Transcript Situational analysis on status of Malaria (North Bastar

Situational analysis on
status of Malaria
(North Bastar Kanker)
Situation Analysis- Malaria
Govt.
Contributing to MDG
Concerned
Goal
Programs
Departments
NRHM
6- Combat HIV/AIDS,
Health, CSACS
(NVBDCP),
malaria and other
NACP – III
diseases.
CHHATTISGARH
Status of API (District in the state)
Basic Profile
As per census 2001
Number of Households
127294
Population-Total
Average Household Size(per
Household)
Rural Population
Proportion of ST (%)
Literacy Rate (%)
6,50,934
5
95.18%
56
73
Key indicators
Parameter
Annual Blood
Examination
Rate=
API =
Slide Positive
Rate =
Description
Status 2008
(Blood Slide Examined )*100 .
Population covered under surveillance
28.40
(+ve Cases) *1000 .
Population covered under
surveillance
16.26
(+ve Cases )*100 .
Blood Sample Examined
5.72
Species responsible for malaria (in Kanker region)
 P. Phalsiparum (> 90% cases)
 P. Vivex
Present study Covers
Findings based on the discussions and secondary data received
from the District Malaria Office
Study includes:
 Present status of API and trend
 Regional variation API in district
 Process of diagnosis and treatment
 Human resource availability
 Challenges/ issues
Malaria
 Total Malaria cases reported in district (2008) = 12707
 In the high epidemic area the Monthly blood examination rate
(MBER) should be equal to fever rate in a chosen month for a
population under surveillance. (provide operational efficacy of
the program)
Point
Epidemiological Information
50
45
40
35
30
25
20
15
10
5
0
38.08
28.4
37.05
16.26
9.73
2004
5.72
2005
2006
2007
ABER
SPR
API
2008
Year



Kanker has made a good progress (trend in API), still API is too high (16.26)
ABER is also decreasing - sufficient number of blood slides should be systematically
obtained & examined for malaria parasite (for accurate API)
Target by 2015 : To halt and reverse the incidences of malaria
Per cent
Distribution of cases in different month, 2004-08
18
16
14
12
10
8
6
4
2
0
16
16
12
14
12
12
9
6
Jan
6
5
5
6
Feb Mar Apr May Jun Jul
Month
Aug Sep Oct Nov Dec
 Highest cases are is between June to December Month
 Opportunity of integration with the other development programme
(during this period)
Treatment of bed nets 2008
90000
80000
70000
Numbers
60000
50000
40000
30000
20000
10000
0
Series1
Own Net
81233
Treated Net
65594
API in different blocks
Antagarh, Bhanupratappur , Koilibeda experienced higher API in year 2008
Source : Malaria Office, Kanker
Process of diagnosis/ treatment
Level
Community Health
Centre
Primary Health
Centre
Facility
Test by
Blood
Test
facility
Lab
Technicia
n/
Institutio
n staff
RDT +
Blood
slides
ANM/
MPW/
Mitanin
Sub Health Centre
Household
Treatment
If positive
Treatment
starts
If RDT
positive ante mal.
drug provided
Human Resources
Staff Position 2008
S.
1
2
3
4
5
6
7
8
8
9
10
11
12
13
14
Name of
Categary
District Malaria Officer
Asstt. Malaria Officer
Lab. Technition
Malaria Inspector
Surveillance Inspector
Pump Mechenice
Superior Field Worker
Driver
Field Worker
Cleaner
Accountant
U.D.C.
L.D.C.
Peon
P.T.S.
Sanction
ed
1
1
1
6
1
2
4
5
2
1
1
1
2
1
No. in
Position
1
1
1
0
1
2
4
3
1
0
1
1
2
1
No. of Post
Vacant
6
2
1
1
-
Besides dedicated staff, all health department institutions (DH, CHC, PHC, SHC
Mitanin) are there to execute the activities in the field.
Effective measures
Preventive:
 Minimize breeding of Mosquito:
 Disinfection of the polluted / stagnant water sources
 Improved water use and sanitation practices
 IRS (Indoor Residual Spray)
 larvivorous Fish (Gambujiya) in ponds & water logged area
 Protection measures :
 Mosquito Net – Plane and treated
 Use of neem oil
 Environmental management measures
Treatment:
Drugs - Chloroquine , Primaquine (at village level
 Timely diagnosis
 Use of ante- malaria medicines
after RDT - by Mitanin / ANM)
Issues of concern






Developing/ promotion of community level action (through PRI/
CBOs)
Availability/ sanction of lab technicians at some(5) PHC
Use & treatment of the mosquito net (study and use of lessons)
Availability of insecticide
Reach of staff in naxal affected region
Coordination for water and sanitation measures
Alternate strategy
Timely
diagnosis &
treatment
Prev.
measures
(inv. of Water,
sanitation
measures)
Strengthening
surveillance
system
Combating
malaria
Strong IEC
(Antemalaria
month,
media cov.)
Training/
refresher of
front line
workers
Encouragin
g PRI/
Community
action
Plan for the 2009
 34 microscopic center in district – training by
June, 2009
 Training and Involvement of the Mitanins
 Focus for 3 nursing homes of urban area
 Distribution of Mosquito nets = 52000
 Plan to cover a total of 623018 population under
149 SHC and in 22 Ward– by use of IRS (Alphe
cyper metharin 5%)
Summary of findings
 Remarkable progress in past, need to make a road for next 5
years (good practice to be documented)
 Special focus in high prevalence regions (Koilibeda, Antagarh,
Bhanupratappur block)
 Need of coordination with the water and sanitation activity (in
long term) and education system
 Strong IEC and community level action (with standing committee
of Panchayat/CBOs)- information about contact person
 Need to improve mechanism for timely reporting, diagnosis and
treatment
THANK YOU