Background

Integration of NTD Control Campaigns with Other Health Interventions

An Exploration of Potential Integration of Neglected Tropical Disease Control Campaigns in Two Districts of Uttar Pradesh, India

Background

Scene in Uttar Pradesh (Credit: Anu Laxmi, NTD Support Center, Task Force for Global Health)

Uttar Pradesh has the greatest share of most communicable and non-communicable disease deaths in India, largely due to its concentration of rural and urban poverty.  NTDs such as lymphatic filariasis (LF), visceral leishmaniasis (known as kala-azar), soil-transmitted helminthiases (STH), dengue, Japanese encephalitis (JE), and rabies are prevalent in the state. In most districts, disease control campaigns occur sequentially throughout the year. These include mass drug administration (MDA) and vaccination campaigns, vitamin A supplementation, blood pressure and blood sugar screening, and COVID-19 education. 

In this study, The International Institute of Health Management Research (IIHMR) explored the integration of campaigns for NTDs with other health interventions in order to develop recommendations for planning and delivery.

Context

Problems and Opportunities

  • The burden of NTDs presents a major social and economic problem in Uttar Pradesh, where the endemicity of LF is estimated to be 14.6%
  • The state’s health system faces challenges such as insufficient infrastructure, shortage of healthcare professionals, increasing costs, and lack of planning and coordination.
  • The effects of COVID-19 have led to a reduction in coverage of childhood immunization, and presumably have also impacted screening campaigns for high blood pressure and diabetes.
  • Uttar Pradesh utilizes a campaign model led by ASHAs called ‘Dastak’ (Hindi for ‘a knock on the door’)  to conduct household surveillance and education for JE, tuberculosis, malaria, dengue, febrile diseases, and water, sanitation, and hygiene behaviors. The Dastak campaign has been lauded for lowering the incidence of JE tremendously, and presents an opportunity for integration with MDA campaigns. Integration of NTD and other health campaigns would present cost, time, and human resource savings.

Research Questions

  1. What insights can be gained from the experiences of key stakeholders about the planning and delivery of integrated campaigns in Gorakhpur and Deoria?
  2. What are the main facilitators and barriers for integrating NTD and other health campaigns, from the perspective of stakeholders involved in planning, operationalizing, and monitoring campaigns?
  3. What is a proposed way forward for collaborative integration of locally relevant health campaigns?

The Dastak campaign has grown from Japanese encephalitis surveillance to integrate other disease surveillance and prevention activities, and has potential as a platform for mass drug administration.