Background:
Malaria control project in Nepal was first initiated in 1954 with the support from USAID (the then USOM), with the objective of controlling malaria, mainly in plain region (Terai belt) of central Nepal.
Nepal’s current National Malaria Strategic Plan (NMSP‐2014‐2025) has identified following vision, mission, goals and objectives:
Vision: Malaria‐free Nepal in 2025
Mission: To empower the health staff and the communities at risk of malaria to contribute towards the vision of malaria‐free Nepal in 2026.
Goals:
- To sustain zero death due to malaria from 2012 onwards;
- To reduce the incidence of indigenous malaria cases by 90% by 2018 (relative to 2012);
- To reduce no. of VDCs having indigenous malaria cases by 70% by 2018 (relative to 2012);
- To receive WHO certification of malaria free status by 2025.
Objective‐1: To enhance strategic information for decision making towards malaria
elimination.
Key targets / milestones:
Ward‐wise risk stratified and appropriate/rational interventions executed:
- By the end of 2015, ward‐wise malaria risk micro‐stratification will be, so the intervention units could be wards in place of current VDC’s and earlier districts.
- Introduction of Case based surveillance in all districts by the end of 2014.
- All malaria cases will be recorded and reported through SMS and Web‐based MDIS by the end of 2015.
- Establishment and expansion of Border check posts: 2 in 2014, 2 in 2015 and 3 in 2016 and continued thereafter.
- Three quarterly reviews will be conducted and validation of data completed by the
- end of each year.
- At least 54 foci will be investigated in 2014, 160 in 2015 and 100 each year after.
- Investigated foci will be eliminated gradually and by the end of 2016 a total of 214
- foci will be eliminated, sustained thereafter and gradually increased as per above
- target.
Objective‐2: To further reduce malaria transmission and eliminate the foci.
Key targets / milestones:
Guideline for IVM developed and rolled over by the end of 2014 for implementation.
Prevention using LLIN: Coverage of high risk VDC population through mass campaign and pregnant women in high and moderate risk VDCs through ANC visits.
Prevention using LLIN: Coverage of high risk VDC population through mass campaign and pregnant women in high and moderate risk VDCs through ANC visits.
- 471,747 LLINs in 2014; 149,969 LLINs in 2015; 252,440 LLINs in 2016; 491,112 LLINs
- in 2017 and 155,851 LLINs in 2018.
Prevention using IRS: Regular annual spray covering people living in high risk every year and responsive spraying as indicated by foci investigation.
- 88,444 households in 2014; 60,000 households in 2015 and 30,000 households in 2016.
- Foci elimination and documentation of lessons learnt for prospective activities.
- 54 in 2014; 160 in 2015 and 100 every year thereafter.
Objective‐3: To improve quality of and access to early diagnosis and effective treatment of malaria.
Key targets / milestones:
Update the malaria diagnosis and treatment policy, manual and roll over its application by the end of 2014
Development of training package on malaria case management: development and roll out by 2015
Training on case management of malaria by 2015
Development of training package on malaria case management: development and roll out by 2015
Training on case management of malaria by 2015
- FCHVs in remote VDCs to detect malaria using RDTs,
- Training on malaria case management for public & private sector health care providers
- Finalize and roll over of the SOP on malaria microscopy
- Establish slide banks for training and reference in malaria microscopy
- Conduct internal competency assessment of malaria lab technicians and assistant
- Conduct external competency assessment lab technicians and assistants
- Conduct instructional skills development training for trainers in malaria microscopy
- Basic and refresher training in microscopy
- training in malaria microscopy
- Training on preventive maintenance of microscopes
- Supportive supervision and monitoring of malaria microscopists
- Cross‐checking / validation of blood smears
Expand the use of RDTs and set up QA QC of combo RDTs‐ by the end of 2015
Procurement and supply of antimalarial drugs and diagnostics to avoid stock out
- Regular monthly recording and reporting through FMIS/MDIS.
- Annual health facility survey conducted to document no stock out of logistics.
Objective‐4: To sustain support from the political leadership and the communities
towards malaria elimination.
Key targets / milestones:
Develop and roll out of comprehensive BCC strategy by the end of 2015
- Develop communication package to mobilize communities for malaria prevention
Develop specific materials (print, audio and video) to improve the following behaviors: sleep under nets every night; seek early diagnosis and treatment for malaria, and adhere to treatment on malaria.
Organize Multi‐sector advocacy meetings at national / district levels to support malaria elimination
- Commemorate World Malaria Day: April 25.
- Cross–border collaboration meetings annually for sharing the information and harmonizing interventions.
Objective‐5: To strengthens programmatic technical and managerial capacities towards
malaria elimination
Key targets / milestones:
- Training key program staffs in malariology, case management, entomology, health informatics, GIS mapping , malaria microscopy etc.‐ annual targets in annex‐ budget sheet
- Convene Malaria Technical Working Group; at least 3/yr
- Periodically update the national malaria strategic plan: by the end of 2018, review and revise as necessary
- Supervision, monitoring and evaluation: Annually as per M & E Plan.
- Strengthen VBDRTC capacity in malaria training and research: Equipment provided and staffs deployed as necessary
- Recruit and fill vacant positions at EDCD, VBDRTC, Regions and Districts: By the end of 2014, vacant positions will be filled and sustained there after
- Strengthen partnership with WHO and other national/international institutions: Collaborative meetings, activities implemented
DoHS, Annual Report 2071/72 (2014/2015) Disease Control: Malaria.