Policy documents & developments to watch 1. Interesting to see the NCDC take on the Indian snakebite agenda under their OneHealth portfolio. See their [National Action Plan for Prevention and Control of Snakebite Envenoming (NAPSE)](https://ncdc.mohfw.gov.in/wp-content/uploads/2024/07/NATIONAL-ACTION-PLAN-FOR-PREVENTION-AND-CONTROL-OF-SNAKEBITE-ENVENOMING-NAPSE.pdf) which demonstrates quite some consultations/involvement of snakebite folks (MCBT among others including Rom and team). 2. One of NAPSE's action points is to make snakebite a notifiable disease - a significant policy achievement which of course can only be realised if the system of notification itself can become easier and engaging of formal and informal private sector. **Update as on Dec 28 2024**: Snakebite has now been made a notifiable disease with GoI writing this to all state governments. It appears Karnataka might have been the pioneer in this (TN too has done it a li'l after), and now with the NAPSE recommendation coming into policy, there is likely to be a nation-wide notificaiton requirement for snakebite. ![[Pasted image 20241228114631.png]] 3. [https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01905-X/fulltext#back-bib11](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01905-X/fulltext#back-bib11) Lancet article by Bhaumik, Gopalakrishnan & Meena on the chronic aspects/morbidity post-snakebite 4. [https://pubmed.ncbi.nlm.nih.gov/33257419/](https://pubmed.ncbi.nlm.nih.gov/33257419/) Bhaumik et. al. 2020 Scoping review on mental health issues following snakebite. This is a scoping reivew. "Of the 11 studies reported, post-traumatic stress disorder (PTSD) was the most commonly studied mental health condition after snakebite, with five studies reporting it. Estimate of the burden of PTSD after snakebite was available from a modelling study. The other mental health conditions reported were focused around depression, psychosocial impairment of survivors after a snakebite envenomation, hysteria, delusional disorders and acute stress disorders." "depression and PTSD are major mental health manifestations in snakebite survivors." 5. [https://bmcprimcare.biomedcentral.com/articles/10.1186/s12875-023-02109-2](https://bmcprimcare.biomedcentral.com/articles/10.1186/s12875-023-02109-2) Structural capacity and continuum of snakebite care in the primary health care system in India: a cross-sectional assessment Bhaumik, Norton & Jagnoor 2023 Generally paints a poor picture of PHC and CHC preparedness with respct to securing snakeite care "Comprehensive strengthening of primary health care, across all domains, and throughout the continuum of care, instead of a piece-meal approch towards health systems strengthening, is necessitated to reduce snakebite burden in India, and possibly other high-burden nations with weak health systems. Health facility surveys are necessitated for this purpose." 6. See Dal Singh & Aghani Bai's story in [JSS's](https://www.jssbilaspur.org/) *An Atlas of Rural Health* which is available for [free reading/download on the PARI website](https://ruralindiaonline.org/media/documents/Atlas_of_Rural_Health.pdf) ![[Screenshot 2024-12-28 at 11.48.51 AM.png]]