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AN OVERVIEW of Child & ADOLESCENT Health program under NHM. Dr Ajay Khera Public Health Specialist Deputy Commissioner In-charge (Child & Adolescent Health) Ministry of Health & Family Welfare Government of India. A Snapshot of Child & adolescent Health in India.
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AN OVERVIEW of Child & ADOLESCENT Health program under NHM Dr Ajay Khera Public Health Specialist Deputy Commissioner In-charge (Child & Adolescent Health) Ministry of Health & Family Welfare Government of India
A Snapshot of Child & adolescent Health in India • 50% adolescents anemic, 30 % undernourished • 10-30% practicing risk behaviour, mental disorder, physically inactive • 7-8% adolescent Pregnancy
Areasof Concern • 62% children die in first 28 days , 75% deaths during first week of life, 20% on day of birth • Four States namely UP, Bihar, MP and Rajasthan account for 57% of total under-5 deaths Gender differential: 4 points at National level Huge intra-district and inter-district variations More children are dying in rural areas- 18 point differential
Strategic Interventions under Child Health Programme Birth Defects Surveillance Stillbirth Surveillance Child Death Review
Activities to address Diarrhoea & Pneumonia • 1) Promotion of Integrated Management of Neonatal and Childhood Illnesses (IMNCI) for early diagnosis and case management and F-IMNCI at facility level • 2) Increasing access to community-based case management leads to 35% reduction in child pneumonia mortality 93% childhood diarrhoeal mortality reduction ORS Use Rate is 50.6% and Zinc use rate <25% Intensified Diarrhoea Control Fortnight (IDCF) observed during 28 May-8th June 2019, with the ultimate aim of ‘zero child deaths due to childhood diarrhoea’
Activities to improve Child Nutrition Early initiation of BF (41.6%) and exclusive BF rates (54.9%) are low • Breastfeeding averts 13% of U5 Deaths • Complementary Feeding averts 5% deaths
Anaemia MuktBharat (6x6 approach) !.Ensure supply chain 2. Demand generation 3. Monitoring
Diseases: dental caries in 50-60% school children, RHD: 1.5/1000 children Defects at birth: 17 lakh babies each year Developmental delays & disabilities: 10% children Deficiencies: 58% anaemic; 36% underweight Rashtriya Bal Swasthaya Karyakram (RBSK) Systemic approach for early identification and management of4Ds - Defects at birth, Deficiency, Diseases at childhood and Developmental Delays forchildren of 0-18 years. Referral • Free of cost management of children identified with ailment in District Early Intervention Centre and referral at pre-identified tertiary level institutions for surgery • Screening for defects at birth • Screening of children at AWCs and in schools • Early Intervention Centre (DEIC) at District hospital for confirmation, further assessment and as referral linkage to appropriate health facility Screening Management
Issues and Priorities Priorities Issues • Strengthening of paediatric care facilities • Implementation of Home Based Young Care and Anaemia Mukt Bharat Program • Anemia Mukt Bharat for addressing anaemia through life-cycle approach • Newborn Screening at the time of Birth • Strengthening AFHS and Expanding the scope of preventive & promotive services to school going children through School Health Ambassadors , engaging civil society to reach marginalised adolescents • Implementation of Early Childhood Care and Development through use of revised MCP Card • Quality of services in SNCUs, underutilization of NBSU & NRC • Quality of HBNC • Slow implementation of newer interventions for newborn health • Procurement Issues- IFA and Zinc • Implementation of RBSK Software • Challenges in establishment of DEIC • Convergence with allied departments for implementation of interventions like WIFS, Deworming • Less attention to adolescent health issues