Situational analysis on status of Malaria (North Bastar Kanker)

Situation Analysis- Malaria

Status of API (District in the state) CHHATTISGARH

Basic Profile As per census 2001 Number of Households Population-Total6,50,934 Average Household Size(per Household) 5 Rural Population95.18% Proportion of ST (%)56 Literacy Rate (%)73

Key indicators ParameterDescriptionStatus 2008 Annual Blood Examination Rate= (Blood Slide Examined )*100. Population covered under surveillance API = (+ve Cases) *1000. Population covered under surveillance Slide Positive Rate = (+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) =  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)

Epidemiological Information  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

Distribution of cases in different month,  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

API in different blocks Source : Malaria Office, Kanker  Antagarh, Bhanupratappur, Koilibeda experienced higher API in year 2008

Process of diagnosis/ treatment Household Sub Health Centre Primary Health Centre Community Health Centre RDT + Blood slides Blood Test facility If RDT positive - ante mal. drug provided If positive Treatment starts Lab Technicia n / Institutio n staff ANM/ MPW/ Mitanin Level Facility Test by Treatment

Human Resources Staff Position 2008 S. Name of Categary Sanction ed No. in Position No. of Post Vacant 1District Malaria Officer11 - 2Asstt. Malaria Officer1 1- 3Lab. Technition11 - 4Malaria Inspector606 5Surveillance Inspector Pump Mechenice11 - 7Superior Field Worker22 - 8Driver44- 8Field Worker532 9Cleaner211 10Accountant U.D.C L.D.C Peon P.T.S.11-  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 after RDT - by Mitanin / ANM)  Timely diagnosis  Use of ante- malaria medicines

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 Combating malaria Prev. measures (inv. of Water, sanitation measures) Strengthening surveillance system Training/ refresher of front line workers Encouragin g PRI/ Community action Strong IEC (Ante- malaria month, media cov.) Timely diagnosis & treatment

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 =  Plan to cover a total of 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