1. Malaria Control Programme, Orissa CDMO Conference 21-22 Jan, 2010

2. Declining trend with hopes for control Maps with API: 2005, 2008 and 2009 YearDists. with API < 2 Dists. with API 2-5 Districts with API 5-10 Dists. with API >10 200573614 2008103413 2009104412

3. Epidemiological situation,2005-09 Year+vePFDeathsABERSPRPf% API 200539657334265825512.368.188610 200637271032489325312.337.59879.4 200737187932315022112.227.52879.2 200837543032963123912.237.46889.1 2009 (provisional)369390 325063 20112.197.26888.8

4. Districts with high mortality, 2007 to 2009 Sl. NoDistricts200720082009% Increase(+) / decrease (-) in 2009 over 2008 1 Kandhamal2949 35 -28.6 2 Keonjhar3123 16 -30.4 3 Rayagada2723 20 -13.0 4 Sundargarh1222 12 -45.5 5 Nuapada2321 18 -14.3 7 Sonepur716 7 -56.3 8 Koraput3015 31 106.7 9 Nawarangapur410 0.0 10 Balasore* ???38 11 37.5 There is no death investigations – * In Balasore out of 6 malaria deaths reported during the month of November only one could be ascertained due to malaria.

5. LLIN distribution : GFATM districts SL NO.DIST LLINs ALLOTED Supply of LLINs to districts (at Block level) No. of LLINs distributed to beneficiaries Expected allotment in 2009-10 1 Angul 61000 60000 2 Bargarh 20000 50000 3 Bolangir 25000 1650050000 4 Boudh 64000 3600050000 5 Deogarh 36000 12000 6 Dhenkanal 44000 60000 7 Nayagarh 19000 50000 8 Sonepur 30000 70000 9 Balasore 50000 10 Bhadrak 20000 11 Cuttack 38000 12 Ganjam 100000 13 Jajpur 50000 14 Khurdha 40000 Total 299000 72500700000

6. LLIN distribution World Bank Districts SL NO. DISTLLINs ALLOTED Supply of LLINs to districts (at Block level) No. of LLINs distributed to beneficiaries Expected allotment in 2009-10 1 Gajpati 40000 2 Jharsuguda 30000 3 Kalahandi 100000 30000 4 Kandhamal 100000 3500030000 5 Koraput 50000 2000030000 6 Keonjhar 100000 30000 7 Malkangiri 40000 30000 8 Mayurbhanj 150000 50000 9 Nawrangpur 30000 40000 10 Nuapada 40000 38000 11 Rayagada 40000 2000030000 12 Sambalpur 30000 13 Sundargarh 150000 5000040000 Total 900000 165000448000

7. Key features of the state LLIN guidelines – Criteria - sub-centre is the unit and in the first phase SCs with API >5 – SCs with API 3-<5 will be included when more LLINs will be available – All villages in a SC irrespective of API status of the village – Cluster approach: to protect entire population in defined high transmission area. Clusters may be intra or inter block, intra or inter-dist. All families irrespective of BPL and APL will be given LLIN Avg. LLIN calculation : 1 LLIN/ 2.5 Persons +3% extra [ 1 LLIN for 1-2 persons, 2 LLINs for 3-5 persons, 3 LLINs for 6-7 persons, 4 LLINs for 8-10 persons.]

8. Key features ……… contd  Identification of cluster areas was done through regional level workshops with state level facilitation. (representatives of 4-5 contiguous districts present at each workshop)  Survey of households in villages under a cluster through Gaon Kalyan Samitis (GKS) for identifying actual need  Distribution by GKS members under the active supervision of block, district and state.  List of beneficiaries to be maintained in designated registers.

9. LLIN Distribution format Block:__________ SC:___________________ Village:_________________ Sl No. Head of the HH Total No. of family members No. of pregna nt women No of U-5 Children No. of LLIN Supplied to HH Sl. No of LLIN Rupees received as contribution Date of Distributi on Sign./thumb impression of the receiver 1 2 Database to be maintained at Block, District and State level. BPO in coordination with MTS and VBD Consultant will maintain the data Data will be uploaded at Dist. & State Health Department Web Site * In the format one extra column has been added to collect the data on under five children in the household who are being protected by LLIN

10. Distribution of 11.99 lakh GoI LLIN in 09-10 Nominal contribution to be collected as a symbol of ownership GKS will collect Rs 10-15 per LLIN from BPL and Rs 20-30 from APL persons - But no one to be left out if unable to contribute. This fund will be used by GKS for malaria control activities, replenishing nets if torn out and BCC at village level.

11. MO- MASHARI – the state initiative Objective: to protect the following special groups by LLINs with special message of ownership 1. Pregnant women in high burden areas (family size LLIN) – LLIN distribution at the time of antenatal registration as a component of ANC package. – This is expected to cover pregnant women during pregnancy and mother and child after delivery. 1.01 lakh LLINs already in the distribution process in five high endemic districts and another 2 lakh LLIN will be procured in 2010-11 2. Boarders of Tribal Residential Schools (single size LLIN) – The boarder will own the LLIN, can take home during vacations and permanently after leaving the school - “will act as the agent of change in his/her community”. Distribution through Headmaster/Headmistress of tribal schools.

12. Current distribution plan under Mo Mashari for pregnant women, 2009-10 Sl NoName of the DistrictLLIN Allotment 1Kandhamal13350 2Keonjhar38000 3Rayagada20000 4Malkangiri11000 5Nawarangpur19000 Total101350 Another 10 high burden districts will be covered in 2010

13. Important activities around LLIN State team will monitor district LLIN implementation Computerized data base of LLIN distribution – BPO are to be involved for data entry at block level which will be consolidated at DPM unit for the districts. – MTS of concerned blocks and VBD consultants of WB Districts will coordinate with BPO and DPM units respectively. Districts while distributing will document with photographs Professional process documentation of LLIN activities will be done by T & MST

14. Important activities …………….. – Appropriate IEC / BCC like use of folk media and other methods along with distribution of LLIN or after the distribution depending upon the ground reality, so that by the peak transmission season, people are in habit of sleeping under LLINs and do not misutilise Dy MEIO/ BEE must be involved in the IEC/BCC activities and whole process – Pre-distribution information on village-wise days of distribution and post- distribution information of number of LLINs given village-wise will be displayed on the swathya kanthas and documented with photography.

15. Important activities …………….. Network and established civil society organisations will be involved for social mobilization around LLIN who will also give hand holding support to GKS – State level initiatives will be taken to involve Red Cross, NYKS, Kalyanee clubs, MNGOs etc. Summary of nets distribution status would be uploaded on the health department website and updated regularly

16. IRS in LLIN areas In 2010, IRS will also be conducted in LLIN areas – This will be done since we are not sure about the extent of acceptance and usage of LLIN in the first year – Accordingly the IRS action plan will revised A total district wise readiness plan will be developed by 1 st week of Feb 2010 so that 1 st round IRS can be conducted with full preparedness by 15 th May 2010. – IRS Action plan meetings will be conducted from 27 th to 29 th Jan, 2010. – VCRC, NIMR, RMRC and RD office will be involved from the beginning in planning and monitoring

17. GKS fund to meet IRS wages & operational cost for bednet impregnation IRS wages The wages for IRS will be met from GKS fund in2010-11 Necessary communication will be made soon In an average Rs 6000/- may be needed per 2 rounds of spray in a village of average 1000 population Net impregnation: Similarly in Non-IRS villages GKS fund can be used for impregnation of community bed nets – Some GKS show interest to impregnate without operational cost– they need only training and SP flow – Hence local appropriate measures can be adopted – SP flow is available in plenty and can be supplied on indent

18. Issues on IRS Non submission of 2 nd round IRS report: – Following district have not submitted the 2 nd round IRS report: Anugul, Dhenkanal, Gajapati, Ganjam, Jharsuguda, Kalahandi, Keonjhar, koraput, Malakanagiri and Nawarangpur, Nuapda, Samblapur, Sundargarh Dhenkanal not submitted both 1 st &2 nd round IRS report

19. Human resource LTs against regular posts: retired LTs will be posted against the vacant posts – communication will be made soon Additional manpower: Districts lagging behind: MTS : Bhadrak (1), Koraput (1) Malkanagiri (1), Baragarh (1), LT: Nayagarh(1), Gajapati (2), Koraput (1), Balasore (1) – As Koraput has not yet recruited 1 LT and such LTs are meant for sentinel sites, this position will be diverted to another dist MPW (Male): Baragarh (35),Ganjam (34), Mayurbhanj (98), Nawarangpur (22), Koraput (43), Rayagarh (40). Dist. Malaria Officer will be posted as per the new cadre structure.

20. MPHW - Male (567poated /816) DistsSancd Rctd Dists SancdRctd Angul7069Nayagarh88 Balasore30 27Sonepur42 Bargarh35Scr Gajpati3824 Bolangir1918Jharsuguda148 Boudh66Kalahandi37 Deogarh66Kandhamal36 Dhenkanal34 Keonjhar66 Ganjam34 scr Koraput43Scr Malkangiri3125Rayagada40Scr Mayurbhanj98Court caseSambalpur55 Nawrangpur22 scr Sundargarh45 Nuapada57 55 More 184 sanctioned for 2010-11 and will be posted in high burden areas only

21. Status of Submission of GIS Data S.noDistrict Sub centre dataVillage dataREMARK 1Angul submitted not in format 2Balasore not submitted 3Baragarh submitted not in format 4Bhadrak submitted 5Bolangir submitted not in format (given only 2008) 6Boudh submittednot submitted 7Cuttack not submittedsubmittednot given all village data 8Deogarh not submitted 9Dhenkanal not submittedsubmittednot in format 10Gajapati not submittedsubmitted not in format (given only 2008) 11Ganjam not submitted 12Jagatsinghpur submitted not in format 13Jajpur not submitted 14Jharsuguda submittednot submitted 15Kalahandi submitted not in format (given only 2008)

22. Status of Submission of GIS Data S.noDistrict Sub centre data givenVillage wise dataREMARK 16Kandhamal not submittedsubmitted 17Kendrapara not submitted 18Keonjhar submittednot submitted 19Khurda submittednot submitted 20Koraput not submittedsubmittednot in format 21Malkangiri not submittedsubmittednot in format 22Mayurbhanj submittednot submitted 23Nabarangpur submitted 24Nayagarh not submittedsubmitted 25Nuapada not submittedsubmittednot in format 26Puri not submitted 27Rayagada not submittedsubmittednot in format 28Sambalpur not submittedsubmittednot in format 29Subarnapur not submitted 30Sundargarh submittednot submitted Total 1317

23. Issues on sentinel sites Trained LTs (Contractual) should be placed in identified Sentinel Sites (Avg. 2 per districts) Data in proper format to be collected, compiled, analysed and feedback to be submitted to the concern Blocks Sentinel site formats are given in ME Module – And in Dec- Jan all sentinel site LTs have been given reorientation training – They have been given the copies of the formats

24. Quality microscopy Microscopy is said to be the gold standard for malaria diagnosis, but unfortunately we have ??? on the quality In many labs the discrepancy rate is very high (In many cases the +ve slides are –ve as observed by RD Lab.) – which is misleading the malariometric indicators and there is complaint that GoI supplied RDTs are not good as they show -ve results in such cases. Due attention must be given at each level to see the quality aspects of each malaria lab and the skill of the technicians – Malaria technicians will be retrained where their skill is doubtful – All efforts are being taken to supply Lens, reagent etc. – Fund will be provided to districts to procure quality reagent and meet the microscope repair cost – Where non functional microscopes are not in repairable stage new microscopes will be provided – Hence urgent review of all malaria labs to be done by the district authority

25. Other issues NAMMIS: All IDSP data entry operators will be trained (many have already been trained) and they will be responsible for NAMMIS M 1 and other new Surveillance format will be printed at district level to meet another 3 months’ requirement All efforts to be taken to make ACT and RDT available at Sub centre and trained FTD (ASHA) level Trainings: training of MPW (male) and rest of the ASHAs and VSS animators Regular monthly review of VBDs, MTS, LTs and MPW(male) and sorting out their genuine difficulties All malaria death must be investigated as per the guideline using the death investigation format : – A simple malaria death investigation format has been developed by Dte. NVBDCP, GOI and will be sent soon

26. Financial issues Except Deogarh, Jharsuguda, Kandhamal, Kendrapada, Keonjhar, Mayurbhanj, Nawarangpur, Nayagarh, Nuapada & Sundergarh other districts have low expenditure under WB (<10%) GFATM districts under with <5% expenditure: –Angul, Balasore, Bhadrak, Boudh & Khurda : <5% –Dhenkanal is with <10% expenditure SOE & UC of 1 st round IRS : Only Dhenkanal, Malkangiri, Bolangir & Angul & Sonepur have submitted- others are yet to submit SOE & UC of the fund under DBS : Districts have not submitted. All measure be taken to submit SOE by 5 th of every month –Is being submitted to GoI, by 10 th of every month

27. Dist (GFATM Fund) Delay in SOE / UC Low expenditure (%) Dist (WB Fund) Delay in SOE / UC Low expenditure (%) Angul-Do-2.38 Jharsuguda -Do- 11.41 Balasore-Do-0.00 Gajapati -Do- 4.67 Bhadrak-Do-0.87 Kalahandi -Do- 8.26 Boudh-Do-0.00 Rayagada -Do- 3.01 Dhenkanal-Do-9.49 Sambalpur -Do- 6.15 Khurda-Do-3.98 Koraput -Do- 00 Sonepur-Do- 10.34Malkanagiri -Do-.74 Total(all dist) 24.88Total(all dist) 14.57

28. GFATM Fund Position 2009-10 (April to Sept), Odisha Sl No Name of the District Opening Balance Fund Released Total SOE Submitted Closing Balance %age of Expenditure 1234567 8 1Angul1273085 500449 17735344228017312542.38 2Balasore236754 454670 6914240 0.00 3Bargarh2461521 629018 3090539935324215521530.26 4Bhadrak253279 332288 58556751005804670.87 5Bolangir2510221 749353 3259574982181227739330.13 6Boudh1201526 333015 15345410 0.00 7Cuttack19783 466658 486441749043-262602153.98 8Deogarh1389651 276908 1666559341381132517820.48 9Dhenkanal838218 417989 125620711919611370119.49 10Ganjam1890447 810371 27008181200641150017744.45 11Jajpur2215996 461657 2677653763504191414928.51 12Jagatsingpur369847 306521 67636820867046769830.85 13Kendrapara396592 318215 71480714571156909620.38 14Khurda172361 372253 544614216655229493.98 15Nayagarh1659946 507546 2167492730780143671233.72 16Sonepur1730808 437095 2167903223126194477710.29 District Total18620035737400625994041646860219525439 24.88

29. PROGRESSIVE SMCS & DMCS(NVBDCP) in the state of Orissa for the month of Nov-09 SL. No. District Amount carried down from the prv.Financial year(O.B as on 01.04.09 ) Amount recived during the current year up to the immediate last month Funds recived during the current mounth including misc.receipt Total funds available during the financial year till month (A+B+C) Expn.for the year from April 1(Current financialyear till the prv.M onth ending Expn.During the current month (as per the annexure encloseed) Progv.Expn for the current financial year till current month Balance % of Expenditur e ABCDEF G H I 1 Angul-206357 240301412600003456657415140 34151431.20 2 Balasore555582 12092000176478200 0 0.00 3 Baragarh1122599 14705810259318010547125320 13079124623895.04 4 Bhadrak485050 343000082805000 0 0.00 5 Balangir1908083 302332934200052734123257000 49477126.18 6 Boudh1455391 6284671080002191858678910 21239673.10 7 Cuttack713270 48069601193966188080 11751581.58 8 Deogarh384627 4504891080009431163424210 60069536.31 9 Dhenkanal194624 1384792612000219141600 0 0.00 10 Gajapati1352632 228335068400043199822016930 41182894.67 11 Ganjam2160650 2562217047228673128140 44100536.62 12 Jagatsinghpur541467 4148000956267113000 9449671.18 13 Jajpur998486 48460001483086168000 14662861.13 14 Jharsuguda1252071 1245007144000264107816606284664 301270233980811.41 15 Kalahandi1355423 516461166600071860345935100 65925248.26

30. SL. No. District Amount carried down from the prv.Financial year(O.B as on 01.04.09 ) Amount recived during the current year up to the immediate last month Funds recived during the current mounth including misc.receipt Total funds available during the financial year till month (A+B+C) Expn.for the year from April 1(Current financialyear till the prv.M onth ending Expn.During the current month (as per the annexure encloseed) Progv.Expn for the current financial year till current month Balance % of Expenditur e 16 Kandhamal2289708 4735022648000767273032059480 446678241.78 17 Kendrapada376732 43140008081321107000 69743213.70 18 Keonjhar3240216 50477151188000947593125574070 691852426.99 19 Khurda180828 327000050782897270 4981011.92 20 Koraput2890559 52885150817907400 0 0.00 21 Malkangiri2032393 32337345580005824127430700 57810570.74 22 Mayurbhanj2352028 836572501071775322499010 846785220.99 23 Nawarangpur2054549 406808806122637128947844988 1334466478817121.80 24 Nayagarh541362 899708144000158507038205675641 457697112737328.88 25 Nuapada617079 40550171026000569809625906280 310746845.46 26 Puri498258 12000051025800 0 0.00 27 Rayagada1455193 5087313065425061966340 63458723.01 28 Sambalpur1820101 20628659000039729662442010 37287656.15 29 Sonepur610792 1710511756000307730300 0 0.00 30 Sundargarh2812535 5418962810000904149728590760 618242131.62 Dist. Total380459317429172891440001214816591779335443061318223967103257692 15.00 SMCS 8467423 612152601458894916034660 12985483 10.99 Grand Total465133548041325491440001360706081939682043061319827433116243175 14.57

31. IRS Fund Release & Expenditure SL. No.District OHSPDBS 1st RoundExpenditure2nd RoundExpenditureIRS IECMPW Salary Expenditu re 1Angul173700158347 43,882 SOE NOT SUBMITTED 42,032 33,60,000 SOE NOT SUBMITTED 2Balasore0 9,100 22,100 9,00,000 3Baragarh152493135600 15,544 30,344 10,50,000 4Bhadrak0 4,200 12,200 - 5Balangir11602691100000 9,32,980 1,01,080 9,12,000 6Boudh2980330 24,250 27,584 2,88,000 7Cuttack10365292132 50,688 29,956 - 8Deogarh1774810 11,280 19,928 2,88,000 9Dhenkanal102834122076 31,204 33,554 16,32,000 10Gajapati333173267082 1,23,080 51,072 18,24,000 11Ganjam844777773918 1,04,704 99,736 10,20,000 12Jagatsinghpur0 2,100 11,100 - 13Jajpur0 8,400 19,400 - 14Jharsuguda15351061376 12,886 20,836 5,64,000 15Kalahandi15462291190000 12,65,403 1,07,204 17,76,000 16Kandhamal12297861100000 11,65,904 84,332 17,28,000 17Kendrapada0 700 10,700 - 18Keonjhar1088805598000 4,42,865 69,070 31,68,000 19Khurda0 9,800 20,800 - 20Koraput11647011020854 10,14,984 1,80,380 12,90,000 21Malkangiri943327908431 3,95,470 90,412 14,88,000 22Mayurbhanj17231971565197 14,77,500 1,26,678 29,40,000 23Nawarangpur11699931083422 10,69,485 1,30,560 6,60,000 24Nayagarh296934263863 16,154 31,820 3,84,000 25Nuapada7928410 7,72,201 57,100 27,36,000 26Puri0 - - 27Rayagada1325516 13,16,682 1,74,590 12,00,000 28Sambalpur562647 4,15,745 75,298 2,40,000 29Sonepur127497116508 29,386 22,228 20,16,000 30Sundargarh1345877 12,74,881 1,45,504 21,60,000 Dist. Total168172721055680612041458184759833624000

32. Thanks