National Project Implementation Plan - NVBDCP

e available within 24 hours. In other PHC blocks, an RDK will only be used
for patients at high risk. This selective use of RDKs will make diagnosis of
PF malaria more cost-effective. The proposed changes will have important
implications for the commodities to be procured by the program, especially
RDKs, and ACTs, and in terms of training, M&E, and quality assurance.
3 Supporting innovations in malaria surveillance
In surveillance, the project will support efforts to de-emphasize the
collection of blood samples through outreach workers through house to
house visit –i.e., Active Case Detection (ACD). Such collection will be
restricted to high-risk areas with weak curative services, and when there is
suspicion of an outbreak. In project districts, surveillance will be primarily
based on the examination of blood samples from suspected malaria cases
i.e., Passive Case Detection (PCD). In the initial phase, States will set
tentative annual targets for the number of patients to be tested in PCD (e.g.
at least 10% in highly endemic areas); when more experience has been
gained NVBDCP will prepare norms adapted to different epidemiological
situations. In the initial phase, blood slides will be collected from all patients
suspected of malaria, whether or not an RDK test is also given. This will
ensure continuity in surveillance and support quality control of the two
methods of confirmatory diagnosis. After two years, the policy of blood
slides on all fever cases where RDK is performed will be reviewed. By then
it is likely that RDKs sensitive to PF as well as PV will be available. In
addition, the project will support introduction of a sentinel surveillance
system in the NVBDCP to monitor hospital admissions and deaths
attributable to malaria at selected representative sites including those from
government and in the private sector, and periodic surveys of health
facilities and households in endemic areas.
4 Monitoring of anti-malarial drugs and insecticides efficacy
The project will support nation-wide actions to update and strengthen
monitoring of therapeutic efficacy of anti-malarial medicines, insecticide
resistance and quality of medicines to contain the problems of drug and
insecticide resistance and ensure their efficacy. Monitoring of therapeutic
efficacy of SP and ACTs will be undertaken so that effective drugs are used
in the treatment of malaria. To maintain the use of effective drugs and get
the desired impact, at least five units will monitor the quality of medicines
and insecticides at different sites in the country. One unit in each State will
be responsible for quality assurance of diagnosis. In addition, there will be
an independent inspection agency monitoring the quality of pharmaceuticals
by testing random samples.
5 Enhancing effectiveness of existing vector control
The project will support improvements in the effectiveness of its vector
control operations in high Pf high burden districts by introducing microstratification
of districts according to revised national guidelines based on
epidemiological and ecological data, to delimit areas and populations which
would be targeted for selected interventions, i.e. IRS or LLINs.
Furthermore, the program will systematize insecticide rotation for IRS to
lessen the risk of insecticide resistance and ensure the implementation of
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