Myanmar Group work 20 th August 2015

In areas targeted for advanced control/reduction transmission, assess how much malaria- we have to considered the following categories of HR. - PCD agents –Midwives and Volunteers - Vector control Agent – Entomology staffs, MA,MI, MS, PS for IRS if epidemiologically and technically appropriate. - Basic Health Staffs and Volunteers for LLIN distribution, some simple entomological work like identification of possible breeding places and Anopheles larvae.

Township RO & TL (Med. Dr.) MA/MIMS/PS Ento staff AE, EA, IC Lab Tech Grade 1 # of VMWs Total confirmed malaria cases (2014) Average Cases/ month State VBDC Bilin Chaungzon Kyaikmaraw Kyaikto Mawlamyine Mudon Paung Thanbyuzayat Thaton Ye Total * Existing Human Resources & Malaria Positive Case load, Township wise, Mon State *65 Health assistant in the whole Mon State. Average of 6.5 HA /Township

ActivityAgentExisting situationPlanTime- line By whom Survei- llance activity (case finding & Treat- ment PCD agent MW, VMW Total MW&VMW (existing surveillance agent for PCD posts) -1183, Total villages – 1214 Each and every village should have PCD posts either by MW or VMW. Additional 31 posts of VMW will be filled up by newly recruited VMWs. New PCD posts in high transmission areas also considered. In non-receptive villages with high vulnerability, PCD posts will be created to detect & T internally imported cases. 2017State PH Director, RO Hospi- tal staffs All CSM cases will be tested by RDT or microscopy. Assigned 1-2 staffs to test CSM cases 2016Med. Superinten dent, TMO,SMO ACD agent MS/PS Each and every township has MS/PS. Altogether 37 MS/PS are there in 10 townships ACD might be done to fill up the gaps of PCD in hard-to-reach, high malaria risk areas, and migrant population.

ActivityAgentExisting situation &PlanTimelineBy whom Case investiga- tion, foci identifica- tion, inves- tigation & response MA, MI, HA, Entom- ology staffs Total positives in 10 townships were 1889 and total 72 staffs (7 MA/MI &65 HA) sanctions are there. There might be some vacancies are there. With full strength, average # of cases investigated per agent per month is about 3. (Township wise requirement will be considered). Entomology staffs, Positive case concerned MW or VMW are also members of investigation team. All vacancies would be filled up before training/orienta tion on elimination State PH Director, DD Malaria, RO RO/ Team leader VBDC Review and verification of case/foci investigation and response activity would be done by RO/TL (VBDC) for approval. Training on Malaria elimination including all other staffs. (Task oriented) 2016VBDC + WHO + Trainees (GMS eliminati on)

ActivityExisting situationPlanTime- line By whom Strength- ening man power in Central level and Mon State Need strengthening man power. (M&E Officer, Data assistant, Data management, Technical Assistant, etc.) Q.2. Approval/agreement from MOH DOPH on strengthening man power. Review of tasks and additional HR requirement. Exploring possible donors for manpower expansion (like ADB, CHAI) Recruitment of additional staffs Training of new additional staffs DG, PM- NMCP Retaining staffsWith the approval of MOH  Policy development (To retain the staff within the project area townships) 2016n on wards DG, PM- NMCP No electronic (IT) based data management system (DMS). Creation of new post and recruitment of staff who has experience on electronic based DMS Training of data assistant on IT based DMS (for data entry) 2016DG, PM - NMCP

Task shifting In Mon State (every States/Regions in the country), entomological staffs are very limited. Some of the easy tasks (e.g., identification of possible breeding sites, identification of Anopheles species) could be shifting to BHS (at least 50 BHS in each townships). Simple guideline and SOP for these tasks will be developed and use in training.

Field monitoring and supervision To which LevelBy which level & by whom? What to monitor?How frequentWhen to start? Field levelTownship level, HA, MA/MI Patient register, Patient record –completeness, quality of data, correctness, timeliness. Achievements, performance against the expected Quarterly and ad hoc. Priority should be given to weak volunteer, not reporting for 2 consecutive months Health Facility levelTPHO, THO, THAAbove + case investigation records, Foci records Quarterly2017 Township levelState RO, Team leader, (VBDC), MA, THA Patient register, case & foci classification records & register – data discrepancies, data validation, completeness, timeliness -Some validation by phone immediately Quarterly in early part and later monthly On-site supervision immediately if necessary 2017 onwards

7. Field monitoring and supervision To which LevelBy which level & by whom? What to monitor?How frequentWhen to start? State levelCentral VBDC, PM, M&E Officer, Patient register, Patient record, Patient register, case & foci classification records & register – data discrepancies, data validation, completeness, timeliness of reporting -Some validation by phone immediately –completeness, quality of data, correctness, timeliness of reporting Quarterly and Elimination phase - monthly Central levelIndependent task force on Malaria Elimination Every 2 months

Will these people be needed once reduction has been achieved? If not, what will happen to them? These people will be needed even reduction has been achieved, because new recruited people (VMWs) are surveillance agent, and in elimination phase, surveillance is core intervention. We need to sustain and provide reorientation to these people.

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