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Progress Report: N ational LF and STH Programme in Nepal

Progress Report: N ational LF and STH Programme in Nepal. Dr Babu Ram Marasini PM & RPRG Meeting, SEARO Jakarta, Indonesia 23-26 September, 2014. Country Profile. Total population: 27,311,978 Geography: Three ecological zone: Mountain, Hills and Plain. Administrative division

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Progress Report: N ational LF and STH Programme in Nepal

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  1. Progress Report:National LF and STH Programme in Nepal Dr Babu Ram Marasini PM & RPRG Meeting, SEARO Jakarta, Indonesia 23-26 September, 2014

  2. Country Profile • Total population: 27,311,978 • Geography: Three ecological zone: Mountain, Hills and Plain Administrative division Development regions: 5 Zones: 14 Districts:75 Eastern region Central region Western region Mid western region Far western region

  3. Health Administration and Service Delivery Central Level Regional level District and Community level

  4. Background: LF N E Non endemic districts (14) MDA stopped (20 Districts) Five rounds completed (10 Districts) Four rounds completed (10 Districts) Two round completed (10 districts) LF Endemicity and MDA Status: 2014 HUMLA • Mapping: 2001, 2005 & 2012 • Average prevalence: 13% • Endemic districts (IUs): 61 • Parasite: W. Bancrofti • Vector: C. Quinquifasciatus • Year MDA started: 2003 • Geographical coverage achieved in 2013 • By 2014, MDA stopped in 20 IUs. DARCHULA BAJHANG MUGU BAITADI BAJURA DADEL- JUMLA DHURA DOTI ACHHAM KALIKOT DOLPA MUSTANG KANCHAN- DAILEKH PUR JAJARKOT KAILALI RUKUM MANANG SURKHET MYAGDI SALYAN BARDIYA GORKHA B ROLPA KASKI A G L LAMJUNG U N G PARBAT RASUWA PYUT- BANKE HAN GULMI DANG SYANGJA SINDHU- ARGHAK TANAHU PALCHOK NUWAKOT HACHI PALPA DOLAKHA DHADING KATHM Index KAPIL- NAWAL SULUK- RUPAN- BASTU PARASI HUMBU SANKHUWA- DEHI TAPLEJUNG P A MAKAWAN- LALIT KAVRE H SABA CHITWAN H C E M A OKHAL- R DHUNGA PARSA SINDHULI KHOTANG R TERHA- A H Continuation after 6 rounds (1 district) BHOJ- THUM T E BARA RAUT- H PUR C A AHAT DHAN- P UDAYAPUR SARLAHI MAHO- KUTA TARI DHA NUSA ILAM SIRAHA SUNSARI MORANG SAPTARI JHAA Three rounds completed (10 Districts)

  5. LF Elimination Programme: Key Milestones Step 1: Mapping Step 2: MDA Implementation Step 3: Surveillance Pre TAS in 16 and remapping in 3 IUs MDA stopped in 15 IUs, TAS1 in 5 IUs, Pre TAs in 10 IUs MDA stopped in 5 IUs Mapping 2003 2011 2013 2012 2001/2005 2010/2011 2014 MDA rolled out to all endemic districts; TAS in 16 districts TAS in 5 IUs MDA initiated in 1 IU & then scaled up in subsequent years

  6. National Programme Overview

  7. PC Programme and Financing • Contributors to the 2013/2014 programme costs (and rough estimate of contributions by each):

  8. PC Programme Achievements 2013

  9. Progress Towards LF Elimination

  10. Progress Towards STH Scale Up

  11. Progress Towards STH Scale Up

  12. PC Coverage, 2013 * 65% for LF and 75% for STH ** reported coverage was verified by coverage survey or similar independent activity

  13. Impacts of MDA in Sentinel Sites (LF) Note: All reports not available

  14. PC Monitoring and Evaluation • Post MDA coverage survey • Transmission assessment survey (TAS) • Pre-transmission assessment survey • Monitoring during PC implementation (MDA) • SAE protocol • Detection: training to volunteers on possible SAEs and reporting/self reporting, • Management: Programme provides free treatment of SAEs • Reporting: number of and types of SAEs

  15. LF Transmission Assessment Survey to Stop MDA • Integrated assessment of STH considered? Yes

  16. LF Transmission Assessment: Forecasting *sum of the total sample size required for each EU assessed;

  17. MDA Status, TAS and Post MDA Survey Plan Note: No colour significance. Resource identified till 2016.

  18. Integrated Vector Management(LF) • No LF specific IVM activities • LLIN distribution (malaria programme) • Space spraying/indoor residual spraying for malaria and Kala-azar • IEC/BCC/awareness • Monitoring and evaluation are done by specific programme (eg: LLIN coverage survey, vector survey, LLIN durability study etc)

  19. LF- MMDP – Strategy

  20. LF- MMDP – Monitoring and Evaluation

  21. Best Practices • Multi-sectoral involvement ( mobilization of school teachers and local leaders) • Media mobilization • School health and nutrition week

  22. Challenges and Issues LF • Urban coverage • Post MDA surveillance • Morbidity management • Low lying river valleys STH • Monitoring • Achieving and sustaining coverage • Reaching non-enrolled school children

  23. Programme Plan

  24. PC Medicine Request for 2015

  25. Thank you !

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