This ppt tries to explain prevention & control of Deafness. Also tells about various policies related to NPPCD.

1. NATIONAL PROGRAM FOR
PREVENTION AND CONTROL
OF DEAFNESS
DR. JASBEER SINGH
DR. MIDHUN LAL VK

2. CONTENTS
 INTRODUCTION
 CAUSES OF HEARING LOSS
 OBJECTIVES OF THE PROGRAM
 STRATEGIES OF THE PROGRAM
 ORGANISATIONAL STRUCTURE
 PROGRAM IMPLEMENTATION
 PROGRAM ACTIVITIES
 ACHIEVEMENTS OF THE PROGRAM
 CONCLUSION

3. INTRODUCTION
> Hearing loss is the most common sensory deficit in humans today
and is the second leading cause for ‘Years Lived with Disability
(YLD)’ , the first being depression.
> As per WHO estimate, in India there are approximately 63 million
people who are suffering from significant auditory impairment.
> There are 291 persons per 1 lakh population who are suffering
from severe hearing loss.
> Noise is the insidious of all industrial pollutants involving every
industry and causing severe hearing loss in every country in the
world.

4. > Occupational hearing loss includes acoustic , traumatic
injury and noise induced hearing loss.
> Noise induced hearing loss is the second most
common acquired hearing loss after age related loss.
> 50% of causes of hearing impairment are preventable
and can be corrected surgically and can be rehabilitated
with the use of hearing aids , speech and hearing
therapy.

5. CAUSES OF HEARING LOSS
> Aging process
> Occupational hazards (those who are working in noisy areas )
> Wax in the ear
> Chronic ear infection
> Diseases of tympanum
> A hole in tympanic membrane
> Growths and masses in the ear & bones and cancer like diseases

6. Types of Deafness
> Conductive deafness : Due to defect in the conducting
mechanism of the ear namely external and middle ear.
> Sensori-neural deafness / Perceptive deafness : Due
to lesions in the labyrinth, 8th nerve & central connections.
It includes psychogenic deafness.
> Mixed deafness : Both the above mentioned types are
present.

7. NPPCD
> The Program was initiated in 2007 on pilot mode in 25
districts of 11 State/UTs.
> In first phase manner , the program was extended to 203
districts of 20 State/UTs by 2012.
> In 12th five year plan, its proposed to expand the program
to additional 200 districts in a phased manner probably
covering all the states and union territories by 2017.

8. OBJECTIVES
LONGTERM
> To reduce the total disease burden by 25% by the end of 11th five year
plan.
IMMEDIATE
> Early identification, diagnosis and treatment of ear problems
responsible for hearing loss and deafness.
> To prevent the avoidable hearing loss on account of the disease/injury.

9. > To medically rehabilitate persons of all age groups
suffering with deafness.
> To strengthen the existing intersectoral linkage for
continuity of the rehabilitation program.
> To develop institutional capacity for ear care services by
providing support for equipment, material and training
personnel.

10. STRATEGIES
> To strengthen the service delivery including rehabilitation.
> To develop human resources for ear care.
> To promote out reach activities and public awareness
through innovative and effective IEC strategies with special
emphasis on prevention of deafness.

11. ORGANISATIONAL STRUCTURE

12. Health Minister
Additional Secretary
Joint Secretary
Central Coordination
Committee
Secretary Health & Family
Welfare
Additional Director
General
Director General of Health
Services
Deputy Director GeneralDirector (Public Health)
Under Secretary(Public Health)
Program Manager
Chief Medical Officer

13. COMPONENTS OF THE PROGRAM
1) Training of all the manpower
2) Infrastructure Building
3) Service provision
4) IEC activities

14. 0

15. CENTRAL LEVEL
> Central Coordination Committee will be constituted at the central
level.
> This will consist of following members :
Representative of DGHS - 2
Representative of WHO - 1
ENT specialists and experts - 2
Audiologists and speech therapists - 2
Public Health expert - 1
Representative of Rehabilitation Council of India (RCI) - 1

16. > This Committee will evaluate and monitor the
implementation plan for program .
> Central Cell will be set up at the central level in the DGHS to
provide necessary leadership, technical support to the State
and District level functionaries.

17. STATE LEVEL
> State Health Society and Program Committee is placed under
NRHM
> It will function for ….
- Preparation of district plans for implementation of NPPCD ,
- Monitoring and supervise implementation of program ,
- Release and Monitoring of flow of funds to the District Health
Societies.

18. > State Technical Committee will have
State Nodal Officer ; ENT Specialist / Surgeon
Audiologist - 1
to provide technical guidance and expertise to the State
Health Society

19. DISTRICT LEVEL
> At the district level , the District Health Society and Program
Committee will function for …..
- Planning and Implementation of the program ,
- Financial and material management ,
- Social mobilization and public awareness ,
- Orientation of various functionaries of health ,
- Arrangement for Screening camps and monitoring the activities
for NGOs

20. > District Hospital will post …
District Nodal Officer ; ENT Surgeon - 1
Audiologist - 1
and they will be the key persons for the implementation of the
program in the district.
> They can also employ additional staff:
Teacher for young hearing impaired – on contractual basis, to look
after the therapy and training of young hearing impaired children
at district level.

21. PROGRAM IMPLEMENTATION
> Center of Excellence – The State Medical College – which
supports the program
> Main Focus of Activity of the Program - The District Hospital
> The program will be strengthened through training of …
- ENT doctors - Audiologist
> They would be provided with equipment for proper diagnostic,
therapeutic, & rehabilitation activities.

22. > The doctors at PHC & CHC will also be given training as well as the basic
diagnostic equipment to enable them to diagnose, treat & refer the
patients requiring treatment.
> The Multipurpose workers at the sub central level and
the gross level functionaries (AWWs, ASHA), including Mahila Mandals will
be sensitized about the program which would facilitate in creating
awareness and mobilizing the communities.
> The School Health system will play a very important role in the program.
The ear check up will be done by the PHC or CHC doctors

23. SCREENING TESTS
1) Audiometry BERA ( Brainstem Evoked Response Audiometry)
- Simple
- Automated
- Reliable
But COST is prohibiting factor to make it available in all the
places

24. 2) Behavioral Observation Audiometry (BOA)
> Assess the baby’s response to different frequency intensity
and duration of sounds presented
> Respond to 70db noise :-
i) a new born baby – eye blink , eye widening or startle
ii) between age of 6 – 16 weeks – arousal , eye blink or
eye shift can be useful to detect to indicate hearing
impairment in early life

26. ACHIEVEMENTS
> Modules of training of doctors , multipurpose workers and
technicians have been developed.
> In some places such as Delhi, training of trainers has been
started.
> In many districts, hearing aids are distributed to poor
children.
> This program is integrated with the NRHM framework.

27. COMMENTS
> Once again loading the information about deafness and
burden of detection and mobilization of deafness on ASHA and
AWWs indicates poor planning.
> These part time workers cannot be the pillars of the health who
are neither the permanent health staff nor skilled enough to
handle.

28. > Once again a series of training program will start for
all levels of health professionals without identifying the
impact factors of previous trainings on other subjects
> In 12th Five Year Plan not much emphasis is given
on this program.
> Similarly in NRHM, it is low priority.

29. CONCLUSION