training module for medical officers primary health centre - NVBDCP

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4.5: COMMUNITY PARTICIPATION AND BEHAVIOUR CHANGE COMMUNICATIONCommunity participationIt is practically impossible to even think of controlling malaria without the active participation andownership of the public at large, particularly of the poorer sections that bear the brunt of the disease. Itis expected that public health action against malaria is a major felt need in high burden areas, and thatpeople do have basic interest and motivation in acting against malaria in these areas.Since there is much misinformation and misunderstanding of the disease among the public, a strongeducational component is a necessity, which can complement the strong “supply-side” interventions(RDT, ACT, ITN/LLIN) that the program now offers. These three interventions have benefits tangible toeveryone thus increasing the likelihood of their acceptability and utilization.In place of microscopy which often involved more than a few days to get results due to distantlaboratories, RDTs can be conducted in front of the patient by anyone with simple training, and resultsbecome available within 15 minutes. ACT is virtually 100% effective against P. falciparum, and has nocommon side effects. LLINs do not require repeated treatment with insecticide and are effective for 3 –5 years and up to 20 washes. The main barrier for use of bednets is that people may not be used tosleeping in the confines of a net. This is particularly true of hot regions in summer season with littlebreeze, and those families that cannot afford fans. However, many of them may quickly find that themosquito-free peaceful rest that a bed net affords is worth the discomfort of getting used to sleepinginside the bed net.Each of these three interventions is likely to be appreciated and demanded by the people, once theybecome familiar with these interventions. The challenge is to get people to start using them. A fourthcomponent of the program having high acceptance potential is the establishment of trained ASHAs whoare providers of RDT and ACT. Other suitable volunteers where ASHAs are not available willcomplement the efforts of the PHC and subcentre staff in high-burden areas in the effort to ensure thatall residents of such areas have ready access to diagnosis and treatment. A communications strategythat seeks to build the recognition and credibility of the ASHA and other volunteers as a provider can becrucial to the success of the programme.Health committees at village and PHC levels serve as forums that link providers and users of servicesand are designed to maximize community and provider ownership of program goals and targets. Thescope for community participation in the malaria control program is enumerated in the following table.Table: Scope for Community Participation in the malaria control programProgramComponentBed netdistributionScope for community supportDetermining the mode of distributionin partnership with district / PHCmalaria authoritiesSupporting educational effortsrelated to consistent and correct useof bed nets, particularly amongScope for community monitoringEnsuring equitable distribution inselected habitations, as per normsMinimizing sale of bed nets byrecipients, particularly the poorerhouseholdsAlerting appropriate authorities77
ProgramComponentBed netimpregnationwith insecticideScope for community supportsmall communities not frequentedby health workersDetermining mutually convenientdates with the MPHW or ASHA wholeads the impregnation workProviding labor for impregnationInsecticideResidual Determining dates of spraying inpartnership with district / PHCSpray Spreading the word about dates Informing communities aboutnecessity of IRS Accompanying spray teams tohouses on day of spraying,convincing people about thenecessityLarval control Supporting source reduction efforts,using local labor and funds* asfeasible Spreading word about steps familiescan take to eliminate breedingEarlydiagnosis andtreatmentplacesDetermining the appropriate personto play the role of the local volunteerSpreading the word about theavailability of RDT and ACT with theASHA or other local person /volunteer, and about back-up facilitywhen this provider is absentSpreading the word about the needto get tested early in the course ofillnessSpreading the word about thereliability of RDT and ACT forfalciparumSpreading the word about theadvisability to save on costs by firstresorting to the local malaria careproviderSupporting the provider in recordkeeping, as neededFacilitating quick transport of slidesto the laboratoryScope for community monitoringregarding any malpracticesEnsuring that assigned volunteers orhealth workers conduct impregnationof bed nets as scheduledProviding feedback about perceivedeffectiveness of impregnated bed netsMonitoring whether actual sprayoperations are conducted as pernorms and plansProviding feedback about perceivedeffectiveness of insecticide sprayMonitoring whether actual field workfor source reduction has beenundertaken as per norms and plansDemanding and ensuring one or moretrained providers within realisticaccess of every habitationAlerting authorities about nonavailabilityor non-functioning ofproviderAlerting authorities about stock-outs oftests or medicinesAlerting local providers and higherauthorities about outbreaks78
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TRAINING MODULEFORMEDICAL OFFICERSP
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Distribution of malariaSESSION - 1:
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National Malaria Eradication Progra
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1.2 : JOB RESPONSIBILITIES OF MO- P
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SESSION - 2: MALARIOLOGY2.1: EPIDEM
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2.2: MORPHOLOGY, LIFE CYCLE AND TRA
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Table 2.1: Differentiation of chara
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2.3: VECTOR MOSQUITOES AND THEIR BI
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Bionomics of vector species in Indi
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2.4: EPIDEMIOLOGICAL AND ENTOMOLOGI
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Entomological parameters should be
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Cerebrospinal fluid (CSF) is clear
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3.2: LABORATORY DIAGNOSIS OF MALARI
Page 27 and 28: Examination of blood films for mala
Page 29 and 30: Plate 1: Plasmodium falciparum thin
Page 31 and 32: 3.3: MALARIA CASE MANAGEMENTAntimal
Page 33 and 34: This ACT is highly effective agains
Page 35 and 36: within 72 hours of treatment. Such
Page 37 and 38: In pregnancy, malaria, especially P
Page 39 and 40: Advice to the patients / caretakers
Page 41 and 42: The choice between IRS and ITN/LLIN
Page 43 and 44: Deploy staff for active case detect
Page 45 and 46: Visit the PHCs, subcenters and vill
Page 47 and 48: The Rapid Diagnosis Test (RDT) is d
Page 49 and 50: It should also be ensured that the
Page 51 and 52: Common problems for reluctance to g
Page 53 and 54: 3. Programme management Monitoring
Page 55 and 56: Worker (SFW) to the PHC-MO where a
Page 57 and 58: The data collected through the syst
Page 59 and 60: Outcome - IRS Coverage - Population
Page 61 and 62: Level Staff FrequencySupervisor (wh
Page 63 and 64: With improved access to quality cas
Page 65 and 66: If an epidemic is predominantly due
Page 67 and 68: 500@ 20-25 houses per pump per day
Page 69 and 70: 3.1.6 Name of Laboratory Technician
Page 71 and 72: 3. Therefore, unless the deceased h
Page 73 and 74: To accord priority for IRS in areas
Page 75 and 76: Consumption of insecticide as deter
Page 77: Step 9: Wash equipments (basin, mea
Page 81 and 82: Benefit of indoor insecticidal spra
Page 83 and 84: The MO-PHC is expected to provide a
Page 85 and 86: Ensure that they have adequate supp
Page 87 and 88: 4.8: LOGISTICS MANAGEMENTPlanningPl
Page 89 and 90: Planning of LLIN coverage is compli
Page 91 and 92: communication among the community f
Page 93 and 94: Examine level of stocksLook for unr
Page 95 and 96: During planned bednet distribution
Page 97: How many of the individuals actuall
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