Monitoring of the Village Malaria Workers to conduct activities of Malaria Elimination Demonstration Project in Mandla, Madhya Pradesh

Background The capacity of the field staff to conduct activities related to disease surveillance, case management, and vector control has been one of the key components for successfully achieving malaria elimination. India has committed to eliminate malaria by 2030, and it has placed significance on monitoring and evaluation at the district level as one of the key strategies in its national framework. To support and guide the country’s malaria elimination objectives, the Malaria Elimination Demonstration Project was conducted in the tribal district of Mandla, Madhya Pradesh. Robust monitoring of human resources received special attention to help the national programme formulate a strategy to plug the gaps in its supply chain and monitoring and evaluation systems. Methods A monitoring tool was developed to test the capabilities of field workers to conduct activities related to malaria elimination work. Between November 2018 to February 2021, twenty-five Malaria Field Coordinators (MFCs) of the project utilized this tool everyday during the supervisory visits for their respective Village Malaria Workers (VMWs). The data was analysed and the scores were tested for variations against different blocks, educational status, duration of monitoring, and post-training scores. Results During the study period, the VMWs were monitored a total of 8974 times using the monitoring tool. Each VMW was supervised an average of 1.8 times each month. The critical monitoring indicators scored well in all seven quarters of the study as monitored by the MFCs. Monitoring by MFCs remained stable at 97.3% in all quarters. Contrary to expectations, the study observed longer diagnosis to treatment initiation time in urban areas of the district. Conclusion This study demonstrated the significance of a robust monitoring tool as an instrument to determine the capacity of the field workers in conducting surveillance, case management, and vector control related work for the malaria elimination programme. Similar tools can be replicated not only for malaria elimination, but other public health interventions as well.

Observational aspects including weather radar for tropical cyclone monitoring

Hkkjr ekSle foKku foHkkx ¼vkbZ- ,e- Mh-½ ds iwokZuqeku izn’kZu ifj;pkstuk ¼,Q- Mh- ih-½ ds lanHkZ esa dh xbZ fofHkUu izs{k.kkRed lqfo/kkvksa vkSj rduhdksa dh leh{kk dh xbZ gSA ftudk iz;ksx pØokr ds iFk dk irk yxkus vkSj m".kdfVca/kh; pØokrksa dks le>us ds fy, fd;k tk ldrk gSA izkS|ksfxdh ds laca/k esa fd, x, iz;klksa ds okLrfod ijh{k.k ls izpkyukRed lanHkZ esa gekjs iwokZuqekuksa ds fu"iknu dk irk pyrk gSA bl laca/k esa vko’;d mik;ksa ij bl 'kks/k&i= esa fopkj&foe’kZ fd;k x;k gSA In the context of the Forecast Demonstration Project (FDP) of the India Meteorological Department (IMD), a review is made of the various observational facilities and techniques which can be deployed, for the detection tracking and understanding of tropical cyclones. The real test of the efforts in terms of technology is the performance of our forecasts in an operational context. The paper discusses the steps needed in this regard.

Outcomes and challenges of Forecast Demonstration Project (FDP) on landfalling cyclones over the Bay of Bengal

Cakxky dh [kkM+h esa m".kdfVca/kh; rwQkuksa ds ekxZ vkSj mudh rhozrk ds iwokZuqeku rduhd esa lq/kkj ykus ds fy, iwokZuqeku fun’kZu ifj;kstuk ¼,Q-Mh-ih-½ uked ,d dk;ZØe rS;kj fd;k x;k gSA ,Q-Mh-ih- dk;ZØe dk mÌs’;] ftu {ks=ksa ls vk¡dM+s vO;ofLFkr :i ls izkIr gksrs gSa ogk¡ muds loaf/kZr izs{k.kksa ds lkFk gh lkFk mRrjh fgUn egklkxj esa pØokrksa ds mRiUu gksus] muds rhoz gksus vkSj mudh xfr dk vkdyu djus ds fy, fofHkUu l[;kRed ekSle iwokZuqeku ¼,u- MCY;w- ih-½ fun’kksZ dh {kerk dk izn’kZu djuk rFkk fo’ks"k :i ls caxky dh [kkM+h ls lacaf/kr ogha mlh LFkku ij fy, x, ekiksa ds vk/kkj ij fun’kksZ esa lq/kkj djuk gSA ,Q-Mh-ih- dk;ZØe rhu pj.kksa esa fu/kkfjr fd;k x;k gS uker% ¼i½ izh&ikbyV pj.k ¼15 vDrwcj ls 30 uoacj 2008] 2009½] ¼ii½ ikbyV pj.k ¼15 vDrwcj ls 30 uoacj 2010&2012½ rFkk ¼iii½ vafre pj.k ¼15 vDrwcj ls 30 uoacj 2013&2014½A Hkkjr] fdjk, ds gokbZ tgkt vkSj MªkWilkSansa iz;ksxksa ls 15 vDrwcj ls 30 uoacj 2013&2014 ds nkSjku caxky dh [kkM+h esa cuus okys pØokrksa dk gokbZ tgkt ds tfj, irk yxkus dh ;kstuk cuk jgk gSA bl mÌs’; ds iwfrZ ds fy, ¼i½ izs{k.kkRed mUu;u ¼ii½ pØokr fo’ys"k.k vkSj iwokZuqeku iz.kkyh dk vk/kqfudhdj.k ¼iii½ pØokr fo’ys"k.k vkSj iwokZuqeku izfØ;k ¼iv½ psrkouh mRiknksa dks rS;kj djuk] mudk izLrqrhdj.k rFkk izlj.k ¼v½ fo’oluh;rk mik; vkSj {kerk fuekZ.k ij izkFkfedrk ds vk/kkj ij dk;Z fd, x,A pØokr ds izs{k.k] fo’ys"k.k vkSj iwokZuqeku esa lq/kkj ykus ds fy, fofHkUu dk;Z iz.kkfy;k¡ viukbZ xbZaA o"kZ 2008&11 ds nkSjku ,Q-Mh-ih- vfHk;ku ds izh&ikbyV vkSj ikbyV pj.kksa esa la;qDr izs{k.kkRed] lapkjkRed vkSj ,u-MCY;w-ih- xfrfof/k;ksa esa vusd jk"Vªh; laLFkkuksa us Hkkx fy;kA ,Q-Mh-ih- ds igys vkSj mlds ckn dh izs{k.kkRed iz.kkfy;ksa dh rqyuk ls {ks= esa jsMkj] Lopkfyr ekSle dsUnz ¼,- MCY;w-,l-½] mPp iou xfr fjdkWMjksa esa egRoiw.kZ lq/kkj dk irk pyk gSA bl lq/kkj ls ekWuhVju vkSj iwokZuqeku esa gksus okyh =qfV;ksa esa deh vkbZ gSA th- ,Q- ,l- MCY;w vkj- ,Q] ,p- MCY;w- vkj- ,Q- vkSj vlsEcy iwokZuqeku iz.kkyh ¼bZ- ih- ,l-½ ds vkjaHk gksus ls ,u- MCY;w- ih- funsZ’kksa ds dk;Z fu"iknu esa o`f) gqbZ gSA bl 'kks/k i= esa bl ifj;kstuk dh miyfC/k;ksa ds egRoiw.kZ y{k.kksa lfgr leL;kvksa vkSj laHkkoukvksa dks izLrqr fd;k x;k gS rFkk mudh foospuk dh xbZ gSA pØokrksa dk gokbZ tgkt }kjk irk yxkus ds fy, ckj&ckj fd, x, iz;klksa ds ckotwn ;g dk;Z vHkh laHko ugha gks ldk gSA o"kZ 2013&14 ds nkSjku Hkkoh vfHk;ku ds le; ;g ,d eq[; pqukSrh gksxhA A programme has been evolved for improvement in prediction of track and intensity of tropical cyclones over the Bay of Bengal resulting in the Forecast Demonstration Project (FDP). FDP programme is aimed to demonstrate the ability of various Numerical Weather Prediction (NWP) models to assess the genesis, intensification and movement of cyclones over the north Indian ocean with enhanced observations over the data sparse region and to incorporate modification into the models which could be specific to the Bay of Bengal based on the in-situ measurements. FDP Programme is scheduled in three phases, viz., (i) Pre-pilot phase (15 Oct - 30 Nov 2008, 2009, (ii) Pilot phase (15 Oct - 30 Nov, 2010-2012) and (iii) Final phase (15 Oct - 30 Nov, 2013-14). India is planning to take up aircraft probing of cyclones over the Bay of Bengal during 15 Oct - 30 Nov, 2013-14 with hired aircraft and dropsonde experiments. To accomplish the above objective, the initiative was carried out with priorities on (i) observational upgradation, (ii) modernisation of cyclone analysis and prediction system, (iii) cyclone analysis and forecasting procedure, (iv) warning products generation, presentation & dissemination, (v) confidence building measures and capacity building. Various strategies were adopted for improvement of observation, analysis and prediction of cyclone. Several national institutions participated for joint observational, communicational & NWP activities during the pre-pilot and pilot phases of FDP campaign during 2008-11. The comparison of observational systems before and after FDP indicates a significant improvement in terms of Radar, Automatic Weather Station (AWS), high wind speed recorders over the region. It has resulted in reduction in monitoring and forecasting errors. The performance of NWP models have increased along with the introduction of NWP platforms like IMD GFS, WRF, HWRF and ensemble prediction system (EPS). Salient features of achievements along with the problems and prospects of this project are presented and discussed in this paper. With repeated attempts, the aircraft probing of cyclones could not be possible till now. It is a major challenge for the future campaign during 2013-14.

Exploring Use of Digital Home Assistants for Older Adults: A Demonstration Project

Emerging digital home assistant technology has potential to support older adults in their homes. Voice-activated assistants can be used for entertainment, environmental control, physical activities, health management, and social engagement. However, many older adults have limited experience with these devices, which are not designed with them in mind. We conducted a demonstration project to explore how seven older adult assisted and independent living residents interacted with digital assistants over four months. We conducted monthly semi-structured telephone interviews and pre/post questionnaires. Participants desired to use their devices to communicate with others, and for a range of health activities, including nutrition tracking, medication management, and health information searching. However, numerous usability barriers emerged. Some participants perceived their device as a social companion. These findings indicate that older adults are willing to use digital assistants for various activities that may enhance independence, although instructional and training materials are needed to support their use.

Feasibility of an Innovative Rehabilitation Program Adapted for the Post-acute Nursing Home Setting

Live Long Walk Strong is a rehabilitation program that produces large clinically meaningful improvements in mobility when implemented as an outpatient program for older adults. We adapted Live Long Walk Strong for the post-acute nursing home setting within the Veterans Health Administration as a clinical demonstration project. The adapted version includes novel elements and bridges the inpatient stay and three months post-discharge. The inpatient phase focuses on maximizing functional recovery and includes activities focused on timing and coordination of gait, leg strength and power, and trunk muscle endurance. The care transition and virtual (telehealth) post-discharge phase focuses on case management and engagement in physical activity programs. Coaching and behavior change are a consistent focus throughout the program. To date, 13 Veterans (mean age 67.9, SD 11.7 years) have completed the inpatient phase, and of those Veterans, six have completed the entire program, five are still active, one was lost to follow-up, and one was rehospitalized. The program demonstrates feasibility, 91% of all inpatient sessions and 81% of all post-discharge sessions were completed. Regarding preliminary efficacy, 83% of Veterans who completed the program exceeded the minimal detectable change score (4 points) on the Activity Measure for Post-Acute Care (AM-PAC) Mobility scale from program enrollment to completion (mean change 6.5, SD 6.9 points). Based on findings from this clinical demonstration project, the program is feasible. However, future research is needed to further examine the program’s impact on mobility and other outcomes important to older Veterans receiving post-acute nursing home care.