Monitoring of the Village Malaria Workers to conduct activities of Malaria Elimination Demonstration Project in Mandla, Madhya Pradesh

Abstract

Background The capacity of the field staff to conduct activities related to disease surveillance, case management, and vector control has been one of the key components for successfully achieving malaria elimination. India has committed to eliminate malaria by 2030, and it has placed significance on monitoring and evaluation at the district level as one of the key strategies in its national framework. To support and guide the country’s malaria elimination objectives, the Malaria Elimination Demonstration Project was conducted in the tribal district of Mandla, Madhya Pradesh. Robust monitoring of human resources received special attention to help the national programme formulate a strategy to plug the gaps in its supply chain and monitoring and evaluation systems. Methods A monitoring tool was developed to test the capabilities of field workers to conduct activities related to malaria elimination work. Between November 2018 to February 2021, twenty-five Malaria Field Coordinators (MFCs) of the project utilized this tool everyday during the supervisory visits for their respective Village Malaria Workers (VMWs). The data was analysed and the scores were tested for variations against different blocks, educational status, duration of monitoring, and post-training scores. Results During the study period, the VMWs were monitored a total of 8974 times using the monitoring tool. Each VMW was supervised an average of 1.8 times each month. The critical monitoring indicators scored well in all seven quarters of the study as monitored by the MFCs. Monitoring by MFCs remained stable at 97.3% in all quarters. Contrary to expectations, the study observed longer diagnosis to treatment initiation time in urban areas of the district. Conclusion This study demonstrated the significance of a robust monitoring tool as an instrument to determine the capacity of the field workers in conducting surveillance, case management, and vector control related work for the malaria elimination programme. Similar tools can be replicated not only for malaria elimination, but other public health interventions as well.

A qualitative study on community perceptions on quality of healthcare services they received in the Malaria Elimination Demonstration Project in district Mandla, India

“…Alongside the IEC/BCC strategy of MEDP and the continuous follow-up of every malaria-positive case under the T4 strategy helped build faith in the community [ 7 ] is also desirable for frontline workers for malaria elimination to consider. The high levels of satisfaction with the services of MEDP reported in the present study can be attributed to strict adherence to an Advance Tour Plan by the VMWs and MFCs, regular availability of diagnostic and drugs, robust training, monitoring and accountability framework, representation from the local community, and sustainability principles of the project [ 5 , 23 , 26 ]. Similar findings were reported by other studies conducted in Odisha and Madhya Pradesh [ 30 , 33 , 34 ].…”

“…The Malaria Elimination Demonstration Project has meticulously documented its operational and technical findings and disseminated them to the scientific community, malaria elimination programmes, and policymakers [ 4 – 7 , 19 – 26 ]. While the scientific rigour is noteworthy, it was essential to assess the project's performance from the end user's perspective, i.e., the beneficiaries (community) of MEDP.…”

Mass screening and treatment (MSaT) for identifying and treating asymptomatic cases of malaria-malaria elimination demonstration project (MEDP), Mandla, Madhya Pradesh

“…The evidence generated by this Malaria Elimination Demonstration Project [3,24,[32][33][34][35][36][37][38][39][40][41] indicates that surveillance, case management, and vector control need the full attention of programmes for eliminating malaria. However, in specific scenarios, such as hard-to-reach areas, pockets of high transmission, and incidence of disease outbreaks, MSaT/MTaT/FSaT might be considered on a priority basis.…”

A Qualitative Assessment of a Malaria Elimination Project in the Tribal District of Mandla, Madhya Pradesh

“…The MEDP has published the learnings from the project including detailed operational and technical findings. 4,5,9,18 Despite the impressive reduction in malaria cases and achieving elimination of transmission of indigenous malaria within four years of field operations, it was important to assess the project's performance through qualitative assessments of the community.…”