National Project Implementation Plan - NVBDCP

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Chapter 16 Enhanced Implementation Support Background: The Project will enhance Government of India’s efforts to control malaria in high burden districts from eight states and eliminate kala-azar from highly endemic districts in three states. The project is expected to contribute to poverty reduction and to achieving the Millennium Development Goals (MDGs). The World Bank has supported an earlier project ‘Enhanced malaria control project’ for control of malaria which closed in December 2005. Based on the feedback from the Quality Enhancement Review, the project design has been significantly changed. From the original concept of supporting a nation-wide program covering all vector borne diseases, the project has now been limited to two diseases causing highest burden among the poorest covering the most endemic districts in 11 states. Some of the states having highest burden of malaria and kala-azar, especially the states of Chhattisgarh, Jharkhand, Orissa and Bihar, have weak implementation capacities and fiduciary oversight. This poses a major challenge for the implementation of new diagnosis and treatment policy for malaria control and elimination of kala-azar. Given the weak implementation environment and experience to-date with externally assisted projects in country, close and intensive implementation support will be critical for achieving the development objectives. 16.1 Strategy for the enhanced Implementation Support The strategy involves a combination of continues oversight and periodic more intensive implementation support and will have specific focus on three broad areas: (a) Progress in Implementation of agreed technical reforms: The scope of these reviews will include new drug policy, introduction of RDKs and LLINs. This will be done through: (1) improvements in project MIS supported by GIS mapping; (2) World Bank tion of MIS through Lot Quality Assurance Surveys (LQAS); (3) two rounds of household surveys out which first will be during the early implementation review; (4) systematic monitoring of therapeutic efficacy of anti-malarial drugs and vector resistance for insecticides being used in the program; (5) monitoring the quality of pharmaceuticals and commodities 186
procured under the project; (6) bi-annual program technical reviews led by WHO and (6) impact evaluation studies. (b) Oversight for decentralized activities: This oversight covers recruitment, availability and functioning of contractual staff supported by the project and implementation of training activities as per the agreed guidelines. This will be done through: (1) semi-annual third party reviews covering 50% of districts included in the first year, 20 % in year II and at least 15% of the districts during the later three years; (2) Early implementation review of the project after 18-24 months of effectiveness; (3) Enhanced field visits during implementation support mission as well as undertaking thematic mini missions and regional reviews. (c) Implementation reviews of GAAP and Joint DIR action plan: This includes review of the progress in project specific GAAP and DIR joint action plan common. The activities will include: (1) A 6 monthly update on the project specific GAAP will be prepared by the MOFHW; (2) Quarterly reports on implementation progress of the DIR joint action plan to the World Bank management; and (3) 100% post review of all procurements undertaken centrally. 16.2 Stakeholder and partner participation in project implementation oversight A key issue in centrally sponsored projects is the lack of ownership by the states and weak implementation at that level. While the severity of malaria and kala-azar in the selected states generates concern among the state governments, continued engagement and dialogue with states will be necessary and this will be ensured throughout the project period. In addition to the capacity building measures included in the project, the task team will regularly visit the key states and participate in state level implementation reviews. In addition to the national project launch workshop, state and district launches to create awareness among the concerned officers to ensure better understanding of the project for effective implementation, are planned as part of the supervision strategy. During the [project preparation technical assistance was sought from WHO, GFATM which is also supporting the NVBDCP program. There will be active engagement of states and other partner agencies working in the area of VBD especially NGOs and social marketing agencies. The other national programme has identified some large NGOs that have strong field presence in the project states and capability to undertake stakeholder consultations as well as help the 187
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Project Credit No.: 4461-IN Project
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TABLE OF CONTENTS Abbreviations and
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CHAPTERS Page. No. 13. Governance a
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Abbreviations and Acronyms ABER ACD
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Chapter 1 Situational analysis Intr
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The following matrix summarizes the
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The Enhanced Malaria Control Projec
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Inadequate attention to mosquitogen
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Current Malaria Treatment Policy in
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chloroquine in P. falciparum cases
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the in depth review in 2006, the co
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incentives to assist kala-azar pati
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provision of general health service
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f. The project will introduce a sen
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Where microscopy result is not avai
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e. Supporting interventions for Kal
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The following table summarizes the
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e available within 24 hours. In oth
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4. Behavior Change Communication A
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and also support the implementation
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Chapter 5 Malaria Control 5.1 Proje
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Result Indicator Activity Severe ca
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contact key informants in the villa
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coverage and its quality. Other tha
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5.2 Other Issues 5.2.1 Therapeutic
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Chapter 6 Elimination of Kala-azar
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Table - 1 Activity schedule for the
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partner with the private and NGO se
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strategy will help economize insect
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esearch proposed for kala-azar will
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implementation of good pesticide ma
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Activity (include s malaria and kal
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Activity Sub Activity Tools Interna
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Environmental studies and impact of
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7.1.1.4.2 Assess drug quality This
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1. as staff responsible for providi
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S. No. Supportive Staff Designation
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The key malaria control and kala-az
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Project Districts for malaria contr
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and appraisal. Additional technical
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Sl. No. 1 2 3 4 5 6 7 8 9 10 11 Act
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Sl. No. 23 24 25 26 27 28 29 Activi
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Cost Summary of Training Training C
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area, and a strengthened supply cha
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Chapter 9 MONITORING AND EVALUATION
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year, covering all endemic district
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treat malaria correctly. Modules fo
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insecticides in use in 200 sites, w
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Purpose Level Person Frequency Comm
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Monitoring and Evaluation will incl
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finger-prick blood sample taken by
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A Total mid-year population B Total
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2a. Elimination of kala-azar a.i. P
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Arrangements for Outcome and Result
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Component Three: Policy and Strateg
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Project Steering Committee: A steer
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service delivery in public and priv
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2 Additional Staff in District VBD
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The quality of Diagnostic Kits on t
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Percentage of individuals in projec
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11.2 Financial Management at the Ce
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separate financial management cell
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World Bank will review of the annua
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In parallel and in support of enhan
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Risk Residual Risk Rating Risk Miti
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Chapter 12 Procurement Arrangements
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agencies for taking up inspections
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contractor/supplier. However, the v
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12.3.4 Procurement Methods The tabl
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(commercial or UN agency acting as
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procurement agent) which are not pr
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Page 147 and 148: monitoring of procurement undertake
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Page 157 and 158: Chapter 14 Economic and Financial A
Page 159 and 160: diagnosis and treatment, causing su
Page 161 and 162: Table 1: Estimated Costs of Current
Page 163 and 164: Table 3: Estimated Incremental Cost
Page 165 and 166: Chapter 15 Safeguard Policy Issues
Page 167 and 168: State/Uni on Territory Number of Pr
Page 169 and 170: 15.3.1 Surveillance, Case Diagnosis
Page 171 and 172: eluctant to allow their homes to be
Page 173 and 174: equipment, optimal coverage and qua
Page 175 and 176: Social Devpt. and BCC Consultants a
Page 177 and 178: Action to be Taken supportive drugs
Page 179 and 180: Action to be Taken Distributing LLI
Page 181 and 182: Action to be Taken At what Level 17
Page 183 and 184: National Level: As the Borrower is
Page 185 and 186: vulnerable groups. estimates. Table
Page 187 and 188: Routine Program Monitoring: At the
Page 189 and 190: 15.11.4 Application activities: Saf
Page 191 and 192: For effective implementation of the
Page 193: Action Responsibility By When Cost
Page 197 and 198: of each identified district to succ
Page 199 and 200: Annexure 1 MALARIA CASES & DEATHS S
Page 201 and 202: Annexure 2 KALA-AZAR CASES & DEATHS
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National Project Implementation Plan - NVBDCP

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