GLOBAL FUND ROUND - 7 Global Fund Round -7, Malaria grant for Pakistan Overview of the Project Goal “To Reduce burden of malaria in 19 high endemic districts” Objective 1: To improve early Objective 2: To scale up coverage Objective-3: To strengthen & diagnosis and prompt treatment of LLIN in the 19 high risk districts build management capacity of services in the 19 target districts. NMCP to co-ordinate , plan, implement and Monitor effective curative & preventative interventions nationwide Service delivery areas 1.1 Strengthening of existing 2.1 To scale-up LLIN coverage with Establishment of a mechanism diagnostic services in target special emphasis on pregnant for monitoring drug and districts: women and children under 5 years insecticide resistance: of age and introduction of LLIN 1.2 Expansion of malaria diagnostic through MCH centres and other 3.2 Enhancement of facilities (RDT's): identified outlets. management and technical capacities of NMCP: 1.3 To enhance the capacities of 2.2 To enhance target population’s malaria related health knowledge and awareness on 3.3 Facility & community professionals: increased uptake, proper utilization survey country wide to estimate malaria burden in Pakistan: 1.4 To pilot test involvement of of LLINs and timely treatment seeking behavior through private sector health care providers 3.4 Improvement / upgrade / aggressive BCC/IEC campaigns. strengthen M & E system at all 1.5 To Roll out ACTs to 165 MCH 2.3 - Advocacy with local leaders levels. centers in 19 districts and 4 pilot and community networking districts in the private 3.5 Improvement of existing 2.4 - Build capacity for scaling-up epidemiological surveillance provision of quality antiretroviral system therapy prophylaxis for opportunistic infections in the public and private sector and promote treatment adherence. National Malaria Control Programs is in partnership with National and international NGOs, i.e. Merlin, Mercy Corps, Association for Social Development, Association for Community Development, Basic development needs and National Rural Support Programme. Targets • API reduced by 50 % 80 % of children U5 sleeping Directorate of Malaria capacity • 60% of U5 children and under an ITN or LLINs developed for effective pregnant women with implementation and monitoring uncomplicated malaria the curative and preventive correctly managed at health interventions. facilities Budget 30 Percent of the Total 65 Percent of the Total 5 Percent of the Total Key Outcomes • Improved percentage of • Increased awareness of • Sentinel sites established to children under five and masses regarding benefits of carry out drug and vector women accessing effective LLINs. resistant studies. treatment in 24 hours. • Increased number of • Improved transparency in • False Malaria reporting household using LLINs operations monitoring and decreased to 5% management. Improved number of health care • Improved capacity to assess providers both in public and • Improved utilization of Ante- disease burden and private sector providing Malaria Natal Care services. epidemiological trends. treatment in accordance to Improved capacity for evidence national guidelines. based timely planning. Basis of Key Interventions • Complementing key implementing gaps in the Malaria Control Programme Strategic Framework for the period (2008-2013) by focusing on supportive interventions. • Ensuring access of healthcare to vulnerable target group of pregnant women and children under five years. • Focusing on key areas of Health Systems to improve the utilization of Ante Natal services. Service delivery with focus on 19 high disease burden districts of the country. 2 Data for website PROGRESS UPDATE Indicator Sindh Balochistan NWFP FATA Total 1.1: Number and percentage of functioning microscopy centers with trained microscopist in 19 target district. The target for period 4 was 224; however PR 56 69 43 37 193 have achieve 205 centers since according to new performance frame work the target for indicator 1.1 was markedly increased. 1.2: Number of RDT used at FLCF in 19 districts and private 13070 59320 14646 7728 93192 clinics in 4 pilot districts. 1.3: Number of quality assurance lab upgraded. The target for this quarter was 3 3 and PR successfully achieved the target. 1.4: Number of health care provider trained. These targets were already achieved successfully in previous 189 368 182 139 878 quarters. A total of 874 providers have been trained in case management guidelines. 1.5: Number of lab/RDT confirmed falciparum cases 1934 8372 583 579 11468 treated with ACT as fist line treatment. 2.1: Number of LLIN distributed to pregnant woman 133907 53772 87389 36832 311900 and or children under 5 2.2: Number of billboards with prime messages displayed. 5 9 4 4 22 2.3: Number of malaria messages aired through TV 60 Channels 3 Data for website 2.4: Number of IEC messages 14 published in local news paper 2.5: Number of opinion leader, health provider and decision maker reached through 7342 3670 2225 13237 community based seminars. 3.1: Number of established sentinel site reporting on efficacy of ant malarial drugs 1 1 1 1 4 and insecticide 3.2 Number of people trained in malaria surveillance, M&E statistics and data 18 20 12 50 management. 4 Data for website Capacity Building The Global Fund Malaria Round 7 proposal comprises of three objectives, one of them being the capacity building of DOMC staff to co-ordinate, plan, implement and monitor effective curative & preventive interventions nationwide. PMU has continuously been working on this objective and has been able to add land mark achievements in this regards. Malaria Information System: M&E unit of PMU, in consultation with national and international experts has developed a robust information system which is not only catering the reporting requirements of GFATM grant but also facilitating Directorate of malaria to collect authentic morbidity data on regular (monthly) basis. The DOMC staff had been an active part of information system development, training curriculum development, training of master trainers at federal and provincial level and replication of training at grass root level. Malaria Microscopy: Microscopy is considered to be the gold standard in diagnosis of malaria. More than 200 microscopy centers have been strengthened and made functional in 19 district of the country with project support. Training of microscopists, being an integral part of the support has contributed in the capacity building component of project effectively. Strengthening of National Institute of Malaria Research and Training (NIMRT) Lahore: NIMRT is being strengthened with the project support both in infrastructure and developing a pool of master trainers at National level. Various trainings of master trainers have been conducted and these master trainers are available for replication of training at provincial, district level and facility level. Rapid Diagnostic Kit (RDT) for malaria diagnosis: Keeping in view the resource constraints superimposed by the accessibility problems, Malaria Control programme has introduced RDTs as gap time intervention, as recommended by World Health Organization (WHO). Training module in this regards has been developed by PMU with the support of malaria experts of programme. Trainings have been replicated to the grass root level and programme experts had been active part of it. Malaria case management: A national protocol has been developed for malaria case management to achieve the uniformity in case management practices. Malaria Control Programme has been facilitated in the development of national protocol. Case Management training has been developed by PMU with the support/ involvement of Malaria experts of the programme. The training in this regards have been conducted following a uniform process adopted for all training i.e. development of master trainers pool at national level followed by a pool of trainers at provincial level and district level. The mechanism of trainer pool development not only ensures the quality replication of training but also contribute in capacity building of DOMC personals. 5 Data for website Monitoring & Evaluation: Project Management Unit of R-7 has developed and implemented a structured M&E system. The monitoring officers of DOMC at federal, provincial and district level are also involved in the monitoring process after trainings. The regular monitoring is continuously enhancing the capacity of DOMC officers. Procurement & Supply Management (PSM): PSM unit has procured the project inputs both internationally (with the help of a supply organization) and nationally following the Public Procurement Regulatory Authority (PPRA) rules, the former being for health items and latter for non health items. DOMC officers are regular members of procurement process. This has greatly enhanced the relevant capacity of the staff. Monitoring Evaluation System Strengthening Training workshop: This training workshop has been conducted by the facilitation of National and International Consultants during the development of M&E plan for the Malaria R-7 grant. There had been wide participation of the DOMC staff in the workshop enhancing the analytical skills of the staff. International / national workshops and seminars DOMC staff is regularly been facilitated/ supported to attend the national/ international training workshops and seminars, contributing in updating the programme knowledge and capacity building of the DOMC staff. 6 Data for website PR’s SRs Management system GFATM R-7 Malaria Grant M&E