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PUBLIC HEALTH CHALLENGES

PUBLIC HEALTH IN INDIA
There are various health
problems that identified in
india causing biggest trouble
in way of public
health.Diseases may be in
the form of
communicable ,non
communicable and
infectious.

TUBERCULOSIS
It is a biggest public health challenge in India.Most of cases
are untreated and undetected even with presence of
various health services.Drugs not only fail to fully eliminate
the TB but cause multiple drug resistant.

INCIDENCE AND PREVALENCE
2.8 million cases in india in 2015.
0.13 million developed multiple drug resistant in 2015 in
india.
According to WHO in india,an estimated 27.9 lakh patients
were suffering from TB in 2016 and upto 4.23 lakh patients
were estimated have died during this year.

POLICIES TO CONTROL TUBERCULOSIS
• Tuberculosis control programme
•Set up PHC
•TB clinics established throughout the country and x-ray
facilities
•Vaccination
•Revised National Tuberculosis Control
ProgrammeRNTCP
•DOTS therapy

CHALLENGES IN IMPLEMENTATION OF PROGRAMS
•WEAK HEALTH SYSTEM
•SHORTFALL IN FUNDING
•INEQUITY AMONG
PEOPLES
•LIMITED NUMBER OF
HEALTH PROVIDERS
•LIMITED ACCESS TO
GOVT POLICIES
•SOCIOECONOMIC
INEQUITIES
•RAPID URBANIZATION

MEASURES TO OVERCOME THESE CHALLENGES
•Awareness regarding DOTS which is free of cost,about
transmission of disease.
•Improving living conditions
•Promote healthy life style
•Spend more funds toward health facilities.
•Early detection of cases and treated as early as possible.
•Isolation of patient,well ventilated houses.

FOUNDATIONOFPUBLICHEALTH
SUBMITTEDBY:Mrs.Gurmeetkaursandhu
13024928
Subjectcode:96702

PUBLICHEALTHCHALLENGES
Indiaisadevelopingcountry,therearenumeroushealth
problemsarisingdaybydayduetopoorhealth
services.poverty,illiteracy,unawareness,lowsocio-economic
statusleadtohealthproblems.Theseproblemsbecomea
challengeforpublichealthdevelopment.
BURDENOFDISEASEORPUBLICHEALTHCHALLENGESININDIA
Indiafacestheburdenofdiseasesintheformofinfectious
diseases,communicableandnon-communicablediseases.Thishigh
burdenofdisease,disabilityanddeathcanbeidentifiedthroughan
effectivepublichealthcaresystem.Indiasuffersfromvariousdisease
duetolackofenvironmentalsanitationandpresenceofsafe
drinkingwater,malnutrition,poorlivingconditions,andlimitedaccess
topreventiveandcurativehealthservices.Tuberculosisisaoneofthe
biggestpublichealthissueinindiawith2.79millionincidenceof
newcasesinaparticularperiodoftime.
TUBERCULOSIS
Tuberculosisisamajorpublichealthprobleminindia.Medicinesnot
onlyfailedtoeleminatethetuberculosisbutcausemultipledrug
resistant.
INCIDENCEANDPREVALANCE
in2006,Indiahas299peoplelivingwithTBper100000populationor
3.4millionprevalentcases.Everyyear,2millionpeopledevelopTB.
IndiahasthehighestburdenofTBwithtwodeathsineverythree
minutes
27%theproportionofTBcasesoftheworldin2015.
2.8millionpeopledevelopedTBinindiain2015.
0.13millionpeopledevelopdmultidrug-resistantorrifampicin
resistansttuberculosisinindiain2015.
AccordingtoWHOinindia,anestimated27.9lakhpatients
weresufferingfromTBin2016andupto4.23lakhpatientswere
estimatedtohavediedduringthisyear.
EstimatedTBcasesnumberRateper100,000
population
Incidence(HIV+TB)870006.6

Incidence(MDR/RR+TB
)
14700011
IncidenceofTB2.790million211
Mortality(HIV+TB)120000.92
MortalitywithTB42300032
PROGRAMSTOCONTROLTUBERCULOSIS
1.Nationaltuberculosiscontrolprogram:In1959theGovernment
ofIndia,withthehelpofWHO,developanationaltuberculosis
controlprogram,withtheaimofestablishingpromptdiagnosisand
ambulatorytreatmentwhichwereintegratedintogeneralhealth
services.
2.Primaryhealthcentres(PHC):Duringsecond5yearplan,primary
healthcentresweresetuptoprovideintegratedpreventive,curative
andrehabilitativeservicesforruralandurbanpopulation.
3.RevisedNationalTuberculosisControlprogramme:
4.DOTStherapy.
5.Vaccinationfortuberculosis.
ChallengestocontrolTuberculosis;
ThereporthighlightedthatTBcasescontinuebeachallengeinindiadue
to;
1.weakhealthsystem:expenditureonhealthbytheGovernment
continuostolow.
2.Shortfallsinfunding:thisisoneofthemainreasonstoreachthe
target,Needmoredomesticfunding,Moreinternationaldonorsupport.
3.Inequityinhealthcare:thegapinhealthbetweenrichandpoor
remainsverywide.failuretodosoproperlywillhavedireconsequences
fortheglobaleconomy,forsocialjusticeasawhole.
4.Limitednumberofhealthproviders.indiahasonly48health
practisionersper100000perpersons.
5.Inequityamongruralandurban.
6.Pooraccesstogovtpolicies;curativesservicesarenotfreeeveningovt
hospitals.insufficientpoliticalcommitmentcancausepublichealth
programtofail,facilitiesareavailablebutaccesswasstilllimited.
7.Poorprimaryhealthcareinfrastructureinruralareas.
8.Lackofawareness:peoplemustbeawareaboutthefreetreatment
insteadofsymptoms.
9.underutilizationoflaboratoryservices,frequentdrugshortage,low
ratesoftreatmentcompletion.

10.FailureofDOTS:afterthirteenyearsofDOTS,estimated3.5million
casesaresputumpositive.Annualincidenceis2.2million,ofwhichabout
1millionareinfectious.0.5millionpeoplediewithtuberculosisinIndia
everyyear.
KeystructuraldeterminantsofTuberculosisepidemiologyincludeglobal
socioeconomicinequalities,highlevelofpopulationmobility,rapid
urbanizationandpopulationgrowth.
Alltheseconditionsleadtounequaldistributionofkeysocial
determinantsofTBincludingfoodinsecurityandmalnutrition,poor
housingandenvironmentalconditions,financial,geographicandcultural
barrierstohealthcareaccess.
MEASURESTOOVERCOMETHESECHALLENGES:
1.AWARENESS:provideeducationaboutsymptoms,modeof
transmissionandDOTStherapywhichisfreeofcostatgovthospitals
2.Livingconditions:safedrinkingwaterandenvironmentsanitation
arecriticaldeterminantsofhealth,whichwoulddirectlycontributeto
70-80%reductionofcommunicablediseases.itisachievableand
affordableinbothruralandurbanareas.
3.Focusonearlycasedetectionandpreventionofdisease.
4.Promotehealthylife-style.
5.Morefocustowardpoorandvulnerablegroupofsociety
6.Wellventilatedhouses.
7.Governmentspendmoremoneyonhealth.Fundsshouldbecollected
nationallyorinternationally.
CONCLUSION:TuberculosisisthebiggestchallengeinIndia.Government
hasstartedvariousprogramandpoliciesbutfailedtoeradicatethe
tuberculosis.Thereshouldbeneedofequityamongpeopleforpolicies,
distributionofhealthservices.Educationandawarenessregarding
treatment,crossinfectionandpreventionoftuberculosisismust
speciallytoilliterateandpoorpersons.
REFERANCES:
TBIndia2017revisednationalTBcontrolprogrammeAnnualstatus
report,NewDelhi,2017,www.tbcindia.nic.in/
WHOGlobalTBreport2017,
www.WHO.int/tb/publications/global-report/en/

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Bookofchronicnoncommunicablediseases:TheHealthChallengesof
21stcentury,Delhi:jaypeeBrothersMedicalPublishers:2015.pp.31-51.
DyeC,GarnettGP,SleemanK.prospectsforworldwidetuberculosis
centralundertheWHODOTSstrategies
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