|
Outputs:
- Increased community and household
knowledge about prevention, early recognition and care seeking
of Kala-azar
- Improved skills of health workers
and better quality health services including early diagnosis control
measures and treatment.
- Improved case management –
referring to community-level improvement in referral, follow-up
and support for identified cases as a means to help individual
cases and also reduce village risk.
Beneficiary
Groups:
- Sixteen affected wards in the same
number of VDCs were targeted for all six interventions.
- Sixteen
VDC were intended to received the general awareness packages including
IEC materials.
- The health system in Dhanusha-Mahottari districts were aimed
to be strengthened through training and some modest supplies to
better respond to the increased referrals and provide quality
case management
Interventions:
The program had six interventions:
1.
Identification of high risk villages
2. Awareness, prevention and care-seeking promotion activities
in targeted 16 wards of 16 VDCs
3. Individual motivation and support for care seeking by people
with suspected cases.
4. Improved diagnosis and treatment of these diseases at more
peripheral levels.
5. Improved referral system (up and back) and follow-up
6. Improved district reporting and surveillance
The
planning of the intervention activities took into account the
necessity of the government in partnership with NGOs and communities
to replicate these interventions to other districts as interventions
must be cost effective, easily managed and monitored.
Implementation
Plan:
The six interventions along with specific activities are listed
below. Activities for the six interventions are further categorized
in sub-headings for greater simplification.
Intervention # 1: Identification of High Risk Villages
Resource limitations require that the health system select and
focus on the high risk areas of districts and then provide interventions
to those areas. A system for identifying high risk areas was established
through micro-stratification. In Dhanusha Mahottari area, clusters
of kala-azar and falciparum malaria cases were identified through
hospital and DPHO records. The records were verified by a field
level reconnaissance to the identified wards with discussions
with FCHV's and the community. Based on the information and field
trip a prioritized list of wards and VDCs to be targeted was prepared.
Target
Area Selection
Based on a preliminary selection process, sixteen high-risk wards
were selected from 16 VDCs in Dhanusha and Mahotari. Focus group
discussions were held at each 16 locations to verify the selection.
Changes to the selections were made as required based on the field
reconnaissance. After testing the selection process a flow chart
was designed to assist the health system to carry similar micro-stratification
and ward selection.
Intervention # 2: Implement Awareness, Prevention, and Care
Seeking Promotion Activities in Targeted VDCs/Clusters
A package of interventions primarily focusing on awareness raising
and improved care seeking behavior was developed for communities
identified as having a significant incidence of kala-azar (and
malaria for year 2 and 3). These messages, largely introduced
through IEC materials were disseminated through the community
by FCHVs, health workers, health posts, schools and families in
order to reach as broad a group as possible in an effective way.
|
