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Paradigm Shift: Malaria Control Program in Odisha

This article discusses the key interventions and impact of the Malaria Control Program in Odisha from 2008 to 2018, focusing on the current trends and major strategies implemented.

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Paradigm Shift: Malaria Control Program in Odisha

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  1. Malaria Control Programme in Odisha – A Paradigm Shift Dr. B.K. Brahma Special Secretary to Govt. H & FW Deptt. Odisha

  2. Malaria over the years 2008-2018 – key interventions influencing the trend

  3. Current trend of Malaria - 2018 – Major Interventions & impact Intervention –II (State support) Large scale Mass screening activity was conducted in inaccessible areas of 23 malaria endemic districts Intervention Period : Aug - Nov

  4. Focused Interventions Strengthening surveillance by Strengthening Community Process • 47174 ASHAs are working as Fever Treatment Depot (FTD) holders and providing services for early diagnosis and complete treatment of malaria at community level • Alternative service providers are engaged for malaria diagnosis & treatment in hard to reach areas • Special surveillance are done actively for screening of Tribal residential School boarders & inmates • Mass screening is done in inaccessible areas for screening of individuals irrespective of fever status under State specific DAMaN programme - done by special camp approach

  5. Improved diagnosis & treatment services • Diagnosis and treatment facilities are available in 6688 SCs, 1168 PHCs, 377 CHCs, 29 SDHs , 32 DHHs and all Govt. Medical Colleges of the state • 67 Sentinel site laboratories are functioning for treatment & tracking of severe and complicated malaria • Special provision is made by Govt. for timely procurement of adequate bivalent RDTs and anti-malarials to avoid stock out • Supply chain management is taken care by OSMCL following advance C-DAC mechanism to maintain uninterrupted supply of logistics • Passive surveillance has increased from 61% in 2012 to 81% in 2017 • 78% of the total diagnosis is done by RDT. All ASHA do test by RDT at village level

  6. Long Lasting Insecticidal Nets (LLIN) • LLIN distributed in Phases; two phases under GF & WB support (2010-11 & 2011-12), State’s own “Mo Mashari (My Mosquito net” programme for Pregnant women & TRS boarders – This could cover only a part of the high risk population. • In 2017,distribution of 1.13 crore LLIN under Global Fund support could cover the 2 Crore high risk population of 17 high endemic districts • Distribution through community mobilization approach involving GKS and other CBOs to protect the most eligible population • Formation of Steering Committee at all level (State, district & Block) by involving all sectors (both Govt. & Pvt.) including members from political platforms for having transparent distribution and follow up monitoring of LLIN use rate • Innovative Social mobilization & BCC campaign: ‘Nidhi Mousa To Mashari Ne’ (Uncle Nidhi! Take your Net) for up scaling the LLIN usage

  7. Intensive & Innovative IEC • Wide dissemination of LLIN messages through various platforms for community sensitization • State level Observance of World Malaria day for advocacy at highest level & for obtaining political and administrative commitment for the programme • State specific Extensive IEC drive in all 30 districts through MDD Campaign • Sensitizing Community by infotainment activities and by traditional drum beating & unique bell –ringing method • Inter personal communication by making House to house visit by the ASHA and HW • Three tier approach was made on LLIN use & maintenance – during pre-distribution survey, during distribution and post distribution

  8. DAMaN Access to Inaccessible (Reaching the Unreached)” • 1st round health camp ( April – May) • Malaria Mass screening + Health check of <5 children + Preg & Lactacting mothers • First round IRS followed by LLIN & intensified routine programme • 2nd round camp ( September – October ) • Malaria Mass screening +Health Check up of <5 children + Pregnant & lactating mothers • Second round followed by IRS & intensified routine programme • 3rd round health camp ( Jan– Feb) • Malaria screening + Health check of <5 children + Preg & Lactacting mothers • All supportive activities – Training, IEC BCC, M&E , OR, Intersectoral coordination etc • Establishment of Non-ASHA FTD • “DAMaN” is a State specific special intervention for inaccessible areas for mass screening of population for malaria and screening of vulnerable population for nutritional parameters • Implemented three rounds a year, in 23 districts of Odisha to address malaria and mal-nutrition Inaccessible villages / hamlets having infrequent visit of ASHA Accessible villages/hamlets getting regularASHA service

  9. Significant Outcomes • Other fringe • benefits: • Treatment of minor ailments like cold& cough, body ache, • Missed immunizations • Disinfection of drinking water sources and defunct tube wells, • Repair of roads and culverts, • . • Community residing in the remote and inaccessible pocket got improved access to services • Population having asymptomatic (a febrile) malaria were identified and treated • Nutritional deficiency and low haemoglobin count were identified in under five children and pregnant women. • 63% decline in malaria positive cases was witnessed in DAMaN areas in 2018 compared to 2017. • 58% decline of afebrile malaria cases was also observed in DAMaN areas. • Test Positivity Rate (TPR) in DAMaN areas have gone down to 2.93% from 6.28 %

  10. Governance & Support: • Regular review of the activity by State Technical task Force under the chairmanship of Commissioner-CuM-Secretary, H & FW Deptt. Govt. of Odisha • Special attention for control of malaria in remote & inaccessible areas with budgetary support • Budget support from state Govt. for Indoor Residual Spray activity • Special budgetary provision by the State for procurement and supply chain management of Drugs and diagnostics • Formation of District Task Force for Malaria Elimination and Periodic review by Collector & District Magistrates • Block Task Force for malaria elimination is being formed under BDO

  11. Impact of Interventions • Overall 82% decrease in malaria positive cases • 87% decrease in malaria deaths

  12. Key achievements Shrinking malaria map of the state • Odisha is showing highest % decrease (82%) of cases in the country in 2018 • Compared to 319407 cases reported last year in the State, by September, there is report of 55346 cases this year (82% less) • Total 3 deaths due to malaria in 2018 (By September) against 24 last year • State TPR is 1.26 against 6.56, last year • With current rate of reduction, Provisional API of Odisha is predicted to be 1.6; All time low in last 4 decades • It is estimated to have only one district (Rayagada) with API >10 in contrast to 9, last year

  13. All you need is the plan, the road map, and the courage to press on to your destination…...… THANK YOU

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