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MALARIA SITUATION IN PAKISTAN

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MALARIA SITUATION IN PAKISTAN PROGRAMME GOALS AND OBJECTIVES To reduce the burden of malaria by 50 percent by the year 2010 RBM Implementation all over the country by 2006 ELEMENTS OF NATIONAL RBM STRATEGY Early detection and prompt treatment of malaria cases

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programme goals and objectives
PROGRAMME GOALS AND OBJECTIVES
  • To reduce the burden of malaria by 50 percent by the year 2010
  • RBM Implementation all over the country by 2006
elements of national rbm strategy
ELEMENTS OF NATIONAL RBM STRATEGY
  • Early detection and prompt treatment of malaria cases
  • Multiple prevention measures including ITNs and focal spraying with insecticides
  • Detection and control of malaria epidemics
  • Operational research
  • Viable partnerships with government, non-government and private sector partners
slide6

2003 DATA - Malaria Control Programme

Annual Parasite Incidence – API/1000 population

More than 3.5

1.6 – 3.5

0.5 – 1.5

Less than 0.5

No data available

slide7

2003 Data - Malaria Control Programme

Annual Falciparum Incidence – API/1000 population

More than 3.5

1.6 – 3.5

0.3 – 1.5

Less than 0.2

No Data available

districts with rbm in place
Districts with RBM in place

PUNJAB: Muzzafargarh, D.G. Khan, Rajanpur, Bhawalnagar, Jhang, Kasoor, Sailkot, Khenewal, Rahimyar Khan, Liayah

SINDH: Hyderabad, Mirpurkhas, Badin, Jacobabad Thatta

NWFP:D.I. Khan, Sawabi, Laki Marwat, Kohat, Karak, Bunner, Bannu, Malakand

BALUCHISTAN:Pishin, Zhob, Kharan, Lasbella, Nasirabad

activities
ACTIVITIES
  • DIPS IN 21 RBM DISTRICTS
  • CAPACITY BUILDING
  • CASE MANAGEMENT
  • TRAINING OF MEDICS/PARAMEDICS
  • TRAININGOF MICROSCOPISTS
  • PROVISION OF LOGISTICS
  • PROVISION OF ANTI MALARIAL DRUGS
activities contd
ACTIVITIES (contd)

VECTOR CONTROL

IRSFOCAL SPRAY IN SELECTED AREAS

PROVISION OF SPRAY EQUIPMENTS

INSECTICIDES

LARVECIDES

ULV FOG GENERATORS (N.W.F.P)

ITNS

treatment diagnostic facilities
Treatment & Diagnostic facilities
  • The district and sub-district hospitals and rural health centers (and few selected basic health units) work as microscopy centers.
  • The primary health care facilities such as basic health units and dispensaries work as treatment centers.
  • The Tehsil and district headquarter hospitals also provide specialist care to complicated/severe malaria cases.
epidemic control
EPIDEMIC CONTROL
  • Epidemics in district, Okara, Mirpurkhas
  • Flood affected areas of Sindh and Balochistan
  • WHO support in investigation & response
progress 1
PROGRESS-1
  • National strategic plan developed.
  • Federal and Provincial PC-1s approved.
  • Case management guidelines and microscopy manual developed (local language).
  • 21 districts initiated RBM activities, as per DIPs.
  • Malaria early warning system (MEWS) drafted.
  • TV, radio and print materials developed.
  • GFATM support for programme strengthening
capacity building advocacy and communication
Capacity Building/ Advocacy and Communication
  • Revitalization of the former NIMRT
  • Training to various levels of malaria workers
  • National plan for advocacy & education in place
  • Advocacy and mass awareness activities started

- TV: 500

-Radio messages: 400

- Newspaper: Advertised in leading News papers for

international national partnerships 1
International & National partnerships-1

WHO

  • JPRM: US$ 72,000 (02 yrs.)
  • Tech Officer (RBM): 01
  • Further commitment for TA

GFATM

  • Grant Round 2 : US$ 4.4 Million

Strengthening microscopy in 23 districts

Enhanced case management capacity in 23 districts

Design and implement BCC strategy

Promote the use of ITNs in 11 pilot districts through public-private partnership

international national partnerships 2
International & National partnerships-2

GFATM Round 3:

Proposal approved by Tech Rev Panel (TRP)

Total grant approved: US$ 1.5 million

DFID

  • DFID-NHF to provide TA and budget support to the MCP for strengthening RBM expansion.

TA includes:

    • Human resource
    • Provincial level strategic planning and PC-1 revision.
    • Development of training materials and manuals
international national partnerships 3
International & National partnerships-3

The programme is piloting implementation of ITNs in 11 districts in partnership with following NGOs:

  • Health Net International Peshawar
  • National Rural Support Programme/ Association for Social Development
  • greenstar
implementation
IMPLEMENTATION
  • Drug resistance sentinel sites needs functional , trainings has been completed & implementation will start shortly.
  • Sentinel sites for recording and reporting of severe malaria morbidity & mortality identified

workers are trained, tools for data collection provided & the sentinel sites will be functional in next quarter of this year.

operational research
OPERATIONAL RESEARCH
  • Drug resistance studies carried out in 12 districts.
  • Research study on care providers and community perspectives (contracted to IPH Lahore)

- Assessment of public & private sector health care delivery capabilities and potential for malaria control

- Assessment of community perceptions and practices regarding malaria and its control

strengthening of fedral dirctorate
STRENGTHENING OF FEDRAL DIRCTORATE

IN PROCESS

A. DFID

  • INTERNATIONAL ADVISOR 01
  • PROGRAMME OFFICERS 02
  • EPIDIMIOLOGIST 01
  • DEVELOPMENT OF GUIDELINES

B. GFATM ROUND-II

  • PROJECT COORDINATOR (FIELD) 01
  • M/TECHNICIANS FOR NIMRT 02
  • M/REPAIR TECHNICIANS 05
strengthening of fedral directorate
STRENGTHENING OF FEDRAL DIRECTORATE

C.GOVERNMENT OF PAKISTAN

1.COMPUTOR PROGRAMMER 01

2.MEDICAL OFFICER 01

3.SCIENTIFIC OFFICER (NMIRT) 01

4.ADMIN OFFICER 01

AND SUPPORT STAFF.*

* Advertisement made

issues
ISSUES
  • Need for provincial and district level strategic planning
  • Need for strengthening supervision and monitoring at provincial and district level
  • Sub-optimal use of malaria human & other resources
  • Inadequate field cost (TA/DA) for malaria staff
  • Involvement of private sector in malaria control
issues29
ISSUES

Drug resistance

  • RII level to chloroquine
  • Resistance is now on increase

Insecticide resistance

  • Two primary malaria vectors are resistant to Organochlorines (DDT, BHC, Dieldrin) and Organophosphates (Malathion)
issues30
ISSUES
  • National Policy on the vector control (rational use of insecticide)
  • National Malaria Treatment Policy to be in line with WHO ACT
  • Integration of MCP activities with EPI and MCH
  • Uncontrolled private sector
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