VECTOR CONTROL NEEDS ASSESSMENT

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• VECTOR CONTROL NEEDS ASSESSMENT
• (VCNA)
• First Steering Committee Meeting of the WHO-EMRO/
  GEF Project
• First Regional Meeting of the GEF- Supported
  Countries in WHO-EMR
• Muscat, 4 - 8 March 200

R Bos, J Williams A Mnzava World Health
Organization
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Outline of Presentation

• Introduction
• Challenges to vector control
• Responding to the challenge The IVM concept
• Vector Control Needs Assessment (VCNA)
• Relevance of VCNA to IVM
• Outline of VCNA guidelines
• Chapter 1 Objectives, target users (cha
• Chapter 2 Assessment procedures
• Chapter 3 Assessment Tools and Method, and
  Products

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Challenges to vector control

• Multivariate multi-sector driving forces to
  local burden
• Natural and manmade
• Diminishing resources (significantly limiting
  management technical scope of country
  programmes)
• Inadequate technical capacities
• Limitation to the implementation of
  cost-effective sustainable intervention
  (chemical non-chemical)
• Diminishing arsenal of cost-effective public
  health pesticides
• Increasing disease burden in some local areas

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Challenges to vector control

• Effective vector control requires a
  multi-sectoral approach to the implementation of
  locally appropriate and cost effective
  interventions
• Need to address vector carrier of disease
• Need to address human target of disease
  (individual and community)
• Require some socio-economic, socio-political
  reconstruct
• The requirement for effective control clearly
  extend beyond the mandate of the health sector

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Development policy and health
Health Policy
DevelopmentPolicy
Social determinants
Environmentaldeterminants
Healthcare
Poverty
Health
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Country Scenario on Vector Control

• 2 general categories observed
• Countries with organized VC services
• Need to strengthen VC to improve
  cost-effectiveness, sustainability and impact
  will involve recalibration of program objectives
  and operations
• Countries with no organized VC services (ad-hoc
  localized)
• Need to establish boundaries and goals for (new)
  cost-effective and sustainable national vector
  control

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Responding to VC Challenges

• Innovation that enables the scale up of
  cost-effective and sustainable interventions,
  through delivery systems that are responsive to
  changing local situations, and which protects the
  continued utility of existing tools
• Develop or improve VC policy and strategy
• Identify and prioritize cost-effective
  intervention options and deployment regimes
  within local settings
• Establish appropriate management/operational
  systems to sustain deployment
• Provide basis for evaluation of impact and
  feedback to improve delivery

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Integrated Vector Management

• Process of evidence-based decision-making
  procedures aimed to plan, implement, monitor and
  evaluate targeted, cost-effective and sustainable
  combinations of regulatory and operational vector
  control measures, with measurable and sustainable
  impacts

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Integrated Vector Management

• CHARACTERISTICS
• A public health regulatory and legislative
  framework
• Collaboration within the health sector with
  other public and private sectors whose actions
  impact on vectors
• Empowerment and involvement of local communities
  and other stakeholders
• Methods based on knowledge of factors influencing
  local vector biology, disease transmission
  morbidity
• Use of a range of interventions, often in
  combination and synergistically

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• Vector Control Needs Assessment
• (VCNA)

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Relevance of VCNA for IVM Strategy

• National action to improve vector control will
  only be realistic if it is based on a
  comprehensive assessment needs and opportunities
  within the context of current and predicted
  vector borne disease burdens
• Are we realizing our goals in reducing burdens ?
• If not, why not ?
• What can be done ?
• What will it require ?
• How can it be accomplished (plan of action)
• VCNA- Rational first step to establishing
  effective national IVM

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VCNA GuidelinesCONTENT

• Chapter 1 Introduction
• 1.1 Purpose of the guidelines
• 1.2 Objectives
• 1.3 Scope
• 1.4 Intended Users of the Guidelines
• Chapter 2 Assessment Procedure
• 2.1 Approaches
• 2.2 Definition of concepts
• 2.3 Principles
• 2.4 Procedure for assessment
• Chapter 3 Tools and Method
• 3A Situation analysis
• 3A.1 Areas of assessment
• 3A.2 Primary information requirement for the
  main areas of assessment
• 3A.3 Data collection, including indicative
  questionnaire tool
• 3B Tools for problem analysis and prioritization
  of constraints
• 3B.1 Identifying the major constraints faced by
  the national vector control
• 3B.2 Determining the root causes of the major
  constraints
• 3C Determining needs and opportunities for
  establishing or strengthening vector control

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VCNA Guidelines

• Objectives
• Provide a framework for assessing needs for
  introducing or improving VC programmes
  (cost-effective, locally appropriate)
• Propose a methodology, procedures and tools for
  the needs assessment.
• Provide guidance on the use of assessment
  outcomes for improving VC programmes.

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VCNA Guidelines

• Intended Users
• Government officials normally charged with
  planning and design of health sector programmes
• Role
• Design, commission, evaluate the VCNA
• Ensure mechanisms to monitor compliance with
  assessment recommendations
• VCNA to be done in close consultation various
  stakeholders.

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VCNA Guidelines

• 2. Assessment Procedure
• Proposes a framework for
• Establishing national mechanisms for assessment
• Conducting assessment
• Stakeholder consultations
• Achieving consensus on outcomes products
• Follow up activities for the development of IVM
  strategies and national pans of action on
  implementation

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VCNA Guidelines

• 3. Proposes assessment tools and methods
• Suggests primary areas of assessment and related
  information requirement
• Suggests data collection processes, including an
  Indicative questionnaire tool
• Evaluation tools
• Situation analysis, including problem analysis
• Identifying and prioritization of major
  constraints
• Determining the root causes of the major
  constraints identified
• Determination of the needs and opportunities for
  establishing or strengthening vector control
• 4. Suggest products of the assessment

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Phases in the VCNA
Three main Phases are identified, each containing
a number of steps/actions
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Steps in the VCNA
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Steps in VCNA
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Steps in VCNA
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Vector Control Needs Assessment

• Assessment Tools and Method

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Assessment Tools and Method

• Question 1
• Are current goals for reducing VC disease burdens
  being realized? If not, why not ? SITUATION
  ANALYSIS
• Identify information needed to answer the
  question
• Gather necessary information
• Determine the constraints preventing the
  achievement of goals
• Identify the root causes of the constraints
• Question 2
• What can be done to improve on the current
  situation? What will it require and how can it be
  accomplished? NEEDS ASSESSMENT
• Determine/adjust goals (realistic vs. desirable)
• Determine the range of, and quantify resources
  that will be needed
• Develop a strategy (i) to obtain needed resources
  (ii) on ways to achieve the adjusted goals
• Follow up
• Develop a plan of action to implement and
  evaluate.

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Data Collection

• Locally appropriate methodologies should be used
• Questionnaire
• Focus group discussions
• Desk top review of existing reports
• Field observation etc.
• An Indicative questionnaire IS proposed - to
  guide country specific questionnaire development
• Need to validate pre-existing information

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Problem analysis
1. Identification of constraints
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Problem analysis
2. Root cause analysis ("fish bone" analysis)
PROGRAMME GOAL
START POINT
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Identification of constraints(example)
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Identification of constraints(try-out example)
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National MVC Capacity Problem Analysis
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Situation Analysis

• Output
• Detailed profile of the major vector borne
  diseases in the country
• For countries with formal VC programs
  information on all aspects of the program is
  derived, including a prioritized list of the
  current major constraints faced and root causes
  of the constraints

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ID of Needs Opportunities for VC improvement

• Output of situation analysis used
• For countries with formal VC programs
• Establishment of boundaries and goals for a new
  and cost-effective national vector control.
• For countries with formal VC programs
• Recalibrate program objectives and operations
  to increase cost-effectiveness and facilitate
  achievement of maximum sustainable benefits
  (reducing VBD burden)

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Products

• Actual VCNA process
• A situation analysis report providing
• Comprehensive evaluation of the current
  vector-borne situation in the country
• Performance of the vector control program,
  constraints and causes of constraints
• A needs assessment report detailing requirement
  and opportunities for strengthening or
  establishing vector control
• A functional stakeholder forum for developing
  national consensus on VC
• Consensus on national vector control strategy and
  implementation, and partnership roles.
• A functional intersectoral arrangement for
  effective collaboration on VC

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Products

• Completion of recommended follow-up Activities
• A national strategy and plans of action for the
  implementation of cost-effective and sustainable
  IVM complimentary strategy on resource
  mobilization.