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National Vector Borne Disease Control Programme

National Vector Borne Disease Control Programme. DTE OF NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME DIRECTORATE GENERAL OF HEALTH SERVICES MINISTRY OF HEALTH AND FAMILY WELFARE. VECTOR BORNE DISEASES OF PUBLIC HEALTH IMPORTANCE. Malaria Filaria Kala Azar (Leishmaniasis)

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National Vector Borne Disease Control Programme

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  1. National Vector Borne Disease Control Programme DTE OF NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME DIRECTORATE GENERAL OF HEALTH SERVICES MINISTRY OF HEALTH AND FAMILY WELFARE

  2. VECTOR BORNE DISEASES OFPUBLIC HEALTH IMPORTANCE • Malaria • Filaria • Kala Azar (Leishmaniasis) • Japanese Encephalitis • Dengue Fever

  3. MALARIA • 2.5 million cases being reported annually in the South East Asian Region • India contributes more than three-fourths of the total cases in the SEA region • 94 million blood smears collected in ’04 • 1.84 million malaria cases reported in 2004 (provisional) • Slide Positivity Rate 1.58 • P. falciparum 46%

  4. Malaria Situation in India (2000-05) (Aug)

  5. PERCENTAGE CONTRIBUTION OF POPULATION, MALARIA CASES, Pf CASES AND DEATHS (Compared to the country total)

  6. ADDITIONAL INPUTS • 1045 PHCs in 100 districts of 8 states are also being provided additional support under Enhanced Malaria Control Project (EMCP) with World Bank assistance. • Northeastern states & Sikkim are being provided 100 per cent support for program implementation.

  7. NEW INITIATIVES: GFATM Assistance Intensified Malaria Control Project (IMCP) • 100 million population in 94 districts of 10 states being covered from 2005-06 • Approved for two years • Use of RDKs and SP-ACT • Provision of bed nets (ITBNs) in remote areas • Impregnation of community owned bed nets • Capacity building by training programmes • Enhancement of awareness and social mobilization

  8. NEW INITIATIVES: World Bankassistance Enhanced Vector Borne Diseases Control Project ( EVBDCP) • Proposed for five years • 189 million population in 191 districts in 13states • Comprehensive programme covering in addition to malaria other vector borne diseases

  9. ELIMINATION OF LYMPHATIC FILARIASIS

  10. FILARIASIS • India contributes nearly 40% of the global problem • 250 districts affected in 20 states/UTs • Approx. 500 million are living in endemic areas • National Filaria Day- 11th NovemberMass Drug Administration OUR RESOLVE :FREEDOM FROM FILARISIS

  11. KALA-AZAR ELIMINATION

  12. KALA-AZAR : ENDEMIC AREAS • 48 districts in 4 states • Sporadic cases in some districts in UP Endemic Area Sporadic Area

  13. Though disease notifiable in Bihar, private sector not reporting cases. Other endemic states advised to make Kala-azar Notifiable disease • Increase in reported incidence & deaths an indicative of better case registration and treatment

  14. KALA-AZAR ELIMINATION • Elimination of kala azar by 2010 is the National Health Policy goal • Decline expected in 2006 in view of initiation of organized vector control in 2005 • Dte of NVBDCP provides technical support and supplies insecticides and anti kala-azar drugs • Implementation by state health authorities through the primary health care since 1990 • 100% support for operational costs since 2003-04 • MOU signed in June’05 between India, Bangladesh and Nepal to eliminate KA

  15. STRATEGY • Vector control through IRS with DDT up to 6 feet height from the ground twice annually • Early diagnosis and treatment • Regular monitoring and close supervision with periodic review/evaluations by experts • Behaviour Change Communication • Capacity Building

  16. ISSUES • Pursue NHP goal KA elimination by 2010 • Strengthening Programme implementation • Support to states for improving optimal resource utilization • Drug policy review to consider introduction of oral drug –Miltefosine for better compliance • Introduction of Rapid diagnostic test kit rk39 • Strengthening of referral system

  17. JAPANESE ENCEPHALITIS

  18. JAPANESE ENCEPHALITIS DISTRIBUTION

  19. TREND OF JE CASES & DEATHS

  20. CONTRIBUTION OF JE BY DIFFERENT STATES Till 8th Sept 2005 Tot 2685 case 657 deaths UP 2499 case 594 deaths Mah. 54 case 28 deaths Asm 95 case 35 deaths Delhi 2 case 2004

  21. STRATEGY • Early Diagnosis & proper case management • Primarily clinical, rapid diagnostics for bed side not available • No specific anti viral medicine, cases managed symptomatically • Vector Control • IRS practically ineffective due to Vector behaviour • Anti-larval operations based on feasibility, large paddy field treatment operationally not feasible • BCC: personal protection, vector-reservoir contact prevention, early reporting of suspected cases, etc. • Capacity Building

  22. DENGUE/DHF

  23. DENGUE SITUATION 1999 -2004

  24. PREVALENCE OF DENGUE 2004 (P)

  25. Dengue 2005 (till Aug)

  26. STRATEGIES • Fever surveillance through the network of • health centers and hospitals • Vector surveillance: sentinel centers & • random areas • Vector control through source reduction with • community participation • Mandatory reporting of cases • Inter-sectoral collaboration with different • departments • Cont…

  27. Contd. • Legislative measures against community / • institutions • Hospital preparedness for diagnosis & • case management • Behaviour Change Communication • Capacity building. • Epidemic preparedness and early • response. • Concurrent supervision and Monitoring.

  28. STRATEGIES UNDER NVBDCP • Vector control: • Indoor Residual Spraying • Insecticide treated bed nets • Introduction of larvivorous fish in identified water bodies, • preferably natural • Parasite elimination: • Early case detection and prompt, complete treatment • Quality Assurance of laboratory diagnosis of malaria • Strengthening of referral services • Cross-cutting interventions: • Capacity Building through integrated training approach • Communication for Behaviour Impact • Inter-sectoral collaboration • Operational research • Close monitoring and supervision with periodic reviews/evaluations

  29. CHALLENGES • Strengthening of surveillance activities • Improving facilities for diagnosis and adequate treatment • Up-scaling entomological surveillance for prediction of outbreaks • Enhancing public private partnership

  30. INTEGRATED TRAINING PROGRAMME FOR HUMANRESOURCE DEVELOPMENT Trained man power is the backbone of any disease control programme

  31. Human Resource Development Strategy Till now- Training was disease wise Same group was trained for each disease differently Only secondary and primary level health care functionaries were trained Now Involvement of the Medical Colleges: Training - to ensure the quality of health man power development Improve referral services for appropriate management of severe and complicated cases Sentinel surveillance Promote operational research Technical support in outbreak investigations Own up national programme strategies

  32. Goal & broad Objective NATIONAL HEALTH POLICY 2002 • Reducing malaria mortality by 50% by year 2010 and efficient morbidity control. • Elimination of lymphatic filariasis by the year 2015. • Elimination of Kala-Azar by 2010 NATIONAL RURAL HEALTH MISSION APRIL 05 • Training needs changed- focused towards Primary Health care system

  33. TRAINING LOAD UNDER NVBDCP • Voluntary Link Workers, Fever Treatment Depots and Drug Distribution Center holders • Multipurpose workers • Health Supervisors/Assistants • Laboratory Technicians/ Microscopists • Medical officers of Primary Health Centre • District Level Officers like DMO/Dy. CMOs • State level senior Programme officers • Zonal Entomologists/Biologists • Physicians/Clinicians of Community Health Centres/District Hospital/Medical Colleges

  34. TRAINING LOAD IN 13 EVBDCP STATES • *Includes Inspectors, supervisors etc. ** Includes DMOs, Biologists, Entomologists, AMOs • Besides these 31 tertiary level intersectoral trainings allotted

  35. I N T E G R A T E D T R A I N I N G SUBJECT EXPERT National Level MEDICAL COLLEGES Case Management & Programme Strategy Tertiary Level 3 days State Core Team DISTRICT HOSPITALS Case Management & Prog. Implementation Secondary Level 3 days District Core Team BLOCK LEVEL Programme Execution Primary Level 3 days Block Core Team 2 days H. W. & MPWs VOLUNTEERS 1 day

  36. Integrated training programme • Operational guidelines prepared and circulated to the states • Course Curricula developed for each level of health functionaries • All the GOI/GFR were included • Monitoring and evaluation proforma is also provided • Maintaining database for training load, assessment and need

  37. Prevention &Control of vector Borne Diseases 4 weeks SPECIALIZED TRAININGS/ Workshops Entomologists/ Biologists 4 weeks 2 weeks (Inducn) 1 week (Orientn) Laboratory Technicians Entomological Assts/Field Workers 2 weeks Private Medical Practitioners 1 day Inter-sectoral partners 3 days (Med Off) 5 days(Lab Tech) Engrs/Town planners/ Developmental project 1 day State/ Reg Programme Managers 3 days

  38. Tertiary Group • Medical College Faculty • Regional State Prog. Manager • Town Planners/Engrs./Administrators Secondary Group 1. District Level Medical Officer 2. Supervisory Staffs at PHC/CHC CURRICULUM PREPARED • Health Workers (M/F)/ Sector Level Supervisor • Volunteers (DDCs/FTDs) Primary Group • Entomologists • Vector Borne Diseases • Lab. Technician (induction/orientation • Entomological Assts/Field Workers) • Private Medical Practitioners Specialized Trainings

  39. BENCH MARK FOR TOTs

  40. TOT for state core team

  41. CHALLENGES Sustainability of the trainings at all level 1 Huge number of Health Work Force to be trained 2 Involvement of the medical colleges 3 Deputation of state/district core team of trainers 4 Update knowledge & skill on newer tools/ technologies 5 Ensure transfer of skills/knowledge from top to bottom 6 Monitoring & Evaluation of the trainings and Feedback 7 Timely release of funds 8

  42. DTE OF NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME Web site: www.namp.gov.in Email: namp@ndc.vsnl.net.in Telephone no: 011-23967780/23967745 Fax no: 011-23968329/23972884

  43. Dr. Kalpana Baruah Dy. Director Synergy of : Our effort & your Support THANKYOU

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