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Malaria Control Programme, Orissa

Malaria Control Programme, Orissa. CDMO Conference 21-22 Jan, 2010. Declining trend with hopes for control Maps with API: 2005, 2008 and 2009. Epidemiological situation,2005-09. Districts with high mortality, 2007 to 2009.

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Malaria Control Programme, Orissa

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  1. Malaria Control Programme,Orissa CDMO Conference 21-22 Jan, 2010

  2. Declining trend with hopes for control Maps with API: 2005, 2008 and 2009

  3. Epidemiological situation,2005-09

  4. Districts with high mortality, 2007 to 2009 There is no death investigations – * In Balasore out of 6 malaria deaths reported during the month of November only one could be ascertained due to malaria.

  5. LLIN distribution : GFATM districts

  6. LLIN distribution World Bank Districts

  7. Key features of the state LLIN guidelines • Criteria - sub-centre is the unit and in the first phase SCs with API >5 • SCs with API 3-<5 will be included when more LLINs will be available • All villages in a SC irrespective of API status of the village • Cluster approach: to protect entire population in defined high transmission area. • Clusters may be intra or inter block, intra or inter-dist. • All families irrespective of BPL and APL will be given LLIN • Avg. LLIN calculation : 1 LLIN/ 2.5 Persons +3% extra [1 LLIN for 1-2 persons, 2 LLINs for 3-5 persons, 3 LLINs for 6-7 persons, 4 LLINs for 8-10 persons.]

  8. Key features ……… contd • Identification of cluster areas was done through regional level workshops with state level facilitation. (representatives of 4-5 contiguous districts present at each workshop) • Survey of households in villages under a cluster through Gaon Kalyan Samitis (GKS) for identifying actual need • Distribution by GKS members under the active supervision of block, district and state. • List of beneficiaries to be maintained in designated registers.

  9. * In the format one extra column has been added to collect the data on under five children in the household who are being protected by LLIN

  10. Distribution of 11.99 lakh GoI LLIN in 09-10 Nominal contribution to be collected as a symbol of ownership GKS will collect Rs 10-15 per LLIN from BPL and Rs 20-30 from APL persons - But no one to be left out if unable to contribute. This fund will be used by GKS for malaria control activities, replenishing nets if torn out and BCC at village level.

  11. MO- MASHARI – the state initiative Objective: to protect the following special groups by LLINs with special message of ownership 1. Pregnant women in high burden areas (family size LLIN) • LLIN distribution at the time of antenatal registration as a component of ANC package. • This is expected to cover pregnant women during pregnancy and mother and child after delivery. • 1.01 lakh LLINs already in the distribution process in five high endemic districts and another 2 lakh LLIN will be procured in 2010-11 2. Boarders of Tribal Residential Schools (single size LLIN) • The boarder will own the LLIN, can take home during vacations and permanently after leaving the school - “will act as the agent of change in his/her community”. • Distribution through Headmaster/Headmistress of tribal schools.

  12. Current distribution plan underMo Mashari for pregnant women, 2009-10 Another 10 high burden districts will be covered in 2010

  13. Important activities around LLIN • State team will monitor district LLIN implementation • Computerized data base of LLIN distribution • BPO are to be involved for data entry at block level which will be consolidated at DPM unit for the districts. • MTS of concerned blocks and VBD consultants of WB Districts will coordinate with BPO and DPM units respectively. • Districts while distributing will document with photographs • Professional process documentation of LLIN activities will be done by T & MST

  14. Important activities …………….. • Appropriate IEC / BCC like use of folk media and other methods along with distribution of LLIN or after the distribution depending upon the ground reality, so that by the peak transmission season, people are in habit of sleeping under LLINs and do not misutilise • Dy MEIO/ BEE must be involved in the IEC/BCC activities and whole process • Pre-distribution information on village-wise days of distribution and post-distribution information of number of LLINs given village-wise will be displayed on the swathya kanthas and documented with photography.

  15. Important activities …………….. • Network and established civil society organisations will be involved for social mobilization around LLIN who will also give hand holding support to GKS • State level initiatives will be taken to involve Red Cross, NYKS, Kalyanee clubs, MNGOs etc. • Summary of nets distribution status would be uploaded on the health department website and updated regularly

  16. IRS in LLIN areas • In 2010, IRS will also be conducted in LLIN areas • This will be done since we are not sure about the extent of acceptance and usage of LLIN in the first year • Accordingly the IRS action plan will revised • A total district wise readiness plan will be developed by 1st week of Feb 2010 so that 1st round IRS can be conducted with full preparedness by 15th May 2010. • IRS Action plan meetings will be conducted from 27th to 29th Jan, 2010. • VCRC, NIMR, RMRC and RD office will be involved from the beginning in planning and monitoring

  17. GKS fund to meet IRS wages & operational cost for bednet impregnation IRS wages The wages for IRS will be met from GKS fund in2010-11 Necessary communication will be made soon • In an average Rs 6000/- may be needed per 2 rounds of spray in a village of average 1000 population Net impregnation: • Similarly in Non-IRS villages GKS fund can be used for impregnation of community bed nets • Some GKS show interest to impregnate without operational cost– they need only training and SP flow • Hence local appropriate measures can be adopted • SP flow is available in plenty and can be supplied on indent

  18. Issues on IRS Non submission of 2nd round IRS report: • Following district have not submitted the 2nd round IRS report: • Anugul, Dhenkanal, Gajapati, Ganjam, Jharsuguda, Kalahandi, Keonjhar, koraput, Malakanagiri and Nawarangpur, Nuapda, Samblapur, Sundargarh • Dhenkanal not submitted both 1st &2nd round IRS report

  19. Human resource LTs against regular posts:retired LTs will be posted against the vacant posts – communication will be made soon Additional manpower: Districts lagging behind: • MTS : Bhadrak (1), Koraput (1) Malkanagiri (1), Baragarh (1), • LT: Nayagarh(1), Gajapati (2), Koraput (1), Balasore (1) • As Koraput has not yet recruited 1 LT and such LTs are meant for sentinel sites, this position will be diverted to another dist • MPW (Male): Baragarh (35),Ganjam (34), Mayurbhanj (98), Nawarangpur (22), Koraput (43), Rayagarh (40). Dist. Malaria Officer will be posted as per the new cadre structure.

  20. MPHW - Male (567poated /816) More 184 sanctioned for 2010-11 and will be posted in high burden areas only

  21. Issues on sentinel sites • Trained LTs (Contractual) should be placed in identified Sentinel Sites (Avg. 2 per districts) • Data in proper format to be collected , compiled , analysed and feedback to be submitted to the concern Blocks • Sentinel site formats are given in ME Module • And in Dec- Jan all sentinel site LTs have been given reorientation training • They have been given the copies of the formats

  22. Quality microscopy • Microscopy is said to be the gold standard for malaria diagnosis, but unfortunately we have ??? on the quality • In many labs the discrepancy rate is very high (In many cases the +ve slides are –ve as observed by RD Lab.) – which is misleading the malariometric indicators and there is complaint that GoI supplied RDTs are not good as they show -ve results in such cases. • Due attention must be given at each level to see the quality aspects of each malaria lab and the skill of the technicians • Malaria technicians will be retrained where their skill is doubtful • All efforts are being taken to supply Lens, reagent etc. • Fund will be provided to districts to procure quality reagent and meet the microscope repair cost • Where non functional microscopes are not in repairable stage new microscopes will be provided • Hence urgent review of all malaria labs to be done by the district authority

  23. Other issues • NAMMIS: All IDSP data entry operators will be trained (many have already been trained) and they will be responsible for NAMMIS • M 1 and other new Surveillance format will be printed at district level to meet another 3 months’ requirement • All efforts to be taken to make ACT and RDT available at Sub centre and trained FTD (ASHA) level • Trainings: training of MPW (male) and rest of the ASHAs and VSS animators • Regular monthly review of VBDs, MTS, LTs and MPW(male) and sorting out their genuine difficulties • All malaria death must be investigated as per the guideline using the death investigation format: • A simple malaria death investigation format has been developed by Dte. NVBDCP, GOI and will be sent soon

  24. Financial issues • Except Deogarh, Jharsuguda, Kandhamal, Kendrapada, Keonjhar, Mayurbhanj, Nawarangpur, Nayagarh, Nuapada & Sundergarh other districts have low expenditure under WB (<10%) • GFATM districts under with <5% expenditure: • Angul, Balasore, Bhadrak, Boudh & Khurda : <5% • Dhenkanal is with <10% expenditure • SOE & UC of 1st round IRS : Only Dhenkanal, Malkangiri, Bolangir & Angul & Sonepur have submitted- others are yet to submit • SOE & UC of the fund under DBS : Districts have not submitted. • All measure be taken to submit SOE by 5th of every month • Is being submitted to GoI, by 10th of every month

  25. Thanks

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