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National Malaria Control Programme

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Article Index
National Malaria Control Programme
Activities
Distribution of Anti Malarials
How engineers can help in malaria control?
Objectives & Strategy
Services Performance & Features
Role of NGO & Achievements
Community Participation & Impact
All Pages
Periodical Development/Historical background
Malaria is an ancient disease as old as human civilization. Malaria is probably one of the oldest diseases known to mankind. Man and Malaria seem to have evolved together and it has been known to mankind for millennia. It was always part of the ups and downs of nations; of wars and of upheavals. Mentions of this disease can be found in the ancient Chinese, Indian and Egyptian manuscripts. The disease supposedly had its origins in the jungles of Africa, where it is still very much rampant.

Malaria has always & will remain as Public Health Problem in Maharashtra, Jeopardizing the development of State on account of heavy morbidity & mortality. At the time of independence, estimated annual incidence of malaria in the country was 75 million cases with 0.8 million deaths. Thus economic loss was enormous & estimated to run into Hundreds Crores of Rupees every year.

Considering this, National Malaria Control Programme (NMCP) was launched in 1953. Spectacular success of NMCP enthused health planner to convert into Eradication Programme (NMEP) in 1958. The success achieved by NMEP was short lived; due to various constraints like financial, logistic, administrative and technical. Resurgence of malaria after 1964, reaches it’s peak in 1975, when State recorded 712 thousand malaria cases. To overcome this situation, Modified Plan of Operation was introduced in 1977.

This led to significant reduction in malaria incidence which has been maintained upto 1986. Since then, there is gradual increase in incidence along with increase in mortality. During 1975, 0.7 million cases of malaria were reported in the state. State responded this challenge by adopting Modified Plan of Operation from 1977 and malaria was once again controlled in the state, which is revealed by the fact that during the year 1986 only 47 thousand malaria cases were reported. This achievement did not last longer. During 1995–96 Malaria outbreaks and deaths due to malaria were reported from tribal parts of the state. In this year there were about 380 thousand malaria cases and 242 death due to malaria.

Reasons of resurgence in 1995 are as under
  1. Unplanned growth of Urban area.
  2. Absence of Bye–laws in Municipal Council/Corporation.
  3. Rapid industrialization.
  4. Labour aggregation at project site.
  5. Population movement across the border.
  6. Inadequate health service in Tribal area.
  7. Suspected insecticide and drug resistance.
This situation was observed not only in Maharashtra State but in many other States of the country. Hence an expert committee was appointed by Govt. of India during Dec.94. The committee highlighted the epidemiological parameters to identify the High Risk areas and suggested specific measures to be undertaken for the effective control of malaria. From April – 99 onwards programme is converted into National Anti Malaria Programme. The programme is implemented as per the guidelines of Malaria Action Programme – 1995. (i.e. MAP – 95)

World Bank Assisted Enhanced Malaria Control
World Bank Assisted Enhanced Malaria Control Project is being implemented in 16 tribal districts in the State, in addition since 2005–06 three districts viz. Ratnagiri, Sangli & Akola have been included in the project. District Malaria Control Societies are established for the implementation of the project in tribal area of the district. The State Malaria Control Society is established during December 2001 for more active implementation of the project. The financial assistance is given mainly on the following item
  • Insecticide.
  • Material & Equipments, Petrol Oil etc., Telephone bills, Payment of spraying staff & honorarium to Malaria Link Volunteers.
  • Officers/Staff training.
  • Health education.
From 2003 the programme is converted in to National Vector Borne Disease Control Programme and includes monitoring of all vector borne diseases like Malaria, Filaria, Dengue , J.E. Plague, Chandipura, Kala Azar etc.

Malaria Control Programme is being implemented in the State since 1953. The mile stones of the programme are as under

1953 National Malaria Control Programme (NMCP).
1958 National Malaria Eradication Programme (NMEP).
1977 Modified Plan of Operation (MPO).
1979 Multipurpose Worker Scheme (MPW Scheme).
1995 Implementation of Malaria Action Plan–1995 (MAP – 95).
1997 Launching of World Bank Assisted Enhanced Malaria Control Project in tribal districts of the State (EMCP).
2000 National Anti Malaria Programme (NAMP).
2004 National Vector Borne Disease Control Programme (NVBDCP).

Activities of National Malaria Control Programme
Early Detection & Prompt Treatment (EDPT)
Identification Of High Risk Area
During the year 1995, the state experienced major malaria outbreaks especially in tribal districts of the state more prominently in Thane, Dhule, Nasik, Yeotmal, Chandrapur & Gadchiroli. Every year High Risk PHCs & Sub Centers are being identified as per guidelines given by Government of India (GOI). following are the epidemiological parameters for identification of High risk area.

Recorded deaths due to malaria with Plasmodium falciparum (Pf) infection during transmission season with evidence of local infection in an endemic area in any of the last 3 years.

Doubling of slide positivity rate (SPR) during last three years provided the SPR of 2nd & 3rd year reaches 4% or more.

SPR does not show doubling trend but the average SPR of the last 3 years is 5% or more.
P. falciparum proportion is 30% or more provided SPR is 3% or more during any of the last three years.
Focus of Chloroquine resistant P. falciparum area.
Tropical aggregation of labour in Project area.
New Settlement in endemic/respective & vulnerable area.

Surveillance
Active Surveillance
Blood smear collection of fever cases through regular house to house visits of multipurpose workers.

Passive Surveillance
Blood smears collection of fever cases coming at Primary Health Centers, rural & cottage hospitals, District Hospitals, & all govt. medical institutions etc.

Contact Mass Nomad (CMN)– Contact
Blood smears collection irrespective of fever of all family members of malaria positive case.

Mass
Blood smears collection irrespective of fever of all families around malaria positive case.

Nomad
Blood smears collection irrespective of fever of all persons of nomadic tribes.

Age group wise Presumptive treatment with Chloroquine is given to all fever cases at during active, passive, CMN collection

Age groups Chloroquine Tablets (150 mg. base)
Below 1 year 75 mg. (1/2 tablet)
1 to 4 years 150 mg. (1 tablet)
5 to 8 years 300 mg. (2 tablets)
9 to 14 years 450 mg. (3 tablets)
Above 15 years 600 mg. (4 tablets)

Blood smears collected are examined in field & district level laboratories. On examination, one day radical treatment is given to Plasmodium falciparum (pf) cases detected and 5 days radical treatment to Plasmodium Vivax (Pv) cases detected as per the age group given below.

Age groups Radical Treatment
PV PF
1st day 2– 5 days 1st day
Chloroquine (mg) Primaquine (mg) Primaquine (mg) Chloroquine (mg) Primaquine (mg)
Below 1 year 75 75
1 to 4 years 150 2.5 2.5 150 7.5
5 to 8 yearS 300 5.0 5.0 300 15
9 to 14 years 450 10.0 10.0 450 30
Above 15 years 600 15.0 15.0 600 45

N.B.: No radical treatment of Primaquine tablets is given to infants and Pregnant women.
  1. Through Drug Distribution Centers (DDCs)
    About 66000 Drug Distribution Centers are established in Grampanchayats, Aanganwadi and Primary Schools at village level Chloroquine 150 mg. tablets are being distributed to fever cases coming to them without obtaining Blood Smears through these Depot holders.
  2. Through Fever Treatment Depots (FTDs)
    1500 Fever treatment Depots are established only in tribal districts of the State. Chloroquine 150 mg. tablets are being distributed to fever cases coming to them with obtaining Blood Smears through these Depot holders.
  3. Through Malaria Clinics
    Malaria Clinics are established in the State in hospitals & Primary Health Centers where Laboratory Technicians are posted. At present, 1028 Malaria Clinics are functioning in the State at various level.

    At these clinics, blood smears are collected from fever cases coming for treatment. Presumptive treatment is administered after collection of Blood smears. These Blood Smears are examined immediately on priority.
Prompt Radical treatment as per age group & species is given on the same day to malaria cases detected after examination.

Vector Control measures
Indoor Residual Spraying Since 1999, State has stopped the use of DDT due to development of resistance in vector species. Synthetic Pyrethroid has been introduced for IRS since 1995–96 in Maharashtra State.

Indoor Residual Spraying (IRS) is being carried out in identified High Risk villages i.e. in Rural area.
Two regular rounds of IRS are being carried out every year during transmission season.
Focal spraying is also being carried out in outbreak areas.
Anti Larval spraying: Weekly spraying of larvicides (Temephos, Fenthion, MLO, BTI etc.) on mosquito breeding places is being carried out in urban areas.

Life Cycle of Mosquito Life Cycle of Mosquito
Mosquito Control – Source Reduction
Source reduction involves preventing development of mosquito larvae. The female anopheles mosquito lays eggs in collections of clean water. Each female anopheles mosquito lays millions of eggs in its lifetime of 4–8 weeks. The eggs hatch into larvae which then develop into pupae and adults in a span of 7–10 days. The best method of mosquito control is preventing the development of the eggs into adult mosquitoes. These anti larval measures are not only simple and cost effective, but also environment friendly.

Urban malaria scheme (UMS)
Is being implemented in selected 15 towns of the State. viz. Mumbai, Nasik, Manmad, Dhule, Jalgaon,Bhusawal, Ahmednagar, Pune, Pandharpur, Solapur, Aurangabad, Parbhani, Beed, Nanded, Akola.

Anti larval measures are the mainstay in malaria control and include the following

a. Preventing egg laying: The easiest, cheapest and most environment–friendly meathod to control malaria is by preventing the mosquito from laying eggs. This is done by avoiding or eliminating the clean water collections. Most such collections are artificial, temporary and man made.

It is common habit to throw the unutilized utensils, buckets, bottles, tyres, tender coconut shells etc. into the open. During the rains, water gets collected in these containers and provides ample breeding locations for the female anopheles mosquito.

Biological activities

Buckets Tender Coconut shells Open tank Tyres
Buckets Tender Coconut shells Open tank Tyres

In the cities, the other sites for mosquito breeding are the water tanks. Shortage of water supply in large cities makes it necessary to have these tanks in virtually every building. Overhead tanks, sump tanks, storage tanks, ornamental tanks etc. are often left uncovered and this provides scope for mosquito breeding.

Paddles Paddles
There is abundant scope for water collection in and around the construction sites: water stored in tanks; the layer of water on the surface of the cement concrete (used for ‘Curing’ the concrete and left as such for 3 weeks); puddles of water in and around the place of construction – all these provide scope for mosquito breeding. To add to the problem, construction workers tend to harbour the malarial parasite, due to frequent infections owing to their poor standards of living. Thus, construction sites not only provide for mosquito breeding but also supply the parasites. This is the reason why malaria tends to be more common in cities where construction activities are in full swing.

Water logged in basement Water logged in basement
The older houses have tiled roofs that are sloping. This helps easy drainage of water during rains, thus minimising water logging. In the recent years, most new constructions have concrete roofs and terraces that tend to be flat and non–sloping. These roofs/terraces may not have proper drains for water–flow. As a result, water tends to collect on these rooftops during the rains and this provides ample scope for mosquito breeding.

In addition, there are the natural collections of water like the wells, lakes, ponds, paddy fields, marshlands etc. where mosquito breeding occurs in abundance.

Unused wells Unused wells
Unused wells
Therefore, unless these breeding sites (most of which are man–made and temporary) are taken care of, it is impossible to control mosquito breeding and hence malaria. And it is impossible to achieve this without the participation of the general public. Education of the people is thus very important for any meaningful action. The following measures are called for to minimize mosquito breeding and these measures require only a trifle of human efforts:

Do not throw utensils, vessels, buckets, tyres, bottles, tender coconut shells etc. in the open. They should be either destroyed or buried or at least kept inverted so that water cannot collect in them. All such things should be cleared during the rainy season.

All tanks should be kept tightly closed. A black plastic sheet can be used for the purpose. Also, all tanks should be emptied, cleaned and allowed to dry for at least half an hour, once every week.

Terraces and roofs should ideally have a slope, particularly in places where monsoon tends to be heavy. All such roofs/terraces should have adequate drainage for water. Any collection of water on these surfaces should be cleared at least once a week.

At construction sites, all the care should be taken to avoid collection of water at one place for more than a week. The layer of water on the surface of the concrete, used for concrete curing, should be cleared at least once a week and allowed to dry for half an hour. All other puddles should be cleared regularly. Collections of water in the toilets and closets under construction should also be cleared. All tanks should be kept snugly closed. All labourers should be frequently checked for parasitemia and adequately treated. They should also be provided with mosquito nets.

All unused wells and tanks should be closed or destroyed. Engine oil or kerosene has been used as a larvicidal on these collections. Another method to prevent egg laying on unused wells is by adding EPS polyesterene beads onto the surface of water. These beads are non–toxic, cheap and long lasting. They coat the water surface and prevent the mosquito from laying eggs.

Wells that are being used and ornamental tanks can be treated with biological larvicides that do not harm the quality of drinking water. Also, these wells should be covered with either mosquito–proof nets or with plastic sheets.
Public Health Engineering has lot to do with malaria control, especially by means of Source Reduction.

Prevent water logging – Design the buildings with sloping roofs to aid easy drainage of rain water; provide drains in adequate numbers and sizes in buildings with flat roofs

Prevent entry of insects – Screening of all windows and vents should be made mandatory. It is observed that this simple, common sense measure followed in every construction in the U.S.A. has in a big way helped in control of all insects including mosquitoes and hence malaria.

Engineering skills are also called for in draining and flushing of water collections; deepening or filling of water logged areas; proper maintenance of water levels and intermittent irrigation in dams and canals and in changing salt content of water so as to make it unsuitable for mosquito breeding. Mosquitoes that breed in irrigation water can be controlled through careful water management.

Anti Larval spraying
Weekly spraying of larvicides (Temephos, Fenthion, MLO, BTI etc.) on mosquito breeding places is being carried out in urban areas.

Urban malaria scheme (UMS)
Is being implemented in selected 15 towns of the State. viz. Mumbai, Nasik, Manmad, Dhule, Jalgaon, Bhusawal, Ahmednagar, Pune, Pandharpur, Solapur, Aurangabad, Parbhani, Beed, Nanded, Akola.

Guppy fish Guppy fish
Biological activities
Considering the adverse effect such as development of insecticide resistance in Vector and environmental pollution by chemical insecticide, State has developed Biological method, under which introduction of larvivorus Guppy fish at suitable mosquito breeding places is started since 1997, in phased manner in Maharashtra State. In first phase, Guppy fish hatcheries were established at all Health Institutions.

Guppy fish Guppy fish
From 1998 onwards, Guppy fish is released in suitable mosquito breeding places. The number hatcheries established is 8269 and Guppy fish are released in 90512 mosquito breeding places in the State so far.

Use of Biocides
It is being used in Navi Mumbai town regularly which is under Enhanced Malaria Control Project. State has purchased additional biolarvicide for another towns from Non Project area.

Entomological studies
Routine Entomological studies such as assessment of impact of insecticides, larvicides which are in use.

Insecticide resistance studies, vector bionomics, investigations of focal outbreaks and to suggest suitable control measures. Monitoring of Biological Control measures.

Life cycle of human malaria



Use of Biocides
It is being used in Navi Mumbai town regularly which is under Enhanced Malaria Control Project. State has purchased additional biolarvicide for another towns from Non Project area.

Bednet Bednet
Personal Protection Method
Use of Medicated Mosquito Nets : Since age long mosquito nets have played a major role in avoiding man mosquito contact. Comparing with Synthetic Pyrethroid Indoor Residual Spraying, use of Medicated Mosquito Nets is cheaper and more acceptable by the community. Considering the benefits of medicated mosquito Bednet.

nets, the State has introduced use of medicated mosquito nets in selected villages on pilot project as per guidelines given by National Anti Malaria Programme. Under personal protection methods the use of Medicated Mosquito nets has been shown good results in bringing down malaria situation in selected villages. Since the year 1996–97, 2.20 lacs Medicated Mosquito nets have been distributed in selected 722 villages so far.

Entomological studies

  • Routine Entomological studies such as assessment of impact of insecticides, larvicides which are in use.
  • Insecticide resistance studies, vector bionomics, investigations of focal outbreaks and to suggest suitable control measures.
  • Monitoring of Biological Control measures.
World Bank assisted Enhanced Malaria Control Project – (EMCP)
The anti malaria activities are being carried out in the State as recommended by the Expert Committee in Malaria Action Plan – 1995.

To intensify malaria control activities, World Bank assisted Enhanced Malaria Control Project started in Oct. 1997 in 7 States; one of them is Maharashtra. 14 tribal districts viz. Raigad, Thane, Ahmednagar, Dhule, Jalgaon, Nasik, Pune, Nanded, Amravati, Yeotmal, Bhandara, Chandrapur, Gadchiroli, Nagpur and Navi Mumbai Corporation area are included in the project.

During 1999, District Dhule & Bhandara are split up in 2 districts Dhule, Nandurbar and Bhandara, Gondia respectively. Accordingly, there are 16 tribal districts under EMCP now.

For effective implementation and monitoring of the project, State Malaria Control Society is established under Chairmanship of the Secretary, Public Health Department.

Project activities under EMCP are as given below
  1. Early Detection & Prompt Treatment. (EDPT)
  2. Selective Vector Control.
  3. Personal Protection method.
  4. Early Detection & Containment of Epidemics.
  5. Inter Sectoral Co–ordination.
  6. Institutional & Management capacity building.

Objectives of National Malaria Control Programme
  • To reduce morbidity due to malaria.
  • To prevent deaths due to malaria.
  • Industrial & Agricultural Development activities should not be affected due to malaria.
  • The gains achieved so far should be maintained.
Strategy of National Malaria Control Programme
Implementation Strategies
State has developed State Implementation Plan for Malaria in tune with guidelines given by Govt. Of India under “Malaria Action Plan 1995”. Major components of Implementation strategies are
  1. Early detection and prompt treatment (EDPT)
    • Identification of High Risk Area.
    • Strengthening of surveillance activities.
    • Decentralization of Laboratory Services.
    • Availability of anti malarial drugs upto the village level.
  2. Selective Vector Control
    • Indoor residual spraying.
    • Anti Larval Measures.
    • Use of Biocides.
    • Personal protection methods mainly Use of Impregnated Bednets.
    • Biological Control Measures.
  3. Capacity Building: Training to field staff & Non Governmental Organisations (NGOs.)
  4. World Bank Assisted Enhanced Malaria Control Project to intensify malaria control activities in tribal belt of the state.
  5. Celebration of Anti Malaria Month June upto village level every year.

    As per guidelines given by Govt. of India “Anti Malaria Month–June” is celebrated every year with various activities upto the village level. (Gram Sabha, Morning Procession, News Paper, Cable T. V., Radio, Handbills, etc.)

    Activities carried out during Anti Malaria Month – June are as under
    • Organization of State level press conference on 1st June.
    • Organization of district level press conference.
    • Special edition of Arogyya Patirika on Malaria.
    • Broadcasting of speech on Aakashwani/Doordarshan by State level officers.
    • Broadcasting of TV spots on Doordarshan.
    • Broadcasting of radio jingles.
    • Advertises in different local news papers.
    • Organization of Malariology workshops for NGO’s.
  6. IEC (Information, Education & Communication)
    For creation of awareness among the community about signs & symptoms of malaria, treatment & management of malaria & control measures.

    Use of different types of media depending nupon the local situation for achieving better community participation. Mass media such as TV/Radio/Cable network, Cinema slides, Pamphlets, Posters, Charts etc.
  7. Urban Malaria Scheme in selected 15 towns.
  8. Implementation of Bye laws.
Future Plans
There is steady decline in malaria cases and deaths. But pockets such as Gadchiroli Districts is posing problem. During 2002–2003, 15.55 % of State malaria cases are from Gadchiroli Districts. Gadchiroli is Tribal/Forest District and having borders with Madhya Pradesh and Andhra Pradesh. Special strategic interventions proposed for this district during this year are
  • Mass Survey in high malarious area.
  • Special round of Synthetic Pyrethroid Residual spraying.
  • Distribution of Medicated Mosquito Nets to all population in Bhamragadh Taluka.
  • Periodic Vector Studies to observe change in vector bionomics.
  • Special G6 PD studies to reduce mortality.
  • Condensed Radical Treatment in the form of tablet Chloroquine 1500 mg. in 3 divided doses and tablet Primaquine 45 mg. to all fewer cases.

Services to Common People
Free blood Smear Collection & Examination at every Primary Health Center/Rural Hospital/Cottage Hospital (PHC/RH/CH) in Rural area. Free treatment is available at every subcenter Primary Health Center/Rural Hospital/Cottage Hospital/Drug Distribuction Center/Fever Treatment Depot (PHC/RH/CH/DDC/FTD)/District Hospitals.

Free distribution of Anti Malarial Drugs through Drug Distribution Centers in every village.

Free distribution of Insecticide Treated Bednets in highly malarious area of the State selected as per the guidelines given by Government of India (GOI).

Free Indoor Residual Spraying in selected high risk villages as per the guidelines of Government of India (GOI).

Service centers available in each district
All District hospitals and Govt. medical college and all corporation dispensaries.

10453 subcenters, 1814 PHCs, 364 Rural Hospitals, 172 Public Health Units & 61 Mobile Hospital Units are available in the State for the treatment of malaria & other vector borne diseases.

1500 Fever Treatment Depots are established in Tribal districts & nearly about 66660 Drug distribution Centers & Malaria clinics, are also established in every Tribal & Non tribal villages/padas/Aashram schools etc. with the help of Sarpanch, School teachers, community leaders & other local bodies. No. of DDCs & Malaria clinics may vary time to time.

Performance – District Wise
Sr. No. District Year Coll Exam Mal. Positives
1. Raigad 1999–2000 346490 346490 4451
    2000–2001 317675 317675 3514
    2001–2002 328131 26834 2142
    2002–2003 338645 338645 2333
    2003–2004 359363 359363 2764
    2004–2005 342130 342130 4269
    2005–2006 326516 321641 3798

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Special Features of National Malaria Control Programme
  1. EDPT – Early detection & Prompt Treatment
    • Identification of High Risk area on the basis of parameters like Slide Positivity Rate (SPR), Annual Parasite Incidence (API), Pf proportion, deaths due to malaria.
    • Strengthening of surveillance activities.
    • De–centralization & strengthening of laboratory services.
    • One day Condensed Radical Treatment, Presumptive treatment to all fever cases & suspected malaria cases at referral institutions.
    • Chemoprofylaxis to Pregnant women.
    • Establishment of Drug Distribution Centers, Fever Treatment Depots in tribal districts & Malaria Clinics in every villages.
    • Treatment on malaria cases at every Sub center, PHC, RH totally free of cost.
    • Introduction of Twin Blister Pack containing Chloroquine 600 mg & Primaquine 45 mg. for easy consumption of tablets & to reduce parasitic load in community.
    • Appointment of pada workers & Malaria Link Volunteers (MLVs) in tribal & remote areas.
    • P–falciparum infection is known to lower Blood glucose level causing death due to hypoglycemia in complicated cases. To avert these death Glucometers are provided at all community health centers.
  2. Vector Control
    • IRS – Insecticidal Residual Spraying with synthetic Pyrethroid in selected high risk population.
    • Use of larvivorus Guppy fish under biological control.
    • Distribution of medicated mosquito bednets in selected villages. Totally free of cost to families below Poverty Line. & Rs.20/– for families above poverty line.
    • Re–impregnation of distributed bednets is made every six months interval. Re–impregnation of bed nets of other users will also be made if required by villagers.
    • Use of biocides in towns under Urban Malaria Scheme.
    • Routine Entomological studies.
  3. To intensify malaria control activities, Establishment of District Malaria Control Societies in 16 tribal districts under World Bank assisted Enhanced Malaria Control Project.
  4. Inter sectoral co–ordination with non health departments such as Building & Constructions, Irrigation, Railway, Urban development, Fisheries, Tribal development, education, Forest etc.
  5. Training of various Health personnel & peripheral staff throughout the year.
  6. Simplified information system of 13 indicators (MIS) as given below.
Ind No. Particulars
30 B. S. Coll thr. Active surveillance
31 B.S. Coll thr. Passive surveillance
32A A Total B/s collected (Act+ Pass)
32B B Total B/s collected (Act+ Pass + CMN)
33A Total examination
33B B/S Exam within 15 days
34A Total malaria cases detected
34B Available for RT
35 No. of Pf + mixed cases
36A A Total No. of malaria cases treated
36B A Total No. of malaria cases treated within 21 days
37 Deaths due to malaria
38 No. of spraying coverage Room + C.S. with insecticide
39 Performance
Of Filaria Control pgm
40 Performance
Of Filaria Survey Unit
41 Performance
Of Filaria night clinic
42 Inventory control
  1. Involvement of Non Government Organizations in malaria control activities.
  2. Implementation of Bye Laws for mosquito prevention.
  3. Emphasis on IEC for active community participation.

Role of NGOs
NGOs work as a catalyst between Govt. & Community. Their involvement is essential in removing misbelief in the community. In Maharashtra, no NGO is working exclusively in malaria field so far. Hence 2 NGOs per district who are working in other health sectors have been identified for their active involvement under EMCP. Their proposed area of operation will be to see treatment seeking behaviour of community, their participation during indoor residual spraying, feasibility study of social marketing of mosquito bednets and creation of awareness in biological control of malaria, etc. Detailed methodology, probable assistance to NGOs and other modalities is being worked out at the State level. Two NGOs i. e DISHA from Dist. Gondiya and KEM Hospital, Pune are included in Maharashtra State Malaria Control Society , as members.

List of Non–Government Organizations of E. M. C. P. Districts
Districts & Non–Government Organization
Raigad
  1. Usuf Mehernali Center Tara, Taluka– Panvel.
  2. Janaseva Sangathan, Taluka–Khalapur.
  3. Bandhilki Sanstha, Kodiwade, Taluka–Karjat.
Thane
  1. Rotary Club.
  2. Lions Club.
  3. Red Cross.
  4. Missionary Society.
  5. Hindu Seva Sangh.
  6. Dongral Durgam.
  7. Vaidyakiya Sanstha.
Ahmednagar
  1. Lions Club, Sangamner.
  2. National Integrated Medical Association.
  3. Rotary Club, Sangamner.
Dhule
  1. M/S Dhanvantri Charitable Trust, Station Road, Dhule
Nadurbar
  1. Jan Kalyan Bahuudaishiya Sanstha, Nandurbar.
  2. Ujjwala Vidya Prasarak Sanstha, Nandurbar.
  3. Shikshanik Sanstha Krida Vikas, Vaghale.
  4. Jivan Dhara Sanstha, Dhanora.
  5. Jiwan Kalyan Trust, Nandurbar.
  6. Lok Samanvayak Prathishthan, Taloda.
  7. Adivasi Research Development, Nandurbar.
  8. Rajiv Aids Trust, Nandurbar.
  9. Gayatri Mahila Shaikshanik Sanstha, Nandurbar.
Jalgaon
  1. Godawari Foundation, Jalgaon.
Pune
  1. Snehdeep Jankalyan Foundation, Pune.
  2. Wir Lahuji Wastad Salve Pratishthan, Pune.
  3. K.E.M. Hospital, Pune.
Nanded
  1. Rugna Seva Mandal, Nanded.
Amravati
  1. Pandita Ramabai Mahila Vikas Sanstha, Amravati.
  2. Apeksha Homeo Society, Tiwasa.
  3. Gurudeo Dispensary, Gurukunj, Mozari.
  4. Prabodhankar Shikshan Sanstha, Amravati.
  5. Dr. K.R. Nawandar, Shri. Venkatesh Nav Vikas Sanstha, Amravati.
  6. Ku Aruna Ulhe, Prashaskiya Sharada Uddyog, A’vati.
  7. Dr. N.N. Katake, Member, Indian Medical Association.
  8. Shri. Raja Gadling, Director, Red Swastik Society, Ramkrishna Colony, A’vati.
Gondiya
  1. DISHA, Gondiya Gadchiroli 1. Search Dhanora, Kurkheda Sanstha.
  2. Lok Biradari Project – Hemalkasa, Bhamaragad.
  3. Christian Missionary Hospital, Allapalli.
  4. Amhi Aamache Arogyasansthi– Kurkheda.
  5. Lokmangal Sanstha, Ghoti.
  6. Dr. Bang.
  7. Dr. Ggulwar.
  8. Shri. B.K. Meshram.
  9. Shri. Shri Ajhar Bakhas.
  10. Shri. Prakash Arjunwar.
  11. Dr. Gedam.
  12. Dr. Dilip Belsagade.
  13. Shri. Bhanuprakashi Sharma.
  14. Shri. Santosh Mamidwar.
  15. Shri. Rohidas Raut.
  16. Shri. M.M. Hepal.
  17. Director, Ashishi Seva Sadan.
Nagpur
  1. Indian Medical Association, Nagpur.
  2. Swami Vivekanand Mission Sanstha,Khapari Rly, Nagpur.
Achievements of National Malaria Control Programme
Malaria situation

Year Malaria Cases Pf + mix cases Pf % Deaths Reported
2001–02 53113 17986 33.8 51
2002–03  43241 13772 31.8 43
2003–04 70574 36902 52.2 82
2004–05 65322 25262 38.7 60
2005–06 45614 15509 34.0 103
2006–07 56848 17888 32.5 133
2007–08 67844 22491 33.2 176
2007–08 Upto May 5212 905 17.4 05

Expected Community Participation
No health programme succeeds without active community participation. In Maharashtra community participation is ensured in Panchyat Raj System since 1962. Till today this has become Hallmark and became way of life. In Maharashtra malaria control is responsibility of local self Govt. i.e. Zilla Parishad, Taluka Panchyat and Gram Punchyat, established under Punchayat Raj System. Various activities are carried out for malaria control, involving community leaders in planning process. Suggestions made by them are incorporated in Implementation Plan and before undertaking activities under malaria control such as Medicated Mosquito Net distribution, Synthetic Pyrethroid Indoor Residual spraying (IRS), Guppy fish introduction, etc. Gramsabha is organized one day prior to activity in respective village to motivate villagers.

For achieving better community participation state, from time to time, uses suitable communication media depending upon the local situation Mass media such as T.V./Radio is used during June i.e. Anti Malaria Month to promote villagers to reduce mosquito breeding places, use of Medicated Mosquito Nets, adopt Guppy fish. Suitable printed material such as Tin plates and P.V.C. charts are displayed at strategic locations. For inter–personnel communication state has developed I.E.C. material in local Tribal languages. Every year state spends 5 to 10 million rupees on development and distribution of various I.E.C. materials.

Inter sectoral Co–ordination
Malaria is the unwanted byproduct of various developmental activities such as Construction of projects, Roadways, Railways tracks, Industrialization, Construction of Buildings. Effective control of malaria needs co–ordinated efforts from all non health departments such as Building & Constructions, Irrigation, Railway, Urban development, Fisheries, Tribal, Forest etc.

For achieving better intersectoral co–ordination state has established “High Power Committee” under the chairmanship of Chief Secretary of the state.

At district level Chief Executive Officer of Zilla Parishad is made Chairman of District Malaria Control Society. HODs of related departments are members. This society reviews malaria situation of District every month and necessary suggestion are given to appropriate authority.

Role of other Sectors
Inter sectoral Co-ordination
Malaria is the unwanted byproduct of various developmental activities such as Construction of projects, Roadways, Railways tracks, Industrialization, Construction of Buildings. Effective control of malaria needs co-ordinated efforts from all non health departments such as Building & Constructions, Irrigation, Railway, Urban development, Fisheries, Tribal, Forest etc.

For achieving better intersectoral co-ordination state has established “High Power Committee” under the chairmanship of Chief Secretary of the state.

At district level Chief Executive Officer of Zilla Parishad is made Chairman of District Malaria Control Society. Heads of the department of related departments are members. This society reviews malaria situation of District every month and necessary suggestion are given to appropriate authority.

For achieving inter sectoral coordination various officers from other related departments such as Irrigation and Public Works Department (PWD) are taken as members in State Malaria Control Society (SMCS).

Impact

Year Mal. Positives Pf + mixed Deaths
1999–2000 131517 32460 60
2000–2001 76169 24962 68
2001–2002 53113 17986 51
2002–2003 43241 13772 43
2003–2004 70574 36902 82
2004–2005 65322 25262 60
2005–2006 45614 15509 123

After effective implementation of Malaria Action Plan – 1995, of Malaria incidence shows sustained decline since 2000–01 up to 2003–04. But during 2003–04 trend shows rise in number of malaria cases and malaria deaths also. During 2004–05 though malaria deaths are less, it shows rise during 2005–06.


Comments (3)Add Comment
0
jaydev tudu
April 15, 2010
115.117.201.7
Votes: +0
standard treatment in pregnancy with malaria

there is nothing written regarding treatment of malaria in pregnancy. prophylaxis and active treatment in pregnancy with confirmed p.vivax and p.falciferum in India is very much required in this text.

0
Guru Narayanasamy
October 06, 2011
59.92.67.7
Votes: +0
Ph.D

The narrative part though brief, is satisfying.
Kindly incoporate the treatment schedule for
various species of human plasmodium recommended
by Govt.Of India ( NV B D C P, Delhi ) and also
that is in practice.

0
Guru Narayanasamy
October 06, 2011
59.92.67.7
Votes: +0
...

The text is satifying. Also cocurs with the comment of Mr.Jaydev

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