National Project Implementation Plan - NVBDCP
National Project Implementation Plan - NVBDCP
National Project Implementation Plan - NVBDCP
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Training and regular reorientation were emphasized as ways to remove some<br />
of the deficiencies noted in service delivery especially in tribal areas. This<br />
would also prevent indiscriminate use of drugs, incomplete treatment and drug<br />
resistance. Health worker training to support the efforts of doctors in<br />
developing local strategies and planning was also mentioned.<br />
15.3.5 Integrated Vector Management<br />
Insecticide-Treated Bed-Nets (ITNs) have been distributed free of cost to the<br />
very poor by the Government. The BPL and APL (Above Poverty Line)<br />
populations were charged highly-subsidized costs of USD 0.25 and 0.50<br />
respectively. Along with health workers and volunteers, panchayats were<br />
involved in ITN distribution and in educating communities about the use of<br />
nets, precautions and re-treatment of nets. However, bed-net use ranged from<br />
about one-third to two-thirds of those who received them. In tribal<br />
communities, the use was particularly low on account of the habit of sleeping in<br />
the open, and the traditional belief that forbids sleeping under a ‘foreign’ object<br />
such as a roof or net. Because of crowded housing conditions (families have an<br />
average of five members), sleeping under one bed net was infeasible. There<br />
was also a lack of perceived benefits. Nevertheless, during a malaria epidemic<br />
in some villages, children were encouraged to sleep under bed nets. Although<br />
bed-nets were reportedly purchased from the market as well, there was very<br />
little information on community-owned bed-nets. About one-half of community<br />
members expressed their willingness to pay for ITNs supplied by the<br />
government. It was recommended that areas be prioritized for bed-net<br />
distribution on the basis of risk, a high proportion of Pf cases, and<br />
inaccessibility for indoor residual spraying.<br />
Social marketing was recommended to increase access to ITNs and other<br />
health products and services.<br />
Some positive traditional practices were mentioned such as driving away<br />
mosquitoes by burning neem leaves, other forest herbs, cow dung or paddy<br />
stubble. Some tribes use repellant body oils.<br />
Although it was widely known that mosquitoes cause malaria, there was little<br />
knowledge of mosquito breeding habits. Only in one study area were people<br />
aware of the need to cover stored water, spray kerosene oil over stagnant<br />
water, etc. Given open drainage systems, garbage disposal and ‘toilets’, the<br />
need to address environmental sanitation and personal hygiene to reduce<br />
vector-borne diseases was discussed.<br />
Some villages had not been sprayed for a year or so. Lack of advance<br />
information for IRS reduced its coverage. However, tribal people were also<br />
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