Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
Preparation of a planNajibullah Safi, MD, MSc. HPM
Learning objectives• Describe the structure of a plan for malaria  prevention, control and elimination• Organize the avail...
Proposed outline• Introduction      – Importance of malaria as public health problem      – Importance of malaria as a soc...
Situation analysis• Country profile    – Demographic data    – Geographical features (e.g. forest, desert, coastal      ar...
Situation analysis cont.• The health care system      – Health care providers            •   Government            •   Hou...
Situation analysis cont.• Health services (public, private, community  based)      –     Organization      –     Human res...
Situation analysis cont.• Other health programs      – Vector borne disease control      – Programs targeting the sick chi...
Situation analysis cont.• Inter-sectoral links      – Environment      – Media and education      – Universities      – Re...
Situation analysis cont.• The malaria problem      – History of malaria problem            •   Epidemiological picture    ...
Situation analysis cont.• Past and current malaria control activities      – Policy and legislation      – Status of the p...
Situation analysis cont.• Current malaria problem      –     Spatial and temporal distribution of malaria      –     Drug ...
Situation analysis cont.• Conclusion    – Priority (place of malaria among other problems)    – Opportunities for malaria ...
Stratification• Identification of major factors responsible for  peculiarities of malaria problem• Identification of addit...
National goals• National economic and development goals• National health goals• Government health policies3/11/2013       ...
Objectives• Existing national countrywide malaria control  objectives• Proposed malaria control objectives by  stratum• Re...
Approaches• Summary statement of approaches by stratum  and objectives• List of activities to be implemented3/11/2013     ...
Research needs• Information gaps• Proposed applied research projects in the plan3/11/2013                                 ...
Operational targets• Tabulation of the operational outputs for each  approach• Operational targets necessary to achieve ea...
Operational milestones• Plan for new services or expansion of existing  services      –     Additional services (e.g. diag...
Organization and responsibilities• Organization of systems and services• Distribution of responsibilities at different  le...
Evaluation plan• Short term      – Epidemiological, operational and other indicators• Long term      – Health impact, soci...
Evaluation plan cont.• Data and information to be reported• Levels of reporting• Frequency of reporting• Type of evaluatio...
Resource requirements•   Must be quantifiable•   Facilities (e.g. new clinics, insectarium)•   Personnel•   Fixed equipmen...
Costing and budgeting•   Salaries and allowances•   Expenses for organizational activities•   Supplies and equipment•   Tr...
Presentation of the plan• Information should be provided in  charts, tables, maps and graphs• Summary for decision makers•...
Example of a plan  Afghanistan national malaria strategic            plan 2008 – 20133/11/2013                            ...
Introduction  • One fifth of the world population is at the risk    of malaria  • Global burden of 300-500 million cases a...
Stratification of malaria in Afghanistan  • Major determinant of malaria transmission in    Afghanistan are:        – Alti...
3/11/2013   29
Trend of Malaria 2002-2007  700000               626839  600000                           585602  500000                  ...
Malaria Reported Cases, 2007                                                                                              ...
Goal      To contribute to the improvement of the      health status in Afghanistan through      reduction of morbidity an...
Objectives   To reduce malaria morbidity by 60% by the    year 2013   To reduce malaria mortality by 90% by the    year ...
Strategies   Prompt and reliable diagnosis and effective    treatment   Application of effective preventive measures    ...
Strategies cont. Strengthening of the health system and  malaria control program   Institutional development   Improvin...
Prompt and reliable diagnosis and              effective treatment  Targets:   By the end of 2013, 90% of uncomplicated  ...
Prompt and reliable diagnosis and            effective treatment cont.  Targets:   By the end of 2013, all CHCs and 90% o...
Prompt and reliable diagnosis and            effective treatment cont.  Targets:   By the end of 2013, all Public health ...
Prompt and reliable diagnosis and           effective treatment cont.Targets: By the end of 2013, 50% of private sector  ...
Application of effective              prevention measuresTargets: By the end of 2010, 85% of households in    targeted po...
Application of effective prevention                 measures cont. By the end of 2009, three entomological sentinel  site...
Detection and control of malaria                        epidemics  Targets:   By the end of 2013, 90% of malaria epidemic...
Detection and control of malaria                    epidemics cont.  Targets:   By the end of 2008, all provincial    Epi...
Capacity building, institutional strengthening,                  and integration• At the beginning of 2009, an assessment ...
Capacity building, institutional            strengthening, and integration cont.Targets: By the end of 2009 in order to s...
Malaria control and border areas   By the end of 2010 a Border Coordination    Committee will be established and fully   ...
Operational research To develop evidence based strategies it is essential  to conduct operation research as needed by the...
Learning objectives• Describe the structure of a plan for malaria  prevention, control and elimination• Organize the avail...
Upcoming SlideShare
Loading in …5
×

Preparation of a plan

314 views

Published on

  • Be the first to comment

Preparation of a plan

  1. 1. Preparation of a planNajibullah Safi, MD, MSc. HPM
  2. 2. Learning objectives• Describe the structure of a plan for malaria prevention, control and elimination• Organize the available information into a realistic plan• Write a preliminary plan for malaria prevention, control and elimination3/11/2013 2
  3. 3. Proposed outline• Introduction – Importance of malaria as public health problem – Importance of malaria as a socioeconomic problem – Place of malaria in the national health program – Brief description of malaria control program – Planning period3/11/2013 3
  4. 4. Situation analysis• Country profile – Demographic data – Geographical features (e.g. forest, desert, coastal areas) – Metrological data (e.g. rainfall, rainy days, temperature) – Economic development (e.g. GDP/GNP, agriculture) – Social and cultural aspects (e.g. education, housing, sleeping habits)3/11/2013 4
  5. 5. Situation analysis cont.• The health care system – Health care providers • Government • Households • Private sector (for profit and non for profit) • Traditional medicines3/11/2013 5
  6. 6. Situation analysis cont.• Health services (public, private, community based) – Organization – Human resources – Facilities and their distribution – Supervisory system – Accessibility and coverage – Drug supplies and pharmacies – General supplies system – Training and educational infrastructure3/11/2013 6
  7. 7. Situation analysis cont.• Other health programs – Vector borne disease control – Programs targeting the sick child – Maternal health – Child health – Laboratory services – Tuberculosis – Health information system – Health education3/11/2013 7
  8. 8. Situation analysis cont.• Inter-sectoral links – Environment – Media and education – Universities – Research institutions3/11/2013 8
  9. 9. Situation analysis cont.• The malaria problem – History of malaria problem • Epidemiological picture • Past epidemics • Special risks that might reappear • Changing trends3/11/2013 9
  10. 10. Situation analysis cont.• Past and current malaria control activities – Policy and legislation – Status of the program and current control activities – Human resources, organization chart – Building equipment and supplies – Budget – Major control activities in the past and the result – Research (past and current)3/11/2013 10
  11. 11. Situation analysis cont.• Current malaria problem – Spatial and temporal distribution of malaria – Drug resistance and efficacy – Vector (e.g. distribution, ecology, susceptibility) – Identification of major epidemiological types – Basic epidemiological data – Intensity and status of malaria – Estimation of burden of disease – Outstanding problems and major constraints – Priority groups3/11/2013 11
  12. 12. Situation analysis cont.• Conclusion – Priority (place of malaria among other problems) – Opportunities for malaria control • Political commitment • Inter-sectoral links • Technological development • Funding • Economical development projects • Opportunities for changes, especially in the context of PHC • Need for a new or revised plan of action3/11/2013 12
  13. 13. Stratification• Identification of major factors responsible for peculiarities of malaria problem• Identification of additional data required to refine and update stratification for improved program implementation3/11/2013 13
  14. 14. National goals• National economic and development goals• National health goals• Government health policies3/11/2013 14
  15. 15. Objectives• Existing national countrywide malaria control objectives• Proposed malaria control objectives by stratum• Relationship between existing and proposed objectives3/11/2013 15
  16. 16. Approaches• Summary statement of approaches by stratum and objectives• List of activities to be implemented3/11/2013 16
  17. 17. Research needs• Information gaps• Proposed applied research projects in the plan3/11/2013 17
  18. 18. Operational targets• Tabulation of the operational outputs for each approach• Operational targets necessary to achieve each objective• Time frame for achieving targets3/11/2013 18
  19. 19. Operational milestones• Plan for new services or expansion of existing services – Additional services (e.g. diagnostic, treatment) – Additional staffing – Additional facilities (e.g. lab, stores, office space) – Time frame for introduction and note for geographical distribution• Training of staff – Basic training, refresher training, distance learning – Timetable of the course3/11/2013 19
  20. 20. Organization and responsibilities• Organization of systems and services• Distribution of responsibilities at different levels• Coordination mechanism• Community services• Private sector3/11/2013 20
  21. 21. Evaluation plan• Short term – Epidemiological, operational and other indicators• Long term – Health impact, socioeconomic and other indicators• Information system – Health information system – Management information system3/11/2013 21
  22. 22. Evaluation plan cont.• Data and information to be reported• Levels of reporting• Frequency of reporting• Type of evaluation and level of responsibility• Analysis of information, level of responsibility and degree of authority• Decision making mechanism• Supervision (for continuing education of the staff at all levels)3/11/2013 22
  23. 23. Resource requirements• Must be quantifiable• Facilities (e.g. new clinics, insectarium)• Personnel• Fixed equipment• Supplies and consumables• Maintenance requirements• Training requirements3/11/2013 23
  24. 24. Costing and budgeting• Salaries and allowances• Expenses for organizational activities• Supplies and equipment• Training costs• Miscellaneous expenses3/11/2013 24
  25. 25. Presentation of the plan• Information should be provided in charts, tables, maps and graphs• Summary for decision makers• Most information – annexes• Planning team• Appropriate format• Pages and figures should be clearly numbered3/11/2013 25
  26. 26. Example of a plan Afghanistan national malaria strategic plan 2008 – 20133/11/2013 26
  27. 27. Introduction • One fifth of the world population is at the risk of malaria • Global burden of 300-500 million cases and 1- 2 million deaths per year • Over 90% Sub-Sahara Africa • Most deaths; under five and pregnant women • Threat 40% of the world population in about 100 countries3/11/2013 27
  28. 28. Stratification of malaria in Afghanistan • Major determinant of malaria transmission in Afghanistan are: – Altitude (below 2000m above the sea level) – Agriculture (rice cultivation) • Three strata – First stratum: medium to high transmission – Second stratum: low transmission – Third stratum: has less potential for malaria transmission3/11/2013 28
  29. 29. 3/11/2013 29
  30. 30. Trend of Malaria 2002-2007 700000 626839 600000 585602 500000 433412 414407 400000 324650 300000 271763 200000 100000 0 2002 2003 2004 2005 2006 2007 Reported Malaria Cases3/11/2013 30
  31. 31. Malaria Reported Cases, 2007 433412 450000 400000 347740 350000 300000 250000 200000 150000 79574 100000 50000 6098 0 Confirmed PV Cases Confirmed PF Cases Clinical Malaria Total Reported Cases Malaria Cases3/11/2013 31
  32. 32. Goal To contribute to the improvement of the health status in Afghanistan through reduction of morbidity and mortality associated with malaria3/11/2013 32
  33. 33. Objectives  To reduce malaria morbidity by 60% by the year 2013  To reduce malaria mortality by 90% by the year 2013  To reduce the incidence of Falciparum malaria to sporadic cases by the end of 2013 with a vision to interrupt transmission of PF3/11/2013 33
  34. 34. Strategies  Prompt and reliable diagnosis and effective treatment  Application of effective preventive measures in the framework of IVM such as ITNs  Detection and control of malaria epidemics3/11/2013 34
  35. 35. Strategies cont. Strengthening of the health system and malaria control program  Institutional development  Improving surveillance system  Human resource development  M&E  Private sector involvement  Operational research and partnership building3/11/2013 35
  36. 36. Prompt and reliable diagnosis and effective treatment Targets:  By the end of 2013, 90% of uncomplicated malaria cases will be managed according to national diagnosis and treatment guidelines  By the end of 2013, 95% of severe and complicated malaria cases will be managed according to national diagnosis and treatment guidelines  By the end of 2013, 60% of targeted Health Posts will be able to diagnose malaria by RDTs3/11/2013 36
  37. 37. Prompt and reliable diagnosis and effective treatment cont. Targets:  By the end of 2013, all CHCs and 90% of targeted BHCs in priority areas (stratum 1) will provide quality microscopy diagnosis for malaria, TB and leishmaniasis  By the end of 2013, all Public health facilities will provide appropriate and effective malaria treatment according to National Treatment Guideline3/11/2013 37
  38. 38. Prompt and reliable diagnosis and effective treatment cont. Targets:  By the end of 2013, all Public health facilities offering laboratory diagnosis will be regularly monitored for quality assurance  By the end of 2010, 90% of private sector in malaria prone areas involved in malaria diagnosis and treatment will be informed about national diagnosis and treatment guidelines3/11/2013 38
  39. 39. Prompt and reliable diagnosis and effective treatment cont.Targets: By the end of 2013, 50% of private sector clinics and doctors will be certified to a standard set by MoPH and technical partners By the end of 2010, a functioning referral system for management of severe malaria cases will be in place in 90% of health facilities in target areas3/11/2013 39
  40. 40. Application of effective prevention measuresTargets: By the end of 2010, 85% of households in targeted population will have at least one ITNs By the end of 2013, 85% of target population will be protected by ITNs through scaling up of effective implementation strategies By the end of 2008, an IVM strategic plan based on a comprehensive vector control needs assessment will be developed 3/11/2013 40
  41. 41. Application of effective prevention measures cont. By the end of 2009, three entomological sentinel sites- including monitoring of insecticide resistance in Kabul, Jalalabad and Kunduz will be fully functional By the end of 2013, 12 million people living in the targeted provinces will be stimulated through COMBI strategy to acquire and regularly use LLINs throughout the transmission season By the end of 2013, 6 million LLINs will be distributed in targeted provinces3/11/2013 41
  42. 42. Detection and control of malaria epidemics Targets:  By the end of 2013, 90% of malaria epidemics will be detected and controlled within 2 weeks  By the end of 2008, 90% of health facilities (CHCs and BHCs) in strata 1 will be strengthened to detect malaria epidemics within one week of the beginning of epidemics by utilizing weekly watch charts3/11/2013 42
  43. 43. Detection and control of malaria epidemics cont. Targets:  By the end of 2008, all provincial Epidemiology, Early Warning, Epidemic preparedness & Surveillance teams will be able to investigate any epidemic notification and respond within one week  By the end of 2013, all epidemic prone provinces have an early warning and detection system for malaria epidemics3/11/2013 43
  44. 44. Capacity building, institutional strengthening, and integration• At the beginning of 2009, an assessment for institutional development of NMLCP will be conducted leading to the development of a framework and action plan for institutional development• By the end of 2009 all malaria control programme staff will be trained in their respective disciplines• By the end of 2009 NMLCP and all PMLCPs will be upgraded (buildings, equipment, vehicles) and made fully functional3/11/2013 44
  45. 45. Capacity building, institutional strengthening, and integration cont.Targets: By the end of 2009 in order to strengthen the malaria control at the community level, NMLCP and all PMLCPs will have a Community Based Initiative (CBI) component From 2008 every two years a thorough evaluation will be undertaken by Malaria Task Force to assess the performance of all national and provincial malaria control staff By the end of 2008 a COMBI plan of action for promotion of effective prevention and treatment of malaria will be designed and implemented in all targeted provinces3/11/2013 45
  46. 46. Malaria control and border areas  By the end of 2010 a Border Coordination Committee will be established and fully functional to coordinate malaria control activities in bordering areas with neighbouring countries3/11/2013 46
  47. 47. Operational research To develop evidence based strategies it is essential to conduct operation research as needed by the program focusing on  Health system research  Prevention  TreatmentTarget  By the end of 2008 malaria taskforce will develop a well define mechanism for setting research priorities and dissemination of research results  By the end of 2010, national institute for malaria and leishmaniasis will be fully functional, equipped and adequately staff 3/11/2013 47
  48. 48. Learning objectives• Describe the structure of a plan for malaria prevention, control and elimination• Organize the available information into a realistic plan• Write a preliminary plan for malaria prevention, control and elimination3/11/2013 48

×