Health Policy Issues and Health Programmes in ... - Amazon S3

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HIV/AIDS in India and Uttaranchalprevalence states, for every infected female there are 2 males; and in low prevalencestates, for every infected female there will be 3 males.l Similarly, for every male STD patient from high prevalence states, it is assumed that therewould be 0.83 females; for moderate prevalence states, there will be 0.5 females; and forlow prevalence states, there would be 0.33 female patients.5. With respect to the HIV prevalence rates.l The median value of HIV prevalence from state-specific and group-specific sentinel datahas been applied.l For states where the HIV prevalence rate has been reported as “0,” the followingassumptions are made.1. If data were available from a previous round where the prevalence is more than “0,”the rate from the previous round will be adopted.2. If the previous round data also shows “0” prevalence, the arithmetic mean of the lowprevalence states will be applicable in place of the “0” value.6. For estimation of HIV infection among IDUs, the HIV prevalence rate will be applied to theestimated size of the IDU population in the state.7. States will be categorized as high, moderate, or low, based on the following definition.l High Prevalence States States where HIV prevalence in antenatal women is one per cent ormore.l Moderate Prevalence States States where the HIV prevalence in antenatal women is lessthan one per cent and prevalence in STD and other high-risk groups is five per cent ormore.l Low Prevalence States States where the HIV prevalence in antenatal women is less thanone per cent and HIV prevalence among STD and other high-risk groups is less than fiveper cent.The justification for the urban–rural and male–female gradients is as follows.1. It is assumed that HIV spreads from urban to ruralareas, and this differential is maintained even at a highlevel of HIV prevalence.2. It is assumed that a higher percentage of males havehigh-risk behaviours as compared to females in India.In the beginning of the epidemic, males outnumberfemales, but the ratio gets closer to 1 with theprogression of the epidemic in the general population.In all the South Asian countries, males outnumberfemales, and in a high prevalence country like Thailandand Cambodia, this ratio is 1.6:2.3. It is also assumed that the infection shifts from thehigh-risk population to the general population over aperiod of time. Therefore, all the states go through astage of low, then concentrated, and then generalizedepidemic in the absence of effective interventions.Using these assumptions and consistence methodology,estimates of HIV infections have been worked out for1998, 1999, and 2000. A range of 20% is applied to thepoint estimate to provide higher and lower values.Keeping this in mind, the fact that all risk groups are notadequately represented (age groups excluding 15–49years are not included and AIDS cases are not includedin this exercise), the upper side of the range has beentaken as a working estimate for the country, as perdetails given below.1998 3.50 million1999 3.70 million2000 3.86 million2001 3.97 million180
HIV/AIDS in India and UttaranchalFig ure 5Comulative Number of AIDS Cases in IndiaDecember 20013500030000Number of AIDS cases25000200001500010000500001986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001YearsAIDS Case SurveillanceAnother aspect of monitoring the HIV/AIDS epidemic isthe reporting of actual AIDS cases (Figure 5). By December2001, 31,336 AIDS cases had been reported to NACO.These figures are considered only a fraction of the AIDSmorbidity. The low numbers and geographic distributionof AIDS cases shows that these numbers do not reflect thetrue situation in the country, and there is under-reporting.Epidemiological analysis of reported AIDS cases revealsthat1. The disease is affecting mainly people in the sexuallyactive age group. The majority of patients (87.7%) areaged 15–44 years.2. As shown in Figure 6, the predominant mode oftransmission of infection in AIDS patients is throughheterosexual contact (83.2%), followed by IDU (3.8%),blood transfusion and blood product infusion (3.7%),and others (7.3%).3. Males account for 76.1% of AIDS cases and females23.9%. The ratio is 3:1, although this varies by agegroup (Figures 7 and 8).4. The major opportunistic infection in AIDS patients istuberculosis (TB), which indicates the possibility of adual epidemic of TB and HIV in the future (Figure 9).Figure 6Mode of Transmission in AIDS Cases in IndiaDecember 2001Figure 7Number of AIDS casesH eterosexual 84.53IDUs 3.36Blood and blood products 3.27Perinatal 2.14Others 6.7Age and Sex Distribution of AIDS Cases in IndiaDecember 2001140001200010000800060004000MalesFemalesAIDS case surveillance data can also supplement the HIVsurveillance data in monitoring the epidemic andcontribute to the planning of hospital and home/200000–14 years 15–29 years 30–44 years >45 y earsAge group181
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Health Policy IssuesandHealth Progr
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ContentsContentsPrefaceList of Part
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I would also like to thank our tech
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List of ParticipantsIndu Kumar Pand
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List of ParticipantsMohmed ShaukatD
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List of ParticipantsR K PurohitAddi
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GlossaryGlossaryAbbreviationsAIIMSA
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GlossaryLHVLILMISMAPMCMCHMDRTBMDTM&
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GlossaryTHRTRCTRIPsTTTUUDCUIPUPUTVC
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Inaugural Sessionwould be the first
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Inaugural SessionOnly 18% of the pr
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Inaugural SessionMadhukar Gupta, Ch
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Inaugural Sessionrotational basis f
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Inaugural Sessiontell you more abou
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Public Health Issues, Priorities, a
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National Health Programmes: An Over
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Implementation of National Health P
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Use of Epidemiological Surveillance
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Designing a Surveillance SystemFurt
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Designing a Surveillance Systemsurv
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National Health Programme in Uttara
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IEC Strategies for Health in IndiaS
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IEC Strategies for Health in Indial
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IEC Strategies for Health in IndiaS
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IEC Strategies for Health in IndiaA
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IEC for Health Programmes in Uttara
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Session 3Private and Public SectorP
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Public-Private Interaction in Healt
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Cost Recovery Measures in Governmen
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Arogya Raksha: Health Insurance Sch
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Page 142 and 143: Session 1Session 4Health Financing
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Page 160 and 161: Session 1Session 4Access to Health
Page 162 and 163: Access to Health Services in Uttara
Page 170 and 171: Session 5STI/RTI, AIDS, and TB Cont
Page 172 and 173: Quality of RTI/STI Case Management
Page 182 and 183: HIV/AIDS: International Perspective
Page 188 and 189: HIV/AIDS in India and UttaranchalSe
Page 190 and 191: HIV/AIDS in India and UttaranchalFi
Page 198 and 199: Tuberculosis Control Efforts in Ind
Page 208 and 209: Session 6Other Health IssuesChairpe
Page 210 and 211: Care of the ElderlySocial care is u
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Page 214 and 215: Hospital Waste ManagementSession 6H
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Page 220 and 221: Hospital Waste ManagementTreatment
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Page 224 and 225: Hospital Waste ManagementTable 6. U
Page 226 and 227: Streamlining the Drug Procurement a
Page 240 and 241: Sanitation and Public Health Issues
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Sanitation and Public Health Issues
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Sanitation and Public Health Issues
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Ayurveda and Unani Department and t
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Specific Health Policy and Programm
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