Briefing on Intensified Malaria Control Project-3 (IMCP-3)

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Briefing on Intensified Malaria Control Project-3 (IMCP-3) India CCM Induction and Orientation Workshop 3 rd -4 th December 2015 Directorate of National Vector Borne Diseases Control Programme, Delhi

Plan of Presentation Introduction Programme goals and Objectives Funds received State/Districts covered Strategies Planned Activities Achievements Way Forward

Introduction GF is supporting malaria control in 7 NE states. Intensified Malaria Control Project-II (IMCP-II) Round-9: allocation of US$ 88 million in 2 Phases: Phase-I: 2 Years, Oct. 2010- Sep. 2012 Phase-II: 3 Years, Oct. 2012- Sep.2015 Central Govt. also provides assistance to the states on the basis of approved norms and technical requirements; and States also spend substantial amount on infrastructure, staff and state components of programme. The focus under the funding model period would continue in 7 NE States an an additional state Odisha due to high disease burden Together, these states have a population of approx. 91 Million in 125 districts. The target group/beneficiaries include marginalized groups, tribal population, and women and children and other key population like Jhum cultivators, forest workers, migrants and mobile population (especially in border areas)

Programme Goal and Impact Indicators To reduce malaria related morbidity by at least 50% and mortality by at least 50% in project areas (08 states) by 2017 as compared to 2012.

Programme Objective and outcome indicators 1. To achieve near universal coverage by 2017 by effective preventive interventions (LLIN) for population living in high risk project areas (API >1) 2. To achieve near universal coverage of fever cases by correct, affordable and appropriate parasitological diagnosis; and prompt, effective treatment according to the national drug policy in project areas by 2017 3. To achieve coverage in project areas by appropriate BCC activities to improve knowledge, awareness and responsive behavior regarding effective preventive and curative malaria control intervention by 2017. 4. To strengthen surveillance and M&E, program planning and management and co-ordination and partnership development to improve service delivery in project areas by 2017 5. To strengthen health systems, community systems through capacity building (training) to improve service delivery in project areas by 2017

Project aids will be utilized for the following Modules & Cost Groups Cost in USD S.No Modules Total Year 1 Total Year 2 Total Year 3 TOTAL % 1 Vector Control (LLIN) 67,065,835 848,647 0 67,914,482 63% 2 3 4 Case Management (Diagnostics & Drugs) HSS - Health Information Systems and M&E HSS - Health and Community Workforce 2,515,512 12,221,134 1,286,634 16,023,280 15% 3,005,282 3,055,468 1,799,800 7,860,550 7% 2,474,452 3,597,064 1,759,016 7,830,532 7% 5 Program Management 3,673,865 2,401,974 1,747,684 7,823,523 7% TOTAL 78,734,946 22,124,287 6,593,134 107,452,367 100%

Proposed Geographical Coverage under NFM JAMMU & KASHMIR HIMACHAL PRADESH PUNJAB UTTARAKHAND HARYANA SIKKIM ARUNACHAL PR. RAJASTHAN UTTAR PRADESH BIHAR ASSAM MEGHALAYA NAGALAND MANIPUR GUJARAT MADHYA PRADESH JHARKHAND WEST BENGAL MIZORAM CHHATTISGARH ORISSA D&N HAVELI MAHARASHTRA ANDHRA PRADESH GOA KARNATAKA PONDICHERRY API - 2012 0-1 >1-2 >2-5 >5-10 >10 & Above A&N ISLANDS States: 8 Districts: 125 Pop n: Approx. 91 Million LAKSHADWEEP TAMIL NADU KERALA N W E S

Strategies: Prevention Early Diagnosis and Complete Treatment Behavior Change Communication (BCC) Monitoring & Evaluation Co-ordination and partnership development. Capacity Building Planned Activities: Human Resource and Capacity Building Case Management including IEC/BCC Vector Control including long lasting insecticidal nets (LLINs)- Mass Campaign Health Information System and Monitoring & Evaluation Programme Management including infrastructure and other equipments

Impact indicator for 7 NE + Odisha for NFM Indicators (Sex, Age disaggregation required) Source 2012 (Baseline) Timeline wise Target 2015 2016 2017 Confirmed malaria cases (microscopy or RDT) per 1000 persons per year Number of confirmed malaria deaths HMIS 3.89 3.77 2.46 1.82 HMIS 192 176 115 96 Total Positivity Rate (Microscopy + RDT) HMIS 3.51 3.00 2.25 1.75

Coverage/ Output Indicators in the Performance Framework Indicators Source Timeline-wise Target 2015 2016 2017 Number of Long Lasting Insecticidal Nets distributed to at-risk populations through mass campaign HMIS 6,517,277 (Oct. 15 Mar. 16) 16,726,505 (Apr. 16 Sep. 16) Proportion of reported fever cases suspected of malaria that received a parasitological test at public sector health facilities Proportion of confirmed malaria (Pf) cases that received ACT as per National Policy at public sector health facilities HMIS 100 100 100 HMIS 100 100 100 Proportion of ASHAs trained/re-trained in malaria diagnosis and treatment HMIS 62.6 (Oct. 15 Mar. 16) 100 (Apr. 16 Sep. 16)

Outcome Indicators in the Performance Framework Indicators Source Timeline wise Target 2016 2017 Proportion of population that slept under an insecticide-treated net the previous night Proportion of children under five years who slept under an insecticide-treated net the previous night Proportion of pregnant women who slept under an insecticide-treated net the previous night Proportion of persons reporting fever within last two years, who have obtained a test result (RDT/Microscopy) within 24 Hrs. of reporting to health care system/provider Proportion of people who know about the cause of symptoms of, treatment for and preventive measures Malaria HHS 60 80 HHS 70 90 HHS 70 90 HHS 60 80 HHS 60 80

Drugs and Diagnostics proposed under NFM LLINS: 7.24 million LLINs for 7 NE States: already procured, being delivered to states, expected to complete by Dec. 2015. 11.34 million LLINs for Odisha are also proposed under NFM RDKs, Inj, Artesunate & ACT-AL Commodity/ State 7 NE States Odisha RDKs 10,185,540 6,251,956 Inj. Artesunate 83,654 83,940 ACT-AL 357,176 569,484

Trainings proposed under NFM Training of ASHAs: 1 Day The targets refer to: i) 07 NE states and Odisha under 'Allocation'. Total ASHA: 52,175 in NE states & 41773 in Odisha = 93948 Targets are set for 79850 ASHAs (85% by PR1 and 15% by PR2). 1000 batches in Year 1 and 597 batches in Year 2 with 50 trainees in a batch Training of non- formal Private health providers: ½ Day 20 in each block (to be completed in Year 1) Training of formal health providers: ½ Day 50 in each district (IMA/IAP) 100 at State HQ. (IMA/IAP) - 1 Day Training of MTSs Induction (10 Days) in Year 1 & Refresher (3 Days) in Year 2. Training of DVBD Consultant (Refresher in Year 2) and left out DVBDCs (no. to be decided in RRM) NIMR, Delhi; 40 Days Training of MOs (Refresher): 3 Days Induction & Refresher training of LTs (1 per district): 7 Days Miscellaneous meetings (High endemic, Low endemic, Medical Colleges etc.) Tea Estates/ Rubber plantation meeting 1 Day SPO/DMO Training 12 Days

Trend of Malaria in NE States (2001 to 2014) 0.25 0.20 0.15 0.10 0.05 0.00 ACT & RDT 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Total Malaria Cases (in Millions) LLIN Pf Cases (in Millions) ACT& RDT in 2005 : 8.99% reduction in Malaria Cases 11.55 % reduction in deaths 2014 against 2005 LLIN in 2009 : 41.68% reduction in Malaria Cases 54.41% reduction in deaths in 2014 against 2009 Deaths 1000 900 800 700 600 500 400 300 200 100 0

API, SPR & SFR ABER Trend of Malaria Parameter in NE States (2001 to 2014) 7.00 6.00 5.00 4.00 3.00 2.00 1.00 0.00 14.00 12.00 10.00 8.00 6.00 4.00 2.00 0.00 API SPR SFR ABER

Way Forward. Effective implementation of the project and programme activities with complete utilization of available funds Early detection and timely public health interventions Increasing community awareness and involvement in VBD control activities Making available the drugs, diagnostics and preventive interventions at all levels with priority to high risk areas Innovative approaches

Intensifying the Fight Against Malaria THANK YOU