MALARIA SITUATION IN PAKISTAN - PowerPoint PPT Presentation

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malaria situation in pakistan l.
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MALARIA SITUATION IN PAKISTAN

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  1. MALARIA SITUATIONIN PAKISTAN

  2. 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

  3. 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

  4. Malaria Occurrence in Pakistan:Annual Parasite Incidence/1000 population

  5. Occurrence of Potentially Dangerous Malaria: Percentage of Plasmodium Falciparum

  6. 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

  7. 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

  8. 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

  9. Programme Expansion – by Province(2002-2006)

  10. ACTIVITIES • DIPS IN 21 RBM DISTRICTS • CAPACITY BUILDING • CASE MANAGEMENT • TRAINING OF MEDICS/PARAMEDICS • TRAININGOF MICROSCOPISTS • PROVISION OF LOGISTICS • PROVISION OF ANTI MALARIAL DRUGS

  11. ACTIVITIES (contd) VECTOR CONTROL IRSFOCAL SPRAY IN SELECTED AREAS PROVISION OF SPRAY EQUIPMENTS INSECTICIDES LARVECIDES ULV FOG GENERATORS (N.W.F.P) ITNS

  12. 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.

  13. EPIDEMIC CONTROL • Epidemics in district, Okara, Mirpurkhas • Flood affected areas of Sindh and Balochistan • WHO support in investigation & response

  14. 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

  15. 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

  16. Training of doctors and technicians

  17. Specialized Courses Conducted

  18. Provincial/District Strengthening through Federal PC-I

  19. PARTNERSHIPS

  20. 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

  21. 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

  22. 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

  23. 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.

  24. 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

  25. 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

  26. 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

  27. ISSUES & CHALLANGES

  28. 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

  29. 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)

  30. 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

  31. THANK YOU