LEPRA implemented major projects under the malaria programme in the states of Andhra Pradesh (AP), Telangana and Odisha. In the Krishna District of AP, Krishna Community Health Interventions Programme (2004-07) funded by Community Fund (UK), was implemented with the purpose to reduce the vulnerability of poor rural and urban communities to the spread of TB, HIV/AIDS, malaria, leprosy and other diseases. It has successfully established a system of working with government health workers to improve diagnosis and treatment skills as well as to increase referrals to the appropriate treatment facility. It has also worked with community-based groups to raise awareness particularly among the scheduled castes, tribes, urban poor and other vulnerable groups. Under malaria control, the project promoted preventive and control measures in partnership with the government’s malaria control programme. The project successfully conducted training programmes and developed a pool of 2,542 community volunteers and distributed 50,000-bednets. The project contributed to reducing malaria incidence through early case detection, behaviour change communication and capacity building of government health staff and frontline workers.

LEPRA implemented the project strengthening health structures for TB, malaria control and leprosy elimination in four districts of Andhra Pradesh with funding support from the European Commission during 2003-07. The overall objective is to contribute to control and provide effective treatment for malaria, TB, leprosy and to enhance access to information, early detection, diagnosis and the project made contribution in decreasing the malaria incidence and mortality by promoting access to early diagnosis and treatment. 9,525 fever cases were referred to PHCs and UHPs and 234 were found positive. The project implemented successfully with various interventions to reduce the malaria problem through piloting various methods like strengthening the fever treatment depots, support the government in indoor residual spray, promotion of larvivorous fish, bednets to pregnant women in tribal areas and integrating malaria slides examination in the TB microscopy centres.

In consultation with district malaria officers, eight lab technicians of tribal and urban areas were trained in examining the malaria slides and reporting formats. In these centres, the project supported the government in diagnosing 6,711 blood smears in Hyderabad urban and tribal areas. District malaria department was supported with IEC and community mobilisation activities during spraying operation in 28 mandals of 334 villages of Adilabad, Medak and Karimnagar districts where positive cases were reported.

In Odisha, Integrated Community Health Project (2006-10), funded by Big Lottery Fund (BLF) was implemented with support from 12 local NGO and CBO partners, in Mayurbhanj district. The overall objective was to improve the health status and quality of life of the rural communities living in remote tribal areas of Mayurbhanj. The project initiated flagship interventions like malaria Samadhan Sibir and strengthened community-based monitoring concepts which were included in the government’s district project implementation plan and scaled up in other districts. Broader strategies adopted included community mobilisation, information promotion and community information management, capacity building of stakeholders, people-centred lobby, advocacy and direct service delivery. 244 malaria Samadhan Sibir was conducted wherein 79,502 villagers including 3,025 panchayat members were sensitised. 3,248 community volunteers received training and 420 fever treatment depots were strengthened, leading to treatment for 36,268 fever cases.

In Telangana state, Adilabad district covering eight tribal mandals (blocks) and 291 revenue villages successfully implemented “Sustainable community-driven responses to prevent malaria, diarrhoea-related mortality and morbidity among tribal communities” project (2013-15), supported by the Jamsetji Tata Trust. The project mobilized and identified 1,46,816 persons suffering from fever, referred 2,192 positive cases for treatment at government facilities, reached 7,249 children with diarrhoea and facilitated enhancement uptake of ORS-Zinc, 411 malnourished children were enrolled in day-care centres for supplemental nutrition. Home-based management of diarrhoea was provided to 8,092 pregnant mothers, women and 2200 long-lasting mosquito bed nets were distributed to them. It led to a 60% increase in outpatients at primary health centres (PHCs), provided training to 659 Accredited Social Health Activist (ASHAs), 410 Anganwadi Workers (AWWs), 100 Auxiliary Nurse Midwife (ANMs), 282 tribal traditional healers, 348 Registered Medical Practitioners (RMPs)/Private Medical Practitioners (PMP)/quacks, 297 Village Health Sanitation And Nutrition Committee (VHSNC) members on malaria and diarrhoea preventive measures. The project contributed to a decrease in the malaria parasite index (4.0 to 1) and zero deaths due to malaria and diarrhoea were reported.

Strengthening the drive for Malaria Elimination through NVBDCP-Civil Society Partnership, LEPRA implemented Intensified Malaria Control Project -3, a Global Fund project, in Odisha state during 2016-18 covering the three highly endemic tribal districts – Keonjhar, Mayurbhanj and Sundergarh which include 1,178 remote tribal and inaccessible villages. The objectives of this project include: (1) achieving 80% coverage by effective preventive intervention through supply of long-lasting insecticide-treated nets (LLIN) to population living in high-risk project areas (API>1); (2) achieving 80% coverage of fever cases by correct, affordable and appropriate parasitological diagnosis and prompt, effective treatment according to the national drug policy; (3) achieve 100% coverage in project areas through Behaviour Change Communication (BCC) activities to improve knowledge, attitudes and practices in malaria prevention and management; (4) improve service delivery through strengthened surveillance and monitoring & evaluation (M&E), program planning and management, coordination and partnership development; (5) fortifying health systems and community through capacity building (training) to improve service delivery.

Achievements:

– 17,718 Long Lasting Insecticidal nets distributed to the high-risk population
– 14072 Plasmodium falciparum cases detected and treated with the ACT at the community level
– 70,874 reported fever cases with blood samples were examined and tested with Rapid Diagnostic Kit at the community level
– Trained 1178 community level volunteers and 3183 ASHAs for malaria early detection and treatment
– 2721 Plasmodium vivax cases were detected and treated by Chloroquine and Primaquine at the community level