Magnitude of the Problem
“Burn” is a major Public Health Programme all over the world. In fact, more people die due to burn injuries than Malaria and Tuberculosis. As per WHO report 2014, in India, over 1, 000, 000 people are moderately or severely burnt every year. As per the data extrapolated from the information received from 3 major Govt. Hospitals in Delhi, approx. 1.4 lakh people die of burn injuries annually. This comes to one death every 4 minutes due to burns. Most of the burn victims belong to vulnerable group of the society. The misery of burn patients is further aggravated as the treatment requires prolonged hospitalization and multiple corrective plastic surgeries, leading to economic hardship.
However, the death and disability due to burn injury are preventable to a great extent if timely and appropriate treatment is provided by trained personnel.
Management of burns is a distinct branch of medical super specialty. However, trained manpower as well as dedicated burn units is almost non-existing in our country. Keeping in view the magnitude of problem, a pilot project was approved during the 11th five year plan period.
Pilot Programme for Prevention of Burn Injuries (PPPBI) - 11th Five Year Plan:
A pilot programme was initiated in the year 2010 by Ministry of Health & Family Welfare in the name of “Pilot Programme for Prevention of Burn Injuries” (PPPBI) with a total budget of Rs. 29 crore. The programme was initiated in the following three Medical Colleges and six Districts Hospitals:
- Haryana: Post Graduate Institute of Medicals Sciences Rohtak; General Hospital, Gurgaon; Civil Hospital, Panipat.
- Himachal Pradesh: Dr. Rajendra Prasad Medical College, Tanda at Kangra, District Hospital, Hamirpur; Zonal Hospital, Mandi.
- Assam: Guwahati Medical College; District Hospital, Nagaon; District Hospital, Dhubri.
The Goal of PPPBI was to ensure prevention of Burn Injuries, provide timely and adequate treatment in case burn injuries do occur, so as to reduce mortality, complications and ensuing disabilities and to provide effective rehabilitative interventions if disability has set in.
National Programme for Prevention & Management of Burn Injuries (NPPMBI) - 12th Five Year Plan:
The proposal for continuation of pilot project as full-fledged programme was approved by Empowered Finance Committee (EFC) on 17.05.2013 and subsequent by Cabinet Committee for Economic Affairs (CCEA) on 6th February, 2014, for covering 67 State Government Medical Colleges and 19 District Hospitals during the 12th Five Year Plan. The District Hospital component was undertaken under National Health Mission (NHM).
Objectives:
- To reduce incidence, mortality, morbidity and disability due to Burn Injuries
- To improve awareness among the general masses and vulnerable groups especially the women, children, industrial and hazardous occupational workers.
- To establish adequate infrastructural facility and network for Behavior change communication, burn management and rehabilitation interventions.
- To carry out Research for assessing behavioral, social and other determinants of Burn Injuries in our country for effective need based program planning for Burn Injuries, monitoring and subsequent evaluation.
Components:
- Prevention Programme (IEC)
- Treatment
- Rehabilitation
- Training
- Monitoring and Evaluation
- Research
Expected Outcome:
- Dedicated Burns Care Services in 70 Medical Colleges & 25 District Hospitals.
- Availability of skilled manpower at the Medical Colleges& District Hospitals.
- Increased awareness regarding prevention of burns Injuries, safety measures and availability of services through IEC.
Achievements during 12th FYP:
- The list of equipment, manpower and the architectural design of the proposed burn unit/ ward has been finalized in expert group meeting, with technical design specifications supplied by Central Design Bureau.
- The Practical Handbook/ Manual for Burn Injury Management developed during the 11th FYP has been revised. A chapter on the Standard Treatment Guidelines for Acid attack victims has been incorporated in the practical handbook.
- Operational Guidelines for the Programme have been finalized and circulated to all States and UTs.
- Screening Committee for Trauma & Burn Programmes has been formed for administrative approval to the hospitals recommended by the technical experts.
- 50 Medical Colleges and 17 District Hospitals in 24 States/ UTs, out of 91 (57 Medical colleges & 34 District Hospitals) visited, have been approved by the screening committee for establishing burn units, so far.
- Memorandum of Understanding for 12th FYP has been concurred by IFD and circulated to States and UTs.
- Burn Data Registry and software have been developed and will soon be implemented at National level to collect, compile and analyze data related to Burn Injuries in the country.
- The Quarterly report format has been finalized and circulated to states.
- Under Information Education and Communication (IEC) activities, the print IEC material (8 posters/ charts/ pamphlets) has been developed and distributed in states. The outdoor publicity campaign through external train wrapping was undertaken in 5 trains in the month of April, 2015.
- Operational Guidelines for the District Hospital component have been finalized and uploaded on the website of NHM Division.
- The 6-day practical training of Medical Officers in Burn Injury management with a batch of 9 trainees each was organized at Safdarjung Hospital and Dr. RML Hospital.
- A two-day workshop was held in collaboration with CDC Atlanta to finalize the burn data registry format on 1st and 2nd Nov, 2016 at India Habitat Centre, New Delhi.
