National Programme for Prevention and Control of Deafness
National Programme for Prevention and Control of Deafness (NPPCD)
Hearing loss is the most common sensory deficit in humans today. As per WHO estimates in India, there are approximately 63 million people, who are suffering from significant auditory impairment; this places the estimated prevalence at 6.3% in Indian population. As per NSSO survey, currently there are 291 persons per one lakh population who are suffering from severe to profound hearing loss (NSSO, 2001).
A large percentage of children between the ages of 0 to 14 years are also suffering from significant auditory impairment. Hence, NPPCD was launched with a purpose of early identification, diagnosis and treatment of ear problems responsible for hearing loss and deafness in them. With such a large number of hearing impaired young Indians, it amounts to a severe loss of productivity, both physical and economic. An even larger percentage of our population suffers from milder degrees of hearing loss and unilateral (one sided) hearing loss.
This programme is being implemented by Ministry of Health and Family Welfare with the technical support of Directorate General of Health Services. At the state level the programme is being implemented by the Department of Health & Family Welfare. State Nodal Officer preferably an ENT surgeon at the Directorate/ Secretariat level will provide technical guidance and expertise to the State Health Society for the purpose of implementation of the programme in the various districts of the state.
National Programme for Prevention and Control of Deafness (NPPCD) was initiated on pilot basis in the year 2006-07(January 2007) covering 25 districts of 10 states and 1 UT and has been expanded to 228 districts of 27 States /Union Territories in a phased manner till now. By the end of the 12th Five Year Plan 384 Districts will be taken up for programme implementation.
Achievements/ Progress•
The programme has been expanded to 228 districts of 27 States / U.Ts in a phased manner.
- Training: Training material in the form of training manuals and training lectures has been developed and field tested.
- Training of medical officers, PHN, AWW, MPW, ASHA and school teachers was undertaken by RCI in 2007-08 in all the 25 districts in Pilot phase of the programme. In the expansion phase, the responsibility of training was transferred to the states, for which funds were provided to the state health societies. States in which training has been completed till date are Chandigarh, Nagaland, 3 districts of Uttarakhand and in stages in Andhrapradesh, TamilNadu.
- Screening camps: Screening camps were carried out at district through support of NGOs as per the guidelines. Regular screening camps have been conducted by the states of Tamil Nadu, Karnataka, Chandigarh, Sikkim and AndhraPradesh during XIth five year plan but in XIIth five year plan it is proposed to organize screening camps in collaboration with NRHM (RBSK)/ M/o SJ&E at the PHC/CHC and District level for screening the general population in respect of ear problems, hearing impairment and deafness. Till date more than 335 screening camps has been organized.
- Procurement of Equipment: To strengthen the ear & hearing care services at the community level, the District Hospitals, CHC and PHC are being strengthened through provision of suitable equipment under the programme.
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- Recruitment of manpower: Two personnel i.e. Audiometric Assistant (AA) and Instructor for Speech & Hearing Impaired are being placed at the district hospital on contract basis to carry out audiological and ear related work under the programme during XIth plan.
- In XIIth plan two additional posts ENT surgeon and Audiologist have been provided to each district to strengthen the delivery of ear care services
- • Hearing Aids: Under the programme, fitting of free hearing aids on identified children up to the age of 15 years with free service for a period of one year was undertaken at the level of the district hospital. Till date more than 6380 hearing aids were distributed in the programme during XI th Plan. In XIIth plan hearing Aids will be distributed by Ministry of social justice and empowerment.(Department of disability). MOU to implement this has already been signed between the two ministries.
Future Strategy and Components of NPPCD
In the 11th FYP and in 2012-2013 the programme is expanded to 20 States /UT’s in192 districts .In the 12th FYP, It is proposed to expand the programme to all States/UT’s by covering 200 additional districts, thereby taking the number of districts served to 384 by the end of 12th Five Year Plan.
OBJECTIVES OF THE PROGRAMME
- To prevent avoidable hearing loss on account of disease or injury.
- Early identification, diagnosis and treatment of ear problems responsible for hearing loss and deafness.
- To medically rehabilitate persons of all age groups, suffering with deafness.
- To strengthen the existing inter-sectoral linkages for continuity of the rehabilitation programme, for persons with deafness.
- To develop institutional capacity for ear care services by providing support for equipment, material and training personnel.
Long term objective: To prevent and control major causes of hearing impairment and deafness, so as to reduce the total disease burden by 25% of the existing burden by the end of 12th Five Year Plan.
COMPONENTS OF THE PROGRAMME
1) Manpower training and development – For prevention, early identification and management of hearing impaired and deafness cases, training would be provided from medical college level specialists (ENT and Audiology) to grass root level workers.
2) Capacity building – for the district hospital, community health centres and primary health centre in respect of ENT/ Audiology infrastructure.
3) Service provision–Early detection and management of hearing and speech impaired cases and rehabilitation, at different levels of health care delivery system.
4) Awareness generation through IEC/BCC activities – for early identification of hearing impaired, especially children so that timely management of such cases is possible and to remove the stigma attached to deafness.
PROGRAMME EXECUTION & EXPANSION
The Programme was a 100% Centrally Sponsored Scheme during 11th Five Year Plan. However, in 12th Five Year Plan, the Centre and the States will have to pool in resources as per the financial norms of NRHM mutas mutandis. The Programme was initiated in year 2007 on pilot mode in 25 districts of 11 State/UTs. The Programme has been expanded to 228 districts of 27 States/UTs.
EXPECTED BENEFITS OF THE PROGRAMME
The Programme is expected to generate the following benefits:-
i. Availability of various services like prevention, early identification, treatment, referral, rehabilitation etc. for hearing impairment and deafness as the primary health centre / community health centres / district hospitals largely cater to their need.
ii. Decrease in the magnitude of hearing impaired persons.
iii. Decrease in the severity/ extent of ear morbidity or hearing impairment.
iv. Improved service network/referral system for the persons with ear morbidity/hearing impairment.
v. Awareness creation among the health workers/grassroot level workers through the primary health centre medical officers and district health officers, which will percolate to the lower level health workers functioning within the community.
vi. Capacity building at the district hospitals to ensure better care.
Strategy:
• To strengthen the service delivery for ear care.
• To develop human resource for ear care services.
• To promote public awareness through appropriate and effective IEC strategies with special emphasis on prevention of deafness.
• To develop institutional capacity of the district hospitals, community health centers and primary health centers selected under the Programme.
The strategy has been approved by Steering Committee on National Programme for Prevention and Control of Deafness (NPPCD) and also validated by an expert group for inclusion in 12th Five Year Plan
Components:
• Manpower training and development – For prevention, early identification and management of hearing impaired and deafness cases, training would be provided from medical college level specialists (ENT and Audiology) to grass root level workers.
• Capacity building – for the district hospital, community health centers and primary health center in respect of ENT/ Audiology infrastructure.
• Service provision–Early detection and management of hearing and speech impaired cases and rehabilitation, at different levels of health care delivery system.
• Awareness generation through IEC/BCC activities – for early identification of hearing impaired, especially children so that timely management of such cases is possible and to remove the stigma attached to deafness
Funds allocation in XIIth plan
• Rs. 304.79 crore were allocated in 12th Plan.
• Rs. 2.32 Crore were allocated to Odisha in 2012-13
• Rs. 17.34 Crores were allocated to 7 new States in 2013-14