(nayi nayi Yojana hai Feb 2013 me ...aa sakta hai UPSC me !!)
---for children up to 18 years of age.
---part of the National Rural Health Mission
---launched on February 6, in Palghar, a tribal dominated block of
Thane district in Maharashtra.
---will be extended to cover all districts of the country in a
phased manner.
---also known as Child Health Screening and Early
Intervention Services aims at early detection and management of ‘4Ds’ prevalent in children.
These are
- Defects at birth,
- Diseases in children,
- Deficiency conditions and
- Developmental delays including
Disabilities.
The health screening
of children is a known intervention under School Health Programme.
The services aim to cover all children
of 0-6 years of age group in rural areas and urban slums, in addition to
children enrolled in classes 1st to 12th in
Government and Government aided schools.
A set of 30 common ailments / health conditions
have been identified for screening and early intervention.
Defects at Birth
- Globally,
about 7.9 million children are born annually with a serious birth defect
of genetic or partially genetic origin which account for 6 percent of the
total births.
- In
India about 1.7 million babies are born with birth defects
annually.
- For
those who do not receive specific and timely intervention and yet survive,
these disorders can cause irreversible life-long mental, physical,
auditory or visual disability.
Deficiencies
- Anaemia
prevalence has been reported as high as 70% amongst under-five children
largely due to iron deficiency.
- The
situation has remained virtually unchanged over the past decade. Almost
half of children under age five years (48 %) are chronically malnourished.
- During
pre-school years, children continue to suffer from adverse effects of
anaemia, malnutrition and developmental disabilities, which ultimately
also impact their performance in school.
Diseases
- The
prevalence of dental caries varies between 50-60 percent among Indian
school children as reported in different surveys.
- Rheumatic
heart disease is reported at 1.5 per thousand among school children in the
age group of 5-9 years.
- The
median prevalence of reactive air way disease including asthma among children
is reported to be 4.75 percent.
Developmental
Delays
- Globally,
200 million children do not reach their developmental potential in the
first five years because of poverty, poor health, nutrition and lack of
early stimulation.
- The
prevalence of early childhood stunting and the number of people living in
absolute poverty could be used as proxy indicators of poor development in
under five children.
- Both
of these indicators are closely associated with poor cognitive and
educational performance in children and failure to reach optimum
developmental potential..
Implementation
mechanism
Facility
Based Newborn Screening
- This
includes screening of birth defects in institutional deliveries at public
health facilities, especially at the designated delivery points by nurses,
medical officers/ gynaecologists.
Community Based
Newborn Screening
- Accredited
Social Health Activists (ASHAs) during home visits for newborn care will
use the opportunity to screen the babies born at home and the
institutions till 6 weeks of age.
- ASHAs
will be trained with simple tools for detecting gross birth defects.
- For
performing this task, ASHA
would be provided with a tool kit consisting of a pictorial
reference book with self-explanatory pictures for identification of birth
defects.
Screening at Anganwadi
Centres and Schools
- The
children in the age groups 6 weeks to 6 years
of age will be examined in the Anganwadi centres by the
dedicated mobile health teams.
- The
children in the age groups 6 to 18 years will be screened in Government
and Government aided schools.
- The
screening of children in the anganwadi centres would be
conducted at least twice a year and at least once a year for school
children to begin with.
Block to be the Hub of Activity
- The
Block will be the hub of activity for the programme.
- At
least three dedicated mobile health teams in each Block will be engaged to
conduct screening of children.
- Villages within the jurisdiction
of the Block would be distributed amongst the 3 teams.
- The
number of teams may vary depending on the number of anganwadi centres,
schools, difficult to reach areas and enrolments of children in the
schools.
- The mobile health team will
consist of four members - two Doctors (AYUSH) one male and one female, one
nurse and one pharmacist.
- The Block Programme Manager will
chalk out a detailed screening plan for all the three teams in
consultation with schools, anganwadi centres and CHC Medical
Officer.
- A
tour diary will be maintained by block health teams.
Early Intervention Centre at District
Level
- An
Early Intervention Centre will be established at the District
Hospital.
- The
purpose of Early Intervention Centre is to provide referral support to
children detected with health conditions during health screening.
- A
team consisting of paediatrician, medical officer, staff nurses,
paramedics will be engaged to provide services.
- This
centre would have the basic facilities to conduct tests for hearing,
vision, neurological tests and behavioural assessment.
Training and
Management
Training of the personnel involved
in Child Health Screening and Early Intervention Services would be
through a cascading training approach. Standardized training modules are to be
developed in partnership with technical support agencies and collaborative
centres. KEM Hospital, Mumbai
and Pune and Ali Yavar Jung National Institute for Hearing Handicapped,
have been identified as public sector collaborative centres in Maharashtra for
imparting training.
Ministry of Health & Family Welfare
has drawn up ‘Operational Guidelines’ for effective planning and systematic
implementation of the programme. These guidelines explain the process of
identification and management of select conditions of huge public health
significance in India.
Impact of the Programme
- By
providing early intervention service, the new initiative is expected to
bring economic benefits in the long run by directly reducing expenditure
in terms of providing critical health care.
“Extending preventive and promotive health care would
impact the National Human Capital, reduce disease burden and also public health
expenditure.” says Union Minister for Health & Family Welfare Ghulam Nabi
Azad.
When fully
implemented, the Rashtriya Bal Swasthya Karyakram is expected to benefit
approximately 270
million (27 crore) children across the country.
===============================================
30 common ailments / health conditions have been identified
for screening and early intervention.
Defects at Birth
|
· Neural
tube defect
|
· Down’s
Syndrome
|
· Cleft
Lip & Palate / Cleft palate alone#
|
· Talipes
(club foot)
|
· Developmental
dysplasia of the hip
|
· Congenital
cataract
|
· Congenital
deafness
|
· Congenital
heart diseases
|
· Retinopathy
of Prematurity
|
Deficiencies
|
· Anaemia
especially Severe anaemia
|
· Vitamin
A deficiency (Bitot spot)
|
· Vitamin
D Deficiency, (Rickets)
|
· Severe
Acute Malnutrition
|
· Goitre
|
Child hood Diseases
|
· Skin
conditions (Scabies, fungal infection and Eczema)
|
· Otitis
Media
|
· Rheumatic
heart disease
|
· Reactive
airway disease
|
· Dental
caries
|
· Convulsive
disorders
|
Developmental delays and
Disabilities
|
· Vision Impairment
|
· Hearing Impairment
|
· Neuro-motor Impairment
|
· Motor delay
|
· Cognitive delay
|
· Language delay
|
· Behaviour disorder (Autism)
|
· Learning disorder
|
· Attention deficit hyperactivity disorder
|
· Congenital Hypothyroidism, Sickle cell anaemia, Beta thalassemia
(Optional)
|
