PUBLIC a biggest public health challenge in India.Most

PUBLIC HEALTH CHALLENGESPUBLIC 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 PREVALENCE2.8 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 therapyCHALLENGES 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 URBANIZATIONMEASURES 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.FOUNDATIONOFPUBLICHEALTHSUBMITTEDBY:Mrs.Gurmeetkaursandhu13024928Subjectcode:96702PUBLICHEALTHCHALLENGESIndiaisadevelopingcountry,therearenumeroushealthproblemsarisingdaybydayduetopoorhealthservices.poverty,illiteracy,unawareness,lowsocio-economicstatusleadtohealthproblems.Theseproblemsbecomeachallengeforpublichealthdevelopment.BURDENOFDISEASEORPUBLICHEALTHCHALLENGESININDIAIndiafacestheburdenofdiseasesintheformofinfectiousdiseases,communicableandnon-communicablediseases.Thishighburdenofdisease,disabilityanddeathcanbeidentifiedthroughaneffectivepublichealthcaresystem.Indiasuffersfromvariousdiseaseduetolackofenvironmentalsanitationandpresenceofsafedrinkingwater,malnutrition,poorlivingconditions,andlimitedaccesstopreventiveandcurativehealthservices.Tuberculosisisaoneofthebiggestpublichealthissueinindiawith2.79millionincidenceofnewcasesinaparticularperiodoftime.TUBERCULOSISTuberculosisisamajorpublichealthprobleminindia.Medicinesnotonlyfailedtoeleminatethetuberculosisbutcausemultipledrugresistant.INCIDENCEANDPREVALANCEin2006,Indiahas299peoplelivingwithTBper100000populationor3.4millionprevalentcases.Everyyear,2millionpeopledevelopTB.IndiahasthehighestburdenofTBwithtwodeathsineverythreeminutes27%theproportionofTBcasesoftheworldin2015.2.8millionpeopledevelopedTBinindiain2015.0.13millionpeopledevelopdmultidrug-resistantorrifampicinresistansttuberculosisinindiain2015.AccordingtoWHOinindia,anestimated27.9lakhpatientsweresufferingfromTBin2016andupto4.23lakhpatientswereestimatedtohavediedduringthisyear.EstimatedTBcasesnumberRateper100,000populationIncidence(HIV+TB)870006.6Incidence(MDR/RR+TB)14700011IncidenceofTB2.790million211Mortality(HIV+TB)120000.92MortalitywithTB42300032PROGRAMSTOCONTROLTUBERCULOSIS1.Nationaltuberculosiscontrolprogram:In1959theGovernmentofIndia,withthehelpofWHO,developanationaltuberculosiscontrolprogram,withtheaimofestablishingpromptdiagnosisandambulatorytreatmentwhichwereintegratedintogeneralhealthservices.2.Primaryhealthcentres(PHC):Duringsecond5yearplan,primaryhealthcentresweresetuptoprovideintegratedpreventive,curativeandrehabilitativeservicesforruralandurbanpopulation.3.RevisedNationalTuberculosisControlprogramme:4.DOTStherapy.5.Vaccinationfortuberculosis.ChallengestocontrolTuberculosis;ThereporthighlightedthatTBcasescontinuebeachallengeinindiadueto;1.weakhealthsystem:expenditureonhealthbytheGovernmentcontinuostolow.2.Shortfallsinfunding:thisisoneofthemainreasonstoreachthetarget,Needmoredomesticfunding,Moreinternationaldonorsupport.3.Inequityinhealthcare:thegapinhealthbetweenrichandpoorremainsverywide.failuretodosoproperlywillhavedireconsequencesfortheglobaleconomy,forsocialjusticeasawhole.4.Limitednumberofhealthproviders.indiahasonly48healthpractisionersper100000perpersons.5.Inequityamongruralandurban.6.Pooraccesstogovtpolicies;curativesservicesarenotfreeeveningovthospitals.insufficientpoliticalcommitmentcancausepublichealthprogramtofail,facilitiesareavailablebutaccesswasstilllimited.7.Poorprimaryhealthcareinfrastructureinruralareas.8.Lackofawareness:peoplemustbeawareaboutthefreetreatmentinsteadofsymptoms.9.underutilizationoflaboratoryservices,frequentdrugshortage,lowratesoftreatmentcompletion.10.FailureofDOTS:afterthirteenyearsofDOTS,estimated3.5millioncasesaresputumpositive.Annualincidenceis2.2million,ofwhichabout1millionareinfectious.0.5millionpeoplediewithtuberculosisinIndiaeveryyear.KeystructuraldeterminantsofTuberculosisepidemiologyincludeglobalsocioeconomicinequalities,highlevelofpopulationmobility,rapidurbanizationandpopulationgrowth.AlltheseconditionsleadtounequaldistributionofkeysocialdeterminantsofTBincludingfoodinsecurityandmalnutrition,poorhousingandenvironmentalconditions,financial,geographicandculturalbarrierstohealthcareaccess.MEASURESTOOVERCOMETHESECHALLENGES:1.AWARENESS:provideeducationaboutsymptoms,modeoftransmissionandDOTStherapywhichisfreeofcostatgovthospitals2.Livingconditions:safedrinkingwaterandenvironmentsanitationarecriticaldeterminantsofhealth,whichwoulddirectlycontributeto70-80%reductionofcommunicablediseases.itisachievableandaffordableinbothruralandurbanareas.3.Focusonearlycasedetectionandpreventionofdisease.4.Promotehealthylife-style.5.Morefocustowardpoorandvulnerablegroupofsociety6.Wellventilatedhouses.7.Governmentspendmoremoneyonhealth.Fundsshouldbecollectednationallyorinternationally.CONCLUSION:TuberculosisisthebiggestchallengeinIndia.Governmenthasstartedvariousprogramandpoliciesbutfailedtoeradicatethetuberculosis.Thereshouldbeneedofequityamongpeopleforpolicies,distributionofhealthservices.Educationandawarenessregardingtreatment,crossinfectionandpreventionoftuberculosisismustspeciallytoilliterateandpoorpersons.REFERANCES:TBIndia2017revisednationalTBcontrolprogrammeAnnualstatusreport,NewDelhi,2017,www.tbcindia.nic.in/WHOGlobalTBreport2017,www.WHO.int/tb/publications/global-report/en/JainDC,RanaR,PrasadJ.NoncommunicablediseaseinIndia:Theburden,prioritiesandfutureplansin:NarainJP,KumarR,editors,TextBookofchronicnoncommunicablediseases:TheHealthChallengesof21stcentury,Delhi:jaypeeBrothersMedicalPublishers:2015.pp.31-51.DyeC,GarnettGP,SleemanK.prospectsforworldwidetuberculosiscentralundertheWHODOTSstrategiesLancet.1998,352(9144):1886-1891PubMed

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