Malaria Control
Malaria Branch, District Panchayat, Gandhinagar

A. Problem Analysis

 1. What was the problem before the implementation of the initiative?
National Vector Borne Disease Control Programme (NVBDCP) is implemented in Gandhinagar district as per the policies, strategies and guidelines formulated by Government of India. Since 2005 all the vector borne diseases have been brought under the ambit of NVBDCP. Malaria and dengue were the Vector Borne Diseases prevalent in the district till 2005. Malaria was one of the public health challenges in Gandhinagar district in 2005 particularly in 16 villages of Hajipur and Rancharda PHCs of Kalol taluka. Annual parasitic Incidence (API) of the district was 1.96 in 2005, while morbidity (API) was extremely high in the affected villages ( 32.15%), PHCs (28.1 – Hajipur, 17.8 - Rancharda) and Talukas (8.5). Intense transmission of malaria took place in the district because of favorable conditions such as heavy rainfall and water logging in the aforesaid areas because of peculiar topography, and less impact of vector control activities. Detailed analysis of the malaria situation in Gandhinagar district revealed that Kalol Taluka alone contributed 83.58% of total malaria cases detected in the district in 2005 The affected PHCs contributed 76.06 % of malaria cases in the district. Proportion of Plasmodium falciparum was 18.38 % in 2005, but it was high in Kalol Taluka (85.81% in 2005) and the affected PHCs too (84.65% in 2005). 16 Villages reported very high API (32.15 %in 2004). Proportion of malaria cases detected in females in the district was 37.6% in 2005. Not much variation could be found in Kalol taluka as the proportion was 37.90 in 2005. Age group wise analysis of malaria cases detected in the district could bring out the fact that 68.46% of malaria cases were in the age group of above 15, while in Kalol taluka it was 84.95 %. Deaths reported in 2005 were nil. All malaria cases were indigenous in nature and 98.09 % of total cases detected received treatment in 2005. Major activities that were implemented in 2005 for the prevention and control of malaria were case detection and treatment and indoor residual Spray with Malathion 25 % WDP. The Annual Blood Examination Rate was 15.76 in 2005 of which active and passive surveillance contributed 33.47% and 66.52% respectively. Room coverage with Malathion was87.5 % but the susceptibility status could not be monitored till 2005 and therefore the effectiveness of Indoor Residual Spray could not be ascertained and its impact doubtful. However there were gaps and shortcomings such as coverage in time and space under surveillance, patient compliance regarding treatment of malaria, insecticide resistance and less focus on inter sectoral coordination and awareness generation activities which resulted in intense transmission of the disease in those areas where the conditions were favorable. Gandhinagar district, with adequate infrastructural facilities, facing the problem of malaria posed as a major public health challenge to the district authorities and in 2005 efforts were made to contain the situation.

B. Strategic Approach

 2. What was the solution?
The sudden rise in the incidence of malaria in 2005 in Gandhinagar district led the district authorities to implement the malaria control strategies in an effective manner. The objective was to reduce the morbidity due to malaria to a very level and to prevent deaths. Focus was not just on the population residing in the high risk villages (16 villages with 32046 population), but the entire district having a population of 1261475 was covered for malaria control activities. The district comprises of 4 talukas and 300 villages. As regards health infrastructure in 2005 there were 24 PHCs, 6 CHCs and 115 Sub centers. In 2014 the numbers of health facilities increased to 25 PHCs, 07 CHCs and 171 Sub Centers, 1 sub District hospital and 1 medical college thereby ensuring the availability of health services to all. The strategies to control malaria are two pronged viz. anti parasitic and anti vector. The first and foremost thing that was done was to ensure fortnightly active surveillance through Multi Purpose Health Workers working in the Sub centers, but the deficiency was taken care of by involving Female Health Workers. Passive surveillance was strengthened in all the health facilities. ASHAs were deployed at the village level in 2009 under National Rural Health Mission. This strengthened the surveillance at the remotest place. The gap identified was about treatment compliance and therefore was given priority and steps were taken to ensure treatment within 24 hours of diagnosis for which daily reporting of cases was started in 2006. Follow up of positive cases were made in a systematic manner. A study was undertaken in this regard which revealed that adherence to the national drug policy along with better compliance can play a vital role to interrupt transmission of malaria as well as reduce the parasitic reservoir in the community. Better cure rate through the administration of effective anti malarial drugs is the right strategy to keep morbidity and mortality under control. Encouraged by the findings of the study, ensuring treatment compliance and follow up of malaria cases was taken up and is being sustained for purpose of bringing down the cases of malaria. Interrupting the transmission of malaria requires effective vector control measures. Malathion was used in 2004 for Indoor Residual spray which did not give the desired impact. So susceptibility status of the insecticide was monitored in 2005 and it was observed that Malathion is no more effective against vector mosquitoes. Therefore Malathion was replaced by Synthetic Pyrethroid from 2005 onwards and all the high risk villages were covered under two rounds of Indoor residual spray during transmission season. Very good impact was observed in 2007 and the API in the sprayed villages was 32.15 in 2005 which reduced to 1.6 in 2007 (95% reduction). In subsequent years villages being covered under spray gradually reduced and in 2014 only 3 villages were covered. This was done by strengthening other preventive measures. The innovative strategies that were implemented in the district are maintaining line list of malaria cases at all levels and monitoring the treatment compliance. The WHO strategy of “Test, treat and Track” was implemented in letter and spirit. Preventive measures like fever surveillance, focal spray, anti larval measures and source reduction were invariably undertaken within 72 hours of diagnosis of the case. The newer tools for prevention and control of malaria like RDTs (in 2012) , LLINs ( in 2011) and ACT for treatment of falciparum ( in 2010) were introduced which did give better impact. The neglected area of inter-sectoral coordination and awareness generation was given due priority.

 3. How did the initiative solve the problem and improve people’s lives?
Effective malaria control requires the reduction of the parasitic reservoir and vector population. Routine activities failed to give the desired impact. Existing strategies were modified with innovations. Every malaria case diagnosed was immediately reported through phone and provided treatment within 24 hours through ASHAs. Subsequently follow up was made through supervisors for treatment compliance as well as cure rate. Preventive actions were implemented within 72 hours when a case is detected. The second aspect that was taken up was implementing Integrated Vector management where in dependency on Indoor residual Spray was gradually reduced by supplementing it with source reduction, use of LLIN, and Biological control and anti larval measures in an area specific manner. Hatcheries were established throughout the district for rearing larvae eating fishes. Currently the district has 498 hatcheries and this number were only 22 in 2005. Innovative IEC/BCC activities such as transmitting messages through traditional media , kites, blood donation cards, tableaus and exhibitions at major events were implemented and top echelons of the district administration was involved which gave much impetus to the efforts towards control of malaria and sustaining it for a period of almost 10 years.

C. Execution and Implementation

 4. In which ways is the initiative creative and innovative?
NVBDCP is implemented through the Primary Health Care Delivery system in Gandhinagar district. Case detection and treatment: As case detection and treatment is mainly carried out through the active and passive surveillance agencies, the plan was to cover the entire rural population of the district while giving priority to the most vulnerable areas. This led to the need for strengthening the surveillance agencies in term of augmenting skill and knowledge of human resource through training, providing necessary equipments and drugs in time and informing the community about the services being rendered through the surveillance agencies. The first task of streamlining the surveillance machinery was achieved. Subsequently efforts were made to have a regular mechanism for daily reporting of malaria positive cases and providing treatment as per drug policy within 24 hours. Laboratory Technicians of concerned institutions report a positive case when it is diagnosed, for initiating the treatment, and the Supervisor or MPHW concerned verifies compliance in the field and collects follow up smears at prescribed interval. Quality of Laboratory services was maintained by training all the Laboratory Technicians in malaria microscopy. Integrated Vector Management (IVM): Vector control activities that were implemented as a part of IVM were two rounds of Indoor residual spray with Synthetic Pyrethroid during the transmission season by deploying daily wages workers, focal spray when a case of malaria is detected, and biological control as a long term measure, anti larval measures and source reduction through the members of the village level committee at weekly interval. Concurrent supervision was the hallmark of all these activities and regular monitoring was carried through district and Taluka level teams. Capacity Building: This was taken up in right earnest and it was keenly followed up that all the Medical and para Medical personnel do get the required training to enhance their skills. Since 2005 22 batches of training for para-medical personnel has been taken up. The trained manpower of the district was a great asset to the programme and helped in effective implementation. External faculties were roped in to provide quality training. Sensitizing the Medical personnel in the private sector was also done regularly. Inter-sectoral coordination: Under NBVBDCP, a proactive approach was taken to involve other sectors in the district like Education (for generating awareness among teachers and children so that they pass on to the community) Road and building ( for source reduction in public buildings and construction sites) , Women and child development ( for involving aanganwadi workers to provide services to the vulnerable group), Industries ( for involving them for screening of laborers and source reduction activities at construction sites) Panchayat ( for involving village panchayats) Urban development ( for involving local bodies like Nagarpalikas) and also NGOs ( awareness generation and donation of mosquito nets etc.). Periodic meetings were organized with different sectors for their support and coordination. IEC/BCC activities; out of box thinking: Various innovative activities were done for generating awareness in the community. Some of them are messages through kites, calendars, diaries, blood donation cards and pens. Spreading messages in the form of Garba was also done. Every major event organized was having an exhibition stall and tableaus were also organized. Quizzes for school children were held in schools. Sensitization sessions for elected leaders were also kept. Supervision, Review and Monitoring: Concurrent supervision was done from District, taluka and PHC level for each of the activity. Review meetings were organized periodically. Day to day monitoring of the situation was also carried by obtaining reports electronically and real time feedback was provided for corrective measures.

 5. Who implemented the initiative and what is the size of the population affected by this initiative?
The entire district administration took up the malaria control efforts as a challenge and the contribution of administrators, public health experts and medical and para medical personnel and community leaders ( elected as well as non elected) made the task easier. At the district level the District Panchayat president and the District Development Officer provided the political commitment and administrative support. The Chief District Health Officer guided the malaria control efforts in the district. The District Malaria Officer and team ensured the smooth and effective implementation of malaria control activities in the field The Taluka Health Officers, Medical Officers, Supervisors, Health Workers and volunteers like ASHAs were the key stakeholders in this campaign. Services of other sectors like school teachers, aanganwadi workers were also involved at the village level for awareness generation in the community. Community leaders at the grass root level played a crucial role in helping the community accept the services being delivered. NGOs were also roped in for implementing activities like distribution of insecticide treated mosquito nets. The local media contributed a lot by disseminating messages to the community and also highlighted the positive achievement which was a morale booster for the team involved in tackling the problem of malaria.
 6. How was the strategy implemented and what resources were mobilized?
National Vector Borne Disease Control Programme is implemented by the State with the support of Government of India. It is a partially centrally sponsored programme. As regards financial support for the programme is concerned State Government bears 90-95% of the total expenditure incurred under the programme, while Government of India provides assistance to certain activities. State Government bears the expenditure for all the human resources deployed in the district. Supply of logistics (drugs, insecticides, larvicides and other materials) is also made by the State Government. Government of India provides support for Monitoring and Evaluation, incentives for ASHAs and Dengue control. The average per annum expenditure under NVBDCP is approximately Rs 93.00 lakhs. Due to the avenues available for synergy with other programmes, financial resources could be mobilized for IEC/BCC activities as well as inter sectoral coordination etc. Detailed analysis of the expenditure incurred under the programme revealed that >75% of the total fund available is made for human resources, while 10-15% is made for vector control activities and remaining for other activities like Monitoring and evaluation, IEC/BCC and training. There were instances when some NGOs and community leaders donated for certain activities such as mosquito nets. Technical support and guidance is received from State NVBDCP cell, ICMR institution like NIMR Nadiad and Regional Office for Health & FW located at Ahmedabad and Medical colleges. The support is in the form of external faculty for trainings, assessment in the field, monitoring the quality of laboratory services and undertaking entomological studies. Chief District Health Officer provides technical guidance on a day to day basis. As already mentioned in the earlier portions, NVBDCP is integrated with Primary Health Care delivery System and therefore except few staff at District level all other personnel have multiple tasks to perform and the activities under NVBDCP are among them. The district is currently in a comfortable position as regards human resources. 100 % of the medical and 98% para medical personnel are filled up. 910 ASHAs are also deployed against the strength of 981. At present 30 Medical officers, 23 AYUSH doctors, 27 Laboratory Technicians, 25 Pharmacists,26 Supervisors and 293 Health Workers (Male and female) are in position in the district. The four talukas in the district are having a total strength of 424, while the district NVBDCP cell has a District malaria Officer and 12 supporting staff. To implement the various activities under the programme the district authorities have not left any stone unturned for mobilizing the resources. Inputs under NRHM have been a great boon as it strengthened the net work of the health facilities in the district. Provision of incentives and funds for monitoring and evaluation further enhanced the effectiveness of the programme. It could be observed that issues of financial, technical and human resources were tackled in an appropriate manner to achieve the objectives laid down under the programme. This helped to reduce the malaria burden in the community and to sustain the achievement.

 7. Who were the stakeholders involved in the design of the initiative and in its implementation?
The five most important outputs that lead to the success of reducing malaria burden are as under. Surveillance: This activity is the back bone of any disease control programme and therefore malaria cannot be an exception. Previously as per Government of India norms (till 2012) 10 % of the population was to be screened for malaria every year through surveillance agencies. But the later on (in 2013) the target was enhanced to 18%. Improving surveillance was given priority and the Annual blood examination rate (ABER- parameter to assess the surveillance) was monitored in each village and urban area of the district. ASHAs deployed under NRHM since 2009 were optimally utilized to improve surveillance. The ABER which was 15.76 in 2005 could be increased up to 24.14 in 2014 (Up to October). This ensured detection and treatment of malaria cases in the community and thereby reducing the parasitic reservoir. Indoor Residual Spray: This activity is the major vector control option to interrupt the transmission particularly in high burden areas. Since 2005 meticulous planning was made to cover the eligible population under spray and achieved room coverage of > 85% in all the years. Concurrent supervision from District, taluka and PHC ensured good quality and coverage. This intervention broke the chain of transmission. Biological control: As a long term sustainable solution to address the problem of vector mosquitoes, 498 hatcheries were established in 25 PHCs of the district. 52 of them were natural water bodies, while 441 were constructed. Larvae eating fishes were transferred to permanent water collections. This safe vector control option prevented mosquito breeding in 493places throughout the district. Survival of the fishes is monitored through field visits. IEC/BCC: Even with limited resource, activities for awareness generation could be implemented by mobilizing the resources from other programs. 22 exhibitions during major events could be organized since 2005. 36 Exhibition panels were provided to the health facilities 523 Programmes were organized in schools, 10 rallies were organized, 20 Tableaus were arranged. Further, messages through FM channel were transmitted and success stories were published through news papers. Capacity building: No programme can succeed without a skilled manpower with adequate knowledge. Minute care was taken to train all the Medical and para-medical personnel in the district. 98 % of the Medical Personnel and 100% of the para-medical personnel were trained under NVBDCP, which can be termed as highly satisfactory.

 8. What were the most successful outputs and why was the initiative effective?
Regular supervision and monitoring is the key to success. So the first and foremost thing that was done was to develop calendar of activities in the form of an activity plan with time frame and monitoring the progress on a monthly basis at the district level. This ensured timely implementation of important activities and helped in equipping the authorities at various levels to meet the challenge in a professional and scientific manner. The monitoring mechanism that was put in place in the district can be listed as under. Fever rate/Malaria case: Fever rate, malaria cases detected are updated daily by collecting the information from all PHCs, CHCs and Hospitals. The reports are electronically transmitted from PHC to taluka as well as district. Treatment: Treatment given to malaria cases (within 24 hours) are monitored at PHC level and cross checked from Taluka and district level. Treatment card is maintained at PHC level for verification. Preventive measures: Within 72 hours of diagnosis of a malaria case preventive measure are undertaken by the team from the PHC. The activities being undertaken are focal spray, anti larval measures, fever and contact survey and source reduction. Cross checking: District level team headed by DMO cross check all field level activities and 4 days in a week are spared for this purpose. The activities being cross checked are treatment provided to malaria cases, performance of ASHA, weekly anti larval measures being done by ASHAs, use of LLINs/mosquito nets, coverage under spray, maintenance of hatcheries and quality of surveillance and laboratory services. Review: Periodic meeting of the staff is organized for the review of various activities at the district and Taluka level. Highest authorities of the district review the performance and takes appropriate measures for improvement. Parameters/indicators: The important paramerts/indicators being monitored are ABER, API, SPR, SFR, % of PF, Case fatality rate, time lag between blood smear collection and treatment, no of instances of stock out, room coverage for IRS, user rate for LLIN and discrepancy rate in case of blood smear cross checking and % of fund utilization. Feedback mechanism: In addition to the above regular feed back to poor performing institutions and staff is also done from the district level on a regular basis. Observations of field visits are also communicated regularly for initiating the corrective steps. Evaluation: Programme evaluation is normally done by independent agencies like Medical colleges, NIMR and directorate of NVBDCP.

 9. What were the main obstacles encountered and how were they overcome?
The main problems encountered during the implementation of the preventive measures for the control of malaria in Gandhinagar are summarised as under. Treatment compliance: Under NVBDCP drug policy for the malaria is modified periodically depending up on the needs of the programme. Duration of the treatment for P. Viavx was changed in 2007 from 5 days to 14 days. Similarly drug regimen for P. falciparum was also changed in 2011 and ACT was introduced. Due to the long duration of treatment, compliance was poor among the patients detected as P. vivax. The problem of compliance and delayed treatment was the major constraint for malaria control in 2005. The district utilised the resources of 910 ASHAs deployed under NRHM for this purpose since 2009. Due to the involvement of ASHAS for providing treatment to malaria cases, 100 % compliance could be achieved in the district in subsequent years and now treatment reaches the door steps of malaria patient with in 24 hours. Insecticide Resistance: The insecticide which was being used for Indoor Residual Spray till 2004 was found to be in-effective in 2005. This issue was tackled by switching over to Synthetic Pyrethroid which gave the desired impact. Insufficient wages for spray staff: Another obstacle was in sufficient daily wages for the staff being deployed for Indoor Residual Spray. District adopted a PPP approach and convinced local leaders to contribute towards this cause.The State Government increased the wages in 2014. Migration of labourers: Several construction projects came up in the district recently, which acted as the focal points for transmission of malaria and other vector borne diseases. To tackle this problem, highest authority of the district (District Collector and District Development Officer) was involved and the contractors were compelled to take the required precautionary steps.

D. Impact and Sustainability

 10. What were the key benefits resulting from this initiative?
The intensified and sustained campaign for the control of malaria in the district has reduced malaria morbidity as well as prevented deaths since 2005. The Annual Parasitic Incidence of the district which was 1.96 in 2005 reduced to 0.36 in 2013. This has down further to 0.19 in 2014(up to October). This is despite the fact that the district is witnessing a lot of developmental activities due to its proximity to Ahmedabad. Migration of labourers is a common phenomenon in the district particularly at the construction sites (major as well as small). The annual blood examination rate which was 15.76 in 2005 increased to 28.08 in 2013. So the morbidity as indicated from API is true and reflects the actual situation prevailing in the community. Analysis of the malaria situation in Kalol Taluka which is one of the worst affected has revealed that the API has reduced from 8.5 in 2005 to 0.3 in 2013. In Hajipur PHC API, reduced from 28.1 in 2005 to 0.6 in 2013, while in Rancharda PHC API has reduced from 17.8 in 2005 to 0.6 in 2013. Malaria situation in 24 villages which were covered under Indoor Residual spray has shown significant reduction in malaria incidence over a period of one year. One of the aspects that need to be highlighted is the fact that Indoor Residual Spray if done effectively can reduce the malaria morbidity substantially. This has been substantiated in a study undertaken in the district in 2007. It was observed that due to IRS, the API reduced from 33.5 to 0.5 within a span of 3 years. Though 21 villages out of 24 were excluded from spray since 2006, malaria incidence could be reduced further and kept under control due to the emphasis given for other preventive measures. So the dependency on Indoor Residual Spray was gradually reduced since 2006. So it is established that once effective reduction is achieved through IRS, it can be sustained, if supplemented by other preventive actions at the local level and the dependence on this activity can be reduced to a larger extent. As far as service delivery is concerned the community is benefitted on the following fronts: 1. Access to treatment for fever in every village (For every 1000 population a trained volunteer with the required medicine is available) 2. All PHCs, CHCs and Hospitals have the diagnostic facility for malaria for which well trained Laboratory Technicians are deployed. 3. All diagnosed malaria cases gets treatment with in 24 hours. 4. Preventive measures are taken in within 72 hours in areas where malaria case is detected. 5. 100 % high risk population protected 6. Pregnant women, children and migrant labourers gets focussed attention and are screened for detection of malaria parasites and mosquito nets are provided to them as protective measure. This perceptible change in the morbidity has helped the local community to believe in the local health providers and thereby increasing the chances of enhanced community participation. Not a single death due to malaria has been reported from the district during last 09 years, which itself reveals the impact of the efforts made by the district for control of malaria. The best indicator/parameter to measure the impact in terms of reduction in morbidity is API, which has come down by 1.96 to 0.3% in 2013 as compared to 2005. This reduction was much more significant in Kalol Talukla (8.5 to 0.3%) and the affected PHCs viz. Rancharda (17.8 to 0.6%) and Hajipur ( 28.1 to 0.6%). Similar reduction is observed in SPR which reduced from 1.24 in 2005 to 0.11 in 2013 in the district. P. Falciparum proportion also reduced to 18.38 % in 2005 to 4.28 % in 2013. Case fatality has been very low since 2005 in the district. So the impact is quite visible and can only be attributed to the intensive efforts made by the district authorities with the involvement of all the stake holders.

 11. Did the initiative improve integrity and/or accountability in public service? (If applicable)
The initiative, taken up in Gandhinagar district, for effective control of malaria since 2005 can be very well sustained and replicated elsewhere provided adequate resources are mobilized. The activities for control and prevention have to be implemented in a systematic and effective manner with time frame for each activity. With respect to finance, sustaining these activities will not be much of a problem as the same level of financial assistance is likely to continue in the coming years from the State as well as Government of India budget. Additional resources may be required to move ahead towards the elimination stage of the disease and that has to come as a part of the commitment at the highest level. However, the support of community and NGOs, if taken, for activities like distribution of mosquito nets, will lead to a more sustainable strategy. A society free from disease is the dream of every citizen. So when they start enjoying the benefits of the activities being implemented for malaria control, they will support the health administrators in the fight against malaria. Moreover this will inculcate the feeling of ownership in the community and they will start taking decisions at their own level for their well being and good health. Less dependency on insecticides and promoting biological control agents (fish and Biolarvicides) will be sustainable from the environment point of view. This will be cost effective too. Malaria control and the activities being implemented for the same have become a part and parcel of the Primary Health care delivery System. This holistic approach will definitely be sustainable because in the long run, the capacity to identify the problem at the PHC level and taking the appropriate measures to tackle it are important. The success of the malaria control efforts in Gandhinagar district has already been disseminated to a wider audience through research papers. Four such research papers were prepared and published in journals (one under publication). More over the papers were presented in conferences organized at State and national level. This helped in conveying the message to the interested agencies. Replicating the efforts in other parts of the State and Country is feasible within the frame work of NVBDCP. The key words for success are holistic approach, inter-sectoral coordination, public private partnership, integrated preventive measures (vector control) and “Test, Treat and Track”. To conclude, the malaria control effort done in Gandhinagar district is sustainable and replicable.

 12. Were special measures put in place to ensure that the initiative benefits women and girls and improves the situation of the poorest and most vulnerable? (If applicable)
The high burden of malaria in Gandhinagar district came as a jolt to the district authorities because the district is considered to be having the best health infrastructural facilities and yet could not manage a treatable and manageable disease like malaria. This prompted the authorities to leave behind the complacent approach and move forward in a pro active manner. The health machinery of the district was sensitized and active involvement of everybody was sought to tackle the menace of malaria. The most important lesson for all the stakeholders was the fact that if firm decisions are taken and resources are mobilized to implement the same, then all constraints can be overcome. This happened in reference to treatment compliance. It was a question of utilizing the available resources in the most appropriate manner. ASHAs played a very crucial role in ensuring complete treatment to all the diagnosed malaria cases. The incentive scheme motivated them further. Up gradation of skills and knowledge of the peripheral level staff also gave the desired impact. Training of ASHAs and MPHWs helped in improving the quality of the surveillance, while similar effort made for supervisors and laboratory Technicians did improve the supportive supervision and quality of laboratory services. Indoor Residual Spray if done with effective insecticide with good coverage and quality can break the transmission cycle and dependency on this method can be reduced when supplemented with other vector control options. This achievement is quite unique as the area under spray drastically reduced from 16 villages in 2005 to 3 villages in 2014. Efforts made for generating community awareness paid dividends on several fronts. The community became aware about the services being made available to them for reduction in morbidity and preventing deaths. More over they were also informed about the ways and means by which they themselves can take desired steps to protect themselves from malaria such as use of mosquito nets (treated as well as simple). Different sectors like Panchayat department, urban development, education, local media, and private medical practioners when sensitized and oriented properly, supplemented the efforts of the District Health Organization to control malaria. This was also a refreshing experience. Roping in the construction agencies/contractors/ project authorities of various projects to deal with the problem of malaria was another lesson learnt. In short the lessons learnt from the efforts made in Gandhinagar district for malaria control are quite valuable for everybody who is interested in public health. It is all about identifying the problem and the gaps in the system and deploying the right mix of strategies in an effective manner. It has been demonstrated that if proper and timely decisions are taken for the prevention and control of malaria, the goal of elimination of the disease will not remain a distant dream. But the approach has to be with a high level of commitment at all levels.

Contact Information

Institution Name:   Malaria Branch, District Panchayat, Gandhinagar
Institution Type:   Government Agency  
Contact Person:   Mamta Dattani
Title:   District Malaria Officer  
Telephone/ Fax:   079-23256948
Institution's / Project's Website:  
Address:   Panchayat Bhavan
Postal Code:   382017
City:   Gandhinagar
State/Province:   Gujarat

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