MALARIA CONTROL PROGRAMME: ROLL BACK MALARIA INITIATIVE

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MALARIA CONTROL PROGRAMMEROLL BACK MALARIA
INITIATIVE
Draft National Strategic Action Plan for ITN
Promotion and implementation 2004-2008
(Pakistan)
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Major Vector Borne Diseases

• MALARIA
• LEISHMANIASIS

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ITN IMPLEMENTATION

• VISION
• 54 of the Households in the highly endemic
  districts would have at least one ITN by the year
  2008
• GOAL
• To reduce malaria and leishmaniasis burden in
  Pakistan using ITNs as a key intervention
• OVERALL OBJECTIVE
• Increase use of ITNs by all household members in
  the target areas.

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Cont..

• OUTCOME 
• 1. 54 of households in the 23 endemic
  districts with RBM components in place will
  have at least one ITN by the end of 2008 by
  adopting and implementing effective strategies.
• 2. 50 of nets used by the households are
  effectively re-treated with insecticides by the
  end of 2008.

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Cont/

• The first phase would be based on the
  implementation and promotion of ITNs through
  public-private partnership involving three major
  NGOs in the country.
• Building upon the lessons learnt from this
  initial implementation (pilot phase) the
  expansion of ITNs would be gradually enhanced in
  a further phased manner by involving more
  partners including public sector and mobilizing
  commercial sector.

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Cont/

• The public sector would take lead role in
  facilitating the NGOs and commercial sector by
  ensuring conducive environment.

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PRODUCTS and ACTIVITIES

• Outcome 1 54 of households in the 23 endemic
  districts with RBM components in place will have
  at least ITN by the end of 2008 by adopting and
  implementing effective strategies.
• Mechanisms for identifying target population are
  developed
• Public/private, private/private partnerships
  being developed.

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Cont/

• ITN distribution systems and mechanisms to be
  developed.
• ITN promotion plan is being developed, using
  communication for behavioural impact methodology.
• Models and guidelines for targeting subsidies are
  being established. Procurement strategies are
  developed.

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Cont/..

• Outcome 2 50 of nets used by target
  populations are effectively treated with
  insecticides by the end of 2008.
• Initial treatment need to be ensured
• Accessible and functional ways and means for
  treatment / re-treatment to be identified.
• BCC strategy developed.

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OPERATIONAL STRATEGIES

• Implementation by Public Sector
• Political Commitment
•  
• At the national level, policy makers in the
  Planning Commission, Ministry of Health and
  Ministry of Finance have shown their commitment
  by making Malaria control a high priority and by
  ensuring that the programme has adequate funds.

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Cont/

• Securing Financial Support
• At the federal level through PC-1
•  
•     With the support from WHO in the form of JPRM
  and GFATM,
•  
• Additional financial support would be managed
  through revised federal and provincial PC-1 and
  with donor assistance.
• Various donors including WHO, USAID, DFID,
  UNICEF, JICA, GFATM, etc would be approached.

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Cont/..

• Integration to Primary Health Care
• The roles and responsibilities and the mechanisms
  to introduce the ITNs through primary health care
  structure including the outreach community health
  workers such as Lady health workers, vaccinators,
  etc need to be evolved through a consultative
  process.
•  

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• Availability of ITNs
• Purchase of LLNs of proven quality would be made
  initially from the international market. However
  the local manufacturers would be encouraged.
• Various incentives such as providing technical
  expertise, advice, removing or minimizing import
  taxes/duties on raw materials for ITNs, etc would
  be discussed and offered to the local
  manufacturers.

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• Category-Specific Training
• The district level institutions (such as
  District Health Development Centers - DHDC) will
  be engaged to conduct training of LHWs and
  vaccinators in a district.

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Supervision, Monitoring and Evaluation

• The federal and the provincial malaria
  directorates will ensure in-time arrangements for
  monitoring and supervision such as logistic and
  technical support, protocols/ tools and
  indicators at the district level.
• The district health office will use the district
  malaria staff to carry out the monitoring of the
  ITNs implementation.

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Development of ITNs Materials including IEC
Material and Messages

• The federal malaria directorate in collaboration
  with its partners will develop various
  context-sensitive guidelines, training materials
  and management tools for ITNs.
• The federal MCP, with the help of partners, will
  continue revising the materials by incorporating
  evidence-based interventions.

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Operational Research Initiatives

• 1.Malaria endemicity and transmission in the
  various regions of the country.
• 2-Demographic data the population at risk of
  malaria.
• 3-To ensure effective distribution, preferences,
  affordability and use of ITNs in the community.
• 4-KAP surveys to determine what topics
  promotional messages should focus and how best to
  promote ITNs.
• 5-Constraints/determinants of ITNs use and
  community beliefs regarding ITNs.
• 6. Research on Monitoring and Evaluation
  indicators 
• 7 Research on Sourcing and Procurement
•  

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Implementation by Public-Private Mix

• Private sector support to public sector
• F   Sharing the implementation
• F   Sharing the experiences and materials (IEC)
• F     Sharing information
• F Designing and conducting operational
  research
•    Organizing support for advocacy and mass
  awareness campaigns

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• Public sector support to private sector
• F   Sharing the technical advice/guidance
• F     Sharing the training resources
• F   Providing material support (ITNs and print
  materials), where feasible

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Implementation by Commercial Sector

•   Brand specific demand creation.
•        Product development.
• Distribution to general population at
  commercial price. 

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Cont/

• Establish Baseline
• Develop and Implement a BBC strategy for ITNS
• Develop and Implement a Marketing Strategy
• Train the Sales Agents in Marketing
• Sale of ITNs including mechanisms of reporting
  and monitoring channels
• Third Party Evaluation

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EXPANSION PLAN
Expansion subject to availability of
additional funds
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  Total Net Implemented by year 2008 is
0.51million.
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AVAILABLE FUNDING
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WHAT NEXT ?

• Review, refine, make consensus, finalization and
  endorsement of National ITN Strategic Action Plan
• Operationalization of ITN strategy
• Initiation of ITN implementation through GFATM

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Directorate of Malaria Control
THANK YOU