tertiary Care Cancer Facilities in the country, funds have been released to five State Cancer Institutes (SCI): (i) Kidwai Memorial Institute of Oncology (RCC), Bengaluru (ii) Cancer Hospital(RCC), Agartala, (iii) Gujarat Cancer Research Institute, Ahmedabad, (iv) Sher-i-Kashmir Institute of Medical Sciences, Srinagar and (v) Cancer Institute (RCC) Adyar, Chennai, and two Tertiary Care Cancer Centers (TCCC): (i) Government Medical College, Kozhikode and (ii) Government Medical College, Burdwan.

The enhanced tertiary care facilities for cancer patients in different states will bring treatment facilities closer to the patients and help to reduce their out-of-pocket expenses.

19. Second campus of Chittranjan National Cancer Institute (CNCI) approved

The Government of India has approved setting up of second campus of the Chittranjan National Cancer Institute (CNCI) at Rajarhat, Kolkata at a cost of Rs. 534 crore including share of the West Bengal Government of 25%.

20. National Urban Health Mission (NUHM)

• So far 906 cities/towns have been covered under NUHM.
• Funding provided for strengthening of 3,995 existing facilities such as Urban Family Welfare Centres, Urban Health Posts, Urban Primary Health Centersetc.
  
• Funds provided for establishment of 1426 new Urban Primary Health Centers (UPHCs).
  
• Support provided for establishment of 35 new Urban Community Health Centers.
  
• 2353 full-time medical officers, 2973 part-time medical officers, 160 medical specialists, 17584 ANMs, 7209 staff nurses, 2978 pharmacists and 3231 lab technicians have been sanctioned, in addition to 56,002 ASHAs.
  

21. National Health Portal (NHP)

The National Health Portal(http:/nhp.gov.in)was launched on 14 November 2014 to provide authentic healthcare information to the citizens of the country. It aims to:

• Improve health literacy
• Improve access to health services
  
• Decrease burden of disease by educating citizens on preventive aspects of various diseases
  

It is available in five languages – English, Hindi, Tamil, Bangla, and Gujarati.

22. Central Government Health Services (CGHS)

• Orders for opening up of CGHS Wellness Centre in 11 state capitals issued. The CGHS Wellness Center at Vishakhapatnam has started operating.
• Empanelment of private hospitals under CGHS has been completed under continuous empanelment scheme.
  
• CGHS facilities extended to retired employees of statutory/ autonomous bodies whose serving employees are already covered under CGHS.
  

23. National Health Policy-2015
The Ministry has formulated the Draft National Health Policy, 2015 and placed it in public domain on 30th December, 2014 for wide stakeholder consultation. The feedback received from the stakeholders is presently being analysed.

The aim of the National Health Policy 2015 is to inform, clarify, strengthen and prioritize the role of the Government in shaping health systems in the country. This covers investment in the health sector, organization and financing of healthcare services, prevention of diseases and promotion of good health through cross sectoral action, access to technologies, developing human resources, encouraging medical pluralism, building the knowledge base required for better health, financial protection strategies and regulation and legislation for health.

24. National Mental Health Policy

The Health Ministry launched the country’s first ever Mental Health Policy in October 2014. The Policy aims to provide universal access to mental healthcare by enhancing understanding of mental health. It clearly spells out the specific roles to be played by the central government, state governments, local bodies and civil society organizations.