National Viral Hepatitis Control Program - Achieving Universal Health Coverage and Elimination Goals

 
 
Universal Health Coverage Umbrella for Viral
Hepatitis- India’s response
MCH
Immunization
NACP
HCW
Injection
Safety
 
Across all geographies, all people ( focus on priority groups), finances under NHM ( domestic budget), Linkages to
other programs and schemes ( NCD, Ayushman Bharat)
Swachh
Bharat
Surveillance
 
Ensuring Universal Health Coverage
 
All states and UTs
Identifying key
Population- for
different viruses
Addressing priority
populations
Identifying appropriate
intervention
Training and
capacity building
Data quality
Quality services
Quality
commodities
Integrated
approach
Avoiding
duplication
Domestic funding
for sustainability
Ensuring
Access
Addressing
Quality
Ensuring
Financing
 
Five key documents
 
Aims
 
Elimination of Hepatitis C
 by 2030
 
Reduction
 in the infected population, 
morbidity and mortality
associated with Hepatitis B and C
 
Reduce
 the risk, morbidity and mortality due to 
Hepatitis A and E
.
 
Key Objectives
 
Enhance community awareness 
on hepatitis and lay stress on
preventive measures
 
Provide 
early diagnosis and management
 of viral hepatitis at all
levels of healthcare
 
Develop capacities for implementation of 
standard diagnostic
and treatment protocols
 
Key Objectives
 
Strengthen the existing infrastructure facilities
build capacities 
of existing human resource
raise additional human resources, only where required
 
Develop 
linkages with the existing programs/ ministerial activities
NACP, Immunisation, MH, Mo Drinking water and Sanitation
 
Develop a 
web-based “Viral Hepatitis Information and Management
System
” to maintain a registry of persons affected with viral hepatitis
and its sequelae.
 
 
Overall Framework- Snapshot
Annual PIP and targets, State
level planning & scaleup,
intersectoral coordination,
M & E
Diagnosis, Treatment,
Referral, Quality Control
-
Guideline and Policy
Formulation
-
M & E, Surveillance, Research
-
Central Procurement
-
Coordination
 
Key Documents:
National Action Plan- costed; Operational plan for roll out of NVHCP; National Laboratory Guidelines for Testing of Viral
Hepatitis; National Guidelines for Diagnosis and management of Viral hepatitis; Technical Guidelines for management of
hepatitis B; National M & E framework and the electronic MIS
 
Key interventions-Prevention
 
Awareness generation & 
Behavior Change Communication
 
Immunization for hepatitis B 
– birth dose, high risk groups, health
care workers
 
Provision of 
safe blood and blood products
 
Injection Safety by 
Use of RUP/AD syringes 
in all government HCFs
 
Safe socio-cultural practices
 
Key interventions-Diagnosis & Treatment
 
Screening - serological tests
 
Confirmation - molecular tests (where required)
 
Treatment of uncomplicated cases - at treatment centres, drug
dispensation up to HWC
 
Treatment of complicated cases at model treatment centres
 
Referral and linkages
Capacity building and quality assurance
 
 
 
 
 
Model for Diagnosis
 
Model for Treatment
 Model Treatment centers  for
Treatment of Hepatitis B & C for
complicated cases & management of
other hepatitis;
 Treatment centers  for Treatment of
Hepatitis B & C; Refer complicated
cases to Model Treatment Centers
Dispensation
Phased
scale
up
 
Key Enablers for NVHCP
 
Inter-sectoral coordination
Harnessing Existing Capacities
Central Procurement for Economies of Scale
Community Involvement
Technical Working Groups
Supply Chain Management
Online M & E System
Sustained Domestic Funding
 
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Inputs
Development of the National Action
Plan- the guiding document
Financing the plan: 100% domestic
budget, integrated planning
Constitution of Technical Resource
Groups: Policy and guidelines
development
Development of standard training
manuals
Laboratory guidelines
Clinical Management guidelines
 
The Process
Advocacy on World Hepatitis Day
and other forums
Constitution of state steering
committees
Inclusion of Viral hepatitis in State
annual plans- integrated approach
Training of master trainers- over
435 across the country
Development of on line recording
and reporting system
Procurement of test kits and
distribution in the vast country
 
O
p
e
r
a
t
i
o
n
a
l
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p
p
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h
 
Outcomes / Progress till date
 95 centers functional in 22 states
20,000 approx. patients started treatment in  short duration (Sept 2018 to
Sept 2019)
Consolidated the smaller projects and state programs under the National
program for harmonization
Introduction of Hepatitis B testing for pregnant women
Guidance on vaccination for health care workers at risk
Guidance to shift towards RUP in government sector in a phased manner
Targeted testing started: vulnerable population groups prioritized
 
S
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National Viral Hepatitis Control Program
 
National Viral Hepatitis Control Program
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The National Viral Hepatitis Control Program in India is working towards combating viral hepatitis and achieving SDG goal 3.3 through a comprehensive approach that includes awareness generation, prevention, management, and financing under the NHM. The aim is to eliminate hepatitis C by 2030, reduce the infected population, morbidity, and mortality associated with hepatitis B and C, as well as decrease the risk and impact of hepatitis A and E. Key objectives focus on enhancing community awareness, early diagnosis, strengthening healthcare infrastructure, building capacities, and developing linkages with existing programs to effectively manage viral hepatitis.


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  1. National Viral Hepatitis Control Program SDG goal 3.3 to .combat viral hepatitis

  2. Universal Health Coverage Umbrella for Viral Hepatitis- India s response Swachh Bharat Awareness generation MCH Immunization NVHCP Prevention Management NACP ( All 5 viruses) HCW Injection Safety Diagnosis Surveillance Across all geographies, all people ( focus on priority groups), finances under NHM ( domestic budget), Linkages to other programs and schemes ( NCD, Ayushman Bharat)

  3. Ensuring Universal Health Coverage Ensuring Access Addressing Quality Ensuring Financing All states and UTs Identifying key Population- for different viruses Addressing priority populations Identifying appropriate intervention Training and capacity building Data quality Quality services Quality commodities Integrated approach Avoiding duplication Domestic funding for sustainability

  4. Five key documents

  5. Aims Elimination of Hepatitis C by 2030 Reduction in the infected population, morbidity and mortality associated with Hepatitis B and C Reduce the risk, morbidity and mortality due to Hepatitis A and E.

  6. Key Objectives Enhance community awareness on hepatitis and lay stress on preventive measures Provide early diagnosis and management of viral hepatitis at all levels of healthcare Develop capacities for implementation of standard diagnostic and treatment protocols

  7. Key Objectives Strengthen the existing infrastructure facilities build capacities of existing human resource raise additional human resources, only where required Develop linkages with the existing programs/ ministerial activities NACP, Immunisation, MH, Mo Drinking water and Sanitation Develop a web-based Viral Hepatitis Information and Management System to maintain a registry of persons affected with viral hepatitis and its sequelae.

  8. Overall Framework- Snapshot - Guideline and Policy Formulation M & E, Surveillance, Research Central Procurement Coordination - - - NPMU Annual PIP and targets, State level planning & scaleup, intersectoral coordination, M & E SPMU Labs and Treatment sites Diagnosis, Treatment, Referral, Quality Control Key Documents: National Action Plan- costed; Operational plan for roll out of NVHCP; National Laboratory Guidelines for Testing of Viral Hepatitis; National Guidelines for Diagnosis and management of Viral hepatitis; Technical Guidelines for management of hepatitis B; National M & E framework and the electronic MIS

  9. Key interventions-Prevention Awareness generation & Behavior Change Communication Immunization for hepatitis B birth dose, high risk groups, health care workers Provision of safe blood and blood products Injection Safety by Use of RUP/AD syringes in all government HCFs Safe socio-cultural practices

  10. Key interventions-Diagnosis & Treatment Screening - serological tests Confirmation - molecular tests (where required) Treatment of uncomplicated cases - at treatment centres, drug dispensation up to HWC Treatment of complicated cases at model treatment centres Referral and linkages Capacity building and quality assurance

  11. Model for Diagnosis

  12. Model for Treatment Model Treatment centers for Treatment of Hepatitis B & C for complicated cases & management of other hepatitis; Medical colleges and Tertiary centers Phased scale up District Hospitals / Secondary care Treatment centers for Treatment of Hepatitis B & C; Refer complicated cases to Model Treatment Centers Sub District level Dispensation

  13. Key Enablers for NVHCP Inter-sectoral coordination Harnessing Existing Capacities Central Procurement for Economies of Scale Community Involvement Technical Working Groups Supply Chain Management Online M & E System Sustained Domestic Funding

  14. Operationalizing the plan for testing and Operationalizing the plan for testing and Treatment: the stepwise approach Treatment: the stepwise approach The Process Advocacy on World Hepatitis Day and other forums Constitution of state steering committees Inclusion of Viral hepatitis in State annual plans- integrated approach Training of master trainers- over 435 across the country Development of on line recording and reporting system Procurement of test kits and distribution in the vast country Inputs Development of the National Action Plan- the guiding document Financing the plan: 100% domestic budget, integrated planning Constitution of Technical Resource Groups: Policy and guidelines development Development of standard training manuals Laboratory guidelines Clinical Management guidelines

  15. Operationalizing the plan for testing and Operationalizing the plan for testing and Treatment: the stepwise approach Treatment: the stepwise approach Outcomes / Progress till date 95 centers functional in 22 states 20,000 approx. patients started treatment in short duration (Sept 2018 to Sept 2019) Consolidated the smaller projects and state programs under the National program for harmonization Introduction of Hepatitis B testing for pregnant women Guidance on vaccination for health care workers at risk Guidance to shift towards RUP in government sector in a phased manner Targeted testing started: vulnerable population groups prioritized

  16. Status update of State/UT Status update of State/UT

  17. National Viral Hepatitis Control Program Issue Action required Establishment of State Viral Hepatitis Management Unit Established : 31 States/UTs Pending in MP, A&N Islands, Chandigarh, D&NH and Daman & Diu Established : 25 States/UTs State Steering Committee Pending in Goa, MP, Mizoram, Uttarakhand & all UTs MTCs Established in 22 States/UTs 24 functional Pending in: AndhraPradesh,Chhattisgarh,Karnataka,Kerala,MP,Meghalaya,Mizor am,Odisha, Puducherry, UP, Uttarakhand, A&N, Chandigarh, Assam Model Treatment Centre/Treatment Centre TCs functional in 95 districts (Completed in Punjab, Haryana, J&K ,Gujarat)

  18. National Viral Hepatitis Control Program Activities Status Medical Officers Training Completed: 18 States Training Progress Lab Tech Training Completed: 15 states Training Completed: 10 states Bihar, Goa & Sikkim have done only for M&E M& E Portal Completed in Himachal & Maharashtra Immunization of Health Workers Started in Gujarat, Mizoram, Tamil Nadu & Telangana, Haryana

  19. Thank You

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