National Project Implementation Plan - NVBDCP

For kala-azar in each district 3 hospitals/health centers will be selected for
undertaking sentinel surveillance where detailed information will be collected.
Besides detailed information on patients who are treated at home the sentinel
surveillance would also provide information on patients of kala-azar who are
hospitalized and include case fatality rates.
(a) A rapid population-based survey system including the LQAS method
This will be established in each project district to track coverage and use of
LLINs, RDTs and ACTs at the PHC level on an annual basis. Similar tracking in
kala-azar would be done for Rapid diagnostic kits/rk39 (presently used), first
line medicines and treatment completion. It will also be used to assess IRS
coverage. LQAS is a rapid survey used by VBD Officer to determine whether
Primary Health Centres (PHC) are reaching pre-established targets for key
project indicators. The same data can be used to calculate point estimates for
outcome indicators at district levels. The project will explore the possibility for
use of hand held computers, tablets etc.for rapid data entry and to avoid
information bottlenecks. A data for decision-making component will be
established to determine underlying program problems identified with LQAS.
All data will be used during annual work planning sessions to restructure and
improve the project, as well as to set targets for the subsequent year. To
ensure the accuracy of the information collected a small sample of
questionnaires will be sampled and the corresponding interviewee, interviewed
again. By counting the concordant pairs, the reliability of the data can be
established. The data collection and preliminary analysis will be carried out by
MTS. The LQAS is being used because it requires the least amount of
information to judge whether outcomes are on track at the PHC level. This is
due to its small sample size requirements. The following describes the process
in more detail.
Each District (N=1.2 to 1.5 million population) will have approximately 6 MTSs
or 6 KATS whose primary job is program monitoring and supervision. As per
NRHM norms each District consists of approximately 45 sectors (PHC areas,
“new PHC” areas) with a population of 20-30,000, so there are about 15
sectors per MTS. Each PHC area is comprised of approximately 30 villages
(N=1000 each). All LQAS analyses will be at the PHC level and measure key
project indicators using focused mini-questionnaires. Three mini-questionnaires
are currently envisioned: (a) an ITN/LLIN coverage and use module, (b) a
fever management and treatment seeking behavior module, and (c) an ASHA
questionnaire. The fever management module may take place in the
household where the previous mini-questionnaire is used or in subsequent
households. It applies only to people who have had a fever in the last 2-weeks.
The third mini-questionnaire requires the MTS to contact the frontline service
provider to inspect the condition of ACTs and RDTs, whether stock-outs have
occurred in the last 3-months, and whether this provider can use RDTs and
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