GFATM Funding Support
Intensified Malaria Elimination Project (IMEP)
(Jan 2018 - March 2021)
Principal Recipient: Dte. NVBDCP, MOHFW GOI
Govt. Sub-Recipients: 7 NE States & Madhya Pradesh
Non-Govt. Sub-Recipients: Bakdil, Meghalaya and
Centre for Peace & Development (CPD), Mizoram
Dr Avdhesh KumarAdditional Director
Dte National Vector Borne Disease Control Programme
Introduction Global Fund is supporting the country Malaria programme.
Intensified Malaria Control Project, Round IX: covered
high endemic 7NE states (Arunachal Pradesh, Assam,
Manipur, Meghalaya, Mizoram, Nagaland, Tripura) for 5
years (Oct. 2010 – Sep. 2015).
IMCP-3, New Funding Model: 27 months (Oct. 2015 – Dec.
2017) 7 NE States and Odisha.
IMEP: 39 months (Jan 2018 – Mar 2021) 7 NE states & MP
Target group/beneficiaries: marginalized groups, tribal
population, women and children & other key population like
Jhum cultivators, forest workers, migrants and mobile
population (especially in border areas).
Achievements under IMCP-3• Significant decline in malaria cases & deaths in NE states.
• 7.24 million LLINs distributed in 7 NE states through mass
campaign in 2015-2016 for universal coverage of all sub
centers with API >1.
• 11.34 million LLINs distributed in Odisha.
• 11.27 million LLINs distributed in Jharkhand & Chhattisgarh:
under pipeline for distribution.
• 95% of ASHAs trained in 7 NE states & Odisha on malaria
prevention & control from October 2015-March 2017.
• 97.5% of total budget for PR1 utilized.
NE States: Malaria Cases & Deaths, 2009-2017*
2017 Vs 2009: decline 84% in cases, 83% in Pf cases & 96% in deaths.
487
290
162113
119
222
135
76
190
100
200
300
400
500
600
0
50000
100000
150000
200000
250000
2009 2010 2011 2012 2013 2014 2015 2016 2017*
Total Cases PF Cases Deaths
De
ath
s
Cas
es
*Provisional
Shrinking Malaria Map, NE States, 2009-2017
Anjaw
Lohit
West Siang
Ukhrul
Sonitpur
Lunglei
Dibang Valley
Kamrup
Upper Siang
Karbi AnglongNagaon
Mon
Cachar
Mamit
Changlong
Jorhat
East Kameng
Kurung Kumey
Upper Subansiri
Tinsukhia
Kokrajhar
Tirap
Dhalai
Dhubri
Chandel
Saiha
East Siang
West Kameng
Senapati
Dibrugarh
Phek
Golaghat
Tamenglong
Dhemaji
West Khasi Hill
Tripura South
N. Cachar Hills
Champhai
Jaintia Hills
Ri-Bhoi
Barpeta
Towang
Papumpare
Churachandpur
Baksa
Lakhimpur
Sibsagar
Peren
Lower Dibang Valley
Tuensang
Udalguri
Wokha
Darrang
Goalpara
East Garo Hills
East Khasi Hill
Kolasib
Chirang
Karimganj
Lawngtlai
Lower Subansiri
Kohima Kiphire
Serchhip
Marigoan
Tripura North
Mokokchung
South Garo Hills
Aizawal East
Imphal
Bongaigaon ASSAM
ARUNACHAL PR.
TRIPURA
MANIPUR
MIZORAM
MEGHALAYA
NAGALAND
N
EW
S
NE States
<1
>1-2
>2-5
>5-10
>10 & Above
API - 2009
ASSAM
ARUNACHAL PR.
MANIPUR
MIZORAM
MEGHALAYA
NAGALAND
TRIPURA
ANJAW
LOHIT
WEST SIANG
UKHRUL
SONITPUR
DIBANG VALLEY
LUNGLEI
KAMRUP
UPPER SIANG
MON
MAMIT
NAGAON
EAST KAMENG
KARBI ANGLONG
CACHAR
KURUNG KUMEY
CHANGLONG
UPPER SUBANSIRI
TINSUKHIA
JORHAT
TIRAP
DHALAI
SAIHA
DHUBRI
CHANDEL
WEST KAMENG
KOKRAJHAR
PHEK
EAST SIANG
CHAMPHAI
SENAPATI
DHEMAJI
RI-BHOI
TAMENGLONG
WEST KHASI HILLN. CACHAR HILLS
DIBRUGARH
PAPUMPARE
GOLAGHAT
BAKSA
TRIPURA SOUTH
TOWANG
JAINTIA HILLS
BARPETA
CHURACHANDPUR
SIBSAGAR
PEREN
TUENSANG
EAST GARO HILLS
KOLASIB
CHIRANG
LAWNGTLAI
KIPHIRE
SERCHHIP
SOUTH GARO HILLS
AIZAWAL EAST
IMPHAL
N
EW
S
NE State
API -2017
>1-2
>2-5
>5-10
>10 & Above
<1
API wise distribution of districts
2009 2017
API < 1 25 75
API 1 To 2 14 7 Gomti, Khowai, N Tripura, S Tripura; E Siang,; Kokrajhar; Jaintia Hills
API 2 To 10 23 7 W Garo Hills, W Khasi Hills, E Garo Hills; Lunglei, Mamit, Saiha; Dhalai
API > =10 24 2 S Garo Hills; Lawngtlai
Total 86 91
Intensified Malaria Elimination Project
• Project Areas : 7 North Eastern States & Madhya Pradesh (for only LLINs);
Odisha LLINs (partially) under PAAR
• Project Period: Jan 2018 to March 2021 (39 months)
• TRP & Grant Approval Committee (GAC) of Global Fund (GF): technically
sound and strategically focused.
• GF did not agree for Caritas as Non-Govt. PR, instead agreed for
supporting two Local NGOs as SRs for high endemic districts of Meghalaya
& Mizoram (Geographical Coverage: 1447 villages in high endemic selected
145 sub-centres (API>10) in 5 districts of 2 states)
– (i) Bakdil, Tura, Meghalaya (for two high endemic districts of Meghalaya
namely East Garo Hills and South Garo Hills).
– (ii) Center for Peace and Development (CPD), Aizawl, Mizoram (for three
high endemic districts of Mizoram namely Lunglei, Lawngtlai and Mamit).
Geographical Coverage
States: 8
Districts: 147
Popn.: 127 million
Goal:• To reduce malaria related morbidity and mortality by at least 70% in project
areas (9 states=7 NE+MP+Odisha) by 2020.
Objectives:1. Achieve universal coverage of population at risk of malaria with an appropriate
vector control intervention (LLIN).
2. Achieve universal coverage of case detection and treatment services at alllevels in project areas to ensure 100% parasitological diagnosis of allsuspected malaria cases and complete treatment of all confirmed cases.
3. Strengthen the surveillance to detect, notify, investigate, classify and respondto all cases and foci in all districts (in project areas) to move towards malariaelimination.
4. Achieve universal coverage in project areas by appropriate BCC activities toimprove knowledge, awareness and responsive behaviour regarding effectivepreventive and curative interventions.
5. Ensure effective programme management and coordination to deliver acombination of interventions for malaria elimination.
IMEP: Strategies/ Activities
a) Early diagnosis and complete treatment
b) Human resource & capacity building
c) Vector Control including LLINs – Mass campaign
d) IEC/BCC
e) Health Information System and Monitoring &
Evaluation
f) Programme Management including Infrastructure
and other Equipments
g) Coordination and partnership development
Inputs under the Project -1Human resource & capacity building
Commodities/ Equipments:
RDK – (bivalent)
ACT-AL for Pf cases
Artesunate injection for severe malaria
cases
LLINs
Mobility support for M&E
Support for IEC/ BCC/ Social
Mobilization
Operational Research
Inputs under the Project - 2Human Resource
• National level: M&E, training, finance, PSCM
• State level:
– Public Health,
– M&E,
– Finance,
– Procurement and
– IEC-BCC consultants
• District: VBD consultants
• Sub-district level: Malaria Technical Supervisor (MTS)
with bike
• Sentinel hospitals: MO, Laboratory technicians to
enhance surveillance
IMEP: Budget Approved by GF (Jan 2018-March 2021)
Approved Funding (PR/SR) Amount in USD Amount in INR
Dte. NVBDCP (PR) 63.46 million 412.48 crores
Local NGOs (Non-Govt. SRs) 1.55 million 10.06 crores
Total 65.01 million 422.54 crores
Approved Funding (PR/SR) Amount in USD Amount in INR
PAAR • Procurement of LLINs for Odisha
in 2020
• Implementation of HMIS
49.40 million 321.10 crores
Summary Budget (IMEP-39 months) - 1
S.
N
o
Module
Amount
in USD
(In
Million)
% of
BudgetActivities
1 Vector
Control 52.33
81% 1. 9.65 million LLINs for MP (2018); 5.71 million LLINs for NE
States (2019), 2.33 million LLINs for Odisha (2020)
2. Distribution cost for MP and NE States (excl. ASHA
Incentives).
3. IEC/BCC Activities. (Flex boards (schools), Public Address
System, Miking Activity and local school activity in high
endemic areas by two local NGOs-Meghalaya & Mizoram)
2 Program
Management 3.87
6% 1. Remuneration for Distrcit VBD Consultants, Acct Asstt.
Cum DEO.
2. Remuneration is kept as 100% for Yr-1; 70% in Yr 2 ; and
50% in Yr 3
3. Regional Review Meetings and State Review Meetings.
4. Office cost of local NGOs
S.
No.
Modules USD (In
Million)
% of
Budget
Remarks
3. RSSH: Human
resources for
health (HRH),
including
community
health
workers
6.76
10% 1. Remuneration cost for MTS and LTs and mobility for
State & District consultants and MTS.
2. Remuneration is kept as 100% for Year 1; 70% in Year 2 ;
and 50% in Year 3 as recommended by GAC
3. Remuneration cost for Field supervisors & CHVs and
their Capacity Building for Local NGOs.
4 RSSH: Health
management
information
systems and
M&E
2.05
3% 1. Large Scale population Surveys, Operational Research
and LQAS.
2. Consultation with Private Sector (Trainings & Meetings).
3. Infrastructure Equipments (Computers) at PHC level
4. Travel related and other costs for local NGOs
TOTAL
65.01 100
Summary Budget (IMEP-39 months) - 2
High Malaria Endemic Areas in India
LLINs supplied/proposed and % contribution of
Population(compared to country total)
States % Population LLINs supplied (million)
N.E. States (7) 4 7.24 + 5.7 (approved in IMEP)
Odisha (1) 3.5 11.34 + 10.13 (proposed under PAAR in IMEP)
Chhattisgarh
+Jharkhand (2)5 11.27
Madhya Pradesh (1) 6 9.7 (approved in IMEP)
Other states & Union
Territories (25)81.5 5+5 million
NE States+ MP
(proposed)10.0
LLINs Distribution and Usage
Activities budgeted under IMEP (Jan 2018-March 2021)
Cost Categories Status
Procurement of LLINs (MP) – approx. 30 million USD In progress
Human resource In place
Regional Review Meetings (4 monthly) 1st meeting held, Apr, Itanagar
State Review Meetings (quarterly) State-wise held; planned
Training cum workshop of IMA & IAP (State level) to sensitize
Pvt. Practitioners for generating malaria data
In progress
Training cum workshop of IMA & IAP (district level) to
sensitize Pvt. Practitioners for generating malaria data
Consultation with Private Sector (at block level)
Communication Material & Publications (CMP)
Operational Research & Large Scale Population Surveys
Computers at PHC level (@ Rs. 32250/-; budgeted in Year 2)
LLINs – NE states (Yr 2); Odisha (Yr 3) 2nd & 3rd Year
NGO SRs Approved, MoU being signed
Challenges… Way ForwardTo sustain the gains achieved so far
• Human Resource: timely recruitment; retention/ attrition; monitoring & supervision; Inter-state non uniformity in remuneration mainstreaming the DMOs, MTS, and ASHAs
• Procurement: timely procurement/ stock outs; inventorymanagement – IMS
• Entomological Support: not only for malaria but all VBDs -State/Zonal; District
• Involving Other Sectors: other Govt. organizations; NGOs;Private Sector (formal & non-formal)
• Financial Resources Utilization: Treasury route; Tally; PFMS• NFME: Launching at state/District; Ownership• PIP Action Plan: additional activities curtailed; HR
remuneration• Monitoring & Supervision: LLIN usage etc., etc.
Indicators-Impact, Outcome & Coverage
Impact Indicators
• Malaria I-1: Confirmed malaria cases (microscopy/RDT): rate per 1000 persons per year
• Malaria I-2(M): Inpatient malaria deaths per year: rate per 100,000 persons per year
• Malaria I-3: Malaria test positivity rate
Outcome Indicators
• Malaria O-1a: Proportion of population that slept under an insecticide-treated net the
previous night
• Malaria O-1b: Proportion of children under five years old who slept under an insecticide-
treated net the previous night
• Malaria O-1c: Proportion of pregnant women who slept under an insecticide-treated net
the previous night
Coverage Indicators
• VC-1(M): Number of long-lasting insecticidal nets distributed to at-risk populations
through mass campaigns.
State Specific targets for Impact Indicators (1) :
Malaria I-1: Confirmed malaria cases (microscopy or RDT): rate per
1000 persons per year
State 2017 2018 2019 2020
Arunachal Pradesh
1.07 0.74 0.47 0.32
Assam 0.16 0.11 0.07 0.05
Manipur 0.03 0.02 0.01 0.01
Meghalaya 5.11 3.53 2.24 1.48
Mizoram 4.94 3.41 2.17 1.43
Nagaland 0.20 0.14 0.09 0.06
Tripura 1.81 1.25 0.80 0.52
Total 0.76 0.53 0.33 0.22
State Specific targets for Impact Indicators (2) :
Malaria I-2(M): Confirmed malaria deaths per year
Zero Death reporting states need to ensure their zero status by
strengthening the surveillance & response
State 2017 2018 2019 2020
Arunachal
Pradesh0 0 0 0
Assam 0 0 0 0
Manipur 0 0 0 0
Meghalaya 12 8 5 4
Mizoram 0 0 0 0
Nagaland 1 0 0 0
Tripura 6 4 3 2
Total 19 12 8 6
State Specific targets for Impact Indicators (3) :
Malaria I-3: Malaria test positivity rate
State 2017 2018 2019 2020
Arunachal Pradesh 1.01 0.71 0.45 0.30
Assam 0.20 0.14 0.09 0.06
Manipur 0.07 0.05 0.03 0.02
Meghalaya 3.90 2.73 1.76 1.17
Mizoram 2.68 1.87 1.21 0.80
Nagaland 0.16 0.11 0.07 0.05
Tripura 1.87 1.31 0.84 0.56
Total 0.86 0.60 0.39 0.26
Outcome Indicators
Indicator 2017 2018 2019 2020
1Proportion of population that
slept under an insecticide-treated
net the previous night
66.9% 80% 85% 90%
2
Proportion of children under five
years old who slept under an
insecticide-treated net the
previous night
57.8% 80% 90% 100%
3Proportion of pregnant women
who slept under an insecticide-
treated net the previous night
71.3% 80% 90% 100%
