Community medicine : High Yield points

 1. James Lind is related to the discovery of Prevention of scurvy 

2. Gap in time between entry of the organism and the appearance of signs and symptoms is the incubation period 

3. Time between entry of the organism and to produce maximum infection is known as generation time 

4. Time interval between disease initiation and disease detection in a noninfectious disease is known as latent period 

5. Serial interval is the time between onset of primary case and secondary case 

6. Occurrence of the polio is an example of propagated epidemic 

7. Bhopal gas tragedy is an example of Point source epidemic 

8 Endemic disease means that a disease is constantly present in a given population group 

9. Secular trends are progressive changes occuring over long period of time 

10. Point source epidemic occurs in one incubation period 

11. First case that comes to notice of physician is Index case

Committees in PSM

The Many Committees in PSM tell a story- lets read it.
(Questions asked have been marked with *) 

The story begins in 1943.
Government of India (still under the British) appointed BHORE (SIR JOSEPH BHORE) to assess
the health situation in India and make recommendations. He took 2 years roaming around and made his recommendations in 4 volumes! Keywords we need to remember-
• Integration of preventive and curative services at all administrative levels
• Development of PHC in 2 stages- short term and longterm (called the 3 million plan) (*)
• Concept of “social physicians” (3 months training) Then we got independence and apparently got smarter. 

We decided to see if what the Goron ka Bhore had recommended is working or not! 

So came the MUDALIAR COMMITTEE in 1962 to provide afresh look. It said strengthen
what we have, don’t build more. 

Next year (1963) came the CHADAH COMMITTEE. It was
made to study arrangements for the NMEP’s maintenance
phase. It said one basic health worker should work for 10,00 population. And they should be
multipurpose health workers-malaria + family planning +
vital statistics (*) 

Then 2 years later (1965) came the MUKERJI COMMITTEE. They very smartly realized that what
Chadah ji said is not working.
Neither Malaria nor Family planning work is being done properly. So let’s separate them.
Let’s make basic health worker work for all other random stuff.
And family planning assistant to do only family planning jobs.
They also said separate malaria from family planning!
Then in 1966, same committee found that it got too much for
the states to do because of lack
of funds. So they worked out a system called “Basic Health Service” being provided at the
block-level to figure out the
administration jargon. 

JUNGALWALLA COMMITTEE came the year after that (1967).
Srinagar mein baithke they
talked about how to eliminate private practice for government
doctors and just how to integrate health services. So they came up with the idea of
“Integrated Health Services” (*) 

Next KARTAR SINGH COMMITTEE
met in 1973 (6 years later) and this committee was called the
“Committee on Multipurpose
workers under Health and
Family planning” (because we like revisiting the past!). They said
• Convert the current Auxilary Nurse-Midwives into Female Health Workers
• Convert the Basic Health Workers/Malaria Surveillance Workers/Vaccinators/Health Education Assistants/Family planning health assistants into
Male Health Workers
• Introduce MPWs first into Malaria maintenance phase and Smallpox controlled areas, then spread them out
• One PHC for 50,000 people
• Every PHC should have 16 subcentres 

• Every subcentre should have 1 male and 1 female health worker Then two years later came

SHRIVASTAV COMMITTEE (1975).
They wanted to make a plan to train all these new position people. They said we need more people (these positions aren’t enough!). So their recommendations were
• Train para and semi-professional workers- like school teachers etc to help out in the community 

• Establish 2 more cadres of health workers- Multipurpose
Health Workers and Health Assistants between the community level and doctors at PHCs 

• Develop a Referral Services Complex

• Something about medical education also

• Most importantly it said that
Primary health care should be provided within the community
itself through specially trained
people – place the health of the
people in the hands of the
people themselves! (*) Its long I know..but I hope it
helps.

INDIA NEWBORN ACTION PLAN

INDIA NEWBORN ACTION PLAN

🔹 Peri conceptional folic acid
🔹Administer corticosteroids in preterm labour and Antibiotics for PROM
🔹Delayed cord clamping and vit K at birth
🔹 care of healthy newborn by ASHA for 6 wks (42 days)
🔹 care of small/sick Newborn (like inj. Gentamicin to prevent sepsis to be given by ANM)
🔹 care beyond Newborn survival

- Screen for 4 Ds  i.e. Defects or birth defects, development delays, deficiency, diseases
- Follow up of SNCU babies by ASHA for 1 year and LBW babies for 2 year

Kindly correct previous one - LBW for 2 years

Bio Medical Waste

Yellow

Type of Waste

(a) Human Anatomical Waste : Human tissues, organs, body parts and fetus below the viability period
(as per the Medical Termination of Pregnancy Act 1971, amended from time to time).

(b) Animal Anatomical Waste : Experimental animal carcasses, body parts, organs, tissues, including
the waste generated from animals used in experiments or testing in veterinary hospitals or colleges
or animal houses

(c) Soiled Waste: Items contaminated with blood, body fluids like dressings, plaster casts, cotton
swabs and

(d) Expired or Discarded Medicines: Pharmaceutical waste like antibiotics, cytotoxic drugs including
all items contaminated with cytotoxic drugs along with glass or plastic ampoules, vials etc.

(f) Chemical Liquid waste : Liquid waste generated due to use of chemicals in production of
biological and used or discarded disinfectants, Silver X-ray film developing liquid, discarded Formalin,
infected secretions, aspirated body fluids, liquid from laboratories and floor washings, cleaning,
house-keeping and disinfecting activities etc.
(g) Discarded linen, mattresses, beddings contaminated with blood or body fluid.

(h) Microbiology, Biotechnology and other clinical laboratory waste: Blood bags, Laboratory cultures,
stocks or specimens of microorganisms, live or attenuated vaccines, human and animal cell
cultures used in research, industrial laboratories, production of biological, residual toxins, dishes
and devices used for cultures.

Type of Bag or Container to be used :Yellow coloured non-chlorinated plastic bags

Treatment and Disposal options :Incineration or Plasma Pyrolysis or deep burial

---

Red

Type of Waste

(a) Wastes generated from disposable items such as tubing, bottles, intravenous tubes and sets,
catheters, urine bags, syringes (without needles and fixed needle syringes) and vaccutainers with
their needles cut) and gloves.

Type of Bag or Container to be used :Red coloured non-chlorinated plastic bags or containers

Treatment and Disposal options: Autoclaving or micro-waving/ hydroclaving followed by shredding
or mutilation or combination of sterilization and shredding. Treated waste to be sent to registered
or authorized recyclers or for energy recovery or plastics to diesel or fuel oil or for road making,
whichever is possible. Plastic waste should not be sent to landfill sites

---

White (Translucent)

Type of Waste

Waste sharps including Metals: Needles, syringes with fixed needles, needles from needle tip cutter
or burner, scalpels, blades, or any other contaminated sharp object that may cause puncture and
cuts. This includes both used, discarded and contaminated metal shar

Type of Bag or Container to be used :Puncture proof, Leak proof, tamper proof containers

Treatment and Disposal options : Autoclaving or Dry Heat Sterilization followed by shredding
or mutilation or encapsulation in metal container or cement concrete; combination of shredding
cum autoclaving; and sent for final disposal to iron foundries (having consent to operate from
the State Pollution Control Boards or Pollution Control Committees) or sanitary landfill or
designated concrete waste sharp pit

---

Blue

Type of Waste

(a) Glassware: Broken or discarded and contaminated glass including medicine vials and ampoules
except those contaminated with cytotoxic wastes. Cardboard boxes with blue colored marking
Disinfection (by soaking the washed glass waste after cleaning with detergent and Sodium
Hypochlorite treatment) or through autoclaving or microwaving or hydroclaving and then sent for
recycling.

(b) Metallic Body Implants

Type of Bag or Container to be used :Cardboard boxes with blue colored marking

Treatment and Disposal options :Disinfection (by soaking the washed glass waste after cleaning
with detergent and Sodium Hypochlorite treatment) or through autoclaving or microwaving or
hydroclaving and then sent for recycling.

International days

FEBRUARY
4- World cancer day [WHO]
6- International Day of Zero Tolerance to Female Genital Mutilation [WHO]
MARCH
21- World Down Syndrome Day
22- World Water Day
23- World Meteorological Day [WMO]
24- World Tuberculosis Day [WHO]
(21 is trisomy 21 day and after that comes Water, Weather and Air – 22nd, 23rd, and 24th)
APRIL
2- World Autism Awareness Day
7 -World Health Day [WHO]
25- World Malaria Day [WHO]
28- World Day for Safety and Health at Work [ILO]
MAY
15-International Day of Families
22-International Day for Biological Diversity
23-International Day to End Obstetric Fistula
31-World No-Tobacco Day [WHO]
JUNE
5- World Environment Day [UNEP]
8- World Oceans Day
12- World Day Against Child Labour
14- World Blood Donor Day [WHO]
15- World Elder Abuse Awareness Day
26- International Day against Drug Abuse and Illicit Trafficking
JULY
11-World Population Day
18- Nelson Mandela International Day
28-World Hepatitis Day [WHO]
AUGUST
12- International Youth Day
19- World Humanitarian Day
SEPTEMBER
10- World Suicide Prevention Day [WHO]
21- International Day of Peace
28- World Rabies Day [WHO]
Last Saturday in September- World Heart Day [WHO]
OCTOBER
10- World Mental Health Day [WHO]
Second Thursday in October- World Sight Day [WHO]
11- International Day of the Girl Child
13- International Day for Disaster Reduction
16- World Food Day [FAO]
17- International Day for the Eradication of Poverty
24- United Nations Day
NOVEMBER
12- World Pneumonia Day [WHO]
14- World Diabetes Day [WHO]
16- World Chronic Obstructive Pulmonary Disease Day [WHO]
DECEMBER
1- World AIDS Day
3- International Day of Persons with Disabilities
9- International Anti-Corruption
10- Human Rights Day

SPM Updates

1. 16th may 2016 celebrated as Dengue day for the first time.
2. Primordial and primary prevention- more effective and more difficult.
3. Secondary and Tertiary prevention- less effective and less difficult.
4.September 8th- world literacy day
Literacy rate of India- 74.6
Male-82.1 & female- 65.5
Tripura = max literacy rate
5.Current crude death rate = 7/1000 population
mid year population = as of 1st of june
6. Latest vaccine to be launched is for Rotavirus(oral drops), before that was IPV (inactivated polio vaccine).
7.Poverty line- amount required to buy 2400kcal/person/day in rural and 2200kcal/person/day in urban setup.
urban- rs42/-, rural- rs32/- per day.
india has 29.5% population BPL
8.most common type of disaster in india= hydrological
dealt by home ministry but head of national disaster management is Prime minister.
2nd wednesday of october = world disaster day
Tamil nadu and west bengal most affected by disaster.
most common post disaster disease = acute gastroenteritis
9.world health day = 7th april
and agenda as of 7th april 2016= beat diabetes
10. child sex ratio= 923
adult sex ratio= 943
Indian TFR = 2.3
11.pearl index of male condom = 2-14/hwy
IUD = 0.5-2.0/hwy
oral pill = .0-.5/hwy
NEW BRAND NAME OF CONDOMS AVAILABLE UNDER NATIONAL PROGRAM IS "ASHA" , previously called as "NIRODH" (2016)
12. SWACH BHARAT ABHIYAN launched on 2/10/14, objective is to clean india by 2019 on 150th birthday of Mahatma Gandhi.
13. MMR = 167/1 LAKH LIVE BIRTHS
IMR = 40/1000 LIVE BIRTHS
NMR = 28/1000 LIVE BIRTHS
U5MR = 49/1000 LIVE BIRTHS
STILL BIRTH RATE = 22/1000 LIVE BIRTHS
INSTITUTIONAL DELIVERIES = 80%
FULLY IMMUNISED = 72%
14. GERIATRICS = AGE >60 YRS
8.5% GERIATRICS ON 15/04/2016
most common health disorder (india) = cataract
most common cause of death = cardiovascular diseases
15. Latest national scheme for BPL is "UJJAWALA" BY NARENDRA MODI that is providing LPG to BPL families.
16. most common cause of paediatric mortality is prematurity.
17. ideal ANC visits(WHO) are,
monthly till 7th month
bi monthly in 8th month
weekly in 9th month
NOW MINIMUM ANC VISITS ARE 4 BY WHO(2015)
FIRST- AT REGISTRATION <12 WEEKS
SECOND- 14-26 WEEKS
THIRD - 28-34 WEEKS
FOURTH- AFTER 36 WEEKS
PNC VISITS = MONTHLY TILL 6 MONTHS.
18. NATIONAL DE- WORMING DAY = 10TH FEB
MEBENDAZOLE (DOC) - 1ST TRIMESTER
ALBENDAZOLE (DOC) FROM 2ND TRIMESTER ONWARDS,
also for adults and child.
19. CAUSES OF MATERNAL MORTALITY
DIRECT- HAEMORRAGE(37%)
INDIRECT- ANEMIA (35%)
20. INDIAN CUT OFF FOR OBESITY - BMI = 22.5
GLOBALLY- 25

SUGGESTED NORMS

SUGGESTED NORMS

🔹1 Doctor
👉3500 population

🔹nurse
👉5000

🔹HWM/HWF
👉5000 in plains & 3000 in hilly areas

🔹trained dai
👉1 for each village

🔹HA male/HA femle
👉30000 in plains & 20000 in hilly area

🔹pharmacist
👉10000

🔹lab tech
👉10000

🔹asha
👉1000

Accredited Social Health Activist (ASHA)

One of the key components of the National Rural Health Mission is to provide every village in the country with a trained female community health activist ASHA or Accredited Social Health Activist. Selected from the village itself and accountable to it, the ASHA will be trained to work as an interface between the community and the public health system. Following are the key components of ASHA :

• ASHA must primarily be a woman resident of the village married/ widowed/ divorced, preferably in the age group of 25 to 45 years.
• She should be a literate woman with due preference in selection to those who are qualified up to 10 standard wherever they are interested and available in good numbers. This may be relaxed only if no suitable person with this qualification is available.
• ASHA will be chosen through a rigorous process of selection involving various community groups, self-help groups, Anganwadi Institutions, the Block Nodal officer, District Nodal officer, the village Health Committee and the Gram Sabha.
• Capacity building of ASHA is being seen as a continuous process. ASHA will have to undergo series of training episodes to acquire the necessary knowledge, skills and confidence for performing her spelled out roles.
• The ASHAs will receive performance-based incentives for promoting universal immunization, referral and escort services for Reproductive & Child Health (RCH) and other healthcare programmes, and construction of household toilets.
• Empowered with knowledge and a drug-kit to deliver first-contact healthcare, every ASHA is expected to be a fountainhead of community participation in public health programmes in her village.
• ASHA will be the first port of call for any health related demands of deprived sections of the population, especially women and children, who find it difficult to access health services.
• ASHA will be a health activist in the community who will create awareness on health and its social determinants and mobilise the community towards local health planning and increased utilisation and accountability of the existing health services.
• She would be a promoter of good health practices and will also provide a minimum package of curative care as appropriate and feasible for that level and make timely referrals.
• ASHA will provide information to the community on determinants of health such as nutrition, basic sanitation & hygienic practices, healthy living and working conditions, information on existing health services and the need for timely utilisation of health & family welfare services.
• She will counsel women on birth preparedness, importance of safe delivery, breast-feeding and complementary feeding, immunization, contraception and prevention of common infections including Reproductive Tract Infection/Sexually Transmitted Infections (RTIs/STIs) and care of the young child.
• ASHA will mobilise the community and facilitate them in accessing health and health related services available at the Anganwadi/sub-centre/primary health centers, such as immunisation, Ante Natal Check-up (ANC), Post Natal Check-up supplementary nutrition, sanitation and other services being provided by the government.
• She will act as a depot older for essential provisions being made available to all habitations like Oral Rehydration Therapy (ORS), Iron Folic Acid Tablet(IFA), chloroquine, Disposable Delivery Kits (DDK), Oral Pills & Condoms, etc.
• At the village level it is recognised that ASHA cannot function without adequate institutional support. Women's committees (like self-help groups or women's health committees), village Health & Sanitation Committee of the Gram Panchayat, peripheral health workers especially ANMs and Anganwadi workers, and the trainers of ASHA and in-service periodic training would be a major source of support to ASHA.

Mission Indradhanush

Mission Indradhanush was launched by Ministry of Health and Family Welfare (MOHFW) Government of India on 25th December, 2014. The objective of this mission is to ensure that all children under the age of two years as well as pregnant women are fully immunized with seven vaccine preventable diseases.

The Mission Indradhanush, depicting seven colours of the rainbow, targets to immunize all children against seven vaccine preventable diseases, namely:

1. Diphtheria
2. Pertussis (Whooping Cough)
3. Tetanus
4. Tuberculosis
5. Polio
6. Hepatitis B
7. Measles.

In addition to this, vaccines for Japanese Encephalitis (JE) and Haemophilus influenzae type B (HIB) are also being provided in selected states.

First Phase of Mission Indradhanush:

For the first phase, 201 high focus districts across 28 states in the country that have the peak number of partially immunized and unimmunized children were identified by the Government.

There were total four rounds in the first phase of the mission. The first round of the first phase was started from 7th April, 2015 and continued for more than a week.

Further, second, third and fourth rounds were held for more than a week in the month of May, June and July starting from 7th of each month. The first phase of this mission was very successful.

The main highlights of the first phase of Mission Indradhanush are as given below:

•   Total 9.4 lakh sessions were organized during these four rounds of Mission Indradhanush
•   About 2 crore vaccines were given to the children as well as pregnant women.
•   Tetanus Toxoid vaccine was given to more than 20 lakh pregnant women
•  75.5 lakh children were vaccinated and about 20 lakh children were fully vaccinated.  
•   More than 57 lakh zinc tablets and 16 lakh ORS packets were freely distributed to all the children to protect them against diarrhoea.

Second Phase of Mission Indradhanush

The second Phase of Mission Indradhanush has been started from 7th October, 2015. The second, third and fourth rounds of this phase will start from 7th November, 7th December 2015 and 7th January 2016. 

The aim is to achieve full immunization in 352 districts which includes 279 mid priority districts, 33 districts from the North East states and 40 districts from phase one where huge number of missed out children were detected.

HOME BASED NEWBORN CARE

Under India Newborn action plan

• Main worker - ASHA
• Institutional delivery - 6 visits (day 3,7,14,21,28,42)
• Home deliveries - 7 visits (day 1,3,7,14,28,42)
• LBW babies, Special newborn care unit (SNCU) babies to be followed for one year
• Incentive for ASHA on 45th day if

Record of birth weight in card
Immunization with BCG, OPV1, DPT1 entry in card
Registration of birth done
Both baby n mother safe till 42nd day of delivery

Source - Latest edition park

Malaria

Malaria:

Urban- Stephensi

Rural- Culicifacies

Brackish water- Sundaicus

Moving water- Fluviatilis

Most efficient- Fluviatilis

Overhead tanks- Stephensi

Anthrophilic- Fluviatilis

Isolation period

Isolation period of some infectious diseases-

👌🏾Chicken pox Until all lesions crusted,
usually 6 days after onset of rash

👌🏾Measles-From onset of catarrhal stage to the
3rd day of rash

👌🏾German measles/rubella None

👌🏾Hepatitis A 3 wks

👌🏾Influenza 3 days onset

👌🏾Polio 2 weeks adult, 6 wks pediatric

👌🏾Tuberculosis Until 3 wks of effective
chemotherapy

👌🏾Herpes zoster 6 days after onset of rash

👌🏾Mumps Until swelling subsides

👌🏾Meningococcal meningitis Until 1st 6 hrs of
effective antibiotic therapy

Spm

SPM
Vit. A prophylaxis program --ministry of health and family
welfare,mohfw
Prophylaxis against nut.anrmia--mohfw
Iodine deficiency disorder Ctrl program.-mohfw
Special nutrition prog--ministry of social welfare,mosw
Balwadis nutrition prog--mosw
Icds--mosw
Mid meal programme--ministry f education
Mid meal scheme--ministry f HRD
A.water born dises--
diarrhoea,cholera,typhoid,dysentery,polio,hepatitis A and e
B.water based disease--snails--schistosomiasi,cyclops--
dracunculiasi
C.water related vector di--malaria,filaria,he,sleep in sickness
D. water source/washed di-
trachoma,scabies,conjuntuvitis,bacillary and amoebic dysentry,skin
sepsis,lice,salmonellosis,worm infestation

��Hardness of Water
--soap destroying power of water
A.temporary h.--d/t bicarbonates of Ca and Mg
B. permanent h.--d/t sulphate,chloride,nitrate of Ca and Mg

��Hardness of Water
Classification of hard water ( as mg/l of caco3)__
Soft--0-50 mg/ l (<1 meq/l)
Mod hard--51-150(1-3)
Hard--151-300(3-6)
��Very hard-->300(>6)

����WASTES
A.sewage--wasts water + excreta
B.sullage--waste water not contaminated with excreta e.g
kitchen,bathroom waste
C.scum--after prim sedimntn f sewage ,organic matter settle
down as sludge and fatty layer float know as scum
D.dry weather flow--avg amount f sewage which flows through sewerage system in 24 hr

����INSTRUMENTS
A.anemometer-fr low air velocity
B.kata thermometer-cooling power f air
C.assman sling psychrometer--humidity f air
D.Symons rain gauze--measurs ppt. f rain,snow,hail,dew,frost
E.dial thermometer-cold chain temp monitoring
F.salter scale--measure b. at
G.Winchester quart bottle--asses physical and chemical quality f
drinking water
H.chloroscope--measur residual cl in water
I.colorimeter--determine colour f water
J.chloronome--mixing cl in water

����Family cycle
��A.formation--marriage to birth f 1 st child
��B.extension--birth f 1 st child to birth f last child
��C.complete extension--birt f last child to 1 st child leave home
��D.contraction--1 st child leave home to last child left home
��E.completed contraction-last child left home to 1 st spouse dies
��F.dissolution--1 st spouse dies to death f survivor
Comfort Zones
��A.pleasant and cool--20
B.comfortable and cool --20-25
C.comfortable--25-27
D.hot and uncomfortable--27-28
E.extremely hot--28+
��F.intolerable hot--30+

����Overcrowding and Accepted standards
��FLOOR SPACE--accepted standards r--
>=110 sq ft.--2 persons
90-100 sq ft--1 and 1/2 person
70-90 sq ft--1 person
50-70 sq ft--1/2 person
<50 sq ft--nil
---baby < 12 month is not counted.children b/w 1-10 yr as half

����Persons per room--accepted standards r--
1 room--2 persons
2 room--3 persons
3 rooms--5 persons
>5 rooms--10 persons( addnl 2 fr each further room)

Mission Indradhanush 2014

Mission Indradhanush 2014

Launch
25 December 2014

Description

Indradhanush depicting seven colors of the rainbow, aims to cover all those children by 2020 who are either unvaccinated, or are partially vaccinated against 7 vaccine preventable diseases (7 VPD’s)

• Diphtheria
• Pertussis
• Tetanus
• Childhood Tuberculosis •Poliomyelitis
.Hepatitis B
•Measles.

Strategy

Focused and systematic immunization drive: “Catch-up” campaign mode to cover all the children who have been left/ missed out.

4 special vaccination campaigns: January-June 2015 with intensive planning and monitoring.

Learning of Polio program: Apply in planning and implementation.

Coverage:
-First phase: 201 districts
– Second phase: 297 districts
– 82 districts in 4 states of UP, Bihar, Madhya Pradesh and Rajasthan.

some high yield points for insects :

some high yield points for insects :

life span of mosquito -2 weeks
life span of hosuefly-----15 days in summer and 20 days in winter
life span of lice----30 to 50 days
life span of tsetse---100 days
life span of tick---1 year
starved flea jupms 6 inch
fed flea jumps 3 inch
flying span of hosuefly 14 mm
distance flown by anopheles---5km
 by culex----11km
 by aedes---1oom
by black fly----100 miles

WHO theme 2015

WORLD Health Day, which is celebrated every 7th of April since 1948 marks the founding anniversary of the World Health Organization.
Every year, a theme is selected to highlight a priority area of worldwide public health concern.
The 2015 World Health Day theme is Food Safety

Drinking water guidelines

Recommended guidelines for drinking water:
. Color < 15 TCU
. Turbidity < 5 NTU
. pH= 6.5-8.5
. Total dissolved solid (TDS)= <600 mg/L
. Zero infection virus
. Zero pathogenic microrganism
. Chlorine < 1.5 ppm
. Nitrate < 45 - 50 mg/L
. Nitrite < 3mg/L
. Gross alpha radioactivity < 0.1 becquerel/L
. Gross beta radioactivity <1 becquerel/L

Water requirements

Recommended water supply norm (lpcd)

Less than 20,000 populatn
a. Population served by stand posts- 40L

b. Population provided with pipe connections
70

20,000 to Less than 100,000 -- 100L

100,000 to Less than 1,000,000

100 (with no sewerage system)

135 (with sewerage system)

1,000,000 and above-
150L

Rural and hills (per elevation difference of 100 m)

40L or one hand-pump for 250 persons within a walking distance of 1.6 km

Rural – additional water for cattle in Desert Development Programme (DDP) areas.
30L

Food safty 2015

Food safty 2015

Guidelines
WHO’s Five
keys to safer food offer practical
guidance to vendors and consumers
for handling and preparing food:
Key 1: Keep clean
Key 2: Separate raw and cooked food
Key 3: Cook food thoroughly
Key 4: Keep food at safe
temperatures
Key 5: Use safe water and raw
materials.

National Programme for Control of Blindness

National Programme for Control of Blindness

National Programme for Control of Blindness was launched in the year 1976 as a 100% Centrally Sponsored scheme with the goal to reduce the prevalence of blindness from 1.4% to 0.3%. As per Survey in 2001-02, prevalence of blindness is estimated to be 1.1%. Rapid Survey on Avoidable Blindness conducted under NPCB during 2006-07 showed reduction in the prevalence of blindness from 1.1% (2001-02) to 1% (2006-07). Various activities/initiatives undertaken during the Five Year Plans under NPCB are targeted towards achieving the goal of reducing the prevalence of blindness to 0.3% by the year 2020. 

Main causes of blindness are as follows: - Cataract (62.6%) Refractive Error (19.70%) Corneal Blindness (0.90%), Glaucoma (5.80%), Surgical Complication (1.20%) Posterior Capsular Opacification (0.90%) Posterior Segment Disorder (4.70%), Others (4.19%) Estimated National Prevalence of Childhood Blindness /Low Vision is 0.80 per thousand

Goals & Objectives of NPCB in the XII Plan

· To reduce the backlog of blindness through identification and treatment of blind at primary, secondary and tertiary levels based on assessment of the overall burden of visual impairment in the country.
· Develop and strengthen the strategy of NPCB for “Eye Health” and prevention of visual impairment; through provision of comprehensive eye care services and quality service delivery.
· Strengthening and upgradation of RIOs to become centre of excellence in various sub-specialities of ophthalmology
· Strengthening the existing and developing additional human resources and infrastructure facilities for providing high quality comprehensive Eye Care in all Districts of the country;
· To enhance community awareness on eye care and lay stress on preventive measures; 
· Increase and expand research for prevention of blindness and visual impairment
· To secure participation of Voluntary Organizations/Private Practitioners in eye Care