S.NO TIME SPECIFIC CONTENT TEACHING A.V.

AIDS EVALVATION
OBJECTIVE LEARNING
ACTIVITY

Lecture cum Black board

1 2min INTRODUCTION discussion
 Community health nursing occurs in
context of health care delivery system
and this system influence community
health nursing practice. Due to lack of
emphasis on health promotion in health
care delivery system increases the need
for health promotion efforts by
community health nurses .Therefore
Heath and health care concern
throughout the world has developed a
system for addressing these concerns.

2 2min To define the Health care delivery concerns Lecture cum Ppt What is the health
health care discussion care delivery
delivery  Throughout the world approximately 4.5 concerns?
concerns million children die each year from
diarrheal diseases, while communicable
diseases of all kinds remains a serious
problem in the last 10 years . An
assessment of the health status is required
to make a plan for the Health care
delivery services. This assessment will
bring out major health problem which are
the major health care concerns.
3 3min Health Concerned Areas Lecture cum Ppt
To elaborate 1.Communicated disease Problem discussion What are the health
the health  Malaria ,TB, Diarrhoeal diseases, Acute concerned areas ?
Respiratory Infection, Leprosy, Filaria ,
concerned
AIDS , Kala Azar, Meningitis, Viral
areas
Hepatitis ,Japanese Encephalitis , Enteric
Fever, Helmenthis infection ,
Immunization problem.

2.Nutrional problem
 Protein- Energy Malnutrition
 Nutritional Anaemia
 Low Birth Weight
 Iodine Deficiency Disorder
 Endemic Flurosis

3. Medical Care Problems

Lack of medical care professionals.
Over– crowding in hospital as a result of
migration of people from rural areas.
Scarcity of resources
Inequitable distribution of services.
Chronic Diseases and Mental health
problem.
Adolescent Pregnancy.

4.Evironmental Sanitation Problem

 Lack of Safe water.
 Primitive method of excreta
disposal.
  Global concern over radiation.
 Destruction of Ozone layer.
 Air pollution.
 Lead poisoning.
 Chemical contamination of food
supplies

5. Population Problems
 The population explosion has inevitable
consequences in all aspects of
development, employment, education,
housing, health care, sanitation and
environment .The country’s growth is
1.93% and the Government’s goal is to
reduce it to 1%.

6.Human Response to Disasters

 Natural and manmade disasters are
affecting large number. e.g. Toxic
chemical leak in Bhopal in 1985.
International efforts coordinated by
WHO and International Red Cross have
lead to the development of disaster
planning groups throughout the world
4 6min
NATIONAL HEALTH PROGRAMMES Ppt What are the
To explain the  To improve the health status of people, to Lecture cum national health
national control communicable diseases, discussion programmes?
health improvement of environment sanitation,
programmes control of population etc. the Central
Government launched the National
Health Programmes.
A)Programmes for Communicable Diseases

1. National Vector Borne Diseases Control

Programme (NVBDCP)
2. Revised National Tuberculosis Control
Programme
3. National Leprosy Eradication Programme
4. National AIDS Control Programme
5. Universal Immunization Programme
6. National Guinea worm Eradication
Programme
7. Yaws Control Programme
8. Integrated Disease Surveillance Programme

B)Programmes for Non Communicable Ppt

Diseases Lecture cum
1. National Cancer Control Program discussion
2. National Mental Health Program
3. National Diabetes Control Program
4. National Program for Control and treatment of
Occupational Diseases
5. National Program for Control of Blindness
6. National program for control of diabetes,
cardiovascular disease and stroke
7. National program for prevention and control
of deafness

C)National Nutritional Programmes

1 Integrated Child Development Services
Scheme
2 Midday Meal Programme
 3 Special Nutrition Programme (SNP)
4 National Nutritional Anemia
Prophylaxis Programme
5 National Iodine Deficiency Disorders
Control Programme

D)Programs related to System Lecture cum Ppt

Strengthening /Welfare discussion

1. National Rural Health Mission

2. Reproductive and Child Health Programme
3. National Water supply & Sanitation
Programme
4. 20 Points Programme

1National Anti-Malarial Programme

(NMCP)
• National Malarial Programme
was launched in April 1953 and
was based on spraying with DDT
. It also paid rich dividends to the
country in different fields like
agriculture, land projects and
industry which changed the
strategy and launched National
Malaria Eradication Programme
in 1958 and renamed as National
Anti-Malarial Programme in
1999 .

2 National Filaria Control Programme

• It has been in operation since
 1955.It was merged with the
urban malaria scheme for
maximum utilisation of available
resources. It includes vector
control through anti-larval
operations, source reduction,
detection and treatment of
microfilaria carriers, morbidity
management and IEC.

3 National Leprosy Eradication Programme

National Leprosy Control Programme has
been in operation since 1955, as a centrally aided
programme to achieve control of Leprosy
through early detection of cases and DDS Lecture cum Ppt
(Dapsone) monotherapy on an ambulatory basis. discussion

In 1983, it was redesigned as National

Leprosy Eradication Programme
which was based on yearly detection of
cases( by Population surveys, school
surveys and voluntary referrals), short
term multi drug therapy, health
education, ulcer and deformity care and
rehabilitation activities.

4. National Tuberculosis Programme

• It has been in operation since 1962 and
its objectives were to reduce tuberculosis
in the community to that level when it
ceases to be a public health problem and
 to detect the maximum number of TB
cases,to vaccinate newborns and infants
with BCG and to undertake the
objectives in an integrated manner
through all the existing health institutions
in the country.

• In 1992, the government of India, WHO,

and World Bank together reviewed the
NTP and this programme is known as
Revised National Tuberculosis Control
Programme which aims augmentation of
case finding activities, involvement of Ppt
NGOs, IEC and improved operational Lecture cum
research. discussion

5. National AIDS Control Programme

• It was launched in 1987 which aimed at
to reduce the spread of HIV infection in
India and to strengthen India’s capacity
to respond to HIV/AIDS on the long term
basis.

• In April 2002, National AIDS Prevention

and control policy were approved by
government of India, which aimed in
reduction of the impact of epidemic and
to bring about a zero transmission rate of
AIDS by the year 2007.

6.National Programme for Control of

Blindness
 • It was launched in 1976 which aimed to
strengthen service delivery, developing
human resources for eye care, promoting
out reach activities and public
awareness; and to establish eye care
facilities for every 5 lakh persons. Ppt
Lecture cum
• Vision 2020:The Right to Sight –to discussion
reduce avoidable blindness by the year
2020.

7.Iodine Deficiency Disorders Control

Programme
• It is in operation since 1962.Its essential
component are use of iodized salt in
place of common salt, monitoring and
surveillance, manpower training and
mass communication.

8. Universal Immunisation Programme.

• In 1974, the WHO launched its
“Expanded programme on
Immunisation”(EPI) against six
preventable childhood
diseases(Diphtheria, Pertusis, tetanus,
polio, TB and Measles).
• Universal Immunisation Programme, was
started in India in 1985.It has two vital
components: Immunisation of pregnant
women against tetanus, and
immunisation against six EPI targeted Lecture cum Ppt
childhood diseases. discussion
 • Introduction of Hepatitis-B Vaccine,
Urban Measles Campaign and Neonatal
Tetanus Elimination.

9. National Cancer Control Programme

• It was launched in 1975-76 with
objectives of prevention, early diagnosis,
treatment.
• It was revised in 1984-85 with objective
of primary, secondary, tertiary
prevention.

10. National Water Supply And Sanitation

Programme
 It was launched in 1954 with object of
providing safe water supply and adequate
drainage facilities for the entire urban
and rural population of the country.

11.Minimum Need Programme

 It was introduced in the first year of the
Fifth Five Year Plan (1974-1978) with
the objective to provide certain basic
minimum needs and thereby improve the
living standards of the people.

12. 20-Point Programme

 It was launched in 1975, by the
Government of India with the objective
to promote social justice and economic Lecture cum
growth. discussion
  Point 1: Attack on rural poverty Point
 Point 7: Clean drinking water Point
 Point 15: Improvement of slums Point
 Point 17: Protection of the environment

13.National Mental Health Programme

 It was launched during 1982 with a view
to ensure availability of Mental Health
Care Services for all, especially at risk
and underprivileged section of the
population, to encourage and social
development.

13.National Mental Health Programme Aims

 Prevention and treatment of mental and
neurological disorders and their
disabilities.
 Use of mental health technology to
improve general health services.
 Application of mental health principles in
total national development to improve
quality of life.

14. Reproductive and Child Health

Programme
Ppt
 It was launched on 15 October 1997 Lecture cum
which incorporated family planning, discussion
child survival and safe motherhood
component, client approach to health
care and prevention / management of
reproductive tract infection, STD and
 AIDS.

The main highlights of RCH Programme are:

1. It integrates all interventions of fertility

regulation, maternal and child health with
reproductive health for both men and
women.
2. The services to be provided are client
oriented, high quality and based on needs
of community.
3. It envisages up gradation of the level of
facilities for providing various
intervention and quality of care. The First
Referral Units (FRUs) being set up at
sub-district level provide comprehensive
emergency obstetric and new born care.
4. Facilities of obstetric care, MTP and IUD
insertion in the PHCs level are improved.
IUD facilities are also available at sub-
centres.
5. The programme aim at improving the
out-reach of services primarily for the
vulnerable group of population

 RCH Phase II It began form 1st April Ppt

2005.whose focus is to reduce maternal Lecture cum
and child morbidity and mortality with discussion
emphasis on rural health care. Its
component include essential and
emergency obstetric care and
strengthening referral system.
15. National Guinea-Worm Eradication
Programme
 India launched this Programme in 1984
with technical assistance from WHO.

16.Degue Fever Control Programme:

 An outbreak was reported in1996.Since
then dengue has been reported. It
includes all aspect of control measure
like identification of outbreak, vector
control, case management, IEC
activities, monitoring and reporting, etc.

17.National surveillance Programme For

Communicable Diseases:
 It was launched by Ministry of Health
and Family Welfare for detection of early
warning signals of outbreak emerging
and re-emerging infectious diseases, and
rapid response for prevention and control
of these outbreak and diseases.

18.National Rural Health Mission:

 The Government of India launched this Ppt
programme on 5th April, 2005 for a Lecture cum
period of 7 years (2005-2012). The main discussion
aim is to provide accessible, affordable,
accountable, effective and reliable
primary health care, and bridging the gap
in the rural health care through creation
 of a cadre of Accredited Social Health
Activist(ASHA).

19.Nutritional Programme:
A)Vitamin A Prophylaxis Programme:
 One of the component of National
Programme for Control of Blindness is to
administer single dose of vitamin A
containing 200,000 IU orally to all to al
preschool children in the community
every 6 month through peripheral health
workers.

B)Prophylaxis against nutritional anaemia:

 It consist of distribution of iron and folic
acid tablets to pregnant women and
young children (1-12 years). MCH in
urban centres in urban areas, primary
health centres in rural areas and ICDS
project are engaged in the
implementation of this programme.

C) Control of iodine deficiency disorder.

D) Special nutritional programme

 It was started in 1970 for the nutritional
benefit of children below 6 years of age, Ppt
pregnant and nursing mother. The Lecture cum
supplementary food supplies about discussion
300kcal and 10-12grams of protein per
child per day .The mother receive daily
 500kcal and 25grams of protein. It is
provided for 300 days in a year.

E) Balwadi nutritional programme:

 It was started in 1970 for the benefit of
children in the age group of 3-6 years in
rural areas. It provides 300kcal and 10
grams of protein per child per day.

F) ICDS(Integrated Child Development

Scheme):
 It was started in 1975 for preschool
children below 6 years and adolescent
girls 11-18 years, pregnant and lactating
mother.

G)Mid- day meal programme is also known

as School Lunch Programme:
 It has been in operation since 1961 with
the objective to attract more children for
admission to schools and retain them so
that literacy improvement of children
could be brought.

20. Kala Azar Control Programme:

 A centrally sponsored programme was
launched in 1990-91 with 3 strategies
which includes reducing vector
population, insecticidal spray twice Ppt
annually, early diagnosis and complete Lecture cum
treatment and health education for discussion
 community awareness.

21.Japanese Encephalitis Control

Programme:
 It is a disease with high mortality rate.
The strategies are care of patient,
development of safe and standard
vaccine, to identify high risk group by
measuring blood level of antibodies,
epidemiological monitoring of disease
for implementation of prevention and
control measures.

22.National Diarrheal disease Control

Programme:
It was launched in 1981 with strategies as
followsa)

A) ORS packet available. At each sub centre

300 packets/ year are stocked. Each
village health guide is given 100 packets
a year.

B) Mass education is imparted to make people

aware of correct feeding of preschool children
and prevention of dehydration through liberal
use of home available fluids.
5 10min
Ppt
NATIONAL FAMILY WELFARE Lecture cum
PROGRAMME discussion
  India launched the National Family
Welfare Programme in 1951
programmewith the objective of reducing
the birth rate to the extent necessary to
stabilize the population at level
consistent with the requirement of
National economy. The Family Welfare
Programme in India is recognised as a
priority area, and is being implemented
as a 100%centrally sponsored
programme. What are the
To describe national family
the national  During 3rd Five Year Plan(1961-1966) – welfare
family Family was declared as the very centre of programme?
welfare planned development. The emphasis was
programme laid on “education approach” for
motivating the people for acceptance of
“small family norm”.

 1965-Introduction of Lippes Loop

 1966-Department of Family Planning by
Ministry of Health.
 1966-1969-The Family planning Ppt
infrastructure (PHCs, sub centres ,district
and state bureaus) was strengthened. Lecture cum
discussion
4 th Five Year Plan(1969-74)-
 The Government of India gave top
priority to programme which was made
an integral part of MCH activities of
PHCs and sub centre.
  1970-An All India Postpartum
Programme introduced.
 1972-The Medical Termination Of
Pregnancy (MTP) was introduced.
 5 th Five YEAR Plan (1975-1980)-Major
changes.
 April 1976-The country framed
“National Population Policy”.
 1977-The Ministry of Family Planning
was renamed as “Family Welfare”. The
launching of Rural Health Scheme and
involvement of local people (e.g. Health
Guides, trained Dais) in Family Welfare
Programme at grass root level were Ppt
aimed at accelerating the pace of Lecture cum
progress of programme. discussion

 1978-Alma Ata Declaration.

Sixth Five Year Plan(1980-1985)

 1982-National Health Policy formed and
was approved by parliament in 1983. It
laid a goal to attain 2-child family norm
through the attainment of birth rate of 21
and death rate of 9 per thousand
population by the year 2000.

Seventh Five Year Plan(1985-90)

 1985-86- The Universal Immunisation
Programme aimed in reduction of
mortality and among infants and children
 due to vaccine preventable disease.
 The oral rehydration therapy was also
started in view of diarrhoea was a leading
cause of death in children.
 MCH was implemented to improve
health status of mother.

For spacing births:

a) Condoms
b) Oral Contraceptive Pill
c) Intra Uterine Devices (IUD)
Terminal Methods:
a) Tubectomy ;
i ) Mini Lap Tubectomy
ii) Lapro Tubectomy

b)Vasectomy;
i ) Conventional Vasectomy
ii) NoScalpel Vasectomy
Ppt
 1992-Child Survival and Safe Lecture cum
Motherhood (CSSM) Programme. discussion
 1994-Implementation of Unified
Reproductive and Child Health
Programme (RCH).

Ninth Five Year Plan(1997-2002)-

 The concept of RCH is to provide need
based, client oriented, demand driven,
high quality integrated services.
  2000-The Government of India evolved a
more detailed and comprehensive
National Population Policy to promote
family welfare.

X Five Year Plan objectives:

 Reduction in the decadal rate of
population growth between 2001 and
2011 to 16.2%; Increase in Literacy
Rates to 75 per cent within the Tenth
Plan period (2002 to 2007) Reduction of
Infant mortality rate (IMR) to 45 per
1000 live births by 2007 and to 28 by
2012.

Impact
 The awareness about family planning
was nil before the launching of the
programme has gone up to 60% in rural
and almost 90% in urban areas.
 The pregnancy rate has declined by more
than 50% , particularly in urban areas.
6 8min The birth rate has declined to 27/1000 Ppt
population. Lecture cum
discussion

INTERSECTORAL COORDINATION
 Intersectoral Coordination is the primary
health care.
 It is a crucial component for promotion
of intersectoral linkages which is
 required for effective implementation of
health services throughout the country.
 It ensure convergence of basic social
service in order to bring all health sector
services providers into closer and more
responsive working relationships for the
benefit of the society.
To discuss the
 This will enable better equity and wider
intersectoral
coverage.
coordination
What is the
 The Health Care System is intended to intersectoral
deliver health care services. It operates in coordination?
context of socio-economic and political Ppt
framework of country. In India, it is Lecture cum
represented by 5 major sectors which discussion
differ from each other.

1. Public Sector(PHC, Hospitals, Insurance

Scheme etc.)
2. Private Sector(Private hospitals, polyclinics,
Nursing homes, dispensaries, general
practitioners and clinics)
3. Indegeneous System of Medicine (Ayurveda,
Unani, Homeopathy, Siddha etc)
4. Voluntary Agencies
5. National Health Programmes

Voluntary Health Agencies

 “A Voluntary Health Agency is defined
 as an organisation that is administered by
an autonomous board which holds
meetings, collect funds for its support
chiefly from private sources and expends
money whether with or without paid
worker, in conducting a programme
directed primarily to furthering the public
health by providing health services or
education, or by advancing research or
legislation for health, or by a
combination of these activities”.

Functions
1. Supplementing the work of government
agencies.
2. Pioneering
3. Education Lecture cum Ppt
4.Demonstration discussion
5.Guarding the work of Government Agencies
6.Advancing Health Legislation

Voluntary Health Agencies are

 Indian Red Cross Society in 1920.
 Hind Kusht Nivaran Sangh in 1950 with
headquarters in New Delhi.
 Indian Council for Child Welfare in
1952.
 Tuberculosis Association Of India in
1939.
 Bharat Sevak Samaj in 1952.
 Central Social Welfare Board in August
 1953.
 The Kasturba Memorial Fund in 1944.
 Family Planning Association of India in
1949 with headquarters at Mumbai. Lecture cum Ppt
 All India Women’s Conference, 1926. discussion
 The All India Blind Relief Society, 1949.
 Professional Bodies
 International agencies.

NON-GOVERNMENTAL ORGANISATION
DEFINITION
 UN says “A non-governmental
organization (NGO) is a not-for-profit,
voluntary citizens’ group, which is
organized on a local, national or
international level to address issues in
support of the public good”.
 Some of the Ngo’s are Rockefeller
7
Foundation, Ford Foundation,
10min Ppt
International Red Cross, TNAI, All India
Women’s conference, Indian Medical
Lecture cum
Association, World Federation of
discussion
Medical Education etc.

ROLE OF NGO
Development and Operation of
Infrastructure:

 Community-based organizations and

cooperatives can acquire, subdivide and
develop land, construct housing, provide
 infrastructure and operate and maintain
infrastructure such as wells or public
toilets and solid waste collection
To discuss the services. They can also develop building
role of NGO material supply centres and other
community-based economic enterprises.
In many cases, they will need technical
assistance or advice from governmental
agencies or higher-level NGOs. What are the role
of NGO ?
Supporting Innovation, Demonstration and
Pilot Projects:
 NGO have the advantage of selecting
particular places for innovative projects Ppt
and specify in advance the length of time
which they will be supporting the project Lecture cum
- overcoming some of the shortcomings discussion
that governments face in this respect.

Supporting Innovation, Demonstration and

Pilot Projects
 NGOs can also be pilots for larger
government projects by virtue of their
ability to act more quickly than the
government bureaucracy.

Facilitating Communication:
 NGOs use interpersonal methods of
communication, and study the right entry
points whereby they gain the trust of the
community they seek to benefit. They
would also have a good idea of the
 feasibility of the projects they take up.
The significance of this role to the
government is that NGOs can
communicate to the policy-making levels
of government, information about the
lives, capabilities, attitudes and cultural
characteristics of people at the local
level.

Facilitating Communication
 NGOs can facilitate communication
upward from people to the government
and downward from the government to
the people. Communication upward
involves informing government about
what local people are thinking, doing
and feeling while communication Ppt
downward involves informing local
people about what the government is
planning and doing. NGOs are also in a Lecture cum
unique position to share information discussion
horizontally, networking between other
organizations doing similar work.

Technical Assistance and Training:

 Training institutions and NGOs can
develop a technical assistance and
training capacity and use this to assist
both CBOs and governments.

Research, Monitoring and Evaluation:

 Innovative activities need to be carefully
 documented and shared - effective
participatory monitoring would permit
the sharing of results with the people
themselves as well as with the project
staff.

Advocacy for and with the Poor:

 In some cases, NGOs become
spokespersons or ombudsmen for the
poor and attempt to influence
government policies and programmes on Ppt
their behalf. This may be done through a Lecture cum
variety of means ranging from discussion
demonstration and pilot projects to
participation in public forums and the
formulation of government policy and
plans, to publicizing research results and
case studies of the poor.

Advocacy for and with the Poor

 Thus NGOs play roles from advocates
for the poor to implementers of
7 2min government programmes; from agitators
and critics to partners and advisors; from
sponsors of pilot projects to mediators.

Provides valuable resources in promoting

health care.
Ppt
Lecture cum
CONCLUSION discussion
 The Indian healthcare sector can be
 viewed as a glass half empty or a glass
half full. The challenges the sector faces
are substantial, from the need to improve
physical infrastructure to the necessity of
providing health insurance and ensuring
the availability of trained medical
personnel. But the opportunities are
equally compelling, from developing
new infrastructure and providing medical Lecture cum
equipment to delivering telemedicine discussion
solutions and conducting cost-effective
clinical trials. For companies that view
To conclude
the Indian healthcare sector as a glass
the topic half full, the potential is enormous.
 The Indian health care sector is predicted
to touch 14.2 billion by 2012 due to
2min rising income levels, high populations,
and change in the illness pattern in the
country
8  The value of domestic health care will
rise up to four times by 2017.
 Private and public spending in Indian
health sector would touch 14.2 billion in Lecture cum
2013, at an annual growth rate of 5.8 discussion
percent from 2009
Ppt

SUMMARY

In both rich and poor nations, public resources

for health care are inadequate to meet demand.
Policy makers and health care providers must
 determine how to provide the most effective
health care to citizens using the limited resources
that are available. This chapter describes current
and future challenges in the delivery of health
care, and outlines the role that operations
research (OR) models can play in helping to
solve those problems.

SCHOOL OF NURSING SCIENCE AND RESEARCH

SHARDA UNIVERSITY

LESSON PLAN
ON
Health care delivery concerns , N.H.P, F.W.P, Intersectoral coordination and role of
nurse
SUBJECT: ADVANCE NURSING PRACTICE
SUBMITTED TO SUMBITTED BY
Ms. Anushi Singh Ms. Bhawna josh
HOD and Assistant Professor M.sc Ist year
Health Nursing pediatric Deppt. SNSR
SNSR

TITLE PAGE

NAME OF THE STUDENT TEACHER : BHAWNA JOSHI

NAME OF THE SUPERVISOR : MS. Anushi Singh

NAME OF THE SUBJECT : Advance Nursing Practice

NAME OF THE TOPIC : Health care delivery concerns , N.H.P, F.W.P, Intersectoral coordination
and role of nurse

DATE :

TIME PLACE :

DURATION : 45 MINUTES

GROUP : STUDENTS SNSR

AV AIDS : BLACK BOARD,PPT,

METHOD OF TEACHING : LECTURE,DISCUSSION,QUESTIONING.

OBJECTIVES

General objectives: By the end of the class students will be able to understand the complete concepts of Health care delivery
concerns , N.H.P, F.W.P, Intersectoral coordination and role of nurse
Specific objective: By the end of the class students will be able to
 Introduce the topic
 To define the health care delivery concerns

 To elaborate the health concerned areas

 To explain the national health programmes

 To describe the national family welfare programme

 To discuss the intersectoral coordination
 REFERENCES
(1) k. Park, Text book of preventive and social medicine, Bhanot publication, 18th edition, Page no.674-699.
(2) B.T.Basvanthappa, Community health nursing, Jaypee, Publication, 6th edition, Page no.584- 605.
(3) K.K. Gulani, Community health nursing, Kumar Publication, 3 rd edition, Page no.591-593.
(4) Dr. Sr. Mary Lucita, Public health and Community Health, Nursing, B.I. publication, 1st edition, Page no.25-34.
(5) John M. Cookfair, Nursing care in the community, Mosby, Publication, 2nd edition, Page no. 65-81.
(6) www.google. com.