Transcript Document

Planning,
Management & Policy
of VBD Control Programme
NVBDCP
Vector Borne Diseases
(under NVBDCP)
•
Prevention and control of VBDs under NVBDCP:
– Malaria
– Lymphatic Filariasis
– Kala-azar
– Dengue
– Chikungunya &
– Japanese Encephalitis (JE)
•
NMEP changed to NAMP in 1997 and was
renamed as NVBDCP in 2003
NVBDCP
• NVBDCP - umbrella programme for prevention
& control of VBD
• an integral part of NRHM.
• the Millennium Development Goal of halting
and reversing the incidence of malaria and
other vector borne diseases by the year 2015
towards reduction of poverty.
Principle
•
In All these diseases some vector is involved
•
So, the disease control includes control of
disease as well as the control of respective
vectors
And so, the planning and management of these
diseases’ control includes:
• Planning for the vector control measures as well
as
• Planning for the disease control
Planning and Management
• Situation Analysis
– Disease trend
– Available resources (man, money, material, mechanisms)
– Available & established strategies
• Need Assessment
– Man, Money, Material, Mechanisms
•
•
•
•
Make available the resources
Implement strategies
Monitor and assess the impact
Revise the strategies based on experience
VBD Control Strategies
The three pronged strategy for prevention and
control of VBD is:
1. Integrated Vector Control
2. Early Diagnosis and Prompt Treatment
3. Supportive interventions
1. Integrated Vector Control
• Indoor Residual Spray
• Insecticide treated Bednets (ITNs) & Long
Lasting Insecticidal Nets (LLINs)
• Source Reduction
Why vector control ?
• VBDs are of major Public Health importance in
rural and Urban areas
• In addition to Case Management – prevention
is also essential
• Vector control will help in reduction of
transmission and /or prevention of VBDs
What should guide vector control?
• Apply methods that are cost-effective (cost &
impact under programme settings)
• Must have health systems to deliver such
tools/interventions
– Technical – capacity to plan & implement – incl.
M&E
– Optimum Trained Human Resources
– Physical infrastructures
• M&E – from planning to impact assessment
Control Measures
• Larval and adult control impact on vector
densities
• Effectiveness of larval control methods depends
on types of breeding sites
• IRS and ITNs/ LLINs reduce vector survivorship
• ITNs reduces man/vector contact
• Important to consider cost & community
acceptance
• Use of safe chemicals for VC
Planning a spraying programme
• Determine areas to be sprayed - stratification
• Number of houses/structures/units/surface
areas to be sprayed – geographical mapping
• Logistics
• Estimate (insecticides, equipment, transport),
train spray teams, supervisors
• Provide awareness/community campaigns to
enhance compliance
Improving quality of IRS
•
•
•
•
Ensure timely application of insecticides
Continuous training of spray teams
Appropriate application of insecticides
Proper maintenance and storage of
equipment and insecticides
• Strengthening supervision and reporting
Scaling up of ITNs/LLINs
• Limited experience with ITNs
• Where implemented – coverage is low
• As part of going to scale – need clear
outcomes
– Increasing coverage of ITNs for epidemiological
impact
– Increasing re-treatment rates –innovative
approaches and/or LLINs
What is a long lasting insecticidal net?
A
net treated at factory level with an
insecticide
 Either incorporated into or coated around
fibres
 Which resist multiple washes
 Whose biological activity lasts as long as the
net itself
3
to 4 years for polyester nets
 4 to 5 years for polyethylene nets
Why do we need LLINs?
 Conventional dipping: insecticide is
rapidly removed by washing or degraded
by detergents
 Factory pre-treated nets (conventional
dipping) are not reliably treated
 Dipping of coloured nets: a potential
problem...
2. Early Diagnosis and Prompt Treatment
• Case Detection & management
• Disease Surveillance
• Epidemic Preparedness
Case Detection and Management
• Diagnostic services at HCs and village levels
– Laboratory facilities: Establish / strengthen /improve
quality / supervision/ monitoring
– RDTs at the village /periphery level
– Quality Assurance of diagnostic services
• Treatment of cases
– Adopt evidence based drug policy / feasibility
– Assess the requirement / availability/ resistance
monitoring
– Ensuring provision of drugs /treatment services from
Hospital to the village level
– Procurement and supply chain management
– Deployment and Training of service providers
Disease Surveillance
• Active surveillance
– In high risk areas
– Assess cost-effectiveness
• Passive surveillance
– Service provision at Health Centers
– Data recording and reporting
• Sentinel surveillance
– Establish SS centers
– Data recording and reporting
Epidemic preparedness
• Establish early detection mechanism by
monitoring the trend (weekly / fortnightly/
monthly trend of the disease)
• Timely and correct reporting
• Planning in advance for managing epidemics
– Buffer stock
– Team formation
– Action guidelines
3. Supportive interventions
•
•
•
•
•
Training & Capacity Building
Behaviour Change Communication
Inter-sectoral Collaboration
Community Participation
Public Private Partnership
(eg. NGO/ CBOs/ IMA etc.)
• Monitoring, Evaluation & Supportive Supervision
• Legislation
Points for drafting Action Plan
•
•
•
•
•
•
•
Situation analysis of the disease
Specific Constraints for implementation of the programme
Prioritization of the areas including the criteria of
prioritization
Strategy & innovations proposed.
Requirement for commodity as per technical norms and
considering balance of stores, consumption capacity and
justification.
Cash assistance required from Centre and unspent balance
available with State
Assistance for Capacity Building and IEC/BCC/PPP
activities may be incorporated.
21
Pattern of Assistance ( Malaria) –
Domestic support
State Resources
Blood Slides Lancets, Regents, Microscope , Lenses and
maintenance.
Mobility, POL/Diesel
Malathion/Synthetic Pyrethroid.
Spray wages, Pumps, accessories etc.
Synthetic Pyrethroid in externally assisted project states
Bednets(except project state)
Synthetic pyrethroid liquid for treatment of mosquito nets
Office maintenance & expenses
AMC of computers and recurring cost of internet and contingencies
GoI fund
DDT
Larvicides (decentralized & cash assistance provided for it)
Drugs ( some decentralized & cash assistance provided for it)
22
Special Assistance
(High malaria endemic districts) –
Domestic support
• Contractual MPWs
• Incentive to ASHAs
23
Pattern of Assistance ( Malaria) –
External support
World Bank
Capacity Building (as per NVBDCP
guidelines)
Monitoring & Evaluation and Mobility
- by GOI
Human Resource
- by GOI
BCC at National Level
- by GOI
- by GOI
GFATM
Human Resource
- by GOI
Planning & Administration
- by GOI
Monitoring & Evaluation
- by GOI
Operational Cost
- by GOI
Training
- by GOI
IEC
- by GOI
24
Pattern of Assistance ( Other VBDs)
Operational cost for Kala-Azar
elimination
-100% by GOI
Elimination of Lymphatic
Filariasis
– 100 % by GOI for
preparatory activities
and MDA
For AES/JE and
Dengue/Chikungunya
-by GOI as per budget
availability
25
District Collector/Zilla Parishad Chairperson
Check List for Review of Malaria --------1
• What is the status of following Case Detection indicators?
• ABER(Surveillance), Total Malaria Cases, Pf Cases, Deaths;
compared to the same period of last year
• Financial
• Have the SOEs of the last quarter / UCs of the last year been
submitted by the district to the state?
• Is the audit of the district society for the last financial year complete?
• Have Funds been received from State society and other sources
timely and are they adequate?
• Logistics
• Have adequate Logistics been received from center and other
sources?
• Have logistics been distributed to all implementation points (PHCs,
SCs, ASHAs, FTDs) on the basis of technical rationale?
• Are monthly logistics report being submitted by the district on time?
• Have all the consignee receipts been submitted?
District Collector/Zilla Parishad Chairperson
Check List for Review of Malaria --------2
• Human Resources / Training
• Is adequately trained staff present against sanctioned
posts?
• Has the existing staff been rationally deployed so that
least vacancies are present in high risk areas?
• Are trained LTs present in all PHCs?
• Whether LTs are being used as multi purpose LTs at
PHCs?
• Are RD Kits being provided to remote and inaccessible
areas?
• Have ASHAs been trained on the use of RDTs? How
many are yet to be trained?
District Collector/Zilla Parishad Chairperson
Check List for Review of Malaria ---------3
• Programme Implementation
• Has the District Action Plan been prepared(Nov) and
submitted by the district?
• Has the district completed preparation of District Microplan(pre-transmission season) for IRS? Is the micro-plan
based on GIS mapping?
• Are the spray squads been trained/reoriented for IRS (before
commencement of spray)?
• Has all the spray equipment been checked and certified?
• Have personnel been nominated for supervision of IRS, areawise?
• Specific activity monitoring
• What is the status of GIS mapping? Has the village wise data
been sent to SPO?
District Collector/Zilla Parishad Chairperson
Check List for Review of Malaria --------- 4
• IEC/BCC
• What are specific BCC activities that have been undertaken
in last one quarter?
• Is the community being given prior information of spray
rounds to improve acceptance of IRS(transmission season)?
If yes, who is doing this?
• Inter- sectoral coordination
• How many NGOs/ CBOs/ Military & Para- military Hospitals
are involved in the programme in the district? How many of
these have been involved in the last quarter?
• Whether state transport corporation & other public transport
are being used for transportation of blood slides and getting
results?
Thank You