Malaria Control Programme,Orissa

CDMO Conference21-22 Jan, 2010

Declining trend with hopes for control Declining trend with hopes for control

Maps with Maps with API: 2005, 2008 and 2009API: 2005, 2008 and 2009

Declining trend with hopes for control Declining trend with hopes for control

Maps with Maps with API: 2005, 2008 and 2009API: 2005, 2008 and 2009

Year Dists. with API < 2

Dists. with API 2-5

Districts with API 5-10

Dists. with API >10

2005 7 3 6 14

2008 10 3 4 13

2009 10 4 4 12

Epidemiological situation,2005-09

Year +ve PF Deaths ABER SPR Pf%

API

2005 396573 342658 255 12.36 8.18 86 10

2006 372710 324893 253 12.33 7.59 87 9.4

2007 371879 323150 221 12.22 7.52 87 9.2

2008 375430 329631 239 12.23 7.46 88 9.1

2009 (provisional) 369390 325063 201 12.19 7.26 88 8.8

Districts with high mortality, 2007 to 2009Sl. No

Districts 2007 2008

2009 % Increase(+) / decrease (-) in 2009 over 2008

1 Kandhamal 29 49 35 -28.6

2 Keonjhar 31 23 16 -30.4

3 Rayagada 27 23 20 -13.0

4 Sundargarh 12 22 12 -45.5

5 Nuapada 23 21 18 -14.3

7 Sonepur 7 16 7 -56.3

8 Koraput 30 15 31 106.7

9 Nawarangapur 4 10 10 0.0

10 Balasore* ??? 3 8 11 37.5

There is no death investigations – * In Balasore out of 6 malaria deaths reported during the month of November only one could be ascertained due to malaria.

LLIN distribution : GFATM districts

SL NO. DISTLLINs

ALLOTED

Supply of LLINs to districts (at Block level)

No. of LLINs distributed to beneficiaries

Expected allotment in 2009-10

1 Angul 61000 61000   600002 Bargarh 20000 20000 20000 500003 Bolangir 25000 25000 16500 50000

4 Boudh 64000 64000 36000 500005 Deogarh 36000 36000   120006 Dhenkanal 44000 44000   600007 Nayagarh 19000 19000   500008 Sonepur 30000 30000   70000

 9 Balasore 50000

10 Bhadrak 20000

11 Cuttack 38000

12 Ganjam 100000

13 Jajpur 50000

14 Khurdha 40000Total 299000 299000 72500 700000

LLIN distribution World Bank Districts

SL NO. DIST LLINs ALLOTED

Supply of LLINs to districts (at Block level)

No. of LLINs distributed to beneficiaries

Expected allotment in 2009-10

1 Gajpati 40000 40000 400002 Jharsuguda 30000 30000 300003 Kalahandi 100000 100000 30000

4 Kandhamal 100000 100000 35000 30000

5 Koraput 50000 50000 20000 30000

6 Keonjhar 100000 100000   30000

7 Malkangiri 40000 40000   30000

8 Mayurbhanj 150000 150000   50000

9 Nawrangpur 30000 30000   40000

10 Nuapada 40000 40000 40000 38000

11 Rayagada 40000 40000 20000 30000

12 Sambalpur 30000 30000   30000

13 Sundargarh 150000 150000 50000 40000

  Total 900000 900000 165000 448000

Key features of the state LLIN guidelines – Criteria - sub-centre is the unit and in the first phase SCs with

API >5– SCs with API 3-<5 will be included when more LLINs will be

available – All villages in a SC irrespective of API status of the village– Cluster approach: to protect entire population in defined high

transmission area. • Clusters may be intra or inter block, intra or inter-dist.• All families irrespective of BPL and APL will be given LLIN• Avg. LLIN calculation : 1 LLIN/ 2.5 Persons +3% extra

[1 LLIN for 1-2 persons, 2 LLINs for 3-5 persons, 3 LLINs for 6-7 persons, 4 LLINs for 8-10 persons.]

Key features ……… contd

Identification of cluster areas was done through regional level workshops with state level facilitation. (representatives of 4-5 contiguous districts present at each workshop)

Survey of households in villages under a cluster through Gaon Kalyan Samitis (GKS) for identifying actual need

Distribution by GKS members under the active supervision of block, district and state.

List of beneficiaries to be maintained in designated registers.

LLIN Distribution formatBlock:__________ SC:___________________ Village:_________________

SlNo.

Head of the HH

Total No. of family members

No. of pregnantwomen

No of U-5 Children

No. of LLIN Supplied to HH

Sl. No of LLIN

Rupees received as contribution

Date of Distribution

Sign./thumb impression of the receiver

1

2

•Database to be maintained at Block, District and State level. •BPO in coordination with MTS and VBD Consultant will maintain the data•Data will be uploaded at Dist. & State Health Department Web Site

* In the format one extra column has been added to collect the data on under five children in the household who are being protected by LLIN

Distribution of 11.99 lakh GoI LLIN in 09-10

• Nominal contribution to be collected as a symbol of ownership• GKS will collect Rs 10-15 per LLIN from BPL and Rs 20-30 from APL persons - But no one to be left out if unable to

contribute.

• This fund will be used by GKS for malaria control activities, replenishing nets if torn out and BCC at village level.

MO- MASHARI – the state initiativeObjective: to protect the following special groups by LLINs with special message of ownership 1. Pregnant women in high burden areas (family size LLIN)

– LLIN distribution at the time of antenatal registration as a component of ANC package.

– This is expected to cover pregnant women during pregnancy and mother and child after delivery.

• 1.01 lakh LLINs already in the distribution process in five high endemic districts and another 2 lakh LLIN will be procured in 2010-11

2. Boarders of Tribal Residential Schools (single size LLIN)– The boarder will own the LLIN, can take home during vacations

and permanently after leaving the school - “will act as the agent of change in his/her community”.

• Distribution through Headmaster/Headmistress of tribal schools.

Current distribution plan under Mo Mashari for pregnant women, 2009-10

Sl No Name of the District LLIN Allotment

1 Kandhamal 13350

2 Keonjhar 38000

3 Rayagada 20000

4 Malkangiri 11000

5 Nawarangpur 19000

  Total 101350

Another 10 high burden districts will be covered in 2010

Important activities around LLIN

• State team will monitor district LLIN implementation

• Computerized data base of LLIN distribution

– BPO are to be involved for data entry at block level which will be

consolidated at DPM unit for the districts.

– MTS of concerned blocks and VBD consultants of WB Districts will

coordinate with BPO and DPM units respectively.

• Districts while distributing will document with photographs• Professional process documentation of LLIN activities will be

done by T & MST

Important activities ……………..

– Appropriate IEC / BCC like use of folk media and other methods along

with distribution of LLIN or after the distribution depending upon the

ground reality, so that by the peak transmission season, people are in

habit of sleeping under LLINs and do not misutilise

• Dy MEIO/ BEE must be involved in the IEC/BCC activities and whole

process

– Pre-distribution information on village-wise days of distribution and post-

distribution information of number of LLINs given village-wise will be

displayed on the swathya kanthas and documented with photography.

Important activities ……………..

• Network and established civil society organisations will be involved for

social mobilization around LLIN who will also give hand holding support to

GKS

– State level initiatives will be taken to involve Red Cross, NYKS, Kalyanee clubs,

MNGOs etc.

• Summary of nets distribution status would be uploaded on the health

department website and updated regularly

IRS in LLIN areas

• In 2010, IRS will also be conducted in LLIN areas– This will be done since we are not sure about the extent of

acceptance and usage of LLIN in the first year – Accordingly the IRS action plan will revised

• A total district wise readiness plan will be developed by 1st week of Feb 2010 so that 1st round IRS can be conducted with full preparedness by 15th May 2010.– IRS Action plan meetings will be conducted from 27th to 29th Jan, 2010.– VCRC, NIMR, RMRC and RD office will be involved from the beginning in

planning and monitoring

GKS fund to meet IRS wages & operational cost for bednet impregnation

IRS wagesThe wages for IRS will be met from GKS fund in2010-11 Necessary communication will be made soon• In an average Rs 6000/- may be needed per 2 rounds of spray in a

village of average 1000 populationNet impregnation: • Similarly in Non-IRS villages GKS fund can be used for impregnation

of community bed nets– Some GKS show interest to impregnate without operational

cost– they need only training and SP flow– Hence local appropriate measures can be adopted– SP flow is available in plenty and can be supplied on indent

Issues on IRS

Non submission of 2nd round IRS report:– Following district have not submitted the 2nd round IRS

report:• Anugul, Dhenkanal, Gajapati, Ganjam, Jharsuguda,

Kalahandi, Keonjhar, koraput, Malakanagiri and Nawarangpur, Nuapda, Samblapur, Sundargarh

• Dhenkanal not submitted both 1st &2nd round IRS report

Human resourceLTs against regular posts: retired LTs will be posted against the vacant posts – communication will be made soon Additional manpower: Districts lagging behind:• MTS : Bhadrak (1), Koraput (1) Malkanagiri (1), Baragarh (1), • LT: Nayagarh(1), Gajapati (2), Koraput (1), Balasore (1)

– As Koraput has not yet recruited 1 LT and such LTs are meant for sentinel sites, this position will be diverted to another dist

• MPW (Male): Baragarh (35),Ganjam (34), Mayurbhanj (98), Nawarangpur (22), Koraput (43), Rayagarh (40).

Dist. Malaria Officer will be posted as per the new cadre structure.

MPHW - Male (567poated /816) Dists Sancd

Rctd Dists Sancd Rctd

Angul 70 69 Nayagarh 8 8

Balasore 30  27 Sonepur 42 42Bargarh 35 Scr Gajpati 38 24

Bolangir 19 18 Jharsuguda 14 8

Boudh 6 6 Kalahandi 37 37

Deogarh 6 6 Kandhamal 36 36

Dhenkanal 34 34 Keonjhar 66 66

Ganjam 34 scr Koraput 43 Scr

Malkangiri 31 25 Rayagada 40 Scr 

Mayurbhanj 98 Court case Sambalpur 5 5

Nawrangpur 22 scr Sundargarh 45 45

Nuapada 5755

More 184 sanctioned for 2010-11 and will be posted in high burden areas only

Status of Submission of GIS Data

S.no District Sub centre data Village data REMARK

1 Angul submitted submitted not in format

2 Balasore not submitted not submitted  

3 Baragarh submitted submitted not in format

4 Bhadrak submitted submitted  

5 Bolangir submitted submittednot in format (given only 2008)

6 Boudh submitted not submitted  

7 Cuttack not submitted submitted not given all village data

8 Deogarh not submitted not submitted  

9 Dhenkanal not submitted submitted not in format

10 Gajapati not submitted submittednot in format (given only 2008)

11 Ganjam not submitted not submitted  

12 Jagatsinghpur submitted submitted not in format

13 Jajpur not submitted not submitted  

14 Jharsuguda submitted not submitted  

15 Kalahandi submitted submittednot in format (given only 2008)

Status of Submission of GIS Data

S.no DistrictSub centre data given Village wise data REMARK

16 Kandhamal not submitted submitted  

17 Kendrapara not submitted not submitted  

18 Keonjhar submitted not submitted  

19 Khurda submitted not submitted  

20 Koraput not submitted submitted not in format

21 Malkangiri not submitted submitted not in format

22 Mayurbhanj submitted not submitted  

23 Nabarangpur submitted submitted  

24 Nayagarh not submitted submitted  

25 Nuapada not submitted submitted not in format

26 Puri not submitted not submitted  

27 Rayagada not submitted submitted not in format

28 Sambalpur not submitted submitted not in format

29 Subarnapur not submitted not submitted  

30 Sundargarh submitted not submitted  

  Total 13 17  

Issues on sentinel sites

• Trained LTs (Contractual) should be placed in identified Sentinel Sites (Avg. 2 per districts)

• Data in proper format to be collected , compiled , analysed and feedback to be submitted to the concern Blocks

• Sentinel site formats are given in ME Module– And in Dec- Jan all sentinel site LTs have been given

reorientation training– They have been given the copies of the formats

Quality microscopy• Microscopy is said to be the gold standard for malaria diagnosis, but

unfortunately we have ??? on the quality• In many labs the discrepancy rate is very high (In many cases the +ve slides

are –ve as observed by RD Lab.) – which is misleading the malariometric indicators and there is complaint that GoI supplied RDTs are not good as they show -ve results in such cases.

• Due attention must be given at each level to see the quality aspects of each malaria lab and the skill of the technicians– Malaria technicians will be retrained where their skill is doubtful – All efforts are being taken to supply Lens, reagent etc. – Fund will be provided to districts to procure quality reagent and meet

the microscope repair cost – Where non functional microscopes are not in repairable stage new

microscopes will be provided– Hence urgent review of all malaria labs to be done by the district

authority

Other issues • NAMMIS: All IDSP data entry operators will be trained (many have already

been trained) and they will be responsible for NAMMIS• M 1 and other new Surveillance format will be printed at district level to

meet another 3 months’ requirement• All efforts to be taken to make ACT and RDT available at Sub centre and

trained FTD (ASHA) level

• Trainings: training of MPW (male) and rest of the ASHAs and VSS animators

• Regular monthly review of VBDs, MTS, LTs and MPW(male) and sorting out their genuine difficulties

• All malaria death must be investigated as per the guideline using the death investigation format: – A simple malaria death investigation format has been developed by

Dte. NVBDCP, GOI and will be sent soon

Financial issues• Except Deogarh, Jharsuguda, Kandhamal, Kendrapada, Keonjhar,

Mayurbhanj, Nawarangpur, Nayagarh, Nuapada & Sundergarh other

districts have low expenditure under WB (<10%)

• GFATM districts under with <5% expenditure:

– Angul, Balasore, Bhadrak, Boudh & Khurda : <5%

– Dhenkanal is with <10% expenditure

• SOE & UC of 1st round IRS : Only Dhenkanal, Malkangiri, Bolangir &

Angul & Sonepur have submitted- others are yet to submit

• SOE & UC of the fund under DBS : Districts have not submitted.

• All measure be taken to submit SOE by 5th of every month

– Is being submitted to GoI, by 10th of every month

Dist (GFATM Fund)

Delay in SOE / UC

Low expenditure(%)

Dist (WB Fund)

Delay in SOE / UC

Low expenditure(%)

Angul -Do- 2.38 Jharsuguda -Do- 11.41

Balasore -Do- 0.00Gajapati -Do- 4.67

Bhadrak -Do- 0.87 Kalahandi -Do- 8.26

Boudh -Do- 0.00 Rayagada -Do- 3.01

Dhenkanal -Do- 9.49 Sambalpur -Do- 6.15

Khurda -Do- 3.98 Koraput -Do- 00

Sonepur -Do- 10.34 Malkanagiri -Do- .74

Total(all dist)

24.88 Total(all dist)

14.57

GFATM Fund Position 2009-10 (April to Sept), Odisha

Sl NoName of the

DistrictOpening Balance

Fund Released

Total SOE

SubmittedClosing Balance

%age of Expenditure

1 2 3 4 5 6 7 81 Angul 1273085 500449 1773534 42280 1731254 2.382 Balasore 236754 454670 691424 0 691424 0.003 Bargarh 2461521 629018 3090539 935324 2155215 30.264 Bhadrak 253279 332288 585567 5100 580467 0.875 Bolangir 2510221 749353 3259574 982181 2277393 30.136 Boudh 1201526 333015 1534541 0 1534541 0.007 Cuttack 19783 466658 486441 749043 -262602 153.988 Deogarh 1389651 276908 1666559 341381 1325178 20.489 Dhenkanal 838218 417989 1256207 119196 1137011 9.4910 Ganjam 1890447 810371 2700818 1200641 1500177 44.4511 Jajpur 2215996 461657 2677653 763504 1914149 28.5112 Jagatsingpur 369847 306521 676368 208670 467698 30.8513 Kendrapara 396592 318215 714807 145711 569096 20.3814 Khurda 172361 372253 544614 21665 522949 3.9815 Nayagarh 1659946 507546 2167492 730780 1436712 33.7216 Sonepur 1730808 437095 2167903 223126 1944777 10.29

District Total 18620035 7374006 25994041 6468602 19525439 24.88

PROGRESSIVE SMCS & DMCS(NVBDCP) in the state of Orissa for the month of Nov-09

SL. No.

District

Amount carried down

from the prv .Financial year(O.B as on 01.04.09 )

Amount recived

during the current year

up to the immediate last month

Funds recived during the

current mounth

including misc .receipt

Total funds available

during the financial year

till month (A+B+C)

Expn .for the year from April

1(Current financialyear till the prv .M onth

ending

Expn.During the current month (as

per the annexure

encloseed)

Progv .Expn for the current

financial year till current month

Balance

% of Expenditur

e

    A B C D E F G H I

1 Angul -206357 2403014 1260000 3456657 41514 0 41514 3415143 1.20

2 Balasore 555582 1209200 0 1764782 0 0 0 1764782 0.00

3 Baragarh 1122599 1470581 0 2593180 105471 25320 130791 2462389 5.04

4 Bhadrak 485050 343000 0 828050 0 0 0 828050 0.00

5 Balangir 1908083 3023329 342000 5273412 325700 0 325700 4947712 6.18

6 Boudh 1455391 628467 108000 2191858 67891 0 67891 2123967 3.10

7 Cuttack 713270 480696 0 1193966 18808 0 18808 1175158 1.58

8 Deogarh 384627 450489 108000 943116 342421 0 342421 600695 36.31

9 Dhenkanal  194624 1384792 612000 2191416 0 0 0 2191416 0.00

10 Gajapati 1352632 2283350 684000 4319982 201693 0 201693 4118289 4.67

11 Ganjam 2160650 2562217 0 4722867 312814 0 312814 4410053 6.62

12 Jagatsinghpur 541467 414800 0 956267 11300 0 11300 944967 1.18

13 Jajpur 998486 484600 0 1483086 16800 0 16800 1466286 1.13

14 Jharsuguda 1252071 1245007 144000 2641078 16606 284664 301270 2339808 11.41

15 Kalahandi  1355423 5164611 666000 7186034 593510 0 593510 6592524 8.26

SL. No.

District

Amount carried down

from the prv .Financial year(O.B as on 01.04.09 )

Amount recived

during the current year

up to the immediate last month

Funds recived during the

current mounth

including misc .receipt

Total funds available

during the financial year

till month (A+B+C)

Expn .for the year from April

1(Current financialyear till the prv .M onth

ending

Expn.During the current month (as

per the annexure

encloseed)

Progv .Expn for the current

financial year till current month

Balance% of

Expenditure

16 Kandhamal  2289708 4735022 648000 7672730 3205948 0 3205948 4466782 41.78

17 Kendrapada 376732 431400 0 808132 110700 0 110700 697432 13.70

18 Keonjhar 3240216 5047715 1188000 9475931 2557407 0 2557407 6918524 26.99

19 Khurda 180828 327000 0 507828 9727 0 9727 498101 1.92

20 Koraput  2890559 5288515 0 8179074 0 0 0 8179074 0.00

21 Malkangiri  2032393 3233734 558000 5824127 43070 0 43070 5781057 0.74

22 Mayurbhanj  2352028 8365725 0 10717753 2249901 0 2249901 8467852 20.99

23 Nawarangpur 2054549 4068088 0 6122637 1289478 44988 1334466 4788171 21.80

24 Nayagarh 541362 899708 144000 1585070 382056 75641 457697 1127373 28.88

25 Nuapada 617079 4055017 1026000 5698096 2590628 0 2590628 3107468 45.46

26 Puri 498258 12000 0 510258 0 0 0 510258 0.00

27 Rayagada  1455193 5087313 0 6542506 196634 0 196634 6345872 3.01

28 Sambalpur 1820101 2062865 90000 3972966 244201 0 244201 3728765 6.15

29 Sonepur  610792 1710511 756000 3077303 0 0 0 3077303 0.00

30 Sundargarh 2812535 5418962 810000 9041497 2859076 0 2859076 6182421 31.62

Dist. Total 38045931 74291728 9144000 121481659 17793354 430613 18223967 103257692 15.00

SMCS 8467423 6121526 0 14588949 1603466 0 1603466 12985483 10.99

Grand Total 46513354 80413254 9144000 136070608 19396820 430613 19827433 116243175 14.57

Thanks