Health Department

The National Family Welfare Program has been implementing in our country since 1979 to control the growing population. In view of the overall living level of the family, both mothers and children are very important in the absence of pregnancy, adversely affecting the nutrition of mothers and children. For this, the Government has made the following indicative, modern and permanent offspring regulation methods / tools to the couple. Indicative

1. IUCD – IUCD is the most effective way of regulation of the offspring and can be used for ten years.
2. PPIUCD – Postpartum IUCD is safe and effective after delivery.  Can be fitted within 48 hours after delivery.
3. Contraceptive pills – Contraceptive pills is an effective and easy way to regulate offspring.
4. Antra Injection  – Antra Injection  can prevent pregnancy for three months. For continuous pregnancy prevention, It has to be take  every three months.
5. Chaaya – Chayya pills is a prevention of pregnancy to take oral. The first three months are taken 2 times a week and then one pill each week from the fourth month.
6. Condom – Prohibition is a means of regulating the offspring of men and provides double protection from sexually transmitted diseases and HIV.
7. Epils – Epils are used to prevent unwanted pregnancy within 72 hours after unprotected sexual relations.

The above options are  available at primary health centers, health sub -centers and rural hospitals in the district. At primary health centers , rural hospitals and sub district hospitals in the district having functional operation theaters  minilap , NSV, and laparoscopic  tubal ligation  fixed day sessions are arranged . Beneficiaries can avail the facility as per their choice.  During the fixed day sessions health  workers provide beneficiaries  minilap , NSV and laparoscopic  tubal ligation facilities  at concerned health institute.

Introduction

Iodine is a natural liquid/substance that is essential for human life. Iodine supply is essential for the growth of the body and brain. The body needs 150 micrograms of iodine daily. Iodine is found in water, fish, and seafood. The amount of iodine is low in water coming from mountains and near mountains. In the natural state, iodine is supplied from food. If the supply of iodine in the soil decreases, the amount of iodine in the crops produced on it also decreases. To avoid this risk, all countries around the world have decided to provide iodine through salt.

Due to Iodine deficiency, the following disorders may occur

• Goiter
• Decreased physical and mental growth
• Decreased/Increased height
• Miscarriges may occur in pregnant women

Outline of Maharashtra State

The Goiter Program in Maharashtra State has been given for the following purposes as per the guidelines of the Central Health Committee

• Conducting goiter survey
• Production of Iodised salt
• Use of Iodised salt
• Ban on use of plain salt (In selected districts)
• Checking Iodine content of salt
• Providing Health Education for the use of Iodised salt
• Reguler distribution of Iodised salt in tribal areas

Objectives of the program

• To plan a program and conduct a survey
• Health Education activities
• To test salt samples
• To provide medical treatment and advice to goiter patients

Routine work in Primary Health Centers and Rural Hospitals

To find suspected patients, testing salt samples, collecting urine samples and health education acivities in reguler visits.

District TB Office, Kolhpaur

• Introduction

In 2020, the RNTCP was renamed as the National TB Elimination Program (NTEP) to emphasize the aim of the Government of India to eliminate TB in India by 2025, five years ahead of the global targets of 2030.

The SDG targets with regard to TB (base line 2015) are:

• 80% reduction in incidence
• 90% reduction in mortality
• Zero TB patients and their households face catastrophic costs as a result of TB disease.

The programme has been guided by the National Strategic Plan 2017-2025, and the key programme activities are implemented under 4 strategic pillars – “Detect – Treat – Prevent – Build” (DTPB).

• Estimated TB Burden in India (as per Global TB report 2023)

India is progressing against the SDG goals at a far greater pace than the global average, with a decline in TB incidence by 16% and in TB deaths by 18% from 2015 to 2022.

• TB Incidence: 2.55 million new TB cases in 2023.
• Mortality: 331,000 deaths in 2022 – 23 deaths per 100,000 population
• Approximately 2% of TB patients estimated to be HIV +ve
• DR-TB (Drug resistant-TB): 2.5% in new cases and 13% in previously treated cases

India is highest TB burden country in the world, accounting for nearly 27% of the global incidence. In 2022, out of the estimated global annual incidence of 10.6 million TB cases; 2.8 million were estimated to have occurred in India.

• Scope of services

Objectives of the programme: The Ministry implements the National TB Elimination Programme with the following objectives:

• Early diagnosis of TB patients, prompt treatment with quality-assured drugs and treatment regimens.
• Engaging with the patients seeking care in the private sector.
• Prevention strategies include contact tracing in high-risk/vulnerable populations.
• Airborne infection control.
• Multi-sectorial response for addressing social Determinants

• Pradhan Mantri TB Mukt Bharat Abhiyaan (PMTBMBA)

Pradhan Mantri TB Mukt Bharat Abhiyaan was launched by the Honorable President of India on September 9, 2022, with the objectives to provide additional support to TB patients in order to improve treatment outcomes, augment community involvement and leverage Corporate Social Responsibility (CSR) activities. As per the clarion call of the Hon’ble Prime Minister of India, Shri Narendra Modi at Delhi End TB Summit in March 2018 to eliminate TB by 2025, five years ahead of Sustainable Development Goal, PMTBMBA initiative was launched to bring together people from all backgrounds and escalate the progress toward TB elimination.

In Kolhapur District following Major Nikshay Mitra given Support to TB patients under Pradhan Mantri TB Mukt Bharat Abhiyaan (PMTBMBA) in 2024 -2025

• D-mart foundation- for 500 TB Patients (Per Month one Poshan aahar kit- for 6 Months.
• Menon Pistons – for 500 TB Patients (Per Month one Poshan aahar kit- for 6 Months.
• Indocount Foundation – for 650 TB Patients  (Per Month one Poshan aahar kit- for 6 Months )

• Case finding

TB case notifications. Health facilities in government sectors outside Health Ministry have been involved viz. ESI, Railways, with the programme. Focused and targeted engagement and programmatic collaborative efforts resulted increase in cases reported from the Government and private sector.

• Diagnostic services

The NTEP continued its tradition of providing free diagnostic services. There has been a huge infrastructure scale-up of TB laboratory services. Designated Microscopy Centres (DMCs) and NAAT Centres.

In Kolhapur District following infrastructure available for diagnosing TB –

• CBNAAT -3,
• TRUENAT – 12
• Designated Microscopy Centres (DMCs) – 96

• Treatment services

Comprehensive care packages and decentralized services have been introduced for TB patients under NTEP, including scale up of shorter oral regimen for DRTB. The programme has emphasized addressing comorbidities such as malnutrition, diabetes, HIV and substance abuse; early assessment of severity of disease and appropriate referral to higher facilities under Differentiated TB care model for improving treatment outcomes.

• TB preventive services

The programme has made significant efforts to expand TB preventive treatment (TPT). In 2021, a comprehensive guideline for the programmatic management of TPT was released. Strong commitment from various states has shown a unified resolve to prevent the emergence of TB disease in vulnerable populations.

• Patient Support Systems

Under nutrition is an important risk factor for TB. Under NTEP, the government provides free diagnostics and quality assured drugs along with financial assistance of ₹ 1000 per month during the course of treatment for all TB patients in the country.

The Government introduced a scheme of Nikshay Poshan Yojana (NPY) in April 2018 for providing   DBT to support the nutrition of TB patients for the entire duration of treatment

• NTEP Schemes:-
  • Nikshay Poshan Yojana (NPY) Incentive to TB patients: – Rs. 1000/- Per Month till Completion Treatment.
  • Private Provider Incentive to Private Sector : – For TB case Notification Rs.- 500/- & For updating Outcome of TB Patient Rs – 500/- = Total – 1000 /-
  • Treatment Supporter Honorarium :-   for Drug Sensitive TB Case- Rs. 1000/- & Drug Resistance TB – Rs.5000/-
  • Informant Incentive to Any Non-salaried person:- 500/- As an informant of TB Case to Health Department.
  • TPT Supporter Incentive to Any  volunteer person :– 250/- Per Patients

• Active Case Finding

For reaching out to missing TB patients, the Government has begun systematic active TB case finding in high-risk groups. The programme has proactively conducted house-to-house searches of TB cases among these vulnerable populations. This includes people living with HIV, diabetics, undernourished, residential institutes like prisons, asylums, old age homes, orphanages, tribal areas, and marginalized populations.

• TB FREE GRAMPANCAYAT ABHIYAN:-

Panchayati Raj institute (PRI) is local government of villages that plays a significant role in its development.

PRI consists of three levels:

• Gram Panchayat at the village/group of villages level
• Block Panchayat or Panchayat Samiti at the intermediate level
• Zilla Panchayat at the district level

A Memorandum of Understanding (MoU) was signed between the Ministry of Panchayati Raj (MoPR) & Central TB Division on 8th July, 2022 to support the ‘TB Mukt Panchayat Initiative’ in an endeavor toward TB-free India. ‘TB Mukt Panchayats Initiative’ is to empower the PRI to realize the extent and magnitude of problems associated with TB, take necessary actions towards solving them, create healthy competition among panchayats, and appreciate their contribution.

In Kolhapur Rural

• Year 2023 – 82 Grampanchayat declared as “TB Free Grampanchayat” (Bronze)
• Year 2024 – 359 Grampanchayat declared as “TB Free Grampanchayat” (Silver – 50, Bronze – 309)

• Advocacy, Communication and Social Mobilization

Advocacy, communication, social mobilization, and community engagement have remained integral to the NTEP’s efforts, strengthening the program’s foundation and encouraging community involvement in TB elimination initiatives. A “Guidance Document on Community Engagement” has been developed to guide the States/ UTs in planning, designing, and monitoring the activities under community engagement.

• Partnerships

Several partners and stakeholders have come together for India’s fight to eliminate TB, bringing numerous innovative approaches and diverse strategies. The programme has established Technical Support Units at National and state levels to strengthen partnerships. A multisectoral approach was adopted to ensure meaningful engagement of key stakeholders, including government agencies, industries and non-governmental organizations (NGOs).

Name of the Scheme  -: – Clean  and  beautiful clinics

Grants Source for Scheme:- Zilla Parishad Self-funded and  Public Participation

Background of the scheme :-  Primary health center provides health care to patients in rural areas. To make the maximum benefit of health facilities provided by the government, the material environment of the Primary Health Center should be enjoyed. At the same time, it is necessary the people should be treated with affection by  officers / employees of the  primary  health center. To make special efforts for this.

Purpose of the scheme:- To make the external  and internal environment healthy  of the primary health center from the public participation.

 Term and conditions of Scheme :-

• Cleanliness and beautification of the premises of the Primary Health Center
• To provide physical facilities from the public participation
• Solving the old non -useful material.
• Managing solid waste / sewage.
• Providing separate clean toilet houses for men and women.
• Provide pure drinking water.
• Creating a welcome room, information room, visitor room.
• Using uniforms and identity cards to office officers / staff.
• Providing informants for the best health for patients.
• Adoption of non -conventional energy sources.
• To keep the office records in good condition.
• Besides, to fulfill the purpose of health work.
• To set up the above objectives, the participation of the officials / staff, the representatives of the people, the villagers to implement a cleanliness campaign one day every month.

Advantages of the  Scheme :-  

After the above criteria are settled, the environment of the primary health center will definitely be healthy, enthusiastic. This will create affection and positive feelings about the health center in the minds of the patients coming to the center. Therefore, the number of patients going to private hospitals will be reduced and the number of patients seeking treatment at the Primary Health Center will increase.

Required Funds :-

In this scheme successful  primary health center will be selected at each block level and a reward of Rs. A prize of Rs. 50000/- . District level first and second rank primary health center will be Selected  form 12 block level selected primary health center and  reward of a prize of Rs 100,000/-  for first rank and Rs.75000/- for second rank

For this

12 x Rs. 50, 000 = 6,00, 000 / – for Block level.

Rs. 1,00,000 + 75,000 = 1,75,000/- for District level.

Administration expenses = 25,000/-

Total expected expenditure = Rs. 8,00,000/-

Implementation of  Scheme – April  to December

Primary Health Centre:-  Block Level – December

Selection  District Level – January 2012

Selection Committee District Level –

1) Chairman, Health Committee Chairman, Pro-official Chairman

2) Deputy Chief Executive Officer (Water and Sanitation) – Member

3) Non-governmental Institution Representative – Member

4) District Doctors Association Representative – Member

5) District Health Officer, Zilla Parishad – Member Secretary

Selection Committee Block Level –

1) Chairman, Panchayat Samiti Chairman

2) Water and Sanitation Department Representative – Member

3) Block level non-governmental institution representative – Member

4) Taluka Doctors Association Representative – Member

5) Taluka Health Officer, Panchayat Samiti:– Member Secretary

Historical background

The Central Government and the World Bank launched the Integrated Disease Survey Programme in Maharashtra on June 21, 2005. Funding for this initiative was provided by the World Bank to the Central Government until 2012. The primary objective of this ambitious project is to consolidate all existing disease surveillance in the state. Another important goal is to enhance the dissemination of information by utilizing modern methods to strengthen the disease surveillance process from one state to another. The health services related to the Integrated Disease Surveillance Programme is located in Pune.

Objectives

1. In rural areas, it is important to develop the ability to identify disease outbreaks promptly and implement necessary actions to manage and control these outbreaks effectively.
2. Laboratories should be empowered to enhance the quality of disease diagnosis and to conduct regular monitoring of food and water safety.
3. We aim to improve the investigate and treatment of diseases covered by this programme.
4. Strengthening urban disease surveillance is essential.
5. Engagement from private medical professionals, medical colleges, and non-governmental organizations is crucial to promote community participation in disease surveillance.
6. It is important to utilize the latest information at all levels of government, from villages to state levels, to improve the dissemination of disease surveillance data.
7. We will strengthen health information systems and vital statistics, and promote the monthly progress reporting of disease surveys.
8. Coordination among all departments involved in the disease survey program is necessary for effective implementation.

Implementation

www.ihip.mohfw.gov.in/idsp  is the system where data is collected through the following survey procedures under the IDSP programme

1. S Forms (Syndromic) – A report is generated using the standardized format (Form S) in the real time data submission. This form includes data on the symptoms associated with ailments commonly observed in the community.

2.P Form (Presumptive) – The portal generates reports in the specified format (Form P) by examining patients with diseases identified among both intra-hospital and external patients through real time data submission.

3) Lab Confirmation Form (L Form) – When laboratory diagnosis is needed, a category is presented in the daily report (Form L) through laboratory diagnosis.

– The IHIP IDSP system collects patient information from all health institutions by retrieving reports from each facility. This data can be accessed on a daily basis using a specified format.

– Current news is monitored through media scanning.

– The toll-free number for the Integrated Disease Surveillance Programme is available nationwide for reporting any health concerns that arise throughout the country.

– The disease surveillance information gathered is sent to both the State and Central Governments through the comprehensive Health information system.

Medical college laboratories have been integrated as part of strengthening laboratory capacities. The primary goal of these laboratories is to offer testing facilities to districts during disease outbreaks.

Responsibilities of the Reference Laboratory

– Provide laboratory services to all districts.

– Maintain regular communication with the State Coordinator regarding laboratory facilities under the IDSP (Integrated Disease Surveillance Programme).

– Send regular IDSP Laboratory Reports.

– Report any laboratory prohibitions promptly to the State Surveillance Officer or District Surveillance Officer.

A toll-free number is available for assistance.

Both the district and state levels are actively working to effectively manage disease situations within the state which is named as RRT (Rapid Response Team). The team includes District Surveillance Officers, District Epidemic Officers, District Epidemiologist, Pediatrician, Microbiologist, Animal Husbandry Officers, and Assistant Commissioners of the Food and Drug Administration. This team addresses each outbreak occurring at the district level.

Surveillance unit are operating at both state and district levels as part of the human health program. A specialized public health expert team is led by the State Surveillance Officer, while the District Surveillance Officer collaborates with the District Epidemiologist, Data Manager, and Data Operator.

Procedure of the scheme

The Joint Director, Health Services, (Malaria, Filaria and Waterborne Diseases) Pune is the program head at the state level and controls the scheme. The Joint Director, Health Services, (Malaria, Filaria and Waterborne Diseases) Pune-6 is assisted by the Assistant Director, Health Services (Filaria) Pune and the State Entomologist at the regional level as well as the Assistant Director, Health Services (Malaria) at the regional level and at the district level, the District Malaria Officer provides this support.

Grant Method

The scheme receives grants from the state government and the National Rural Health Mission.

Following are the various anti-Malarial measures implemented in the state under the guidelines of the central government.

(A) Survey

• Survey by staff at all padas, wadaya wasti, village level in the state to find new Malaria patients.
• Entomological survey by health workers.
• Involvement of ASHA Swayamsevika / Pada Swayamsevak in Vector Born Disease Control Program at local level,

(B) Laboratory

• Laboratory technicians are also available at district and rural hospital level.

• One Lab Technician post sanctioned at each Primary Health Center.

• Supply of rapid diagnostic test kits for immediate diagnosis of Malaria in remote and extremely remote areas.

• Functional training to “Asha” For P. falciparum falciparum early diagnosis and treatment.

• There are 23 sentinel centers in the state for the diagnosis of Dengue / Chikungunya disease out of which 8 centers are newly established and operational since 2011-12.

Measures for mosquito control

Insecticide Spraying – House to house spraying of synthetic pyrethroid group insecticides is carried out in selected and outbreak-prone villages in the state that are highly susceptible

to Malaria.

Antilarval spraying –  Temiphos, BTI at mosquito breeding sites in selected 15 cities of the state (including Mumbai) under Nagri Hivatap Yojana, this antilarval is sprayed. The 15 cities

included in the Urban Malaria Scheme in the state are Aurangabad, Beed, Nanded, Parbhani, Dhule, Nashik, Manmad, Jalgaon, Bhusawal, Ahmednagar,

Pandharpur, Solapur, Akola, Pune and Mumbai. Although not included in this scheme, Temiphos is being used in Kolhapur district.

Scientific measures – Mosquito-eating Guppy Fishes are released in suitable breeding sites in the state considering the pollution caused by pesticides. The said measures are taken in  rural as well as urban areas.

Leprosy is mild infectious disease caused by Micobacterium leprae, mainly affecting skin and nerves and completely curable with Multi drug therapy.

National Leprosy Control programme was launched in 1955.  The drug  dapsone was used for treatment at that time. Since 1982 Multi drug therapy (MDT) is used for Leprosy treatment. The programme was renamed as National Leprosy Eradication Programme as Leprosy is a  curable disease.

The incubation period of leprosy is usually 2 to 10 years. 98 percent of people have natural immunity to fight this disease.

Signs and symptoms of Leprosy

• Non itchy and non painfull lessions with loss of sensation
• Thick and tender nerves
• Clawing of fingures –hand, leg
• Planter and Palmar anasthesia

Types of Leprosy and treatment

Three drugs, Rifampicin, Clofazimine, and Dapsone, are used in Multi drug therapy (MDT)  for treatment of leprosy. There are two types of leprosy, Multibacilary (MB)  and Paucibacilary (PB). Leprosy is classified as MB if more than 5 lesions or nerve involvement  is present, and PB if 1 to 5 lesions are present. MB patients are treated for 12 months and PB patients for 6 months. Free diagnosis and treatment of leprosy is available in all primary health centers and government and semi-government hospitals in Kolhapur district.

Achivement

In 2005 Kolhapur district have  achived the target of Leprosy elimination ( prevalence rate of leprosy less than 1 case per 10,000 population ).   Now District is moving towards eradicating Leprosy.

Brief Information of the Scheme:- Family Planning Indemnity  Scheme in the state as per the Government Resolution  Number Kunio-2013/Pr.No.74/Ministry of Family welfare  Mumbai dated 9 May 2013  the scheme  has been implemented in the state  from 1^st April 2013 retrospectively.   The above GR revised on 18 july 2016 as Kunish-1/No.1/KU. According to this G.R.  the compensation of the Central Government is paid from the funds available under the National Health Mission. As per the G.R. dated 11 October 2019 the amount of compensation same as the centeral Government has  paid is paid from the State Government’s funds to the beneficiary .

Section I  –  Death due to family planning surgery in the hospital or  death after discharge within 7 days . Rs.200000/-

Section II –  Death due to family planning surgery within 8 to 30 days after date o f discharge . Rs. 50000/-

Section IC –  Failure of Family planning sterilization Rs 30000/-

Section ID –  Complication  after family planning sterilization arise within 60 days  in connection with family planning sterilization – actual costs but within the limit of Rs. 25000/-

Where to apply – The application should be submitted within 90 days from the date of diagnosis in the health institution where sterilization surgery performed .

Launched :  PMMVY scheme launched on 1^st September, 2017

Aim :-

1. To improve health of mother and child.
2. To provide nutritional diet to the mother at the time of pregnancy.
3. To reduce maternal and infant mortality rate.

Benefit: –  The mother is getting benefited during first delivery by the benefit of Rs.5,000/-  in 3 steps.

1. 1st Installment Rs. 1000/- given primi woman after registration govt. Hospital (upto 5 Month of ANC)
2. 2nd Installment Rs. 2000/- given after first ANC Checkup  govt. Hospital or Private Hospital.(upto Delivery)
3. 3rd Installment Rs. 2000/- given after basic Vaccination done. (For this Birth Certificate child is mandatory)

Condition – 

1. Scheme is applicable first Live Child, Applicable only one time.
2. Scheme is not applicable for woman who working in Govt. & Non-Govt Org. having paid Maternal leave.

Launched : PMMVY scheme launched on 1^st September, 2017

Aim :-

1. To improve health of mother and child.
2. To provide nutritional diet to the mother at the time of pregnancy.
3. To reduce maternal and infant mortality rate.

Benefit: –  The mother is getting benefited during first delivery by the benefit of Rs.5,000/-  in 3 steps.

1. 1st Installment Rs. 1000/- given primi woman after registration govt. Hospital (upto 5 Month of ANC)
2. 2nd Installment Rs. 2000/- given after first ANC Checkup  govt. Hospital or Private Hospital.(upto Delivery)
3. 3rd Installment Rs. 2000/- given after basic Vaccination done. (For this Birth Certificate child is mandatory)

Condition – 

1. Scheme is applicable first Live Child, Applicable only one time.
2. Scheme is not applicable for woman who working in Govt. & Non-Govt Org. having paid Maternal leave.