National Project Implementation Plan - NVBDCP
National Project Implementation Plan - NVBDCP
National Project Implementation Plan - NVBDCP
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The Enhanced Malaria Control <strong>Project</strong> (EMCP) was implemented with the<br />
support of the World Bank during 1997 to 2005 with the objectives of<br />
creating an enhanced and more effective malaria control program focusing<br />
on the tribal areas with high disease burden and supporting the introduction<br />
of mix of cost-effective and sustainable strategies. The <strong>Project</strong> was<br />
implemented in 1045 Primary Health Centers (PHCs) in 100 districts of 8<br />
states (Andhra Pradesh, Chhattisgarh, Gujarat, Jharkhand, Madhya Pradesh<br />
Maharashtra, Rajasthan and Orissa) predominantly inhabited by tribal<br />
population. In the EMCP areas, the number of cases have declined from<br />
1.17 m in 1997 to 0.76 m in 2005 (44% decline) and deaths from 522 to<br />
301 (42%). The Pf cases reduced from 0.71 m to 0.51 m (28%).<br />
India adopted WHO- RBM strategy and was successful in bids during the<br />
GFATM Round IV. Under GFATM, <strong>NVBDCP</strong> is supporting malaria control in<br />
the states of Assam, Arunachal Pradesh, Meghalaya, Tripura, Nagaland,<br />
Mizoram, Manipur, West Bengal, Jharkhand and Orissa.<br />
1.3. Kala-azar Control in India<br />
Kala-azar has been endemic in India for a long time and earliest outbreaks<br />
date back to early nineteenth century. With the implementation of<br />
successive <strong>National</strong> Malaria Control operations from 1953, the disease<br />
declined to negligible proportions due to collateral benefit of IRS. However,<br />
withdrawal of IRS from some erstwhile malaria endemic areas resulted into<br />
a gradual build up of vector population that ultimately led to resurgence of<br />
kala-azar in seventies initially in 4 districts of Bihar. Slowly the disease<br />
started spreading to other areas in Eastern India.<br />
Concerned with the increasing incidence of Kala-azar, the GOI launched a<br />
centrally sponsored Kala-azar Control Program in the year 1990-91. The<br />
initial success of the program resulting in a significant decline in Kala-azar<br />
morbidity could not be sustained by the states. An expert committee<br />
chaired by the Director General of Health Services reviewed the program in<br />
2000 and recommended the feasibility of eliminating Kala-azar from India<br />
and the NHP (2002) has endorsed this recommendation and set a goal for<br />
eliminating Kala-azar by 2010.<br />
1.4 Program Constraints<br />
The <strong>NVBDCP</strong> is also affected by the generic constraints of public health<br />
system in India such as large number of vacant staff positions, weak<br />
program management capacities, delays in procurement, ineffective<br />
distribution of supplies, weak financial management, and insufficient<br />
supervision and monitoring. Further, non- engagement and lack of<br />
oversight of private sector plays an important role in the diagnosis and<br />
treatment of malaria and Kala-azar cases.<br />
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