PIP NVBDCP 2014-17 - Pbhealth.gov.in

PIP NVBDCP2014-17Dr. Gagandeep Singh GroverMD, MIAPSM, MIPHA, MTBETN, MBPNI, WHO Fellow (Dengue & DHF)State Epidemiologist, NVBDCP

General Instructions• The National Health Mission (NHM)– NRHM– NUHM• NVBDCP– “flexi pool for communicable diseases”• Project Implementation Plan (PIP) for the year 2014-15 to 2016-17– Control of Malaria, Dengue, Chikungunya, JapaneseEncephalitis and Elimination of Lymphatic Filariasis and Kalaazar.

Planning• Rational use of relevantepidemiological data to– make the most effectivepossible utilization ofprogram resources– achievement of programgoals.• Planning is a cyclical processwhich is initiated with theidentification ofopportunities for changeand improvement.

• Situation AnalysisPIP Draft– Current Status and projection for 3 years– Key issues adversely affecting the performance• Targets– Setting targets for service delivery• Prioritization of area including criteria of prioritization• Strategy or innovation proposed– Strategy to provide services and achieve targets• Commodity Requirement– (As per technical requirement & considering balance,consumption capacity and justification)

NVBDCP Goals (12 th Plan)• Elimination of -Kala-azar and LymphaticFilariasis - 2015• Control and contain Dengue, Chikungunyaand Japanese Encephalitis• Paving the way for pre-elimination phase ofMalaria– ABER > 10%,– API

Surveillance in NVBDCPActiveSurveillance• MPHWs• ASHAPassiveSurveillance• DH, SDH• CHC,PHC, SHCSentinelSurveillance• Malaria• Dengue

Resource allocationDistrict wise resource allocationNVBDCP under NHMState Resources

Demographic Profile• Population of the District• Urban Areas with Population and area• District Hospital• Sub-divisional Hospitals• CHCs• PHCs• Subcentres• Villages• Malaria Clinics• FTDs

Human ResourcePosts Required Sanctioned In Position VacantDMO/ DVBDOAssistant Malaria officerMedical OfficersMPHS (M)MPHW(M)MPHS(F)MPHW(F)Lab TechniciansASHASwasthaya Sahayaks

HR (Urban areas)Posts Required Sanctioned In Position VacantEntomologist/ParasitologistInsect Collector/sSFWField WorkersSeparate Data for separate urban areas and compiled for allthe urban areas as District compiled

Epidemiological ProfileBlockBloodSlidesPrepared &ExaminedTotalPositiveCasesPf Deaths ABER API Pf% SPR SFRABER/ MBER is an index of operational efficacy of the programmeAPI indicates burden of malaria in an areaPf% >25% of all cases show high risk area for MalariaTrends in SPR/SFR can be utilized for predicting epidemicsituations in the area.

Urban Malaria Scheme• Vector Surveillance –detailed plan• Any additional towns to be covered withlarvicides may also be reflected forconsideration.TownPopulationArea Staff PersonsexaminedTotalMalariaCasesDeathsBiologistIC SFW FW

Entomological surveillance• State & 3 Zonal Levels– Prevalence of Vector– Adult Density– Outdoor collection of vectors– Larval Density– Susceptibility– Man Biting rate– Baits– Human resource and funds

• RuralPrioritization of Area– Case Load: age wise/ sex wise incidence– ABER: SC wise: Moga, Fzp, Ptl– API: SC wise: Fdk, Mns– IRS/ Focal: SCs/villages/population/houses/rooms• Urban– Towns/ Localities: areas– Cases: age wise/ sex wise- incidence- Ldh, Ptl, FGS,Gsp, Hsp– Entomological Surveillance: SAS, Sang,Bnl– Breeding areas

Innovations for Malaria• If any for rural/ urban areas• Every DH - designated as Sentinel Site forMalaria for severe Malaria cases– Oxygen– I/V Fluids– Diagnosis– Management as per protocol of GOI

Requirement of CommoditiesCommodityBlood SlidesBlood lancetsAnnual Requirementformula• 10% Population•25% Buffer10% Population10% BufferBalanceConsumptionJustifiedDemandFundsAppx 1.5/Appx 1.5/Tab CQ BSC/2 X 6 Appx 0.37/Tab PQ 7.5Tab PQ 2.5 Pv Cases X 60% X 2 X14 Pf Cases X 60% X 6 Pf Cases X 40% X 4 Pv Cases X 40% X 4 X14Appx 0.14/Appx 0.20/ACT Adult Pf X 80% Appx 180/ACTPaediatric Pf X 20% Appx 182/Inj Quinine Pf Cases X 40% X 10%X10

CommodityDDTMalathion 25%wdpRequirement of CommoditiesAnnual Requirementformula150 MT per millionpopulation for 2 rounds900 MT per millionpopulation for 2 roundsBalanceConsumption JustifiedDemandFundsGOI75/ KgTemephos 0.5 KL per million Pop 788/ ltPyrethrum 2% 1 KL per million pop 1733/ ltBti WP 42 MT per million pop 1099/ KgBti ASStirrup Pumps forIRS & Focal SprayKnapsack SprayPumpsContinuous SprayPumpsFogging MachinesNo.No.No.No.1450/lt

Larvicides/ InsecticidesRequired for townsName ofthe TownTotalPopulationLarvicides RequiredSpace Spray(Pyrethrum)PollutedWaterCleanWaterTotal of theDistrict

Financial Malaria• F.1.1.a - Contractual Payments :• F1.1.b: ASHA: Against vacant posts of MPHW(M): Rs 15/ for slidecollection & transport and Rs 75/ for radical treatment• F.1.1.c.i & ii – Spray Wages and operational cost for IRS• F1.1.c iii – Impregnation of Bed-nets: for areas API>5• F.1.1.d : M & E:– Hiring of vehicles– Supervision – TA/DA– Epidemic Preparedness – For capturing early warning signals,Rapid Response Team etc.– Printing of formats for reporting– Monthly & Review Meetings– Operational Costs– Computer/ Printer etc

Financial Malaria• F.1.1.e IEC / BCC– Subcentre to Block wise action plan– Activities• F.1.1.f PPP / NGO– involvement of Pvt Sector• F.1.1.g Training/ Capacity Building– Paramedical Staff after calculating training load

F.1.1.h Zonal Entomological Units– Human Resource• Consultant Entomologist• Insect Collector– Hiring of Vehicles• for field visits– Commodities• entomological kits ,• microscope,• Computers etc– Contingencies

Financial Malaria• F.1.1.i Biological and EnvironmentalManagement– Taken up under Dengue Head• F.1.1.jLarvivorous Fish support– Except Faridkot, Fazilka, Ferozepur, Mansa, Mukatsar,Bathinda & Tarn Taran• F.1.1.lAny other activity (Pls specify)

Dengue and Chikungunya• Disease Situation Dengue & ChikungunyaDistrict Town Suspected CasesSamplesCollectedPositiveCasesDeaths• Age wise/Sex wise/Area wiseUrbanRural

• Spot mapsDengue and Chikungunya– Identification of areas (high burden)• Specific constraints,– inter-sectoral coordination• Emergency Hospitalization Plans• RRTs• Mobility of RRTs• M & E– Daily Reporting from towns and then to State– SSHs reporting and recording

Blood BanksDengue and ChikungunyaBlood Component SeparatorsAphresis MachinesDengue Wards with mosquito proofingNewer strategy and innovations proposed forimplementation of the programmeIntensification of the entomologicalsurveillance– Area wise monitoring of HI, CI & BI to review your controlstrategies and operational efficacy

Diagnostic Facilities (D & C)Name ofthe SSHFunctional(Yes/ No)Ig M MacELISA Kits(NIV Pune)NS1 Ag KitsSamplesTestedSamplesfoundpositiveReceivedUtilizedReceivedUtilizedName of the SSHFunctional(Yes/ No)Ig M Mac ELISAKits (NIV Pune)SamplesTestedSamples foundpositiveReceivedUtilized

• Proposal ofDiagnostic Facilities (D & C)– new SSHs in 2014-15 and– replacement of existing if any with justifications.• Details of kit requirement for 2014-15, 2015-16 & 2016-17 separately for– IgM Dengue,– IgM Chikungunya and– NS1 ELISA for Dengue.

Vector control teamsTown Population DengueCases2013DengueDeaths2013CHk Cases2013Volunteersrequiredforbreedingchecking& sourcereductionFundsrequiredTotalDistrict•The towns should be categorized:•Population more than 40 lakhs, 10-40 lakhs and 1-10 lakhs.•Honorarium: Daily wagers as per approved rate by labourDepartment per day per volunteer X 20 days X 5 months ortransmission period whichever is less.

Commodity Requirement-Dengue• Insecticides and larvicides– decentralized items dealt under UMS• Monthwise, institution wise requirement oftest kits– Dengue and– Chikungunya

D&C Financial• F.1.2.a Strengthening surveillance– F.1.2.a (i) Apex Referral Labs recurrent– F.1.2.a(ii)Sentinel Surveillance Hospital recurrent @Rs. 1.00 Lakhs per lab as operational cost– F.1.2.a(iii)ELISA facility to Sentinel SurveillanceLabs: @ Rs. 3-5 lakhs per SSH.• F.1.2.b Test kits to be supplied by GOI (kindly indicatenumbers of ELISA based NS1 kit and IgM ELISA Kitsrequired separately

D&C Financial• F.1.2.c Monitoring/supervision and Rapidresponse:– Mobility Support– Review meetings– Sample Transportation to SSHs– Strengthening of reporting• F.1.2.d Epidemic preparedness- for epidemicpreparedness and containment of outbreak.@ tentative Rs.2 lakhs for district

• F.1.2.eD&C FinancialCase management:– Strengthening District Hospitals for Dengue andChikungunya case management– Should also include mosquito proofing of wards.• F.1.2.f Vector Control & environmentalmanagement:– source reduction activities by hiring field workers attowns /cities with population. The State NRHM norms/approved rate by labour dept. may be followed for theField Workers.

D&C Financial– Fogging Machines – Hand operated foggingmachines needed for Indoor Space Spray• F.1.2.g IEC/BCC for Social Mobilization:• F.1.2.h Inter-sectoral convergence– DLMCs– IMA meetings• F.1.2.i Training & printing of guidelines,formats etc. including operational research– Training Load of MOs for D&C

SummaryDisease/ Head(Includingactivities insubheads)UnspentbalanceCommittedExpenditure2013-14CashAssistanceRequired2014-15CashAssistancerequired2014-17• Malaria• Dengue• DecentralizedProcurement

THANKS