National Viral Hepatitis Control Program (NVHCP)

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.

Aim:

1. Combat hepatitis and achieve country wide elimination of Hepatitis C by 2030;
2. Achieve significant reduction in the infected population, morbidity and mortality associated with Hepatitis B and C viz. Cirrhosis and Hepato-cellular carcinoma (liver cancer);
3. Reduce the risk, morbidity and mortality due to Hepatitis A and E.

Key Objectives:

1. Enhance community awareness on hepatitis and lay stress on preventive measures among general population especially high-risk groups and in hotspots.
2. Provide early diagnosis and management of viral hepatitis at all levels of healthcare
3. Develop standard diagnostic and treatment protocols for management of viral hepatitis and its complications.
4. 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.
5. Develop linkages with the existing National programs towards awareness, prevention, diagnosis and treatment for viral hepatitis.
6. Develop a web-based “Viral Hepatitis Information and Management System” to maintain a registry of persons affected with viral hepatitis and its sequelae.

Components:

1.Preventive component: This is the cornerstone of the NVHCP. It includes

1. Awareness generation & behaviour change communication
2. Immunization of Hepatitis B (birth dose, high risk groups, health care workers)
3. Safety of blood and blood products
4. Injection safety, safe socio-cultural practices
5. Safe drinking water, hygiene and sanitary toilets

2.Diagnosis and Treatment:

1. 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.
2. 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.
3. Provision of linkages, including with private sector and not for profit institutions, for diagnosis and treatment.
4. 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.

Activities performed under NVHCP and SVHMU:

• The National Viral Hepatitis Control Programme was launched in April 2019 in the state
• It was followed by training for GMC Doctors, Residents, Consultants and Medical Officers and lab technicians of Directorate of Health Services
• 1 Model treatment centre (MTC) is setup at Department of Medicine(GMC) and 2 Treatment Centers (TC) are setup at district hospitals
• State Laboratory is setup at Department of Microbiology, Goa Medical College and 2 district labs are setup at district hospitals and are all are functional from 15-07-2019
• Hepatitis B vaccine for the health care workers and other logistics are stored at Directorate of Health Services under supervision of the Vaccine Cold Chain Manager & is distributed as and when required
• Patient screening and treatment details from viral hepatitis requisition forms and registers are entered in the NVHCP MIS portal at Goa Medical College and both district hospitals
• Viral Load testing for Hepatitis B & Hepatitis C is outsourced to Core Diagnostics, Gurgaon
• Screening of High Risk Group (HRG) population is done at ICTCs, blood banks and dialysis centers
• Screening of jail inmates is done once a year