Innovative Endeavors and Challenges for Malaria Elimination in Chhattisgarh: An Analysis

Abstract

Bastar Division comprising seven districts located in southern part of Chhattisgarh State, is highly endemic for malaria. The division is dominated by tribal population. The Annual Parasite Incidence (API) of Bastar, Bijapur, Dantewada, Kanker, Kondagaon, Narayanpur, Sukma were 12.83, 66.59, 60.61, 16.12, 14.67, 31.06, 62.11 in the year 2015 which were reduced to 3.99, 24.53, 19.05, 1.62, 2.81, 13.98, 9.76 in the year 2021 respectively. The significant reduction is attributed to combination of control measures implemented and its intensification during a campaign “Malaria Mukth Chhattisgarh Abhiyan” (“Malaria Free Bastar”) an initiative of State Chief Minister. Despite marked reduction in malaria incidence, there are many challenges out of which the crucial ones are community response to testing and treatment as local traditional healers and self-medication are preferred. Remoteness and inaccessibility of tribal villages and hamlets are another challenge in informing villagers prior to spray and achieving desired coverage with Indoor residual spray (IRS). The fixed spray schedule with no flexibility in dates is another challenge in completing the spray if its start is delayed. Proper and regular use of LLIN within its expiry is a bigger challenge because old nets are continued to be used and new nets are kept safe due to mindset. Over and above, entomological surveillance and field activities are the issues being flagged at many platforms but instead of data generation by skilled persons, its analysis and providing feedback to state, the priority is towards visibility. The gaps need to be assessed, evidenced and resolved to ensure implementation of programme guidelines and achieve expected outputs.