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. 2022 Nov;11(11):7233-7262.
doi: 10.4103/jfmpc.jfmpc_1005_22. Epub 2022 Dec 16.

Assessment of frontline health workers in providing services for malaria elimination in the tribal district of Mandla, Madhya Pradesh

Harsh Rajvanshi  1 , Farzana Islam  1 , Varun Kashyap  1 , Rambha Pathak  1 , Rashmi Agarwalla  1 , Ekta Gupta  1 , Altaf A Lal  2
Affiliations

Assessment of frontline health workers in providing services for malaria elimination in the tribal district of Mandla, Madhya Pradesh

Harsh Rajvanshi et al. J Family Med Prim Care. 2022 Nov.

Abstract

Background: The Accredited Social Health Activists (ASHAs) and Auxiliary Nurse Midwives (ANMs) are the frontline health staff that provide essential health care services, including diagnosis and treatment of malaria. To support India's malaria-free goal by 2030, a project known as the Malaria Elimination Demonstration Project (MEDP) in the tribal district of Mandla was initiated. This study assessed the capabilities of ASHAs and ANMs of Mandla district to diagnose and treat malaria.

Methods: A cross-sectional study was conducted in the 71 sub-centers and their villages where at least one positive malaria case was diagnosed in 2019. Pre-designed and validated tools were used to assess the knowledge, attitude, and practices of ASHAs and ANMs. Analysis was performed using descriptive statistics and multivariate logistic regressions.

Results: Malaria is the fifth priority of the ASHAs and ANMs of Mandla district. Good level of knowledge regarding malaria etiology, diagnosis, and prevention was found, but the ability to treat a malaria case as per the national drug policy was below expectations. Frequent and prolonged stockouts of drugs and diagnostics were found. Logistic regressions revealed better capacity of ANMs to dispense correct treatment as compared to the ASHAs. Improvement was seen in the ASHAs ability to interpret rapid diagnostic test (RDT) results following trainings by MEDP Mandla.

Conclusion: There is a need to increase the capabilities of the frontline health staff of Mandla for malaria diagnosis and treatment. Continuous trainings and a robust supply chain management system is required to equip the ASHAs and ANMs to effectively deliver malaria diagnosis and treatment services.

Keywords: ANMs; ASHAs; malaria elimination; supply chain management; tribal malaria.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
A blown-up map of the study district Mandla showing the nine blocks with its location in the state of Madhya Pradesh in central India
Figure 2
Figure 2
Sample selection flowchart for the study
Figure 3
Figure 3
Age distribution of the ASHAs and ANMs of Mandla district
Figure 4
Figure 4
Educational qualifications of the ASHAs and ANMs of Mandla district
Figure 5
Figure 5
Other professions of the ASHAs and ANMs of Mandla district
See this image and copyright information in PMC

References

    1. World Health Organization. World Malaria Report 2021. Geneva: World Health Organization; 2021.
    1. National Strategic Plan for Malaria 2017-2022. New Delhi: National Vector Borne Disease Control Programme, Ministry of Health and Family Welfare, Government of India; [Last accessed on 2022 Aug 16]. Available from:https://nvbdcp.gov.in/WriteReadData/l892s/nsp_2017-2022.pdf .
    1. MoH& FW. [Last accessed on 2022 Aug 16];About Accredited Social Health Activist (ASHA):National Health Mission. 2014 Available from:http://nhm.gov.in/communitisation/asha/about-asha.html .
    1. [Last accessed on 2022 Aug 16];Guidelines for Involvement of ASHAs in VBDs:NVBDCP. Available from:https://nvbdcp.gov.in/WriteReadData/l892s/Guidelines-Involvement-ASHAs.pdf .
    1. [Last accessed on 2022 Aug 16];Rural Health Care System in India:National Health Mission (NHM), Ministry of Health and Family Welfare, Government of India. Available from:https://www.nhm.gov.in/images/pdf/monitoring/rhs/rural-health-care-syste... .