India bares a large malaria burden that requires major support to be addressed and eliminated. The disease continues to add pressures on the public healthcare systems and affect everyday life. While malaria cases are witnessed across rural and urban areas, rural India is exposed to higher threats with the abundant sources of mosquito breeding, the lack of timely testing and treatment options and the unfavorable impacts of climate change.

While the rural population lacks the access to quality resources, they majorly depend on community healthcare workers such as ASHA’s and malaria saathis when faced with a case of Malaria. Addressing malaria at the last mile is key in achieving national elimination. A number of organizations along with national and state governments have been tremendously working towards achieving the national malaria elimination goal.

Community workers have today made community engagement initiatives a success to help address malaria issues at the last mile. From cleaning initiatives to door-to-door checkups efforts are being made to prevent as well as timely identify and eliminate malaria. During the monsoon months, The NVBDCP, Koraput has instructed to all ASHA’s to visit 10 households to find out fever case, mobilize the community though bell ringing to ensure usage of Long-lasting insecticidal nets (LLIN) in the night, and early test and treatment within 24 hours in case of any Malaria case found along with conducting village cleanliness drive to reduce mosquito breeding sources with the support of SHG group and GKS members of the village. Malaria No More, a non-governmental organization with its Malaria Doots and Saathis has been supporting the health service providers to mobilize community leaders and SHG group members to observe dry day in the village and ensure LLIN usage along with daily household visit for identification of Malaria cases and ensuring complete treatment to the positive cases and contact tracing to the positive cases.

Once a malaria case has been identified, it is important to contact trace to identify potential new cases to initiate treatment and halt the spread of the disease. When a person is found to be malaria positive in the district of Koraput, Malaria Saathis and Doots are supporting health providers by conducting a RDK test of all family members to find out infected persons of the family to check for transmission of Malaria through early test and treatment. Furthermore, they test members from surrounding 10 households who showcase symptom of fever for the last 15 days. In efforts to control the surge of Malaria in villages, they also sensitize the villages to reduce mosquito breeding sources with the use of indoor residual spray, observation of dry day on every Sunday, early test and treatment within 24 hours. 

Malaria No More issues RDK and Antimalarials to the Malaria Saathis. Malaria Saathis maintain the stock position in their M-Saathi register. They maintain the record of drug received, drug utilized and drug balance in the M-Saathi register in a regular basis.

Equipped with Rapid Diagnostic Tests and information-packed job-aids, the Doot/Saathi duo has changed the paradigm of malaria surveillance and care. From treatment and referral, following up at any hours, and assisting and following up with hospitalization, and treatment completion, the Saathi has become a faithful companion of each malaria patient, executing the concept of 360° care in the districts of Koraput and Malkangiri in Odisha, thus helping the state move towards malaria elimination.

Village level community mobilization is going to be crucial in addressing malaria across rural India and requires interventions across all at-risk regions to successfully eliminate the disease. Successful implementations models and such as engagement and training of the Doot/Saathi duo to address the diseases as seen in districts of Koraput and Malkangiri can be replicated across India to reach elimination and reduce the burden on the public health systems.