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 India in the Ministry of Health changed the strategy from malaria control to eradication and launched the more ambitious National Malaria Eradication Programme in 1958.

 

          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          In this phase surveillance is withdrawn and vigilance is introduced.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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