National Project Implementation Plan - NVBDCP

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elimination target in at least half of these districts at the sub district level. This will contribute to the achievement of the national goal since the project focus will be on the districts that contribute maximally to the cases of Kalaazar in India. 6.1.1 Sub Component 2.a: Improving Kala-azar Case Management 6.1.1 2.a. a) Early diagnosis, complete treatment and referral Early diagnosis and complete treatment strategy would help elimination of the parasite, reduce case fatality rates and increase the credibility of the health system, which in turn will help to increase the utilization of health services by people affected by Kala-azar The case definition of kala –azar will be uniformly applied. A case of kalaazar is a person from an endemic area who has fever of more than 2 weeks with splenomegaly and positive dipstick test. All Patients suspected to be suffering from kala-azar should be tested by dipstick test. Confirmation of Kala-azar cases can be done by examination of bone marrow aspiration in hospital settings since these are envisage. However, this would be required in a few patients only since dipstick test is quite reliable. Once diagnosed, Miltefosine a safe oral drug will be administered under direct observation. In order to retain its efficacy and delay the appearance of drug resistance, treatment cards and patient wise box would be made available at the treatment point. Drug can not be used during early pregnancy and married women in reproductive age who do not use contraception regularly and in infants. The programme will undertake pharmaco vigilance as a part of efforts to maintain the usefulness of this drug in the programme for a long time. Miltefosine will be introduced in 16 districts. In other districts, SSG will continue to be used provided that the resistance level to SSG is less than 10%. Monitoring of side effects and management of side effects will be intensified to minimize the complications from this drug. Efforts will be made to intensify completion of medicine and the use of rescue drugs if there is unresponsiveness and toxicity from SSG. In the districts where resistance levels are higher than 10%, amphotericin B will be used as recommended by the national programme. The activity schedule for the first year is presented in Table 1. A detailed log-frame for subsequent years will be developed later, based on lessons learnt in the six months of implementation. 44
Table – 1 Activity schedule for the first year Result Indicator Activity Time Schedule Respon sibility 30% of Kala-azar cases are diagnosed and given complete treatment with first line drug No of PHC offering Dx Rx according to national guidelines and SOPs No of PP/ NGO sector facilities offering Dx Rx Develop district action plan Identify areas for use of RDK & Mf Map the high risk areas, Calculate need Supply RDK, Miltefosine Train staff Use diagnostic kits and Miltefosine Nov 08 Nov 08 Jan 09 Jan 09 Feb 09 District, state District, state NVBDCP , state State, NVBDC State, District Compliance follow up ongoing District Severe cases treated at referral centers Case fatality is less than 10% Case fatality rate District Action Plans are made Referral centers identified and mapped Health workers are trained to identify severe cases Sept 08 Jan 09 Feb 09 MO PHC District MO PHC District MO PHC District Staff at referral centers are trained to treat severe cases Including reserved beds for for treatment of Kala-azar Feb 09 MO PHC District PHC/ CHC MO are trained to treat severe cases of Kala-azar Feb 09 State NVBDCP Centers are equipped with medicines needed Feb 09 State NVBDCP 45
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 and 36: e available within 24 hours. In oth
Page 37 and 38: 4. Behavior Change Communication A
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: Chapter 6 Elimination of Kala-azar
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
Page 95 and 96: insecticides in use in 200 sites, w
Page 97 and 98: Purpose Level Person Frequency Comm
Page 99 and 100: Monitoring and Evaluation will incl
Page 101 and 102: finger-prick blood sample taken by
Page 103 and 104:
A Total mid-year population B Total
Page 105 and 106:
2a. Elimination of kala-azar a.i. P
Page 107 and 108:
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
Page 115 and 116:
2 Additional Staff in District VBD
Page 117 and 118:
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
Page 123 and 124:
separate financial management cell
Page 125 and 126:
World Bank will review of the annua
Page 127 and 128:
In parallel and in support of enhan
Page 129 and 130:
Risk Residual Risk Rating Risk Miti
Page 131 and 132:
Chapter 12 Procurement Arrangements
Page 133 and 134:
agencies for taking up inspections
Page 135 and 136:
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
Page 141 and 142:
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
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 and 194:
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
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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