National Project Implementation Plan - NVBDCP

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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. 28
4. Behavior Change Communication A three pronged BCC strategy is proposed for the NVBDC program: This includes: (a) decentralized BCC activities financed by NVBDCP; (b) central BCC activities implemented by a professional media agency to be financed by the project; and (c) social mobilization activities with specific focus on promoting LLINs to be implemented by NGOs or social marketing agencies having strong field presence financed by the project. The decentralized locale specific BCC activities are detailed in the operational guide for antimalaria month campaign. This PIP provides a clear roadmap for initiating and implementing structural and institutional framework for implementation as well as institutional arrangements and monitoring and evaluation processes along with a budget template. However, random state visits undertaken during the project preparation suggest that the implementation capacities across the states vary widely. The project will provide consultant support at state and national levels and the primary focus will be on interpersonal communication and group discussions to inform community based institutions like Panchayat Raj and self help groups, and vulnerable populations about new diagnostic and treatment services made available at village level. A professional media agency will be selected following QCBS process at national level to undertake formative research, develop and pretest multi-media campaign and undertake media buying for a nation-wide campaign with strong focus on endemic states. The project also provides for hiring Services of NGOs and social marketing agencies having strong field presence will be used to undertake social mobilization of beneficiaries in villages selected for LLIN intervention. 5. Training The focus will be on competency based and inclusive training. The program has well defined operational guidelines for each cadre of staff and a well defined training plan supported by clear operational guidelines. Under the project additional consultant support for training has been provided at national and state levels to ensure effective planning and oversight for decentralized training activities. National & State trainers for malaria and Kala-azar have been trained at Bhubaneswar (Orissa) and Patna (Bihar) during December 2007 and early part of 2008 by a team of experienced national and international experts and this opportunity has been used to update the training modules. The national, state trainers in addition to training the core vertical contractual staff proposed under the project (such as malaria and Kala-azar technical supervisors and the district VBD officer and consultant) will also monitor the quality of training. One dedicated NVBDCP focal point has been identified for each project state who will be regularly visiting the state to provide technical oversight for decentralized activities and for trouble shooting. Further, an independent agency will be monitoring the physical progress of decentralized training including compliance with the program guidelines. The proposed early implementation review by the World Bank (after 18-21 months) will also assess the competencies of the staff at different levels. 29
Page 1 and 2: Project Credit No.: 4461-IN Project
Page 3 and 4: TABLE OF CONTENTS Abbreviations and
Page 5 and 6: CHAPTERS Page. No. 13. Governance a
Page 7 and 8: Abbreviations and Acronyms ABER ACD
Page 9 and 10: Chapter 1 Situational analysis Intr
Page 11 and 12: The following matrix summarizes the
Page 13 and 14: The Enhanced Malaria Control Projec
Page 15 and 16: Inadequate attention to mosquitogen
Page 17 and 18: Current Malaria Treatment Policy in
Page 19 and 20: chloroquine in P. falciparum cases
Page 21 and 22: the in depth review in 2006, the co
Page 23 and 24: incentives to assist kala-azar pati
Page 25 and 26: provision of general health service
Page 27 and 28: f. The project will introduce a sen
Page 29 and 30: Where microscopy result is not avai
Page 31 and 32: e. Supporting interventions for Kal
Page 33 and 34: The following table summarizes the
Page 35: e available within 24 hours. In oth
Page 39 and 40: and also support the implementation
Page 41 and 42: Chapter 5 Malaria Control 5.1 Proje
Page 43 and 44: Result Indicator Activity Severe ca
Page 45 and 46: contact key informants in the villa
Page 47 and 48: coverage and its quality. Other tha
Page 49 and 50: 5.2 Other Issues 5.2.1 Therapeutic
Page 51 and 52: Chapter 6 Elimination of Kala-azar
Page 53 and 54: Table - 1 Activity schedule for the
Page 55 and 56: partner with the private and NGO se
Page 57 and 58: strategy will help economize insect
Page 59 and 60: esearch proposed for kala-azar will
Page 61 and 62: implementation of good pesticide ma
Page 63 and 64: Activity (include s malaria and kal
Page 65 and 66: Activity Sub Activity Tools Interna
Page 67 and 68: Environmental studies and impact of
Page 69 and 70: 7.1.1.4.2 Assess drug quality This
Page 71 and 72: 1. as staff responsible for providi
Page 73 and 74: S. No. Supportive Staff Designation
Page 75 and 76: The key malaria control and kala-az
Page 77 and 78: Project Districts for malaria contr
Page 79 and 80: and appraisal. Additional technical
Page 81 and 82: Sl. No. 1 2 3 4 5 6 7 8 9 10 11 Act
Page 83 and 84: Sl. No. 23 24 25 26 27 28 29 Activi
Page 85 and 86: Cost Summary of Training Training C
Page 87 and 88:
area, and a strengthened supply cha
Page 89 and 90:
Chapter 9 MONITORING AND EVALUATION
Page 91 and 92:
year, covering all endemic district
Page 93 and 94:
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
Page 109 and 110:
Component Three: Policy and Strateg
Page 111 and 112:
Project Steering Committee: A steer
Page 113 and 114:
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
Page 119 and 120:
Percentage of individuals in projec
Page 121 and 122:
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
Page 131 and 132:
Chapter 12 Procurement Arrangements
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agencies for taking up inspections
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contractor/supplier. However, the v
Page 137 and 138:
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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B) Consultancy Services (>US$200,00
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4. Contract Awards for Consultancie
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monitoring of procurement undertake
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Topic Type of risk Mitigating Actio
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Page 153 and 154:
use, fraud, corruption may still re
Page 155 and 156:
Page 157 and 158:
Chapter 14 Economic and Financial A
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diagnosis and treatment, causing su
Page 161 and 162:
Table 1: Estimated Costs of Current
Page 163 and 164:
Table 3: Estimated Incremental Cost
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Chapter 15 Safeguard Policy Issues
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State/Uni on Territory Number of Pr
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15.3.1 Surveillance, Case Diagnosis
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eluctant to allow their homes to be
Page 173 and 174:
equipment, optimal coverage and qua
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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
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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
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Action Responsibility By When Cost
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procured under the project; (6) bi-
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of each identified district to succ
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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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