National Project Implementation Plan - NVBDCP

good pesticide management practices. The use of IRS will be restricted to
those high risk areas where LLINs are unacceptable for the population or
there is other evidence for superior effectiveness of IRS and for the control
of epidemics with a focus on quality and completeness of IRS coverage.
6 Introduction of Long Lasting Insecticidal Nets (LLINs)
An important thrust of the program during the project period will be
promoting the use of Long Lasting Insecticidal Nets (LLINs). Areas
consistently reporting high Annual Parasite Incidence (API) in all age-groups
(indicating intra-domiciliary transmission) will be given priority in this
regard, with a target of achieving 80 percent coverage. The success of this
thrust will require effective Behavior Change Communication (BCC)
strategies for proper use and demand generation. Current BCC activities
lack focus in objectives, media, messages and target audiences; there is a
lack of clear articulation of the behaviors to be changed and most BCC
activities are input based with limited attention to desired outcomes. A BCC
strategy and Action Plan will be prepared. LLINs would, in the first years,
normally be distributed by the public sector free of charge (possibly through
performance contracts with NGOs), but it is expected that a progressively
larger share of nets will be distributed through public-private initiatives
(social marketing), with the government providing a partial subsidy,
depending on household economy in a given area.
4.1.2 Kala-azar Elimination
1. Improving access to quality Kala-azar diagnosis and treatment services
in endemic district
The project will support to achieve the goal of eliminating Kala-azar by 2010
focusing on 46 districts in the three States that account for practically all
Kala-azar cases in India (Bihar, Jharkhand, and West Bengal). Specifically
the project will provide inputs to improve access to better-quality and more
specific diagnosis and treatment of Kala-azar patients, mainly by
introducing Rapid Diagnostic Test for Kala-azar dipsticks in the government
health services (for appropriate diagnosis of the disease), and the use of
effective new first-line drugs such as miltefosine and new emerging drugs.
These measures will be accompanied by the required staff training and
intensive monitoring of each case.
2. Improving quality of Kala-azar case management in private sector
In addition to improving services in the government sector, the program will
seek to establish public-private partnerships with private health care
providers whenever feasible.
3. Supporting supply-side interventions for Kala-azar
The project will support piloting of supply side interventions, backed by
expanded BCC efforts to educate the public in endemic areas and to
motivate infected persons to seek treatment from qualified providers at an
early stage of the disease. Because many Kala-azar patients are very poor,
the project will support innovations such as cash subsidies to patients, to
compensate for the loss of income during Kala-azar inpatient treatment.
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