Several measures
INTRODUCTION
Several
measures have been undertaken by the National Government to improve the health
of the people prominent among these measures are the National Health
Programmes, which have been launched by the central government for the control
/ eradication of the communicable diseases and to improve the rural health.
NATIONAL MALARIA CONTROL PROGRAMME [NMCP]
It was started in the year 1953 as a Joint
Venture of State and Central Governments with the assistance from international
organizations like WHO and USAID.
The
main objective of NMCP was to reduce the incidence from massive proportions to
such low level that the disease would cease to be public health problem.
The
main strategy of NMCP was indoor residual spraying with DDt dose 100 mg per square feet twice with in a year during
transmission season. Areas with spleen
rate below 10 percent of population were left out.
This
programme was renamed as ‘National Antimalaria Programme [NAMP] in 1999.
Achievements
Before
the start of operation, there were 75 million cases, with spleen rate of 15.7
percent proportional case rate of 10.8 percent, child parasite rate -3.9
percent and infant parasite -1.6 percent.
At the end of operations total case were reduced to 2 million spleen
rate, 8.2 percent, proportionate case rate -0.8 percent and infant parasite
rate 0.6 percent.
NATIONAL MALARIA ERADICATION PROGRAMME (NMEP) 1958
Government of
According
to international standards, the programme was divided into preparatory, attack,
consolidation and maintenance phases.
1.
Preparatory phase
An
organizational programme was planned based on the results of surveys.
2.
Attack phase
This
phase is to take antimosquito measures, prompt treatment of infected cases and
search for malaria cases.
3.
Consolidation phase
This
phase is last for 3 years. The main
activities undertaken during this phase were active surveillance, passive
surveillance presumption and radical treatment epidemiological investigation of
foci, and institutional remedial measures to eliminate foci.
4.
Maintenance phase
In
this phase surveillance is withdrawn and vigilance is introduced. No case of malaria of indigenous origin for
consecutive 3 years.
MODIFIED
PLAN OF OPERATION
1.
OBJECTIVES
The
modified plan of operation under the national Malaria Eradication Programme
came into force from 1st April 1977 with the following objectives.
To
prevent death due to malaria. To reduce
malaria morbidity. To maintain
agricultural and industrial production by undertaking intensive antimalarial
measures in such areas. To consolidate
the gains so far achieved.
2. RECLASSIFICATION
OF ENDEMIC AREA
The
report of the consultative committee of experts indicated that in order to
stabilize the malaria, situation in the country, areas with annual parasite
incidence 2 and above should be taken up for spray operations.
3. AREAS WITH API MORE THAN 2
Ø Spraying
Ø Entomological
assessment
Ø Surveillance
Ø Treatment of cases
4. areas with api less than
Ø Spraying
Ø Surveillance
Ø Treatment
Ø Follow up
Ø Epidemiological
investigation
5. DRUG
DISTRIBUTION CENTRE AND FEVER TREATMENT DEPOTS
With
the increasing number of malaria cases the demand for anti-malarial drug has
increased tremendously. It became clear
the drug supply only through surveillance workers and medical institution was
not enough. This led to the
establishment of wide network of drug distribution centre and fever treatment
depots.
6. URBAN
MALARIA SCHEME
The
urban malaria scheme was launched in 1971 to reduce or interrupt malaria
transmission in towns and cities.
7.
P.FALLIPARUM CONTAINMENT
The
specific purpose of this component is the prevent or contain or control the
speed of falciparum malaria.
8. research
Six monitoring teams are now working in
different parts of the country to identify P.falciparum sensitivity to chloroquine.
9.
HEALTH EDUCATION
It
emphasis the health education given to the public to enlist their co-operation
in malaria control activity.
10.
REORGANIZATION
Before
the implementation of modified plan of operation the NMEP was on population
basis which in many places did not confirm to the administrative boundaries. This has now been remedied and antimalarial
unit have been reorganized in conformity with the geographic boundaries of the
district making the District Health Officer (DHO) responsible for the
implementation of the programme.
ENHANCED
MALARIA CONTROL PROJECT
The
main components strengthened the project include:
Ø Early case detection
and treatment
Ø Selective vector
control and personal protection methods including insecticide treated mosquito
nets.
Ø Epidemic planning and
rapid response.
Ø Intersectoral
co-ordination, institutional and management capabilities strengthening and
Ø Use of larvivorous
fish.
GOALS
FOR THE TENTH PLAN
The
set goals for malaria control in the country during the tenth five year plan
are
1.
Annual
Blood examination rate over 10 percent
2.
Annual
parasite incidence 1.3 or less
3.
25
percent reduction in moribidity and mortality due to malaria by 2007 and 50
percent by 2010 (National Health Programme 2002).
CONCLUSION
National
Malaria control programme launched in the 1953 as a joined venture of state and
central governments with the assistance from International organization in
order to reduce the incidence felt from massive proportions to such a low level
that the disease would cease to be public health problem. Modified plan of operation objectives and its
classification on the basis annual parasiteincidence are also sustain in this
presentation.
BIBLIOGRAPHY
1.
K.PARK
Parks text book of
Preventive and Social Medicine
18th
Edition
Pg.no.329-331
M/s. Banassidas Bhanot
Publishers
2.
B.T.Basavanthappa
Community Health
Nursing
2nd Edition
Pg.No.365-370.
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