National Action Plan Combating Viral Hepatitis in India
The National Viral Hepatitis Control Program has been launched by Ministry of Health and Family Welfare, Government of India on the occasion of the World Hepatitis Day, 28th July 2018. It is an integrated initiative for the prevention and control of viral hepatitis in India to achieve Sustainable Development Goal (SDG) 3.3 which aims to ending viral hepatitis by 2030. This is a comprehensive plan covering the entire gamut from Hepatitis A, B, C, D & E, and the whole range from prevention, detection and treatment to mapping treatment outcomes. Operational Guidelines for National Viral Hepatitis Control Program, National Laboratory Guidelines for Viral Hepatitis Testing and National Guidelines for Diagnosis and Management of Viral Hepatitis were also released.
- Combat hepatitis and achieve country wide elimination of Hepatitis C by 2030;
- Achieve significant reduction in the infected population, morbidity and mortality associated with Hepatitis B and C viz. Cirrhosis and Hepato-cellular carcinoma (liver cancer);
- Reduce the risk, morbidity and mortality due to Hepatitis A and E.
- Enhance community awareness on hepatitis and lay stress on preventive measures among general population especially high-risk groups and in hotspots.
- Provide early diagnosis and management of viral hepatitis at all levels of healthcare
- Develop standard diagnostic and treatment protocols for management of viral hepatitis and its complications.
- Strengthen the existing infrastructure facilities, build capacities of existing human resources and raise additional human resources, where required, for providing comprehensive services for management of viral hepatitis and its complications in all districts of the country.
- Develop linkages with the existing National programs towards awareness, prevention, diagnosis and treatment for viral hepatitis.
- Develop a web-based “Viral Hepatitis Information and Management System” to maintain a registry of persons affected with viral hepatitis and its sequelae.
1. Preventive component: This is the cornerstone of the NVHCP. It includes
- Awareness generation & behaviour change communication
- Immunization of Hepatitis B (birth dose, high risk groups, health care workers)
- Safety of blood and blood products
- Injection safety, safe socio-cultural practices
- Safe drinking water, hygiene and sanitary toilets
2. Diagnosis and Treatment:
- Screening of pregnant women for HBsAg to be done in areas where institutional deliveries are < 80% to ensure their referral for institutional delivery for birth dose Hepatitis B vaccination.
- Free screening, diagnosis and treatment for both hepatitis B and C would be made available at all levels of health care in a phased manner.
- Provision of linkages, including with private sector and not for profit institutions, for diagnosis and treatment.
- Engagement with community/peer support to enhance and ensure adherence to treatment and demand generation.
3. Monitoring and Evaluation, Surveillance and Research
Effective linkages to the surveillance system would be established and operational research would be undertaken through Department of Health Research (DHR). Standardised monitoring & evaluation framework would be developed and an online web based system is established.
4. Training and Capacity Building:
This will be a continuous process and will be supported by NCDC (National Centre for Disease Control), ILBS (Institute of Liver and Biliary Sciences) and state tertiary care institutes and coordinated by NVHCP. The hepatitis induction and update programs for all level of health care workers would be made available using both, the traditional cascade model of training through master trainers and various platforms available for enabling electronic, e-learning and e-courses.
National Viral Hepatitis Control Management Unit
The NVHCP will be coordinated by the units at the centre and the states.
- National Viral Hepatitis Management Unit (NVHMU): The NVHMU is established at the centre with in the NHM (National Health Mission) and will be responsible for implementation of program in the country. The NVHMU will be headed by a Joint Secretary who will report to the Mission Director (NHM).
- State Viral Hepatitis Management Unit (SVHMU)- The State Health Society with nodal officer and required essential manpower will coordinate the program at state level.
- District Viral Hepatitis Management Unit (DVHMU)- A program officer at the district level from available manpower would act as the nodal person to supervise the program and facilitate the logistics, supply chain, outreach, training at district level.