PIP NVBDCP

2014-17

Dr. 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, Japanese

Encephalitis and Elimination of Lymphatic Filariasis and Kala-

azar.

Planning

• Rational use of relevant

epidemiological data to

– make the most effective

possible utilization of

program resources

– achievement of program

goals.

• Planning is a cyclical process

which is initiated with the

identification of

opportunities for change

and improvement.

PIP Draft

• Situation Analysis

– 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 (12th Plan)

• Elimination of -Kala-azar and Lymphatic

Filariasis - 2015

• Control and contain Dengue, Chikungunya

and Japanese Encephalitis

• Paving the way for pre-elimination phase of

Malaria

– ABER > 10%,

– API<1 per thousand population

– Category 1: States with less than1 API including all the

districts in the state with less than 1 API

Surveillance in NVBDCP

Active Surveillance

• MPHWs

• ASHA

Passive Surveillan

ce

• DH, SDH

• CHC,PHC, SHC

Sentinel Surveillanc

e

• Malaria

• Dengue

Resource allocation

District wise resource allocation

NVBDCP under NHM State 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 Resource

Posts Required Sanctioned In Position Vacant

DMO/ DVBDO

Assistant Malaria officer

Medical Officers

MPHS (M)

MPHW(M)

MPHS(F)

MPHW(F)

Lab Technicians

ASHA

Swasthaya Sahayaks

HR (Urban areas)

Posts Required Sanctioned In Position Vacant

Entomologist/

Parasitologist

Insect Collector/s

SFW

Field Workers

Separate Data for separate urban areas and compiled for all

the urban areas as District compiled

Epidemiological Profile

Block Blood

Slides

Prepared &

Examined

Total

Positive

Cases

Pf Deaths ABER API Pf% SPR SFR

ABER/ MBER is an index of operational efficacy of the programme

Trends in SPR/SFR can be utilized for predicting epidemic

situations in the area.

API indicates burden of malaria in an area

Pf% >25% of all cases show high risk area for Malaria

Urban Malaria Scheme

• Vector Surveillance –detailed plan

• Any additional towns to be covered with

larvicides may also be reflected for

consideration.

Town Populatio

n

Area Staff Persons

examine

d

Total

Malar

ia

Cases

Death

s

Bio

log

ist

IC 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

Prioritization of Area

• Rural

– 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 for

Malaria for severe Malaria cases

– Oxygen

– I/V Fluids

– Diagnosis

– Management as per protocol of GOI

Requirement of Commodities

Commodity Annual Requirement

formula

Balance Consump

tion

Justified

Demand

Funds

Blood Slides • 10% Population

•25% Buffer

Appx 1.5/

Blood lancets �10% Population

�10% Buffer

Appx 1.5/

Tab CQ BSC/2 X 6 Appx 0.37/

Tab PQ 7.5 � Pv Cases X 60% X 2 X

14

� Pf Cases X 60% X 6

� Pf Cases X 40% X 4

Appx 0.14/

Tab PQ 2.5 � Pv Cases X 40% X 4 X

14

Appx 0.20/

ACT Adult � Pf X 80% Appx 180/

ACT

Paediatric

� Pf X 20% Appx 182/

Inj Quinine � Pf Cases X 40% X 10%

X10

Requirement of CommoditiesCommodity Annual Requirement

formula

Balance Consumption Justified

Demand

Funds

DDT �150 MT per million

population for 2 rounds

GOI

Malathion 25%

wdp

�900 MT per million

population for 2 rounds

75/ Kg

Temephos �0.5 KL per million Pop 788/ lt

Pyrethrum 2% �1 KL per million pop 1733/ lt

Bti WP �42 MT per million pop 1099/ Kg

Bti AS 1450/lt

Stirrup Pumps for

IRS & Focal Spray

No.

Knapsack Spray

Pumps

No.

Continuous Spray

Pumps

No.

Fogging Machines No.

Larvicides/ Insecticides

Required for towns

Name of

the Town

Total

Population

Larvicides Required Space Spray

(Pyrethrum)

Polluted

Water

Clean

Water

Total of the

District

Financial Malaria• F.1.1.a - Contractual Payments :

• F1.1.b: ASHA: Against vacant posts of MPHW(M): Rs 15/ for slide

collection & 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 Environmental

Management

– Taken up under Dengue Head

• F.1.1.j Larvivorous Fish support

– Except Faridkot, Fazilka, Ferozepur, Mansa, Mukatsar,

Bathinda & Tarn Taran

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

Dengue and Chikungunya

• Disease Situation Dengue & Chikungunya

Urban

• Age wise/Sex wise/Area wise Rural

District Town Suspecte

d Cases

Samples

Collected

Positive

Cases

Deaths

Dengue and Chikungunya• Spot maps

– 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

Dengue and Chikungunya

�Blood Banks

�Blood Component Separators

�Aphresis Machines

�Dengue Wards with mosquito proofing

�Newer strategy and innovations proposed for

implementation of the programme

�Intensification of the entomological

surveillance

– Area wise monitoring of HI, CI & BI to review your control

strategies and operational efficacy

Diagnostic Facilities (D & C)

Name of

the SSH

Functional

(Yes/ No)

Ig M Mac

ELISA Kits

(NIV Pune)

NS1 Ag Kits Samples

Tested

Samples

found

positive

Recei

ved

Utiliz

ed

Rece

ived

Utiliz

ed

Name of the SSH Functional

(Yes/ No)

Ig M Mac ELISA

Kits (NIV Pune)

Samples

Tested

Samples found

positive

Receiv

ed

Utilize

d

Diagnostic Facilities (D & C)

• Proposal of

– 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 teams

Town Population Dengue

Cases

2013

Dengue

Deaths

2013

CHk Cases

2013

Volunteers

required

for

breeding

checking

& source

reduction

Funds

required

Total

District

•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 labour

Department per day per volunteer X 20 days X 5 months or

transmission period whichever is less.

Commodity Requirement-Dengue

• Insecticides and larvicides

– decentralized items dealt under UMS

• Monthwise, institution wise requirement of

test 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 Surveillance

Labs: @ 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

D&C Financial

• F.1.2.c Monitoring/supervision and Rapid

response:

– Mobility Support

– Review meetings

– Sample Transportation to SSHs

– Strengthening of reporting

• F.1.2.d Epidemic preparedness- for epidemic

preparedness and containment of outbreak.

@ tentative Rs.2 lakhs for district

D&C Financial• F.1.2.e Case management:

– Strengthening District Hospitals for Dengue and

Chikungunya case management

– Should also include mosquito proofing of wards.

• F.1.2.f Vector Control & environmental

management:

– source reduction activities by hiring field workers at

towns /cities with population. The State NRHM norms/

approved rate by labour dept. may be followed for the

Field Workers.

D&C Financial– Fogging Machines – Hand operated fogging

machines 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

(Including

activities in

subheads)

Unspent

balance

Committed

Expenditure

2013-14

Cash

Assistance

Required

2014-15

Cash

Assistance

required

2014-17

• Malaria

• Dengue

• Decentralized

Procurement

THANKS