National Deworming Day

A School and Anganwadi-based Mass Deworming Program

Soil-transmitted helminth (STH) infections are among the most common infections worldwide and affect the poorest and most deprived communities. They are transmitted by eggs present in human faeces which in turn contaminate soil in areas where sanitation is poor.

Several studies show the detrimental effects of soil-transmitted helminths on children's educational performance and school attendance. Children with the highest intensity of STH infestation are often too sick or too tired to concentrate at school or attend school at all. STHs interfere with nutrient uptake in children; can lead to anaemia, malnourishment and impaired mental and physical development. Rigorous research has shown that they also pose a serious threat to children's education, and productivity later in life.

In areas where parasitic worms are endemic, administering safe, effective deworming drugs to children at schools is a development “best buy” due to its impact on educational and economic outcomes and low cost . The evidence shows that mass deworming leads to significant improvement in outcomes related to education, career choice, earnings and long-term well-being.

NATIONAL DEWORMING DAY

India has the highest burden of soil-transmitted helminths in the world, with 241 million children at risk of parasitic worm infections. Under-nutrition and anaemia in children has been well documented in India: almost 7 in 10 children in the 6-59 months age-group are anaemic, with even higher rates of anaemia in rural areas.

To combat this situation, in February 2015, the Ministry of Health and Family Welfare (MoHFW) Government of India launched the National Deworming Day (NDD) as part of National Health Mission. NDD aims to deworm all children between the ages of 1-19 years through Government, Government-aided, private schools and anganwadi centres in order to improve their overall well-being, nutritional status, access to education and quality of life. Under this program, all school teachers and anganwadi workers are provided training and resource material to effectively administer the deworming drug (Albendazole tablets) at school and anganwadi centres.

The NDD has emerged as the world's largest public health campaign for treatment of intestinal parasitic worms. After the unprecedented coverage of NDD with national coverage of more than 89 million children, the MoHFW mandated the observation of the NDD at pan-India level on 10 February 2017. The NDD will be followed by a Mop-up Day on 15 February to cover children who might be left out earlier due to sickness or absenteeism, and will ensure maximum coverage with optimal utilisation of resources. In addition, the fixed day strategy will prioritise deworming within anganwadi and school health programmes, increase awareness, and standardize campaign messages across the country.

STAKEHOLDERS

The Ministry of Health and Family Welfare, Government of India is the nodal agency for providing all States and UTs with operational guidelines related to NDD, with the Ministries of Education and Women and Child Development (ICDS) as the key stakeholders for NDD implementation. Other key stakeholders are Ministries of Panchayati Raj, Tribal Welfare, Rural Development, Urban Development, Drinking water and Sanitation. Evidence Action's Deworm the World Initiative is the technical assistance partner to MoHFW, Government of India.

IMPLEMENTING NATIONAL DEWORMING DAY

Key components to implement a successful NDD include drug procurement and management, adverse event management systems, monitoring and supervision plan, and recording and reporting processes. Strategies have been put into place to ensure that these components are rolled out in a streamlined and effective manner. These strategies include:

• Steering Committee Meetings at States and Districts prior to NDD
• A robust integrated distribution of drugs, IEC, and training handouts during training at block, sector, and project level to ensure all material for the program are made available on time
• Community awareness and mobilization, with specific efforts towards ASHA engagement to include out-of-school children into the program
• Adverse Event Management protocols that provide clear instructions on the management of adverse events
• A monitoring and reporting cascade to ensure that NDD is being implemented as planned and to assess whether desired resulted are being achieved.

National Deworming Day 2017 will be observed on 10 February 2017 in all States and UTs of India. Children between the ages of 1 to 19 will be dewormed with administration of the safe Albendazole 400 mg chewable tablet in anganwadis and schools.