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NVBDCP Format for inclusion in PIP of NRHM for the year 2014-15, 2015-16 & 2016-17 General Instructions

National Vector Borne Disease Control Programme (NVBDCP) was subsumed under NRHM and states/UTs have been submitting Programme Implementation Plans (PIPs) on an annual basis under the overarching umbrella of NRHM. The approval is accorded by MOH&FW after a process of appraisal each year. The National Health Mission (NHM) now subsumes National Rural Health Mission (NRHM) and National Urban Health Mission (NUHM). In view of this, the PIP for 2014-15 will be appraised under overarching umbrella of National Health Mission. NVBDCP portion is reflected under disease control programmes and the financial resources are covered under “flexi pool for communicable diseases”. The Action Plan/Project Implementation Plan (PIP) for the year 2014-15 to 2016-17 in respect of National Vector Borne Disease Control Programme (NVBDCP) for prevention and control of Malaria, Dengue, Chikungunya, Japanese Encephalitis and Elimination of Lymphatic Filariasis and Kala-azar should be formulated as per the instructions contained in this document. Priorities: The priorities in the 12th five year Plan period are:

1. The elimination of two diseases namely Kala-azar and Lymphatic Filariasis by 2015. 2. Control and contain the outbreaks of Dengue, Chikungunya and Japanese

Encephalitis. 3. Paving the way for pre-elimination phase of malaria.

The following points are required to be considered for drafting the PIP.

1. Situation analysis: Disease & district wise situation analysis for all Vector Bone Diseases (VBD) for previous completed year and current year should be indicated in Action Plan/PIP. For kala-azar the block-wise details of Kala-azar cases detected and treated may be indicated. The endemicity map for the diseases, the map of vector prevalence and vector susceptibility map should also be included. The situation analysis should indicate: � Current status � Key issues adversely affecting performance � Setting of targets in view of achieving national goal � Setting of targets for service delivery � Strategy to provide services and achieve target

2. Resource allocation: Corresponding cost to implement various strategies should be

indicated in the format attached (in excel sheet and in English only). District wise resource allocation indicating the assistance required from NVBDCP under NHM (NRHM and NUHM) and state resources should also be indicated in a separate sheet (as per attached format).

3. Diseases wise details should be indicated in the PIP as per guidelines attached which will facilitate in reviewing the PIP on physical performance, proposed activities and corresponding requirement of financial resources.

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4. While preparing the PIP, the consultation with IDSP, ICMR institutions (NIMR, its field station VCRC, CRME), Medical Colleges and RD offices of GOI may be made for their inputs especially on monitoring, evaluation and operation research.

5. The PIP should also enclose the executive summary as per the format enclosed.

The general strategy for Prevention and Control of Vector Borne diseases are:

• Early diagnosis and complete treatment

• Vaccination only against J.E.

• Case management for Dengue, Chikungunya and J.E.

• Annual Mass Drug Administration for Lymphatic Filariasis Elimination

• Integrated Vector Management (IRS, fish, chemical and bio-larvicide, source reduction)

• Behaviour Change Communication and capacity Building.

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NVBDCP Format for inclusion in PIP of NRHM for the year 2014-15

EXECUTIVE SUMMARY

Executive Summary should give an overview of diseases prevalent in the state, strategy, goals set for the year and financial support required. The disease situation in the state is as below:

Year Malaria cases

Malaria Deaths

Dengue cases

Dengue deaths

Chikungunya cases

AES/JE cases

AES/JE deaths

Kala-azar cases

Kala-azar deaths

Microfilaria rate (%)

2012 2013

In the state (Name the diseases) vector borne diseases are major public health problem. Malaria is endemic in --- (No.) districts viz; --------------------------------------. Dengue is endemic in --- (No.) districts viz; --------------------------------------. Chikungunya is endemic in --- (No.) districts viz; --------------------------------------. Acute Encephalitis Syndrome(AES) is endemic in --- (No.) districts viz; ----------------------------------. Japanese Encephalitis (JE) is confirmed in ---- (No.) districts viz.--------------------------. Filaria is endemic in --- (No.) districts viz; --------------------------------------. Kala azar is endemic in --- (No.) districts viz; --------------------------------------.

The requirement for programme implementation has been indicated in detail and the summary is indicated below:

Disease Unspent Balance as on -----January, 2014

Committed expenditure for 2013-14

Cash assistance required from NVBDCP for 2014-15

State resources

Malaria a. Domestic Budget Support b. World Bank fund for project states c. GFATM fund for project states

Dengue (from Domestic Budget)

Chikungunya (from Domestic Budget)

AES including JE (from Domestic Budget)

Filaria (from Domestic Budget)

Kala-azar (from Domestic Budget)

Kala-azar World Bank Project assistance

Total

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Guidelines for preparing Annual Action Plan/PIP (2014-15) in respect of National Vector Borne Disease Control Programme

The Action Plan/Project Implementation Plan (PIP) for the year 2014-15 in respect of National Vector Borne Disease Control Programme (NVBDCP) for prevention and control of Malaria, Dengue, Chikungunya, Japanese Encephalitis and Elimination of Lymphatic Filariasis and Kala-azar should include the technical activities alongwith cross cutting issues viz. human resource management, capacity building, IEC/BCC activities, quality assurance, establishment, monitoring and evaluation of technical activities as well as utilization of funds as per the guidelines. Demographic profile should be indicated as per the format given below: Demographic Profile:

Population of the State:……………………….

Infrastructure Number Districts CHCs PHCs HSCs Villages FTDs Any other

2. District-wise status of Manpower (sanctioned & vacant)

Regular Posts Required Sanctioned In Position Vacant District Malaria Officer/District VBD Officer

District Filaria Officer Assistant Malaria/ VBD Officer Medical Officer Senior Malaria Inspector Malaria Inspector Multi Purpose Health Supervisor Multi Purpose Health Assistant or Multi Purpose Worker

Lab. Tech. Any other category ( pl. specify) Contractual Posts (applicable for the states where MPWs have been sanctioned by NVBDCP and Project staff in project districts ( World Bank & GFATM Distt)

Post Sanctioned In position

Vacant Remarks/reasons for vacancy

MPW Regular

MPW Contractual under NVBDCP

Lab.Tech.

Consultants (District level & State level)

Malaria Technical Supervisors/Kala-azar technical supervisors

Project monitoring unit staff both at state and district level ( indicate positions )

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Drafting PIP: The following points are required to be considered for drafting the Action Plan/PIP:

1. Situation analysis of the disease indicating:

a. Current status b. Key issues adversely affecting performance

2. Setting of targets in view of achieving national goal a. Setting of targets for service delivery

3. Prioritization of the areas including the criteria of prioritization 4. Strategy & innovations proposed.

a. Strategy to provide services and achieve target 5. Requirement for commodity as per technical norms and considering balance of stores,

consumption capacity and justification. 6. Certain commodities like Chloroquine tabs. 2.5 mg, Primaquine tabs. 2.5 mg, Primaquine

tabs. 7.5 mg, Quinine sulphate tablets, Quinine Injections, Temephos, Pyrethrum Extract 2%, Bti(wp), Bti(AS), DEC (100 mg), Albendazole (400 mg.) tablets and NS1 antigen Kit for Dengue have been decentralized which means that the States have to procure these items themselves out of cash grant made available from NVBDCP. ACT and RDT for the States/districts which are not supported under external assistance (World Bank/GFATM) have also been decentralized. The most important point to be considered is that the cost required for individual items should be reflected in the Action Plan/PIP, which will facilitate to process for approval and release the funds.

ALL THE ABOVE MENTIONED POINTS SHOULD BE REFLECTED IN RESPECTIVE

DISEASES WITH JUSTIFICATION TO FACILITATE PIP APPRAISAL AND TO AVOID DELAY IN SANCTIONING DUE TO REQUIRED CLARIFICATIONS.

1. Malaria

Target: During XII plan period the proposed target is as below: ABER > 10%, API<1 per thousand population (during 12th plan, the objective is to bring down annual incidence of malaria cases to less than 1 per 1000 population at national level by 2017 and its monitoring at district level). The state/UT should indicate their target to be achieved.

Epidemiological Data for 2012 & 2013 (give district-wise details)*

District Persons Examined

Positive Pf No. of deaths

ABER API Pf% SPR SFR

BSE RDT

* Identify districts based on epidemiological situation (using map) for prioritization for focused Interventions and for epidemic preparedness (like deployment of RDK, ACT and targets areas for IRS, LLINs and improvement in surveillance).

The initiatives to be taken during 2014-15 should be in accordance with the proposed activities as mentioned below:

The strategy adopted during XI Plan period was for malaria control. Considering the feasibility of malaria elimination defined as “no indigenous transmission”, it is proposed to change the focus of strategies based on endemicity level. This will facilitate in achieving long term goal of elimination. This necessitates the stratification of states based on incidence as to decide and execute area specific intervention. This would lead to reduction of incidence in high endemic areas and sustain it in low endemic areas which will pave the way to enter the country into “Pre- Elimination stage”. To reach “Pre- Elimination stage”, entire country would require adequate inputs in terms of technical, logistic and financial support. Accordingly the states have been stratified as under:

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o Category 1: States with less than1 API including all the districts in the state with less than 1 API

o Category 2: States with less than 1 API with few districts reporting more than 1 API o Category 3: States with more than 1 API with either all the districts with more than 1 API

or few districts with less than 1 API and few with more than 1 API

Urban Malaria Scheme Plan of surveillance and Vector control should be detailed in action plan. Every State/UT should reflect that how many towns in their State/UT are covered under Urban Malaria Scheme, for which the assistance in form of larvicides and Pyrethrum Extract are provided by Govt. of India. Since these items have been decentralized, the plan should propose the requirement and respective cost separately for different larvicides. While proposing the plan, the state should also mention the number of NFCP towns covering under NFCP because the requirement of larvicides has to be worked out for all NFCP towns covered under UMS and NFCP. From GOI support in respect of larval and adult control, the Larvicides and pyrethrum Extract. are supplied to states/UTs for all towns covered and UMS (131) and NFCP (206). This will facilitate the anti-larval and vector control operations in all these towns. Any additional towns to be covered with larvicides due to epidemiological situation of Malaria/ Dengue/Chikungunya etc., may also be reflected for consideration. UMS Town

Population Staff Persons examined during 2012

Total malaria cases

Pf Cases

Deaths

Biologist Field Worker

Insect Collectors

Technician

NFCP Town/ clilnics/ survey units

Population Staff Persons examined during 2012

Mf positive

Disease Positive

Biologist Field Worker

Insect Collectors

Technician

Note: status of integration of NFCP units/clinics/survey units may be indicated.

Number Total

population Larvicides required For space spray

For polluted water (Qty. in ltrs.)

Cost For non-polluted water (Qty. in ltrs./Kgs)

Cost Pyrethrum Extt. 2% (Qty.)

Cost

of UMS Town

of NFCP town

Total

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Entomological surveillance The entomological surveillance need to be strengthened in all the States/UTs. Considering the importance of entomological activity, Govt. of India has proposed various initiatives to strengthen the entomological component, surveillance and monitoring. The States/UTs should reflect the available staff strength, mobility support and project the requirement for strengthening the zonal team as well as the State Team (entomological team at state headquarter) etc. The available funds provided for mobility and monitoring & evaluation should also be provided for carrying out field activities by the zonal entomologist and insect collectors. The performance on entomological surveillance done during 2012 and 2013 should be indicated as below:

1. Prevalence of vector in the districts under the jurisdiction of zonal team (district-wise). 2. Monthly density of vector (either in table or graph) 3. Susceptibility status if conducted and reason if not conducted 4. Sporozoite incrimination if done and found positive 5. Any other parameter conducted 6. Status of zonal team in terms of human resource

Name of zonal team

Functional Entomologist sanctioned

Entomologist in position

Technician sanctioned

Technician in position

Insect Collector sanctioned

Insect Collector in position

7. The activities to be performed and logistics with respective cost should be reflected

a. Monthly field activities for vector surveillance with cost b. Susceptibility test with logistics (kits) c. For other parameters specify

F.1.1 Malaria: Following points are provided to facilitate in making plans, however, the states may propose their financial requirement considering the NRHM norms based on the realistic needs. (The guidelines are tentative and approval will depend on availability of funds) F.1.1.a - Contractual Payments :

• F.1.1.a.i - Contractual Multi Purpose Workers (Male) are provided by NVBDCP @ Rs.

6000/- per month in identified states namely Arunachal Pradesh – 356, Assam – 391,

Manipur – 165, Mizoram – 75, Meghalaya – 100, Nagaland – 200, Tripura – 500, Andhra

Pradesh – 85, Bihar – 919, Chattisgarh – 1144, Madhya Pradesh – 1000, Maharashtra –

216, Orissa – 1000, Rajasthan – 100, Karnataka – 100, Jharkhand – 2304, West Bengal

- 1000.

• F.1.1.a.ii - Vacancies of Laboratory Technicians at PHCs, CHCs, Zonal Malaria Office

and District level should be worked out against sanction and/or against the requirement.

After rational deployment to high endemic districts, the shortage may be worked out and

requested in PIP which is subject to approval & availability of funds. The remuneration

should be worked out according to the State’s NRHM norms.

• F.1.1.a.iii – On the pattern of MTS/KTS, VBD Supervisor has been proposed in 12th Plan.

The States may work out their requirement and project. The remuneration should be

worked out according to the State’s NRHM norms.

• F.1.1.a.iv - District VBD Consultant - one for each district as per the norm of State

NRHM, may be projected for considering subject to approval and availability of funds. If

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approved, the detailed guidelines for recruitment and their TOR may be obtained from

NVBDCP. The remuneration should be worked out according to the State’s NRHM

norms.

• F.1.1.a.v – At State level, one Consultant for monitoring, one VBD Consultant, one

Finance Consultant and one Secretarial Assistance-cum-Data Entry Operator need to be

projected depending on the availability of HR at State level and justification for the

requirement. If justified, it should be projected as per the State’s NRHM norms which will

be for consideration of funds. The remuneration should be worked out according to the

State’s NRHM norms.

F1.1.b – The existing norm of ASHA incentive was proposed to be enhanced from Rs. 5, Rs.20 &

Rs.50 to only two slabs Rs. 15 & Rs. 75 which is yet to be approved, however, the State

may project. If approved, the revised incentive may be paid, otherwise the existing norm

will continue. The remuneration should be worked out according to the State’s NRHM

norms.

F.1.1.c.i & ii – Spray Wages and operational cost for IRS the North-eastern States & UTs without

Legislation may project their total requirement under this Head with justification. The

other States may also project, however, the approval will depend on availability of funds,

therefore states should have a provision in their State funding also so that the

implementation of activities is ensured. The remuneration should be worked out according

to the State’s NRHM norms.

• F1.1.c iii – Impregnation of Bed-nets - The impregnation of bed-net shall be done in the

areas which have the API less than 2 and where IRS is not being done and it has not

been covered by LLIN also. The state should carry out survey to find numbers of

community owned bed-net. North Eastern states are being funded. The states other than

NE must mention the requirement of impregnation of Bed-nets with the requirement of

Synthetic Pyrethroid (Liquid formulation) and the use of such nets by community.

F.1.1.d should include following activities

o Monitoring & Evaluation – Hiring of vehicles at the state level with the norms of

NRHM / State Health Society

o Supervision – TA/DA shall be applicable as per the norms of NRHM / State health

Society

o Epidemic Preparedness – For capturing early warning signals, Rapid Response Team

etc.

o Printing of formats for reporting etc.

F.1.1.e IEC / BCC - Routine IEC activities which may be specified – Norms of NRHM / State

Health Society shall be followed for the unit cost. Anti- Malaria Month to be budgeted and

the activities to be specifically mentioned in the budget with unit cost in the PIP.

F.1.1.f PPP / NGO and Sectoral Convergence – As per the 6 schemes hosted at the NVBDCP

web-site based on the need of the State and available NGO/other partners.

F.1.1.g Training/ Capacity Building - The state must provide the un-trained health staff and

work plan to train them. The Financial norms for training, NRHM/State Health Society

norms must be followed for training at the state/district/sub-district level. The curriculum

may be adapted from NVBDCP guidelines.

F.1.1.h Zonal Entomological Units – Detailed Plan related to strengthening of Zonal entomological units may reflect following details and financial implications thereof: o Human Resource- In identified Entomological Zone

� Consultant Entomologist – Salary as per State health society � Insect Collector– Salary as per State health society

o Training o Operational Research o Hiring of Vehicles - for field visit

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o Commodities and products such as entomological kits , microscope, Computers etc o Contingencies

F.1.1.i Biological and Environmental Management

The biological and environmental management shall be done in the areas which are not covered by IRS or by LLIN. The intervention shall be for areas which have API less than 2. The details of activities which are to done under source reduction by means of environmental manipulation, de-silting, de-weeding of drawings, etc must be clearly defined with the budget requirement.

F.1.1.j Larvivorous Fish support

To establish sustainable Hatcheries preferably natural and perennial water bodies not exceeding more than 2 per districts. Releasing of Larvivorous Fish in seasonal water bodies as per feasibility.

F.1.1.k Construction and maintenance of Hatcheries The requirement with the unit cost may be highlighted in PIP.

F.1.1.l Any other activity (Pls specify)

Note - * Activities have been proposed in 12th Five year. The allocation shall be made according to the approval F.2 Externally Aided Component – World Bank: Following components should be projected as per the project guidelines and norms

• F.2.b - Human Resource as per guidelines

• F.2.c - Training / Capacity Building

• F.2.d- Mobility support for Monitoring supervision & Evaluation including printing of format

& review meetings, reporting formats.

F.3 Externally Aided Component - GFATM – NE States: Following components should be projected as per the project guidelines and norms

• F.3.a- Human Resource – As per the project approval.

• F.3.b- Training • F.3.c - Planning and Administration

• F.3.d- Monitoring and Evaluation

• F.3.e - Communication Material (IEC / BCC activities)

• F.3.f- Procurement and Supply chain Management cost

• Infrastructure and Equipment.

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Dengue and Chikungunya

1. Disease Situation: The disease situation for 2012 & 2013 may be given district-wise and separately for towns as per following table:

Sl. No.

Name of district/ Corporation

Dengue Chikungunya Remarks

Suspected cases

Blood samples tested

Positive cases

Deaths Suspected cases

Blood samples tested

Positive cases

1

2

Total

2. Specific constraints, newer strategy and innovations proposed for implementation of the programme: In this section problems related to social mobilization for vector control, inter-sectoral coordination, involvement of the village health and sanitation committee, other community based organizations etc. should be highlighted. Besides, emergency hospitalization plan in case of epidemic/ outbreak in each district, availability of rapid response team & their performance, problems for monitoring & evaluation and constraints for analyses of entomological indices for early warning signals, time lag in receiving reports from Sentinel Surveillance Hospitals & implementation of remedial measures etc should also be described. Availability of the blood banks and blood component separation facility at district level & state level should also be mentioned.

Based on the analysis and constraints, the innovative plan in prioritized districts with high disease prevalence should be described with detail calendar of activities.

3. Strategy and innovations proposed for implementation of Mid Term Plan strategies in

urban and rural areas: This section should describe the strategy for reducing the morbidity due to both dengue & Chikungunya and to reduce the dengue case fatality rate like,

a) Intensification of the entomological surveillance, vector control strategies including community involvement for elimination of vector breeding for transmission risk reduction and prevention of occurrence of outbreak. Pl mention the nos of volunteers/breeding checkers engaged in each district/city/Corporation by utilizing the funds provided during 2013-14 for source reduction activitites.

b) Diagnostic facilities: No. of Sentinel surveillance Hospitals (SSH) functional against number identified should be mentioned district-wise and the performance should be given in the following table:

c) It has been observed that many states are procuring Rapid Card Tests (RDT) for Dengue though it is not recommended under the programme. The states where such RDTs are procured/used, the details should be provided in the following table:

Name of

district

Name of the SSH

identified

Name of SSH functional

Kits received from NIV,

Pune/utilized

NS1 kits

procured

Samples received/ tested by ELISA

based

Found positive

Dengue Chik. Dengue Chik. Dengue Chik.

-/- -/- Igm NS1 Igm NS1

Total

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d) Number of new SSHs proposed in 2014-15 and replacement of existing if any with justifications.

e) Details of kit requirements for 2014-15 separately for IgM Dengue, Chikungunya and NS1 ELISA for Dengue.

f) Vector control teams selected and population targeted in each district should be annexed as per format below. Methodology to be adopted including trainings should be indicated.

Name of Towns

Population Dengue cases reported in 2013

Deaths due to Dengue

Chikungunya cases in 2013

No. of volunteers required for breeding source reduction & social mobilization

Funds required

Note:

• The towns should be categorized into 3: Population more than 40 lakhs, 10-40 lakhs and 1-10 lakhs.

• Honorarium should be calculated @ as per approved rate by labour Department per day per volunteer X 20 days X 5 months or transmission period whichever is less.

4. Requirement for commodity as per technical norms and considering balance of stores, consumption capacity and justification

Insecticides and larvicides are decentralized items and dealt under urban malaria scheme (UMS). Please indicate the requirement for Dengue and Chikungunya together with UMS. Monthwise, institute wise requirement of test kits should be worked out for both Dengue and Chikungunya and included in the PIP. For Dengue both ELISA based NS1 antigen detection kit and IgM capture ELISA should be worked out based on the epidemiological situation (both the kits 1 = 96 tests). IgM kits both Dengue and Chikungunya will be supplied by NIV, Pune. NS1 kits needs to be procured by states as per the recommended specification.

5. Financial Requirement for Dengue and Chikungunya: The assistance required should be

indicated for 2014-15 for which following points have been made to facilitate.

Name of

district

Nos of Rapid Diagnostic Kits

procured

NS1 kits

procured

Samples received/ tested by Rapid Diagnostic Kits/ Found positive

Remarks

NS1 IgM Any other

NS1 IgM Any other Pl mention brand / manufacturer -/- -/- -/-

Total

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F.1.2 Dengue & Chikungunya (The guidelines are tentative and approval will depend on availability of funds) F.1.2.a Strengthening surveillance: This budget head includes various subheads as follows:

F.1.2.a (i) Apex Referral Labs recurrent @ Rs. 3.00 lakhs per lab is the operational cost and includes hiring of manpower/procurement of consumables/Computerization of lab/ Equipment maintenance/cost of EQAS etc. Only the states which are having the Apex Referral Laboratory should project their requirement (Total 14 Apex Labs only).

F.1.2.a(ii)Sentinel Surveillance Hospital recurrent @ Rs. 1.00 Lakhs per lab as operational cost

will be provided. Presently, the GOI has identified 394 Sentinel Surveillance Hospitals in various States of the country.

F.1.2.a(iii)ELISA facility to Sentinel Surveillance Labs: Out of identified SSH, State may reflect

requirement of ELISA facility for those centres where it is not existing and require support @ Rs. 3-5 lakhs per SSH.

F.1.2.b Test kits to be supplied by GOI (kindly indicate numbers of ELISA based NS1 kit and IgM ELISA Kits required separately) - The total requirement for dengue and chikungunya IgM kits and NS1 antigen should be mentioned for the year 2013-14. The cost of NS1 kit may be reflected under the head of decentralized item (F.6.h.).

F.1.2.c Monitoring/supervision and Rapid response- It includes strengthening of reporting and various other miscellaneous expenses like mobility support for field visit, review meetings etc at state and district level. State may workout monthly plan and project their requirement for M&E with unit cost per month per district and for state as well.

F.1.2.d Epidemic preparedness- This head includes the activities required at both State and district levels for epidemic preparedness and containment of outbreak. State may project tentatively Rs.2 lakhs for district and Rs.3 lakhs for State.

F.1.2.e Case management- Strengthening District Hospitals for Dengue and Chikungunya case management is very crucial. Besides the case management it should also include mosquito proofing of wards.

F.1.2.f Vector Control & environmental management: It includes source reduction activities to be carried out by hiring field workers at towns /cities with population between 10 to 40 lakhs and towns /cities with population between 1 to 10 lakhs. The State NRHM norms/ approved rate by labour dept. may be followed for the Field Workers.

Fogging Machines – Hand operated fogging machines needed for Indoor Space Spray in the houses and its surroundings from where cases are reported. While calculating the requirement, available fogging machines (in working conditions/ repairable) should also taken into consideration.

F.1.2.g IEC/BCC for Social Mobilization: IEC/BCC activities including media campaign, advocacy

campaign for community awareness at State and district level. F.1.2.h Inter-sectoral convergence: This is very important activities for prevention and control of

Dengue/Chikungunya and requires cooperation of other departments/ Ministry. They need to be sensitized about the disease to avoid breeding of mosquitoes by organizing meetings at State and district level for which State may project the plan and requirement.

F.1.2.i Training & printing of guidelines, formats etc. including operational research: It includes training of clinicians and other paramedical staff at State and district level which is necessary for dengue case management. This also includes cost for printing of guidelines and formats locally.

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Acute Encephalitis Syndrome including Japanese Encephalitis

1. Disease Situation: The number of cases and deaths of the 2012 & 2013 year may be given in the following table:

2.

Sl.No

Name of the District *

No. of AES/JE cases

No. of Deaths

No. of Sera/CSF Sample tested

No. Confirmed for JE

No. of vaccinated children confirmed with JE infection

* Please mention in the footnote if the AES/JE cases are reported from municipal areas.

3. Specific constraints, newer strategy and innovations proposed for implementation of the programme: Details of the specific constraints and innovations made therewith at various levels in the following format may be given:

Sl.No Name of the District

Implementation level at which constraint observed (village/PHCs/CHCs)

Type of constraint

Suggested Solutions

Any new Innovations in light of constraints

4. Monitoring of functioning of Sentinel surveillance Hospitals/Sentinel Sites separately for Japanese Encephalitis.

Sl.No Name of the District

Total No. of Sentinel Sites identified

No. of functional

Reasons for non functional status

Suggested solutions

5. The FMR code-wise guidelines are indicated below:

F.1.3 Acute Encephalitis Syndrome including Japanese Encephalitis (The guidelines are tentative and approval will depend on availability of funds) In addition to ongoing activities like diagnostic and case management, training, IEC activities, vector control (fogging with technical malathion) and monitoring and evaluation, the support for 60 priority districts have been considered as described below. Therefore, for other districts of the states not covered under GoM previous the NVBDCP PIP guidelines may be adopted. High priority districts For effective implementation of intervention/activities for prevention and control of JE/AES GoI has identified high priority districts in 5 states namely Assam, Bihar, Tamil Nadu, Uttar Pradesh and West Bengal. In view of high mortality and disability due to AES/JE GoM was constituted on advice

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of the PMO. The disease situation (AES/JE) was discussed in GoM and it was concluded that multi pronged strategy is to be adopted in 60 high priority districts of 5 states mentioned below:

1. Assam (10 districts): Barpeta, Dhemaji, Dibrugarh, Golaghat, Jorhat, Lakhimpur, Sibsagar, Sonitpur, Tinsukia and Udalgiri

2. Bihar (15 districts): Araria, Darbhanga, East Champaran, Gaya, Gopalganj, Jahanabad, Muzaffarpur, Nalanda, Nawada, Patna, Samastipur, Saran, Siwan, Vaishali and West Champaran

3. Tamilnadu (5 districts): Madurai, Karur, Thanjavir, Thiruvarur and Viliupuram 4. Uttar Pradesh (20 districts): Azamgarh, Balia, Balrampur, Basti, Behraich, Deoria, Gonda,

Gorakhpur, Hardoi, Kanpur Dehat, Kushinagar, Lakhimpur Kheri, Maharajganj, Mau, Rai Bareilly, Sant Kabir Nagar, Saharanpur, Shravasti, Siddharth Nagar and Sitapur

5. West Bengal (10 districts): Bankura, Birbhum, Burdwam, Dakshin Dinajpur, Darjeeling, Hoogly, Howrah, Jalpaiguri, Malda and Paschim Midnapur

The recommendations of GoM were approved by Cabinet on 18.10.2012. The following activities are to be undertaken in high priority districts (60) of 5 states.

(i) To strengthen and expand JE vaccination in affected districts (budgetary requirements for JE vaccination have to be reflected in RCH PIP as vaccine and other related material is being procured by Immunization division of MOH&FW).

(ii) To strengthen surveillance, vector control, case management and timely referral of serious and complicated cases;

(iii) To increase access to safe drinking water and proper sanitation facilities to the target population in affected rural and urban areas;

(iv) To estimate disability burden due to JE/AES, and to provide for adequate facilities for physical, medical, neurological and social rehabilitation;

(v) To improve nutritional status of children at risk of JE/AES; (vi) To carry out intensified IEC/BCC activities regarding JE/AES;

In view of the above, it is requested that all the SPOs of 5 states to incorporate above activities in their identified districts in PIP 2014-15. F.1.3.a Strengthening of sentinel sites including diagnostics and case management

• There are 78 total sentinel sites for JE. These sites need strengthening with Elisa Reader and washer and also with computer, printer, UPS and other accessories. Based on the need assessment, the states may project @ Rs.5,00,000/- for Elisa Reader + washer and Rs.50,000/- for computer etc. Annual maintenance contract may start from next year.

• Human resource for district level strengthening: 1 data entry operator as per NRHM norms and cost towards spare and reagents for sentinel sites may be worked out and projected (60 districts).

• Training for diagnostic facilities: Tentatively Rs.1,00,000/- per district for 60 priority districts may be projected for training the staff of diagnostic facility.

• Reagents etc. for diagnostic facility: Tentatively Rs.1,00,000/- per district for 60 priority districts may be projected for reagents etc for diagnostic facility.

F.1.3.b IEC/BCC

• These activities may include Community education and printing material, Nukkad Natak at block PHcs, Nukkad Natak at prominent places and Advocacy workshops. The states may project the plan of these activities especially for 60 priority districts and the tentative cost may be Rs.1.40 lakh per district. For other districts it may be worked out at lesser cost, however, unit cost may be reflected separately for priority and other districts.

• Advocacy meeting for ASHAs/Aanganwadis: Sensitization meeting for ASHAs/Aanganwadis in high priority districts may be conducted. (tentative cost per district may be Rs.3,00,000/-) for 60 districts only.

15

• Advocacy meeting for Community Volunteers: Sensitization meeting for Community volunteers in high priority districts may be conducted. (tentative cost per district may be Rs.20,000/-) for 60 districts.

F.1.3.c Capacity building

• Two training workshops per district may be projected for 60 priority districts. (tentative cost

per batch may be Rs.50,000/-).

F.1.3.d Monitoring and supervision

• This includes mobility support for hiring vehicles @ Rs.90,000/- per district for 60 priority districts. However, the states may project according to the realistic planning.

• The 5 priority states and 60 districts should be equipped with computers with accessories, laptop and fax and accordingly the states may project.

• Human resource at state level for monitoring: The 5 priority states should strengthen state headquarter with 1 state consultant, 1 finance officer, 1 data manager. The financial implication and its related administrative and travel cost (including field visits and review meetings) may be projected as per NRHM norms.

• Human resource at district level for monitoring: The 60 priority districts should strengthen districts with 1 district consultant and 1 technical assistant. The financial implication and its related administrative and travel cost (including field visits and review meetings) may be projected as per NRHM norms

F.1.3.e Procurement of insecticides

• Technical Malathion: Approx. 3 Metric Ton (MT) of Malathion Technical may be required per district, however, it may be projected according to the assessed need for which the unit cost may be about Rs.1.25 lakhs per MT

F.1.3.f Fogging machine

• Thermal Fogging Machine: In the 60 priority districts, provision of fogging machines @ 20

per district may be kept and accordingly budget may be reflected (tentative cost per machine

may be Rs.70,000/-).

F.1.3.g Operational cost for malathion fogging

• Diesel and Petrol for running the fogging machines: The cost towards this activity need to be projected (tentative cost per district may be Rs.5,000/-). If all the 20 machines are functioning then it will be Rs.1,00,000/- per district.

• Wages for spray men: To operate fogging machine, 2 persons may be required for which a

provision of wages @ tentatively Rs.200/- per person may be reflected for 60 priority districts. F.1.3.h Operational research F.1.3.i Rehabilitation setup for selected endemic districts (10 Medical colleges in 5 priority states)

• Physical medical rehabilitation in 10 medical colleges of 5 states are to be established and the states may reflect the cost towards required equipment, human resource like professors, assistant professors, residents, physiotherapist, occupational therapist, clinical psychologist, social worker and vocational counsellor. In addition, the provision for catheter attendant, orthotist, administrative staff, AMC of equipment and office expenses etc. May be projected for which the detailed unit cost and requirement may be indicated

16

F.1.3.j ICU establishment in endemic districts (60)

•••• This includes ICU beds @ 10 per district hospital. The cost of per bed may be Rs.5,00,000/-. Accordingly the states may reflect it in their PIP.

•••• The other non-recurring expenses for establishing these units would be towards bed side monitors @ 10 per district hospital. The cost of per bed side monitor may be Rs.5,00,000/-. Accordingly the states may reflect it in their PIP.

•••• Central Monitoring station: 1 per district hospital need to be established for 60 priority district. The tentative cost may be Rs.5,00,000/- towards establishment per such station.

•••• Defibrillator: This is another important component in paediatric intensive care unit. The requirement would be 2 per district hospital @ tentatively Rs.2,00,000/- per unit. Accordingly it may be projected in PIP.

•••• Central gas pipe line (Oxygen, compressed air, vaccum): May be projected @ 1 for each district hospital in priority districts @ tentatively Rs.15,00,000/- per unit.

•••• Pediatric ventilators: May be projected @ 5 for each district hospital in priority districts @ tentatively Rs.13,00,000/- per unit.

•••• ABG analyzer: May be projected @ 1 for each district hospital in priority districts @ tentatively Rs.5,00,000/- per unit.

•••• Syringe pumps: May be projected @ 10 for each district hospital in priority districts @ tentatively Rs.50,000/- per unit.

•••• Misc instruments/equipment: A provision of Rs.2,00,000/- per district may be projected for each priority districts.

•••• Civil work: May be projected @ 10,00,000/- for each district hospital in priority districts, if required.

•••• Human Resource: Provision of 5 Medical Officers, 20 nursing staff, 4 ancillary staff (to be outsourced) may be kept per district and accordingly the financial requirement based on NRHM norms may be projected.

•••• Annual maintenance cost should be worked out and for first year it would be under warranty, hence no financial implication.

•••• Administrative and operational cost may also be worked out and projected.

•••• Capacity building of medical officers (towards two hands-on-training per district for 10 days & three refresher training per district for 2 days) may be required, however, refresher training may start from 2nd year hence may not be projected in PIP. Similar hands-on-training for 5 days for nurses may also be projected @ 3 such trainings per district.

F.1.3.k ASHA incentives for sensitizing community

• Rs.100/- for early referral of AES/JE cases to health facilities may be provisioned which need to be validated by a medical officer. Tentatively Rs.1,00,000/- per district for 60 priority districts may be projected.

F.1.3.l Other charges for training/workshop, meeting & payment to NIV towards JE kits at headquarter

• Contingency: This includes three entomological kits, cage, traps, vials, test, tudes stationery and postage etc. This is very crucial activity and districts may project the financial requirement tentatively @ Rs.1.50 lakh per district.

F.1.3.m Establishing district counseling centre

• One counseling centre per district in 60 priority districts of 5 states need to be established

which may require computer, printer etc. and human resource like district counselor. There

may be some administrative and operational cost and would also require re-orientation of

medical officer at least 3 per district alongwith the district counselor. States may project

accordingly

17

Lymphatic Filariasis

1. Goal: Elimination of lymphatic filariasis by 2015. To achieve elimination, the micro-filaria rate in all the endemic districts should be less than 1% to interrupt the transmission. The status of LF endemic districts should be described below for the year 2012 and 2013 (against MDA 2011 round and 2012 round):

SI. No.

Name of Districts

Population at risk

Eligible population

Coverage of eligible population under MDA

Microfilaria rate

No. of line listed total lymphoedema cases

No. of line listed total hydrocele cases

No. of hydrocele operations

2. The analysis should be done for the districts:

a. Less hydrocele operations conducted & whether any target was fixed. . b. Reporting microfilaria rate more than 1%

3. After the analysis, the plan should be indicated for the poor performing districts. The plan

should describe for all the preparatory activities with time schedule and the funds requirement for performing activities as per the format.

4. DEC and Albendazole has been decentralized and the requirement of drugs along with cost for the districts to be covered under MDA 2013 and 2014 should be given as per the format indicated below and the same should be indicated in Annexure for financial requirement under Decentralized commodity:

Name of District Population at risk

DEC 100 mg. (population x 2.5)

Deducting balance stock

Albendazole 400 mg tabs. (Population x 1)

Quantity (in lakh)

Cost (Rs. in lakh)

Quantity (in lakh)

Cost (Rs. in Lakh)

TOTAL

5. Most of the districts have observed 7-8 rounds and as per the state reports the districts

reporting less than 1% microfilaria rate in Sentinel and Random sites separately need to be

identified for further validation of the data and initiating Transmission Assessment Survey

(TAS) through ICT test as per WHO guideline 2011. Those districts should be included for

such validation and for budgetary requirement of these activities (XIIth plan document may be

referred).

The plan should include:

• Number of districts targeted for MDA and the requirement of drugs thereof.

• Preparatory activities related with MDA with required budget.

18

• Honorarium to Drug Distributors and Supervisor

• Number of districts to be allocated for assessment of coverage & compliance through Medical Colleges/Research Institutions/Regional Offices for Health & F.W.

• Microfilaria survey in sentinel and random sites of each LF endemic district.

• Number of districts proposed for verification of microfilaria prevalence for MDA stoppage.

• Number of district proposed for assessment through ICT survey for MDA stoppage.

• Completion of line-listing Lymphoedema in every village, PHC of the LF endemic districts as well as to enlist the cases in non-LF endemic districts so as to intensify the home based morbidity management to all the Lymphoedema cases.

• Completion of the listing of Hydrocele cases in all the districts of the States and motivating them for operation. The Hydrocele operations are to be done in hospitals or in camps as per the guidelines. The target should be fixed in such a way so that all the Hydrocele cases listed and operatable, should be completed in next three years.

6. Financial requirement for Elimination of Lymphatic Filariasis (ELF): Following points

are provided to facilitate in making plans, however, the states may propose their financial

requirement considering the NRHM norms based on the realistic needs.

F.1.4. Lymphatic Filariasis (The guidelines are tentative and approval will depend on availability of funds) F.1.4.a: State Task Force, State Technical Advisory Committee meeting, Printing of

forms/registers, mobility support, district coordination meeting, sensitization of media etc. morbidity management, monitoring & supervision and mobility support for Rapid Response Team

• State Task Force meeting & Technical Advisory Committee meeting to be held before ELF activities (including MDA) every year and Rs. 30,000-50,000 per state per year may be provisioned. In case of state of Uttar Pradesh and Bihar where number of LF endemic districts are more, the amount may be increased to Rs.50,000-75,000/- as per the realistic requirement for the meeting.

• Printing of forms/registers: The form and registers are required to maintain the data of village, Sub-centre, PHC and district/state. The requirement of these forms and registers alongwith their cost may be projected.

• Mobility Support: Mobility support is required for monitoring of pre MDA, during MDA and post MDA activities. The mobility support for each LF endemic district may be provisioned @ Rs.50,000-80,000/- per district and 10% of the total amount of mobility support may be provisioned for monitoring from state level. This fund may also be used for attending Review Meetings. Example: In Andhra Pradesh, there are 16 LF endemic districts and @ Rs. 50,000/-, the mobility support works out to be Rs. 8 lakhs. The 10% of it is Rs. 0.8 lakhs which may be provisioned for state level monitoring and thus the total amount becomes Rs. 8.8 lakhs (as per the decision of the State, the NRHM norms may be applicable without effecting the monitoring of the programme activities).

• District Coordination Committee Meetings including sensitization of media etc.: Three such meetings are to be conducted in each LF endemic districts pre, during and post MDA and Rs. 5000-10000/- may be provisioned for each such meeting for each district.

• Morbidity Management: o Each district should project the updated line-listed Lymphoedema cases. For a fixed

target of Lymphoedema patient, the morbidity management kit (comprising of one mug or small bucket, one soap, small towel and anti-bacterial or anti-fungal cream) should be provided to each patient after imparting home based morbidity management training. This kit may cost to about Rs. 150/- per patient.

19

o The morbidity management also includes surgical intervention of hydrocele and the existing norms of incentive (Rs.750/-) for hydrocele operations may be adhered only for the operation conducted in the camp mode (NOT FOR ROUTINE OPERATIONS).

• Monitoring & Supervision and Mobility for Rapid Response Team: This may be met from the mobility support, explained above. NOTE: The total funds required for all these above activities may be reflected in F1.4.a.

F.1.4.b Microfilaria Survey: Microfilaria Survey in four sentinel & four random sites (spot check site) of each LF endemic district need to be conducted before MDA every year. This is mandatory and the unit cost of Rs.50,000 per district may be provisioned (TA @ Rs. 225 for 4 persons for 8 sites = Rs. 7200; Honorarium of Rs.150 for 4 persons for 3 days for 8 sites = Rs. 14400; Contingency Rs. 500 each for 8 sites = Rs. 4000; Replenishment of slides = Rs. 20200 and Honorarium of Rs. 500 for examination of 500 slides to Technician as minimum 500 slides are to be collected from each site. The Technician should be given training before examining the slides.

F.1.4.c. Post MDA assessment by Medical colleges (Govt. & Private)/ Research/ICMR

Institutions: Number of districts may be allocated for assessment of coverage and compliance through Medical College/Research Institutions/Regional Offices for Health & F.W. The funds for such assessment may be provisioned @ Rs. 15000/- per district (TA Rs. 2000 each for 2 persons, Honorarium of Rs 1000 each for 4 days for 2 persons, Contingency of Rs 1000 and POL of Rs. 2000). This is mandatory items and state should release the fund to the concerned institution for conducting assessment and take necessary action according to the assessment report.

F.1.4.d. Training/sensitization of district level officers on ELF and drug distributors including Peripheral health workers:

• Special Training/Sensitization of district/PHC level officers on ELF is required at the district for which Rs. 60,000/- per district may be provisioned.

• Training of para-medical workers and lab. Technicians are very essential on MDA, morbidity management and LF microscopy (for technicians) for which Rs. 50,000/- per district may be provisioned.

• Training of Drug Distributors (ASHAs, volunteers etc.) is crucial for Annual Mass Drug Administration and is given every year to sensitize them. Number of such drug distributors may be worked out and Rs. 100 for each participant during training of Drug Distributors may be provisioned.

F.1.4.e Specific IEC/BCC at state/district, PHC, Subcentre and village level including

VHSC/GKs for community mobilization efforts to realize the desired drug compliance of 85%. : Rs. 2-3 lakh per district for specific IEC/BCC campaign during MDA may be provisioned. Additional 10% of total IEC fund proposed, may also be reflected for state headquarter for state level IEC & BCC activities.

F.1.4.f. Honorarium for Drug Distribution (including ASHAs, volunteers) and supervisors

involved in MDA: There shall be one supervisor per 10 drug distributors. Each drug distributor is allotted the quota of drug distribution to 250 persons in 50 houses. This work is to be completed in 3 days time for which he or she may be paid honorarium. A provision of Rs.300/- for completing the task may be reflected. In case, it is not completed in 3 days, he or she should complete more than 85 % drug administration without any extra remuneration.

20

F.1.4.g Verification and Validation for stoppage of MDA in LF endemic districts F.1.4.g.i Additional MF survey: MF survey need to be done in additional 10 sites in district

showing variation in microfilaria rate (less than 1%). Rs.70,000/- per district for this activity may be provisioned for such districts to validate that the district is actually with less than 1% mf rate.

F.1.4.g.ii ICT Survey: Number of district proposed for assessment through ICT survey for MDA stoppage after completion of additional round of mf survey and their budget (Rs.1.5 lakhs per district excluding the cost of ICT).

F.1.4.giii ICT Cost: To assess the impact of MDA on interruption of transmission, children of 6 year age need to be tested with ICT. Each evaluation unit (not more than 20 lakh population) requires about 1700 ICT cards and one such card costs approximately Rs. 325/-. The districts with minimum 5 effective MDA rounds (i.e more than 65% coverage against total population at risk) and microfilaria prevalence below 1% individually in all the four sentinel and four spot check sites, may be selected for transmission Assessment Survey and the cost of ICT may be reflected.

F.1.4.h Verification of LF endemicity in non endemic districts F.1.4.h.i LY. & Hy. Survey: Every PHC and Medical Officer In-charge should be instructed to get

the survey done in the villages for one time to list the Name, age and sex of all Lymphoedema and Hydrocele cases by health workers or ASHAs and for this, one time incentive of Rs. 100/- may be provisioned.

F.1.4.h.ii MF survey in non endemic districts: If in any non endemic district more Lymphoedema and Hydrocele cases are found, microfilaria survey is required to be done for which Rs.70,000/- per districts may be provisioned.

F.1.4.h.iii ICT Survey: To check the transmission in the non-endemic district, ICT survey can be proposed after gathering the data and in consultation with NVBDCP.

F.1.4.i Post MDA Surveillance: Applicable only where MDA has been stopped and the budget

of Rs.70,000/- per districts for microfilaria survey may be projected.

21

KALA – AZAR (Endemic only in Bihar, West Bengal, Jharkhand and parts of U.P.)

Goal: Kala-azar is targeted for elimination by 2015. The elimination is to bring down the number of kala-azar cases less than 1 per 10,000 population at block level.

1. Disease Situation: The number of Kala-azar cases detected and treated may be indicated

in a tabular format district-wise as mentioned below. The map of each district showing PHC, sub-centres and villages should be drawn indicating the number of Kala-azar cases and deaths.

Monitoring of Diagnosis and Treatment Compliance of Kala Azar Patients (2012 & 2013)

% age of people treated after diagnosis % age of people received complete treatment

Districts Cases Deaths Cases treated Cases received complete treatment

% Treatment compliance

2. Situation Analysis and implementation plan for next year: The districts with poor

treatment compliance and poor spray coverage should be identified and the detail plan should be indicated in PIP for improvement of treatment compliance and also the plan for spray coverage of targeted population with date for first and second round alongwith the previous year’s performance should be given.

3. Strategy & innovations proposed: This section should describe the strategy for elimination of Kala-azar to achieve the goal of its elimination by 2015. The intensification in implementation of strategy would require innovations at local level which need to be highlighted in this section. If any success due to such innovations has been experienced in the past, the same may also be highlighted with its achievement.

4. Requirement for commodity as per technical norms and considering balance of stores,

consumption capacity and justification: The requirement of all the commodities (drugs, DDT and material & equipment) as per technical norms and the balance available should be projected.

5. Financial assistance required from Centre: 100% support for operational cost for IRS and

spray wages is provided under domestic budget support from GoI and additional support is also provided under assistance from EAC (World Bank as per project guidelines). Therefore, the demand should be as per the format indicated below:

F1.5 KALA-AZAR UNDER DOMESTIC BUDGET SUPPORT (DBS) (The guidelines are tentative and approval will depend on availability of funds)

F 1.5 Case Search/ Camp Approach: Under this head the state is to prepare a detailed action

plan on Kala azar case search/camp approach in endemic areas/villages on quarterly basis in advance. The action plan shall include the component on advance information to community on case search for better compliance. The block BMO should be made responsible for conducting case search in his/her villages. The whole activity is to be monitored by concerned VBD officer (erstwhile DMO). The specific role of VBD consultant, KTS and others like Malaria Inspectors/supervisors should be defined in

22

action plan. Motivation to ASHA /Sahiya involvement is important to search the hidden cases of KA in the community. Similarly, a separate record of PKDL cases is to be maintained as these cases are source of infection. The state may decide the unit cost of camp search/camp approach per district keeping the printing of limited numbers of IEC posters / flex boards /munadi /small pamphlets /mobility /tent (if required)/ mobility and training etc. for sensitization the community to avail the facility. State should ensure availability of diagnostic test and drugs before starting such camps. At least four camps per district may be organized in a calendar year in endemic district in such a way that the routine IRS operation may not be hampered. The camps may be organized during transmission season.

F 1.5.a Spray pumps & accessories: Under this head GoI is providing 100% cash assistance

since 2003 for Kala-azar elimination for meeting expenditure on spray pumps & accessories. State is to ensure that the pumps which are repairable may be repaired under the above head before starting of 1st round and also for 2nd round. The new spray pumps may be procured only if old pumps are beyond repair and need replacement. The state may decide to choose either Stirrup Pumps or Compression Pumps as per specifications available with ISI organization. This head also includes spares of pumps, laboratory articles and other equipments and small emergency purchases which can be purchase locally.

F 1.5.b Operational cost for spray including spray wages: This head will cover, contingencies,

operational cost for spraying (dumping, transportation of insecticide etc) including spray wages under Kala-azar. The spray wages rates shall be applicable as per prevailing state /district for skilled worker wages (for spray supervisor) and non skilled worker wages (for spray workers). The norms should be followed as per NVBDCP guidelines for working out the operational cost except the spray wages which will change according to the state’s norms.

F 1.5.c Mobility/POL/Supervision: Monitoring & supervision is one of the important components

to achieve the target set for elimination. The Action Plan may be prepared in such a way that the district authorities including VBD officer (erstwhile DMOs), Consultants, MI, MPWs, KTS and other health workers engaged in VBD activities should visit at least 15 days in a month with a set of checklist and tour report which should be invariably be sent to State Programme Officer looking after VBD. This head will cover mobility (includes hiring of vehicle as per state’s /district NRHM society rules), maintenance of vehicle, supervision of KA elimination activities. Similarly, the state official & Consultants may also visit field for 5-7 days in endemic areas.

F.1.5.d Monitoring & Evaluation: For strengthening M&E activities the state /district may prepare action plan with greater emphasis on M& E and supervision. A twelve month calendar /matrix is to be prepared by state /district officials indicating the visit plan, date of visit and tour report. A check list to be prepared for each level of functionaries for effective supervision and monitoring The Zonal Entomological team mobility may also be met under the above head for entomological surveillance for which the team may prepare a 12 months activity chart covering all the endemic areas The susceptibility test kits to be conducted each year prior to pre and post spray. The susceptibility papers and Kits shall be supplied by Dte NVBDCP, Delhi for which requirement is to be sent in advance (at least 5-6 month) before undertaking susceptibility test. This head also includes meetings, workshop, visit to NVBDCP HQ and other states to see the best practices adopted to replicate in their own state. The state official & Consultants may visit field for 5-7 days in endemic areas. The guidelines of NRHM as described at F.1.5.c are also applicable for this head.

F.1.5.e Training /Capacity building: The funds provided under this head may be utilized

exclusively for training & capacity building as per state/NRHM training guidelines

23

applicable to the similar nature and duration of the training. State is to ensure to prepare training load no. of training & duration to be conducted in calendar year with batches of participants. The best trainers may be chosen for providing quality training particular to grass root worker i.e. ASHA/Sahiya/Health workers. The training should not be conducted during IRS period and during transmission period. Printing of forms, guidelines, manual can also be met from this head.

F.1.5.f IEC/BCC/Advocacy for KA: This is a one of the important component for elimination of

Kala-azar where community can play a greater role in terms of acceptance of indoor residual spray, compliance of treatment and referring a suspected Kala-azar to the nearest health worker. Interpersonal communication, advocacy session is to be organized at regular interval to keep the community in loop for prevention of Kala-azar. More emphasis may be given for preparing drug schedule chart at each block PHC sub-center, ASHA diary with drug doses and do’s and don’ts. The IEC materials for camp search, camp approach and preparation of posters, hand bills for IRS operation may be met from this head. The involvement of VHAI body working in the state may also be utilized to avoid duplication of work. The pictorial guidelines for ASHA/Sahiya is to be developed by the state and pre tested before distribution to the targeted group.

F.1.5.g Incentive to ASHA: A sum of Rs. 50/- has been kept for referring a suspected a Kala-

azar case to the nearest health facility center and Rs. 150/- shall be paid only after ensuring the complete treatment. Thus, a total of Rs. 200/- has been kept for ASHA as incentive.

F.1.5.h Loss of wages: Rs. 50/- is to be paid to the Kala-azar patient during the entire treatment

period which includes PKDL cases also.

F.1.5.i Free diet to patient and attendant: As the treatment period is long, it has been decided that Kala-azar patient would receive free diet for himself and one attendant from the hospital.

Kala-azar World Bank Assisted Project (As per standard cost Norms) F.2.e Human Resource: As per project guidelines and norms F.2.f. Capacity building and training: All the training activities for Medical Officers, VBD

Officers, VBD Consultants, KTS and all other Health Functionaries is to be met from this head. A calendar of the activities for each level is to be reflected in the PIP. The institution like RMRI, Medical Colleges services can also be availed for quality training as per standard cost. Where the unit cost is not available the prevailing state NRHM training norms of similar nature and duration may be followed. The TA/DA outside the state boundary for capacity building and training can also be met under this head.

F.2.g Mobility: Under this head the guidelines mentioned at F.1.5.c and F.1.5.d may be

adopted under the activities for effective M&E activities so that project benchmark /deliverables can be achieved. The norms for mobility should be as per state’s NRHM society /district societies rules.

24

Annex 1.1c Technical Strategies – Disease Control Programme

Malaria Dengue Chikungunya

Japanese

Encephalitis

Lymphatic

Filariasis Kala-azar

Community

Strategy

• Early detection of the cases

by blood test by slide/RDT

and complete treatment with

the help of ASHAs and

community volunteers

• Indoor Residual Spray

(IRS) in high risk areas

• Up-scaling of use of LLINs in high risk areas

• Impregnation of Bed nets

• Use of larvivorous fish,

anti larval and

biolarvicides in the urban

and rural areas

• Awareness on

specific ally on

dengue

• Improved

surveillance

• avoidance of

mosquito breeding

conditions in homes, workplaces

and minimizing

the man-mosquito

contact

• • Awareness on

specific ally on

Chikungunya

• Improved

surveillance

• avoidance of

mosquito breeding

conditions in homes, workplaces and

minimizing the man-

mosquito contact

• Routine

Immunization for JE

• Awareness on

prevention method,

signs, symptoms and

quick referral of

patients

• Segregation of pigs and social

mobilization for

safety measures

• Malathion fogging if

required

• Drug compliance

by intensive social

mobilization

• Affected

Lymphodema

patients practicing

home based

morbidity management

(hygiene)

• Kala-azar case

search in hot spot

areas through

Rapid Diagnostic

Test

• Involving

ASHA for

ensuring the complete

treatment in Kala-

azar

• DDT spray in all

endemic areas

Primary

• All the above, plus

• Primary Management of

severe cases and referral to

appropriate center

• Epidemic preparedness and

rapid response

• Improved

surveillance and

early referral and

• Case

management

• Improved

surveillance and early

referral and

• Case management

• All the above, plus

• Strengthened Public

Health measures

related to water and

sanitation

• Adequate IEC

• To provide drugs

for ensuring

improved drug

compliance

• Morbidity

management services

(foot hygiene for

lymphodema and

operations for

hydrocele cases) at

each PHC/CHC

• Adequate IEC and

its display in each

PHC

• Use of oral drug

– Miltefosine to

all the kala-azar

endemic districts

as first line of

treatment.

second line of

treatment with

alternate drug

First Referral

• EDCT

• Management of severe

malaria cases

• Improved

surveillance and

early referral

• Case

management

• Improved

surveillance and early

referral and

• Case management

• All the above, plus

• Provision of ICU in

districts hospitals

• Medical Rehabilitation of

disabled cases

• Adequate IEC

• Morbidity

management services

(foot hygiene for

lymphodema and operations for

hydrocele cases) at

each PHC/CHC

Adequate IEC and its

display in each PHC

• All the above

plus single dose

treatment with

Ambisome for critically ill KA

patients in

identified districts

25

Malaria Dengue Chikungunya

Japanese

Encephalitis

Lymphatic

Filariasis Kala-azar

Higher Referrals

and Tertiary

• EDCT

• Management of specific

complication of severe malaria

• All the above

plus with advanced diagnosis & case

management

• Improved

surveillance and early

referral and

• Case management

• All the above • case management

especially Grade

III/IV Lymphodema and

Monitoring &

evaluation of filaria

elimination

• All the above

plus single dose

treatment with Ambisome for

critically ill KA

patients in

identified districts

All Levels:

Community

Primary Referral

• Entomological surveillance

• Monitoring of drug

resistance and insecticide

susceptibility

Breeding check

and source

reduction plus

adequate IEC/BCC

and early referral

Breeding check and

source reduction plus

adequate IEC/BCC

and early referral

Adequate IEC and its

display in each PHC

Morbidity

management

advocacy

Adequate IEC and

its display in each

PHC

Environmental

sanitation

26

Statement showing the Budget District -wise/Scheme-wise break-up 2013-14 in respect of NVBDCP

(Figures in Lakhs)

Sl.No

Name of

District

Malaria

De

ng

ue &

Ch

iku

ng

un

ya

AE

S / J

E

EL

F

KA

LA

-AZ

AR

De

ce

ntr

ali

ze

d C

om

mo

dit

ies

TO

TA

L D

om

es

tic

Su

pp

ort

( 3

-1

3)

World Bank GFATM

To

tal

of

WB

+G

F -

(1

4-2

1)

To

tal B

ud

get

fro

m N

VB

DC

P

(14+

22

) A

llo

cati

on

fro

m N

RH

M F

lex

i F

un

d

GR

AN

D T

OT

AL

(2

3+

24

)

State Fund

Co

ntr

actu

al

MP

Ws

Ince

nti

ve

s t

o A

SH

As f

or

iden

tifi

ed

dis

tric

ts

IEC

Tra

inin

g

M&

E i

nc

lud

ing

E

pid

em

ic P

rep

are

dn

es

s

Mo

bilit

y

Hu

man

Res

ou

rce

Tra

inin

g

M&

E a

nd

Mo

bil

ity

Su

pp

ort

Hu

man

Res

ou

rce

IEC

/ B

CC

M &

Mo

bil

ity

Su

pp

ort

E

Oth

ers

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26

Total:

Note 1 : The total should be projected in detail in PIP. This is to facilitate district wise allocation from NRHM while release the funds

Note 2 : These are not the financial head but only for activities

Note 3 : Any acitivity(s) which is required for the programme may be added in a separate column