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DIRECTORATE GENERAL OF HEALTH SERVICES

Ministry of Health & Family Welfare
Government of India

National Programme for Prevention and Control of Fluorosis

NATIONAL PROGRAMME FOR PREVENTION AND CONTROL OF FLUOROSI

Fluorosis, a public health problem is caused by excess intake of fluoride through drinking water/food products/industrial pollutants over a long period. It results in major health disorders like dental fluorosis, skeletal fluorosis and non-skeletal fluorosis. 

Problem:      Dental Fluorosis affects children and discolours and disfigures the teeth. The teeth could be chalky white and may have white, yellow, brown or black spots or streaks on the enamel surface.  Discoloration is away from the gums and bilaterally symmetrical.    Skeletal Fluorosis affects the bones and major joints of the body like neck, back bone, shoulder, hip and knee joints with severe pain, rigidity or stiffness in joints. In severe forms results in marked disability.  Non-Skeletal fluorosis is an earlier manifestation of fluorosis seen as gastro-intestinal complaints etc and may overlap with other diseases leading to misdiagnosis.

Prevalence:   Fluoride prevalence was earlier reported in 230 districts of 19 States earlier.   As per present data from Ministry of Drinking Water and Sanitation, there are 14,035 habitations (as on 1.4.2016) from 17 States which are yet to be provided with safe drinking water.  The population at risk based on population in habitations with high fluoride in drinking water is 115.3 lakh.            

Programme coverage:         The Government of India started the National Programme for Prevention and Control of Fluorosis (NPPCF) as a new health initiative in the 11th Five Year Plan (2008-09) with the aim to prevent and control Fluorosis in the country.  100 districts of 17 States were covered during 11th Plan and additional 32 districts have been covered during the 12th Five Year Plan.  State wise list of districts under implementation of NPPCF is at      

 

Annex-I.  

 Goal and Objectives:-   The NPPCF aims to prevent and control Fluorosis    cases in the country.   The Objectives of the National Programme for Prevention & Control of Fluorosis are as follows:

 

  •     Assess and use the baseline survey data of fluorosis of Ministry  of Drinking water & Sanitation;
  •    Comprehensive management of fluorosis in the selected areas;
  •    Capacity building for prevention, diagnosis and management of fluorosis cases.

       The strategy followed under the programme is  surveillance of fluorosis in the community ;  capacity building (Human Resource) in the form of training and manpower support ; establishment of diagnostic facilities in the district ; health education for prevention and control of fluorosis cases ;  management of fluorosis cases including supplementation, surgery and  

Activities :

 

 

 

  • Community Diagnosis of Fluorosis village/block/cluster wise.
  • Facility mapping from prevention, health promotion, diagnostic facilities, reconstructive surgery and medical rehabilitation point of view – village/block/district wise.
  • Gap analysis in facilities and organization of physical and financial support for bridging the gaps, as per strategies listed above.

(a) Diagnosis of individual cases and providing its management.

(b) Public health intervention on the basis of community diagnosis.

·                     Behaviour change by IEC.

·                            Training

Assistance provided to States:-

·          Strengthening manpower in endemic district by providing for :     

        - Consultant 

         -Laboratory Technician

         -Field Investigators (3) for six months        

  Achievements: -

  •   132 districts of 19 States affected by Fluoride are covered under the Programme.
  •   85 Districts have established Labs with ion Meter.
  •   309 Health personnel i.e. State Nodal Officer, District Nodal Officer, District Consultant and Laboratory Technicians were trained at NIN, Hyderabad.
  •  74 districts reported trainings for Medical Officers, Paramedical, ASHA/AWWs, teachers, VHSNC members.
  •   Regional Review meeting of (Southern Region) cum capacity Building Workshop of State Programme     Officers  from five Fluorosis affected States for review of NPPCF was organized at Hyderabad in March, 2017 at Hyderabad.
  •   A video documentary film on Fluorosis in 8 regional languages i.e. Assamese, Telugu, Gujarati, Kannada, Malayalam, Marathi, Oriya and Bengali is under progresS.

 

 

Annex 1

 

         States/Districts under National Progrmme for Prevention and control of Fluorosis (NPPCF) -

 

S.No.

State

Total districts in the State

No. of districts

NPPCF

Districts under NPPCF

 

1.

Andhra Pradesh

13

3

 Nellore,  Guntur,  Prakasam

2

Telangana

9

3

 Mehboobnagar,    Nalgonda,   Karimnagar

3.

Assam

26

4

 Nagaon, Kamrup, Karbi  Anglong, Dhubri

4.

 

Bihar

38

10

 Nawada, Banka,.Aurangabad,Bhagalpur,Gaya,

 Jammui,Nalanda,Shekhpura, Kaimur .Munge

5.

Chattisgarh

27

4

 Durg, Kanker, Kondagaon, Korba,

6.

Gujarat

33

4

Jamnaga, Sabarkantha, Vadodara, Banasklantha

7.

Haryana

21

2

Mehendragarh, Mewat

8.

Jammu & Kashmir

22

1

Doda

9

Jharkhand

24

13

Palamu,Garhwa,Chatra,Hazaribagh, Ranchi, Pakur, Sahebgann, Ramgarh, Jamtara, Simdega,  Dhanbad,  Giriih,  Godda

10.                                                                        

Karnataka

30

18

Ballary, Mysore, Chikballalpur, Koppal, Davangere, Tumkur,Bagalkote,Bangalore(U), Bijapur,  Raichur,   Chitradurga, Gadag, Gulbarga, Hassan, Kolar, Mandia,  Ramanagara,  Shimoga

11.

Kerala

14

2

Palakkad, Alapuzha

12

Madhya Pd.

51

15

Ujjain,Chindwada, Mandla, Dhar,  Seoni, Betul

Jhabua, Raigarh, Sehore, Alirajpur, Dindori, Khargoan,  Raisen, Shajapur, Ratlam

13

Maharashtra

34

7

Nanded, Chandrapur, Latur, Washim, Yavatmal. Beed, Nagpur

14.

 

 

Rajasthan

 

33

28

Nagaur, Ajmer, Bhilwara,  Churu   (Ratangarh) Dausa, Dungarpur, Rajsamand, Tonk, Bikaner, Jalore,  Jaisalmer, Jodhpur, Jaipur, Pali, Sikar, Udaipur, Swaimadhopur, Banswara, Karauli, Chittaurgarh, Ganganagar, Jhalawar, Jhunjhunu, Barmer, Alwar, Bharatpur, Kota, Sirohi

15.

Odisha

30

3

Nayagarh,  Angul,  Nuapada

16

Punjab

22

3

Sangrur,  Firozepur, Patiala

 17.

Tamil Nadu

31

1

Dharmapuri

18.

Uttar Pradesh

75

5

Unnao, Rae Bareli, Pratapgarh, Firozabad, Mathura

19.

West Bengal

18

6

Bankura,  Purlia,  Birbhum,  D. Dinajpur, Maldha, Uttar Dinajpur

 

TOTAL

 

132

 

 

Note: For further details, please visit NPCB website: www.npcb.nic.in

 

 

 

 

Last Updated On 06/07/2017