Planning, Management & Policy of VBD Control Programme

1. Planning, Management & Policy of VBD Control Programme NVBDCP

2. 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

3. 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.

4. 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

5. 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

6. VBD Control Strategies The three pronged strategy for prevention and control of VBD is: • Integrated Vector Control • Early Diagnosis and Prompt Treatment • Supportive interventions

7. 1. Integrated Vector Control • Indoor Residual Spray • Insecticide treated Bednets (ITNs) & Long Lasting Insecticidal Nets (LLINs) • Source Reduction

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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...

16. 2. Early Diagnosis and Prompt Treatment • Case Detection & management • Disease Surveillance • Epidemic Preparedness

17. 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

18. 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

19. 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

20. 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

21. 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

22. Pattern of Assistance ( Malaria) – Domestic support 22

23. Special Assistance (High malaria endemic districts) – Domestic support • Contractual MPWs • Incentive to ASHAs 23

24. Pattern of Assistance ( Malaria) –External support 24

25. Pattern of Assistance ( Other VBDs) 25

26. 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?

27. 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?

28. 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 Micro-plan(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, area-wise? • Specific activity monitoring • What is the status of GIS mapping? Has the village wise data been sent to SPO?

29. 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?

30. Thank You