Reaching people at risk of malaria in remote areas of Chhattisgarh, India
In recent years, India has made impressive gains in reducing its malaria burden, with cases dropping by more than 40% between 2015 and 2021. Most of the remaining cases are concentrated among tribal populations living in rural areas. This photo story describes efforts by local health workers to reach people at risk of malaria in remote areas of Chhattisgarh, a state that accounts for nearly one fifth of the country’s malaria burden.
Health workers walk on a trail to a remote village in the Bastar District of Chhattisgarh (March 2023).
Travelling over difficult terrain to access remote populations
People living in hard-to-reach, hilly and forest-fringe areas of Chhattisgarh are the most vulnerable groups affected by malaria. Here, health workers and Accredited Social Health Activists (ASHAs) travel over difficult terrain to access the remote hamlet of Korangali. In areas with high malaria transmission, ASHAs receive special training by India’s National Center for Vector-Borne Disease Control Programme on how to identify malaria symptoms, diagnose the disease, and treat confirmed cases with appropriate antimalarial medicines.
ASHA Sanki Manadovi marks a child's nail after testing him and his mother Majhali for malaria in Korangali village in Bastar District of Chhasttisgarh, India (March 2023).
Rapid diagnostic tests for malaria provide results within 15 to 30 minutes
After reaching the village of Korangali, the team of health workers and ASHAs conducted a door-to-door malaria outreach campaign. Members of the community with suspected cases of malaria received a rapid diagnostic test (RDT), which allows for quick results within 15–30 minutes. Here, an ASHA marks the toenail of a child with an indelible pen as part of a process to keep track of all those who have been tested for malaria.
Santosh Panigrahi, 39, crossed the Indrawati river to reach the village of Chandela in the Bastar District of Chhattisgarh (March 2023).
Travelling long distances over water to reach people at risk of malaria
In some areas, health workers must travel long distances over water to reach people at risk of malaria. In this image, Santosh Panigrahi, a 39-year-old rural health worker, returns from the remote village of Chandela after crossing the raging Indrawati river. While in Chandela, he delivered a range of health services to local residents, including immunization and guidance on sanitation and nutrition.
Health check up in a governmental primary school in Binta village in Bastar District of Chhasttisgarh, India (March 2023)
Routine health check-ups in schools ensure children receive care free of charge
At a primary school in the village of Binta, a Rashtriya Bal Swasthya Karyakram (RBSK) health worker tests a student for malaria and performs a basic health check-up. Launched in 2013 by India’s Ministry of Health & Family Welfare, the RBSK programme is focused on preventing disease and disability in children by routinely testing for the “4Ds”: defects at birth, diseases, deficiencies, and development delays. Children diagnosed with illnesses receive follow-up care at the district level free of charge.
Sulwati Thakur, 30, sits under a mosquito net with her son Niranjan in their house in Bheja village in Bastar District of Chhasttisgarh, India (March 2023).
Sleeping under an insecticide-treated net is one of the most effective ways to prevent malaria
In the village of Bheja, health workers provide members of the community with insecticide-treated nets to prevent malaria and other vector-borne diseases. Sleeping under such nets is one of the most effective ways to prevent malaria. As part of the state’s malaria programme, ITNs are distributed widely by health workers across Chhattisgarh.
Field worker conducting indoor residual spraying in a home in Bheja village in Bastar district of Chhattisgarh, India (March 2023).
Indoor residual spraying: another effective intervention to prevent malaria
Indoor residual spraying (IRS) with insecticides is another effective malaria prevention method. It involves coating the inside walls and other resting surfaces for mosquitoes with insecticides. In this image, a field worker conducts IRS at a home in the village of Bheja.
School children put up mosquito nets in Ashram School in Korangali village in Bastar District of Chhasttisgarh, India (March 2023).
School children receive nets – and training in how to use them
In many schools across Chhattisgarh, teams of health workers train children at risk of malaria in how to set up insecticide-treated nets correctly and the benefits of sleeping under them. Here, students at the Balak Ashram School in the village of Mutanpal install and sit under such nets.
Theater artist performing street play to promote malaria awareness at Haat Bazaar in Mutanpal village in Bastar District of Chhasttisgarh, India (March 2023).
Malaria campaigns to build awareness around malaria prevention
In the weekly Haat Bazaar (open-air market) in Mutanpal malaria campaigns employ theater artists to build awareness around the importance of sleeping under an insecticide-treated net. Here, an artist demonstrates for members of the community how to use a net, as well as recommended techniques for washing and drying it.
Health workers and volunteers on a rally to raise community awareness on the use of treated nets in Mutanpal village in Bastar District of Chhasttisgarh, India (March 2023).
Campaigns use rallies to raise awareness of the risk of malaria
Health workers also organize evening rallies to boost awareness among community members of the risk of malaria and how to prevent it. In this rally, held in the village of Mutanpal, they highlighted the importance of using insecticide-treated nets and of eliminating mosquito breeding sites around homes.
Gunmani Dhansingh, 34, adjusts a bed net for her father-in-law Dhansingh Thakur, 70, in their house in Bheja village in Bastar District of Chhasttisgarh, India (March 2023).
Malaria control efforts appear to be paying off
The dedicated efforts of health workers in Chhattisgarh appear to be paying off. In the district of Bastar, which accounts for about three-quarters of the state’s malaria burden, there was an estimated reduction in cases of more than 60% since 2018, according to state health officials.