GENERAL ISSUES MALARIA AND KALAAZAR 1 Micro analysis

GENERAL ISSUES – MALARIA AND KALA-AZAR (1) • Micro analysis of epidemiological data to find out hot spots for concerted efforts • Filling up of vacancies of regular (District Malaria Officers, Multipurpose Workers (Male), Lab Technicians) and contractual staff (state level consultants, Vector Borne Disease consultants, Malaria Technical Supervisors, Kala-Azar Technical Supervisors, Multipurpose Workers, Lab Technicians) • Strengthening of Surveillance (ABER>10% in all blocks)

GENERAL ISSUES – MALARIA AND KALA-AZAR (2) • Micro-action Plan for Indoor Residual Spray (IRS)- to ensure >80% quality coverage • Requirement and distribution plan for LLIN (for saturation by sub-centres) • Utilization of funds and timely submission of SOE and UC

State Specific Issues • Maharashtra – 125 out of 152 malaria deaths in Brihan Mumbai Corporation, Thane and New Mumbai Corporation. Need for special action plan in coordination with local bodies • Bihar – – Need to create 14 and recruit 22 DMOs Large number of MPW posts vacant Appointment letters not issued to 31 VBD consultants Kala-azar Technical Supervisors (186) appointment pending – Very Poor Surveillance – ABER only 0. 16% – IRS Micro- plan not prepared, wages for spray workers for previous years not paid (Sitamarhi, Muzaffarpur)

• Uttar Pradesh – – Very Poor surveillance (ABER 2. 18%) 15 posts of DMO vacant Large number of MPW posts vacant Vector Borne Diseases being looked after by different officials without co-ordination – No information about IRS Plan • West Bengal – – Inadequate Surveillance (ABER 5. 39%) Large number of malaria deaths (100) No contractual MPW recruited against 500 Micro plan for IRS not ready, non availability of spray workers for IRS – ASHAs used only for RCH / MCH

• Jharkhand – – – Surveillance not satisfactory ( ABER 8. 3) No full time SPO 13 DMOs Posts to be created and 17 to be filled up Only 46/89 MTS recruited, No KTS recruited Micro-plan for IRS not ready • Chhattisgarh – Only 2 DMOs out of 16 districts – High Pf proportion (77%) – under reporting of malaria deaths – Micro-action plan for IRS not ready – LLIN distribution through PDS?

• Madhya Pradesh – Only 15/50 DMOs in position – Only 28/516 contractual MPWs recruited – Micro-action plan for IRS yet to be prepared • Andhra Pradesh – 10/23 posts of DMOs vacant – MTS (0/30) and no LT (0/15) contractual posts recruited on • Rajasthan – IRS outsourced - Quality coverage questionable – District plan for IRS yet not finalized

IRS- Micro-Plan (1) • API-wise stratification of sub-centres • Prioritization of sub-centres with API 2 and above for IRS • Estimation of insecticide • Transportation of insecticide to sub-centres • Estimation of requirement of spray pumps and accessories • Engagement of spray workers and their hands-on training

IRS- Micro-Plan (2) • Funds estimation and approval • Deployment of spray workers for spray • Informing community about the date of spray, benefits, and importance of coverage of all rooms • Supervision plan for each level i. e. Sub-centre, PHC, district and State levels • Maintenance of daily dairy by village level supervisor • Submission of daily coverage report

LLIN- Estimation and Distribution Plan (1) • Sub-centres should be the operational Unit for LLIN distribution • API-wise stratification of sub-centres • Prioritization of sub-centres with API 5 and above for LLIN coverage • Estimation of LLIN requirement for procurement • Allocation of LLINs to the State by GOI

LLIN- Estimation and Distribution Plan (2) • Micro-plan for Distribution of LLINs allotted to State by GOI • Distribution schedule for LLINs and the identification of agencies for distribution • Implementation of distribution plan to identified subcentres • Informing community about benefits of LLINs and importance of regular use of nets by involving PRIs, VHSC, ASHA, NGOs • Supervision and monitoring of distribution of LLINs

LLINs Procurement 2009 -10 Supplies Completed S. No. States Global World Fund Bank Total Under Procurement Global Fund World Bank Total Grand Total 1 Orissa 29900000 1199000 700000 448000 1148000 2347000 2 Meghalaya 150000 155000 305000 3 Tripura 166000 300000 466000 4 Mizoram 5 Arunachal Pd. 70000 80000 150000 0 20000 6 Assam 400000 1010000 7 Manipur 0 55000 8 Nagaland 0 50000 9 Jharkhand 0 230000 200000 350000 10 West Bengal 11 Chhattisgarh 12 Andhra Pd. 13 Madhya Pd. Total 150000 100000 1010000 1410000 230000 200000 100000 448000 548000 0 227000 227000 1235000 1000000 2235000 2570000 1580000 4150000 6385000

Audit Reports ( 2008 -09 ) not received from : 1. Andhra 2. Bihar 3. Chhattisgarh 4. Haryana 5. Himachal 6. J&K 7. Orissa 8. Rajasthan 9. UP 10. West Bengal 11. Maharashtra

Budget Allocation & Utilization (2009 -10) (1) State Per Cent Utilizatio Funds Unspent Funds Balance n release Expendi Balance as Allocat + against during ture on 1. 4. 09 ed Released Balance 2009 -10 + released Andhra Pd. 478. 11 554. 00 470. 30 948. 41 405. 51 42. 76 Bihar 1205. 95 704. 00 193. 02 1398. 97 757. 75 54. 16 Chattisgarh 176. 73 650. 00 442. 21 618. 94 293. 23 47. 38 Goa 52. 70 31. 00 23. 91 76. 61 27. 07 35. 33 Gujarat 49. 76 195. 00 641. 91 691. 67 147. 71 21. 36

Budget Allocation & Utilization (2009 -10) (2) State Haryana Per Cent Utilizatio Unspent Funds Balance n Balance release Expendi Allocat + against as on during ture ed Released Balance 1. 4. 09 2009 -10 + released 0. 44 Himachal Pd 46. 00 252. 47 252. 91 0. 00 22. 50 5. 12 0. 00 10. 50 21. 40 29. 43 1. 81 6. 15 J&K 8. 03 Jharkhand 1129 1298. 50 94. 52 1223. 52 418. 63 34. 22 Karnataka 354. 46 171. 50 200. 47 554. 93 21. 58 119. 74

Budget Allocation & Utilization (2009 -10) (3) State Haryana Per Cent Utilizatio Unspent Funds Balance n Balance release Expendi Allocat + against as on during ture ed Released Balance 1. 4. 09 2009 -10 + released 0. 44 Himachal Pd 46. 00 252. 47 252. 91 0. 00 22. 50 5. 12 0. 00 10. 50 21. 40 29. 43 1. 81 6. 15 J&K 8. 03 Jharkhand 1129 1298. 50 94. 52 1223. 52 418. 63 34. 22 Karnataka 354. 46 171. 50 200. 47 554. 93 21. 58 119. 74

Budget Allocation & Utilization (2009 -10) (4) State Per Cent Utilizatio Unspent Funds Balance n Expendi Balance release Allocat + against ture as on during ed Released Balance 1. 4. 09 2009 -10 + released Kerala 226. 26 196. 00 161. 98 270. 60 69. 70 Madhya Pd 241. 58 714. 50 831. 04 1072. 62 158. 97 14. 82 Maharashtra 38. 39 294. 50 442. 50 87. 47 18. 19 Orissa 323. 4 983. 40 708. 98 1032. 38 958. 66 92. 86 Punjab 9. 96 28. 00 2. 97 238. 81 388. 24 480. 89 248. 77 7. 38

Budget Allocation & Utilization (2009 -10) (5) State Per Cent Utilizatio Unspent Funds Balance n Expendi Balance release Allocat + against ture as on during ed Released Balance 1. 4. 09 2009 -10 + released Rajasthan 132. 66 130. 00 377. 59 510. 25 124. 10 24. 32 Tamil Nadu 231. 24 272. 00 453. 71 684. 95 461. 89 67. 43 117 762. 00 645. 54 762. 54 129. 96 17. 04 30. 13 4. 70 15. 60 569. 23 104. 04 18. 28 Uttar Pradesh Uttarkhand 24. 58 19. 00 5. 55 West Bengal 191. 49 748. 30 377. 74

State-wise Status of DMOs S. No. State 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Orissa Jharkhand Goa Chhattisgarh Haryana Madhya Pradesh West Bengal Rajsthan Kerala Gujarat Maharashtra Uttar Pradesh Tamil Nadu Andhra Pradesh Uttarakhand Punjab Karnataka J&K Himachal Pd Bihar No. of Districts 30 24 2 16 21 3 11 1 2 21 27 13 0 14 0 In position 3 7 1 2 21 50 50 44 6 15 35 20 33 14 26 37 71 42 20 33 14 26 36 70 42 0 0 1 1 0 20 33 11 24 25 56 42 0 0 3 2 12 15 0 23 23 22 1 13 10 13 20 29 22 12 38 9 20 28 6 4 0 1 5 11 25 6 8 9 4 0 24 14 16 22 Required Sanctioned To be Created Vacant 27 17 1 14 0

VBD Consultants (World Bank) State Consultants State Dist. VBD Consultants Allotte Recomme In Allotted d nded Position Recomme In nded Position Andhra Pradesh 5 4 1 5 5 2 Chhattisgarh 5 4 4 11 11 9 Jharkhand* 5 4 3 12+4 10+3 Madhya Pradesh 5 3 2 9 9 7 Orissa 5 3 3 13 11 11 Bihar (KA) 6 31 31 0 11 11 8 W. Bengal (KA) * Malaria + KA 4 Process initiated by NHSRC

Malaria Technical Supervisor (MTS) under World Bank Project MTS States Allocated Recruited Trained Andhra Pradesh 30 0 0 Chhattisgarh 66 48 45 Jharkhand 72 30 30 Madhya Pradesh 54 45 33 Orissa 78 77 58

Kala-azar Consulants & KTS S. No. State No. of VBD Consultants No. of KTS Sanctioned Joined 1. Bihar 31 Nil 186 0 2. Jharkhand 4 3 24 0 3. West Bengal 11 7 66 0 Total 46 10 276 0

Laboratory Technicians (LTs) under World Bank Project LTs State Allocated Recruited Trained Andhra Pradesh 15 0 0 Chhattisgarh 33 21 0 Jharkhand 36 32 0 Madhya Pradesh 27 20 20 Orissa 39 36 36

Multipurpose Workers (Male-Contractual from NVBDCP) S. No MPW )from Domestic Budget( States Sanctioned Recruited Trained 1 Jharkhand 1116 1080 2 Orissa 816 561 204 3 West Bengal 500 0 0 4 Andhra Pradesh 55 40 40 5 Chhattisgarh 830 0 6 Madhya Pradesh 516 28 0 7 Maharashtra 116 95 0 8 Rajasthan 66 66 66 9 Karnataka 156 Total 4171 State is filling from their own fund 2592 1350

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