National Deworming Day February 2017 Training of School

National Deworming Day- February 2017 Training of School Headmaster/Teacher Ministry of Health and Family Welfare | National Deworming Day (February 2018)

Session Details 1. 2. 3 4 5 6 7 8 National Deworming Day Overview Types of Worms and Symptoms Impact of Worms on Health, Nutrition, Education Benefits of Deworming Benefits of School-based Deworming Community Awareness and Mobilization National Deworming Day and Mop-up Day Adverse Events and Adverse Event Management (AEM) Steps to be Followed by the School on NDD and Mop-up Day Recording and Reporting Ministry of Health and Family Welfare | National Deworming Day (February 2018) 1

National Deworming Day Overview Fixed day approach for the deworming program Objective: Deworm all children (boys and girls) aged 1 -19 at schools and anganwadis for improved child health, nutritional status, access to education and quality of life. Stakeholders: Department of Health and Family Welfare, Department of Education, Department of Women and Child Development (ICDS); , Department of Urban Development, Development of Rural Development; Department of Tribal Development; Department of Drinking Water and Sanitation; Department of Panchayati Raj; Department of Human Resource Development; Evidence Action. Deworm the World Initiative; Development partners Ministry of Health and Family Welfare | National Deworming Day (February 2018) 2

Common Behaviours in the Community • Playing barefoot outside • Not washing hands before eating food • Defecating in the open • Not washing hands after using the toilet • Eating fruits and vegetables without washing • Not keeping food covered, which may result in food contamination Ministry of Health and Family Welfare | National Deworming Day (February 2018) 3

Types of Worms are parasites that thrive on nutrition from the human intestine How do worms spread? § § Worm infections result from poor sanitation and hygiene conditions Hook worm Whip worm Worm transmit through contact with infected soil Round worm Ministry of Health and Family Welfare | National Deworming Day (February 2018) 4

Symptoms of Worm Infections § The greater the amount of worms in a child (intensity), the more symptoms the infected individual will have § Severe infections can cause a range of symptoms including diarrhoea, abdominal pain, weakness, vomiting, and loss of appetite § Children with mild infections usually show no symptoms Ministry of Health and Family Welfare | National Deworming Day (February 2018) 5

Worm Transmission Cycle 1. An infected child contaminates soil with faeces containing worm eggs. These eggs develop into larvae in the soil 2. Other children are infected by eggs ingested through food or dirty hands, or by larvae penetrating the skin 3. In an infected child, eggs and larvae develop into adult worms, which produce eggs and have an ill effect on the child's health Ministry of Health and Family Welfare | National Deworming Day (February 2018) 6

Impact of Worms on Health and Nutrition Worm infections impair the nutritional status of the people they infect in multiple ways: § Worms feed on host tissues, including blood, which leads to anemia. § The nutritional impairment has significant impact on growth and physical development. § Worms consume nutrients meant for the human body and cause blood loss, poor nutrition and stunted growth. § Roundworm may compete for vitamin A in the intestine. Ministry of Health and Family Welfare | National Deworming Day (February 2018) 7

Impact of Worms on Children’s Education and Long Term Productivity § Due to heavy infection, children are often too sick or tired to concentrate at school or attend school/anganwadi. § Worm infection negatively affect children’s physical and cognitive development, which could have long term negative impact on their work potential and wages in adulthood. Studies show that absenteeism in schools decreases by 25% with regular deworming. Ministry of Health and Family Welfare | National Deworming Day (February 2018) 8

Preventing Worm Infection Ministry of Health and Family Welfare | National Deworming Day (February 2018) 9

How to Treat Worms Deworming Drug- Albendazole 400 mg (available free-of-cost) Albendazole should be administered to all children aged 1 to 19 in age-specific doses. Albendazole is a safe drug for both children and adults and has been used to treat millions of people across the world for Soil Transmitted Helminths. Albendazole tablets that are not chewed or crushed may have significantly lower effectiveness. 10 Ministry of Health and Family Welfare | National Deworming Day (February 2018)

Benefits of Deworming Direct Benefits: Indirect Benefits: • • Controls anemia Improves nutritional uptake • Helps improve concentration, capacity to learn, and attendance at school and anganwadi. • Helps improve work potential and livelihood opportunity. • Benefits the community by reducing worms in the environment. Ministry of Health and Family Welfare | National Deworming Day (February 2018) 11

Benefits of School-based Deworming Schools: • Offer a unique opportunity and platform to deliver deworming drug to a large number of children in a safe manner • Enable the program to reach high coverage in a single day as majority of targeted children are available at the schools Teachers: • Are an invaluable resource for administering deworming drug • Can pass on knowledge about prevention and treatment for worm infections as they are highly respected by the community, including parents and children Ministry of Health and Family Welfare | National Deworming Day (February 2018) 12

National Deworming Day and Mop-up Day • Albendazole will be administered on National Deworming Day (NDD), 10 February 2018, across all schools and anganwadis for all children aged 1 to 19. • Teachers will administer Albendazole to all school-enrolled children aged 6 -19 years at the school. • AWWs will administer Albendazole to all children aged 1 -5 years and unregistered, out-of-school children aged 1 -19 years at the anganwadis. • Unregistered and non-enrolled children will be mobilized to the nearest anganwadi for deworming with support from the ASHA. • Children who are sick or are on medication should not be administered the tablet. These children should be advised to have the Albendazole upon recovery. • Children who could not be dewormed on NDD must be administered the drug on mop-up day (MUD) on 10 February 2018. Ministry of Health and Family Welfare | National Deworming Day (February 2018) 13

Community Awareness and Mobilization Ministry of Health and Family Welfare | National Deworming Day (February 2018) 14

Community Awareness and Mobilization Teachers should • Inform community about benefits of deworming and NDD • Inform the children at the morning assembly and in the classroom about deworming and having Albendazole on NDD • Motivate all parents, relatives to get their children to school on NDD for deworming. Share the messages at the School Management Committees and parent-teacher meetings • Provide adequate information to the parents or children on how the tablet should be administered and consumed • Inform students and parents about the benefits of deworming and dates of deworming • Inform parents, children, and community members about deworming messages appearing in newspapers, radio, and TV that they should watch/listen to carefully Ministry of Health and Family Welfare | National Deworming Day (February 2018) 15

Adverse Events and Its Management What are Adverse Events? • Deworming has very few side effects on children • Events such as nausea, vomiting, diarrhoea, and weakness may occur among few children especially those with high worm infections • Any adverse events are temporary and generally can be managed easily at the anganwadi. Role of the Teacher: • Use a spoon to administer Albendazole to the child yourself and not give it to the parents to take home • Do not forcefully administer the tablet to any child • Inform parents about mild side effects and that it is expected only in children with high worm load • Build confidence in parents that the child will be taken under observation and care if they show any serious side effects • Must be prepared to take care of the child during any adverse event • Call_____ for any medical assistance Ministry of Health and Family Welfare | National Deworming Day (February 2018) 16

Adverse Event Management Albendazole is safe for both children and adults: • • • Albendazole is an easily chewable tablet Choking is not to be considered a serious adverse event and is a medication error Instruct older children to chew the tablet properly. Ensure safe drinking water is available Albendazole tablets that are not chewed or crushed may have significantly lower effectiveness. Still, if the child chokes on part of the tablet, make the child bend over on your lap and pat the child on the back till the tablet comes out Take the child to an open and shaded place and allow the child to lie down and rest Call ______ for any medical assistance Do’s Don’ts Always ask children to chew the tablet. Ensure safe drinking water is available. Never administer the tablet to children who are sick or are on any other medication Use a spoon to administer Albendazole to the child themselves Do not instruct children to swallow the tablet Do not allow the child to take the tablet home DO NOT PANIC AND FOLLOW PROTOCOL Do not forcefully administer the tablet to any child Manage the Adverse Events as per protocol- call Toll Free Number of Pharmacovigilance Programme of India (PVPI) 1800 180 3024 for assistance in reporting of Adverse Drug Reactions (ADR) and its management. Ministry of Health and Family Welfare | National Deworming Day (February 2018) 17

Steps to be Followed at the School on NDD and MUD 1. Before NDD – Checklist • Ensure availability of sufficient drugs • Keep the phone number of the nearest PHC, MO- Block PHC, ANM handy for Adverse Event Management support • NDD reporting forms • Inform children, parents, and community about NDD kit= Tablets+ Training handout + IEC+ Reporting form • Properly display banner, posters, and other IEC Ministry of Health and Family Welfare | National Deworming Day (February 2018) 18

Steps to be Followed at the School on NDD and MUD 2. Albendazole Administration One full Albendazole tablet is to be chewed properly § Instruct children to chew the tablet completely. Ensure safe drinking water is available. § Do not forcefully administer the tablet to any child. § Use a spoon to administer one full tablet to the child yourself. § Albendazole tablets that are not chewed may have significantly lower effectiveness § Teachers must use a spoon to administer Albendazole to the child themselves and not give it to the parents to be given at home § Teachers must never administer the tablet to children who are sick or are on any other medication § Call______ for any medical assistance. Manage the AE as per protocol and also use of Toll Free Number of Pharmacovigilance Programme of India 1800 180 3024 for reporting the AE. You may also contact the nearby ADR Monitoring Centre Ministry of Health and Family Welfare | National Deworming Day (February 2018) 19

Steps to be Followed at Schools on NDD and MUD 3. Recording Teacher: • On National Deworming Day, along with administering the tablet, must ensure that they mark a single tick (√ ) next to each dewormed child’s name in the class register • On mop-up day, mark a double tick (√ √ ) next to the child's name NDD MUD Ministry of Health and Family Welfare | National Deworming Day (February 2018) 20

Reporting • Every teacher will count the number of ticks on the form after National Deworming Day and mop-up day separately and report this number to the headmaster • The headmaster must ensure the accuracy of the reported data before filling it into the form. Seek help from teacher from your school for cross checking the calculations before submitting the form • After mop-up day, headmaster should report all data in the NDD School Reporting Form and submit to ANM by 20 February, 2018 • Keep one copy of the form in your school for records and verification purposes • ANM to only collect the reporting form and submit it to the MO-BPHC Ministry of Health and Family Welfare | National Deworming Day (February 2018) 21

Reporting Cascade AWW, ASHA to ANM by 20 February ANM to MO-BPHC by 27 February MO-BPHC to District M&E officer by District M&E Officer to State Nodal Officer by 14 March 21 March Ministry of Health and Family Welfare | National Deworming Day (February 2018) State Nodal Officer to Child Health, Mo. HFW by 30 March 23

National Deworming Day 10 February 2018 and Mop-up Day 15 February 2018 All teachers should fulfil their role in this program with enthusiasm and play a part in giving children a brighter future. Ministry of Health and Family Welfare | National Deworming Day (February 2018) 23

Thank You Ministry of Health and Family Welfare | National Deworming Day (February 2018) 24