Unity CDTI annual project technical report submitted to Technical Consultative Committee (TCC): January to December 2013

UNITY CDTI PROJECT + I {, ORIGINAL : Enelish ANNUAL PROJECT TECHNICAL REPORT SUBMITTED TO TECHNTCAL CONSULTATTVE COMMTTTEE (TCC) DEADLINE FOR SUBMISSION: To APOC Management by 31 Januarv for March TCC meeting To APOC Management by 31 Julv for September TCC meeting AFRICAN PROGRAMME FOR oNcHocERcrASrs coNTRoL (APOC) I I COUNTRY/NOTF: Republic of South Sudan Proiect Name: Unity CDT! Proiect Approval vear:2012 Launchins vear: 2013; not officially launched Reportinq Period: From: Janua ry 2013 To. December 2013( Month/Year)(Month/Year) APOC fundinq vear: (1) 2 3 4 5 67 8 I 10 11 12 13 APOCProiectimplementationvearreport: (1) 2 3 4 5 6 7 8 I 10 11 12 13 Date submitted: ,{ Juty 2014 Partners:- Ministry of Health - African Programme for Onchocerciasis Control (APOC) - Mectizan Donation Program (MDP) - Christoffel Blinden Mission - Affected communities tUNITY CDTI PROJECT 2013 TECHNICAL REPORT TO TECHNICAL CONSULTATIVE COMMITTEE (TCC) ENDORSEMENT Please confirm you have read this report by signing in the appropriate space. OFFICERS to sign the report: Country: Republic of South Sudan National Coordinator: Dr, Ton g Chor Malek Signature Date: .*Sll.trty tzo14 No Ix'Et+ Proiect coordinator Css"ai\^d'tov -V'ge't -signature: . p"r"ntative: John Alal Ujwok Date: ... ..../Julyl2O14 NGDO Not i^w Date: ... ...lJulyl2014 This report was prepared by: Dr. Tong Chor Malek Designation nal Coordinator Signature: Date: .il5.5.1u 014 Signature Table of contents ACRONYMS................... DEFtNtTlONS........... FOLLOW UP ON TCC RECOMMENDATIONS EXECUTIVE SUMMARY........... SECTION 1: BACKGROUND INFORMATION SECTION 3: SUPPORT TO CDT!... V VI 1 .2 .3 1.1. GeneRRl rNFoRMATIoN........ 1.1.1 Description of the project (briefly) 1.1.2. Partnership 1.2. PopumrroN.......... SECTION 2: IMPLEMENTATION OF CDTI.... 2.1 . Tttr,tEltrue oF ACTrvrlES ..... 2.2. Aovocncv ..........8 2,3. MoelLIZATIoN, SENSITIZATIoN AND HEALTH EDUCATION OF AT RISK COMMUTIrIES.S 2.4. Cotur,tutttty TNVoLVEMENT ........... ........9 2.5. Cnpncrrv BUTLDTNG ...............10 2.6. TRrnrrrreruTs............. .....12 2.6.1. Treatment figures .......12 2.6.2 What are the causes of absenteeism?....... .......14 2.6.3 What are the reasons for refusals? ............... .........14 2.6.4 Briefly describe all known and verified serious adverse events (SAEs) that 14 2.6.5. Trend of treatment achievement from CDTI project inception to the current year ......... .....15 2.7. ORoeRtruc, SToRAGEAND DELTvERyoF tvERMECTtN ......16 2.8. Cotr,ttr,turutrv sELF-MoNrroRrNG RNo SrnrrHoLDERS MrrrtNc... ......17 2.9. SupeRvrsroN .............. ..............17 2.9.1. Provide a flow chart of superuision hierarchy. ....17 2.9.2. What were the main issues identified during superuision? ...................17 2.9.3. Was a supervision checklist used? ....................17 2.9.4. What were the outcomes at each level of CDTI implementation supervision? ............ ......17 2.9.5. Was feedback given to the person or groups superuised?...................17 2.9.6. How was the feedback used to improve the overall performance of the project? 18 3 3 4 5 3.1 3.2 3.3 3.4 Eourpruerur FINnUcIRl CoNTRIBUTIoNS oF THE PARTNERS AND COMMUNITIES OrneR FoRMS oF CoMMUNITY SUPPORT .............. ExperuotruRE PER ACTrvtrY.... 18 18 18 22 22 22SECTION 4: SUSTAINABILITY OF CDTI 4.1. lrurrRrunl; TNDEpENDENT pARTrcrpAToRy MoNrroRrNc; Evn1un1oN.................22 4.1.1 Has the project ever been evaluated/monitored? (Tick any of the following which are applicable) ........... 4.1.2. What were the recommendations?... ..................22 4.1.3. How have they been implemented? ............ .......22 4.2. Sustnrrunarlrry oF eRoJECTS: eLAN AND sET TARGETS (unxonroRY AT...... ......22 llt Yn 3)........ 4.2.1. Planning at all relevant levels. 4.2.2. Funds 4.2.3 Transport (replacement and maintenance)..... 4.2.4. Other resources 4.2.5. To what extent has the plan been implemented. .-.-. 4.3. 1rurEcRnrtoN.............. 4.3.1. lvermectin delivery mechanisms...... 4.3.2. Training 4.3.3. Joint supervision and monitoring with other programs 4.3.4. Re/ease of funds for proiect activities.. 4.3.5 ls CDTI included in the PHC budget?. .. 4.3.0. Describe other heatth programmes that are using the CDTI structure and how fhis was achieved. what have been the achievements?... 4.3.7. Describe othersissues considered in the integration of CDTI. 4.4. OpennloNAL RESEARCH 4.4.1. Summarize in not more than one half of a page the operational research undertaken in the proiect area within the reporting period. 4.4.2. How were the results applied in the proiect?. SECTION 5: STRENGTHS, WEAKNESSES, CHALLENGES, AND 22 22 22 22 22 22 23 23 23 ZJ 25 25 25 SECTION 6: UNIQUE FEATURES OF THE PROJECT/OTHER MATTERS......... 25 25 OPPORTUNITIES o lv Acronyms a APOC ATO ATrO CBO CBM CDD CDTI CSM LGA MOH NGDO NGO NOTF OV PHC REMO SAE SHM African Programme for Onchocerciasis Control Annual Treatment Objective Annual Training Objective Commu nity-Based Organ ization Christoff Blinden Mission Commu nity-Directed Distributo r Community-Directed Treatment with lvermectin Community Self-Monitoring Local Government Area Ministry of Health Non-Governmental Development Organ ization Non-Governmental Organ ization National Onchocerciasis Task Force Onchocerca Volvulus Primary health care Rapid Epidemiological Mapping of Onchocerciasis Severe adverse event Stakeholders meeting Technical Consultative Committee (APOC scientific advisory group) Trainer of trainers United Nations Children's Fund Ultimate Treatment Goal World Health Organization TCC TOT UNICEF UTG WHO Definitions (i) Total population: the total population living in meso/hyper-endemic communities within the project area (based on REMO and census taking). (ii) Eliqible population: calculated as 84o/o of the total PoPulatton in meso/hyper-endemic communities in the project area. iii) Annual Treatment Obiective: (ATO): the estimated number of persons living in meso/hyper-endemic areas that a CDTI project intends to treat with ivermectin in a given Year. (iv) Ultimate Treatment Goa I (UTG): calculated as the maximum number of u people to be treated annually in meso/hyper endemic area project area, ultimately to be reached when the project has s within the reached full geographic coverage (normally the project should be expected to reach the UTG at the end of the 3'o year of the project). (v) Therapeutic coveraqe: number of people treated in a given year over the total population (this should be expressed as a percentage). (vi) Geooraphical coveraoe: number of communities treated in a given year over the total number of meso/hyper-endemic communities as identified by REMO in the project area (this should be expressed as a percentage). (vii) lnteqraliqn: delivering additional health interventions (i.e. vitamin A supplements, albendazole for LF, screening for cataract, CDTI (using the same systems, training, supervision and etc.) through personnel) in order to maximise cost-effectiveness and empower communities to solve more of their health problems. This does not include activities or interventions carried out by community distributors outside of CDTI. (viii) Sustainabilitv: CDTI activities in an area are sustainable when they continue to function effectively for the foreseeable future, with high treatment coverage, integrated into the available healthcare service, with strong community ownership, using resources mobilised by the community and the government. (ix) Communitv self-monitorinq (CSM): The process by which the community is empowered to oversee and monitor the performance of CDTI (or any community-based health intervention programme), with a view to ensuring that the programme is being executed in the way intended. lt encourages the community to take full responsibility of ivermectin distribution and make appropriate modifications when necessary. vl FOLLOW UP ON TCC RECOMMENDATIONS TCC session There are no recommendations to the project since this is the first year of APOC funding and this is the first report to be prepared to the TCC a Number of Recommendatio n in the Report TCC RECOMMENDATIONS ACTIONS TAKEN BY THE PROJECT FOR TCC/APOC MGT USE ONLY Executive Summary This report is meant to cover the CDTI activities that should have been implemented by Unity CDTI project in the period from January 2013 to December 2013, the first year of APOC funding; however CDTI activities were not implemented in this reporting period. Control activities were not implemented in the project area in previous years as in the rest of South Sudan since the results of Rapid Epidemiological Mapping of Onchocerciasis (REMO) conducted in 2002-2004 showed that all foci surveyed in Unity state showed prevalence below 20% and were thus not eligible for onchocerciasis control activities. With the paradigm shifting from control to elimination, it was decided that CDTI activities begin in the Unity CDTI project area beginning with the 2013 funding year. ln 2013, the project area had a total population of 679,104 an ATO of 543,283 during this reporting period. The project covered Unity state that covers a total of 9 counties, 72 payams ind 275 bomas. The total number of communities will be enumerated in the later phases of the implementation of activities in the project. CDTI activities were not launched as anticipated in2013 in Unity CDTI project. The National Coordinator had an initial meeting and a number of telephone discussions with the Unity state health authorities that in turn had to second health staff to begin implementing oncho elimination activities. However, later on in the year there was insecurity that caused all activities to come to a halt. The major challenge faced by the project included: . Lack of proper launching of CDTI activities in the area and thus there was no kick-starting of project activities. . The state was not able to nominate/appoint a project Coordinating Officer to head project activities. . lnsecurity that happened towards the end of the year caused all the plans to be put on halt. THIS REPORT WAS PREPARED AT THE NATIONAL LEVEL AND NOT AT THE PROJECT LEVEL BECAUSE THE PROJECT IS NOT YET OPERATIONAL. .. 2 aSECTION 1: Background information 1.1. General information 1.1.1 Description of the project Geographical location, topography, climate The Unity CDTI project is located between latitudes 7.0'N and 10.5'N and longitudes of 29.0"E and 30.8'E. The topography of the project area is mainly of flat expanses of plains of savannah grasslands. The project area experiences cold and wet weather during the rainy season that runs between May and September; and it is hot during the dry season that runs from October to April with temperatures going above 40'C. Population: activities, cultures, language |n2013, the population of the Unity CDTI project area was 679,104 people. The main activity of the inhabitants of this area is predominantly nomadic cattle rearing, with the minority engaged in subsistence farming. The main the languages spoken are Arabic, Nuer and Dinka. Communication systems (roads...) Road networks exist within the project area and they interconnect the different counties; some of which are resurfaced; though there are others that are very difficult to use in the rainy season. The project area can also be accessed through air by planes and helicopters from Juba, and Rumbek. The project area is accessed by air through the Rubkona airstrip. The project area is also covered by the available mobile telephone networks. Administration structure The Administrative structure in the state follows that set by the government of the Republic of South Sudan; that is tiered through the state, county, payam, boma and village levels that are administered by a State Governor, County Commissioners; Payam Administrators; Boma Local Councils and localVillage Chiefs respectively. Health system & health care delivery ln Unity state, the state ministry of health is responsible for overseeing the implementation of all the health policies through the state health authorities and the County Health Departments. There is a state hospital situated in Bentiu town; and a number of primary health care centers and primary health care units. An update of the actual numbers will be provided in subsequent reports. Number of health staff in project area and number of health staff involved in CDTI activities 1,050 health workers existed in the project area in 2013; none of these were engaged yet in were involved in CDTI activities. ln future when the activities get kick started; there will be some staff to work with in supervision of CDTI activities. Below is the distribution of the health facility staff per county. 3 Table 1: Number of health staff involved in CDTI County Number of health staff involved in CDTI activities. Total Number of health staff in the entire project area B1 Number of health staff involved in CDTI Bz Percentage BFBzlBr *100 Panyiiar 123 0 o% Leer 98 0 Oo/o Mayendit 147 0 0% Koch 79 0 0% Guit 67 0 Oo/o Mayom 139 0 0% Rubkona 201 0 0% Abiemhom 89 0 0% Pariang 107 0 o% Total 1,050 0 0% 1.1.2. PartnershiP lndicate the partners involved in project implementation at all levels lmplementation of project activities did not take off in 2013 as anticipated. Describe overall working relationship among partners This is not applicable since activities did not take off. State plans, if any, to mobilize the state/region/districULGA decision- makers, NGDOs, NGOs, GBOs, to assist in CDTI implementation A phone call discussion was held between the National Coordinator and both the state minister of health and the state director general of health services. However no field visit materialized due to security concerns in the second half of the year. I 4 oz G.!, o o cL o) c E o o. o o -c E" 'trf!, otr ot, o o 'd o o o o :, oc o o o o G 3 o o -o(E @ o -o(E o ; o G .9 E' .; o oN o o o o(u o o .c .2 (u Ec G oE otr o o .9 E oEtr oI o o. .t2 G o G o o .6. o. tro o .E f -\ o 0) 0 o.Gnr .sst\ --oUEo! tsa)ge Y.*qO q) o t 'o o o o o oa o\ o ! o q) o o F- q) o ap) o b o) oo a-xo q) ab =o U) (.) q) P o_ o \ o{oS o O) Qq) oo o a- e o, oq) O) c bq) oo Q U) G IE PS5E CD =q(E o o() q)t o o a. s()(r) otr t o obo oo oa o o a_oq) o_ o oa E tr f, xo E o q o E') c o o. o o -c o) c ! o c o E o G'o o(! o -c o -tr oE! (U o G oo 'd CL o tr o o .E J o (E c o ! CL o o- Etr(E o .9 =c Eo E oo 6rl 6,l lll lElFI tr o s :, CL o o. "i tr) o f gE ! HEE50 = E" N$o- t-!(r sr- o,$ O) F- @- O)s o CO$- o,(o O)o(o- o(o s rO o)- (o o- N o) @t-t- ro O) rr) a.(o l- c, @ C\l (Y'tlo + il a ,oLC o,aE CLi *€ E;oq, . oE'FC o o o o o o o o o o o . og- b'EE I e3€;0H <rEEO o O o O o o o o o o o tr o (U o. o(L (JgcOO.o o I9'o Ul .Y o-o S Ee hEeCco.- O o o o o o o o o o + il ro 616c o_;: ;F9XEEioo . o!,9c -o o o O o o o o o o o .9 EE EE;:o': g -r od, tF g - N o o o o o o o o o o .= oo olg o o .E =E E o o o L ol -ct1trl =lzl ttO.o6I9-.oo.Y o-0, # E.e EE'€CEo.- o o o o o o o o o o o(!tr.= O .9EE * ov Eie.E.6o:gF CL.= O No @- @(o r-(o !if- (o ct)$(f) N(o r- @N(o @ r(o ry @(f) N$ o)_ O)(f) r ro c\l @ r NN\ O) sF-|r)- ro o, toq o)N(o tr oo L o c(!(L L o)oJ =Ec -o (E = .cooY = =o E o o oco .Y -o =E, E oE E .9 -o o)Eo L(5 tL J F oF \o E '6 o6raEE ) =P;_o L(E(o Jctr E '<n c) <otoz ts_co^^:;oEcO)Oo(o-tr J o(f).LSSE€ : (!- 5g-L . =o o(o@ >F g -n)LJ:YL- == o= oE.9 >.6 o E^ -=(o =\!- J*t\. HE E* g F:- ;E El--!r- .=t( +. O) I3q 83" airi EE I olfi =* tu-Y o) 6?- cla E>ei 8; 5o.9 *,9 'EEZ, (g'= Gtvt-vt-:E < C, fA. $ 'E CL A) a o.E >. OAs.Eo* o €E EHE Se3 "r9E EoY ;rEd -ogE E'PE N EE FFE ;z2 bgs p!B g6H € €R :45 Eot tr (g o,F.=?Li.(J E.(/, E obE 3=5 H - rvts ?o o FE (t) tr(J-c E ='= L- =: se! €;t e=s ':oX {" o o ofI s?: € Efl e=i E3: (u3,F E ^-! r (g.= oo E O== EZ o >> X +' =h, =<.E I c .9 o .E oo) U' o_Eto-o EEo-o- z z z z z z z z z 9-c ke €L z z z z z z z z z tr o) -o L .t2E o) o o EE cLotrtr o-o- z z z z z z z z z ED. H9(rt - z z z z z z z z z o (g !, CLf o =otr oo .9- E?o-o EEo-o- z z z z z z z z z 9-c ke o' z z z z z z z z z E') .E .g o F .9- E? cLo EEo-(J- z z z z z z z z z ED- he o- z z z z z z z z z oo -o (E=NE 6E6o 5tl c o o= cLo EE o o z z z z z z z z z E'- ke aut * z z z z z z z z z tr oo (E C o(L o oJ =Ec o (I, = Eo oY = =o E a o (E co .v. -of,tr E o .C E .o -o o)c G L(!(L c- (! o)L(5 oo '6' L o- oE .c EooC o E E oo o .o = o(o Fo O oz I o tr o E E oo Go tr o o o .s E o (u o oGo (U o -c o oo 't o(E o o E o .E c"ir 6,I ttl(El FI oo 't (,(u o o .= o .EF c.i tro o rts o tr o +. G+,e o trg CL E (\ z o F C) ul @ 2.2. Advocacy State the number of poticy/decision makers mobilized at each relevant leve! during the current year; the reason(s) for undertaking the advocacy The sGte minister of health and the state Director Generalfor Health Services were talked to about the need to establish onchocerciasis elimination activities in Unity state. Reason(s) for undertaking the advocacy The reason in undertaking the advocacy by the National Coordinator was to inform the heatth authorities of the need to begin onchocerciasis elimination activities in state; seeking for their involvement and support in decision making about the need to establish onchocerciasis elimination activities in Unity state. The outcomes The officials talked to were positive to the idea and they pledged support in the process of establishing onchocerciasis elimination activities in the state. Desc ri be d iffic u lties/constrai nts bei ng faced The difficulties that were faced during the reporting included. the lack of proper launching of CDTI activities in the area and thus there was no kick-starting of project activities; the state delay in to nominate/appoint a Project Coordinating Officer to head project activities; and the insecurity that happened towards the end of the year caused allthe plans to be put on halt. Suggestions on how to improve advocacy When the security situation improves, there will be a mission to the Project area and the health authorities will be met, sensitized and the details of what is expected of them for the implementation of oncho elimination activities will be explained' Z.g. Mobilization, sensitization and health education of at risk communities The use of media and/or other local systems to disseminate information This has not been done; but will be considered in future since FM radio stations exist in the project area. The other ways of disseminating of information like verbal communitations at community gatherings/meetings, and through the community leaders will also be Pursued. Types of IEG materials used This has not yet been done. Mobilization and health education of communities including women and minorities: This has not yet been done. Response of target communities/villages: Not applicable yet Accomplishments: Not applicable yet Suggest ways to improve mobilization and sensitization of the target communities: Not aPPlicable Yet 8 2.4. Communityinvolvement Table 4: Communities participation in the CDTI A count of the number of communities has not yet been done and that's the reason why this table above is blank. Attendance of female members of the community at health education meetings Not applicable yet ln general, how do you rate the participation of female members of the community meetings when CDTI issues are being discusses Not applicable yet lncentives provided by communities for the CDDs Not applicable yet Attrition of CDDs. ls attrition a problem for the project? lf yes, how is it addressed? Not applicable yet 9 County - LGA Number of comm unities/villages with community members as supervisors Number of CDDs and the communities involved Number of communities /villages with female CDDs Total no. communities in the entire project area Br Number with community members as supervisors Percentag e Bo= 85/ 84 *100 Male CDDs Bt Female CDDs Bs Total Be= B7+flg Number of communities with female CDDs Bro Percentage Brr= Bro/Br-100 Panyiiar Leer tVayendit Koch Guit Mayom Rubkona Abiemhom Pariang Total Other issues - None Bs 2.5. Capacity building Describe the adequacy of available knowledgeable manpower at all levels. It is expected that there will be some manpower available in the project area since there are health facilities in the project area. There is also a functional state ministry of health and 9 county health departments in the project area. When the security situation improves in the future, there is high expectation that there will be adequate health staff to work with. The details of the adequacy of available knowledge will be reported on in future. Where frequent transfers of trained staff occur, state what the project is doing, or intends to do, to remedy the situation. Not applicable. l0 :6rro EJ*=() i. :d o o O o o o o o o o o O o o o O o o o o o o o o o o o o o o E(, tr 'G ooo o o o .cl E J z aio o o o o O o o o o o tr o E o .9 o s so :trro Ed*=o &d ]. *d o o o o o o o o o o o o o o o o o o o o o o o o o O o o o o 9. o .20FFEO Ll-ol-EoEE o.-- -FoE!l 5Eol =lzl ooF o o o o O o o O o o c o E o .g o s so (J o toq i ll) = E,, d F o'+- -() o o o o o o o o o o o o o o o o o o o o O o o o o o o o o o !, o .= G G o .o o CL L] ol cl OIo ! =6or o olt E z o o F o o o o o o o o o o tr o Eo .g o s so o () .*-.:rtF (-) Ioq io2 o o ;' o o o o o o o o o o o o o o o o o o o o o o o o o o o o 9zoo Uto or o(! boll E z ooF o o o o o o o o o o tr oo o c(U(L L o c)J =Ec o o = Eo oY =f(, E o (! = oc o .Y -of v. Eo -c E .q -o olc o L o(L J F oF c o E o .9 o s so O)c q5oo o afoE oc q Eo L o o- o)E E o o- oL o .E oo(! o- lz o o o) .c .c(! L oz tr o E E oo e5 a4() r<o E iq o (E o O) .-cEco a- eoo d aG G o oc G o 'b tr o (! c o Eg .E tro o o L o -g tr o oE E o -c IE .g c lE F F o Trainees Others (specify MOH staff or Other Politic al Leader S Health Workers (frontline health facilities)CDDs Other Community members e.g Community supervisors Type of training Program management Health education Management of SAEs CSM SHM Data collection Data analysis Report writinq Others (specify) of traini undertaken Any other comments - No training took place in the reporting period 2.6. Treatments 2.6.1 . Treatment figures lf the project is not achieving 1OO% geographical coverage and a minimum of 65% therapeutic coverage or the coverage rate is fluctuating, state the reasons and the plans being made to remedy this. Treatment did not take place in this reporting period. t2 ca ! f o q o o .o.\ a. o €t a EL o c o El a o o a ft .! € t E, o o Er ; o o G o q a o .E o'\(q' 5P Cq00>{T'BiY ct o 5c!I =:to q.! aE EE:O O E€o ts 9boI o P.::o E a-earSo$ 5 ::-EA = ElE o 9l ESr5 = ioriE i EI.E g 35HE E FE'O = E iXQ.) e E.IeE .s r o'EF 3 9i.s6 = =trSEEIE E8TS:15 E:ITEI:i sErhall = !-sx ol E o o': =ElO = t ts st5 EIE st sg E ! ;lp eJ f ;lg ;l.s.i I e , EIEEltEIEEIEE$$ ElEs Elt "1EEt SEtslE! 8lE 8li lits h3lq aEf bls blE 3 E g ElIlsEl: Elh El: ! Er EI EIE EIE EI = EIE.:5 Og3e ae Z€:lP.Pt S8l rs:q gC Epl q.Q.o cl OOoOl O O! :l ' rr rr " E*btiEl t tEul aa\ol o E E-slg E i !.t ytl o s - _ 'ilB 3 5Sr*EIE O g lEU El8.e.5=E $iiEteo\=o\ oo\ o o Er .91.9 - ij - E -E o o -5 tlF g i q [t$ ':lf (3 k s QS€ J ..2 (E o Go G G o (, .12!, o IJJ o !,tr a! tr o E(! o : g;gEgEE€. o o o o o o o o o o -Oe otr ou.l Eaa o o o o o o o o o o bEv = o LL-=O)E=tsH_.s: E >o (tr u o ; E E'e E o o o o o o o o o o O= Eb s 3l --o ozo O a O o o o o o o o 5=a;€:EE o O o O o o o o o o o -> ll -Oo 5 ddi,o OO)O-(o(EoLLE d)of> -coFO sO so so so so so sO so sO so o o-q69 !@oEbe z* o o o o o o o o o o o cO6 o.>itroF 6.s2.<9!FU o N$O. r-$ st- o)v o)t- @- o,$ o(o$- o,(o o)o(o- o(f, (o o)- N o) @f.-I- ro o, r() v-(o f- e? @ C\t COtlll) C o (! =o.l ol o-l : r,, s=e$gEHI ** oo+ o No @- @() t-(o$- r(o o,s(O- N(o I- @ r-_(o @ r @ c\{ @(f) N$ Or- ct)(f, o ry(o NN\ o) tt-()_ lr, o, $o ott\(o oo tr Fdd' o oo) =cna!E s988u(96 so so so so so so so so so so q FO) d) =(! o6 =: (l)Eb F: EE da co O) z OO E I I I I I I I o (trcE E E E.q,<F o I I I I I I I I oo o,o a @ o) .E) E E oO o_ =.o ! 6,, tEt*;E fr"trb> oo tr I I I I I I I I I I r! <,ooJO L G (!(L L ooJ .=Ec o (I, -cooY =) o E o o Gc o -v, -oft EoE E .o -o oc o .E (E& oF I I 2.6.2 What are the causes of absenteeism? Not aPPlicable 2.6.3 What are the reasons for refusals? Not aPPlicable 2.6.4 Briefly describe atl known and verified serious adverse events(sAE;) that occurred during the reporting period and provide (in iable ti1 tn" required information when available. Not aPPlicable Parasitotogist trained? None has been trained Existence of microscope? None is available Has the project reported all sAEs to Mectizan Donation Program (MDP)? Please tick one. Not aPPlicable XNo a ln case the project did not have any cases of serious adverse events tseel during ttiis reforting period, please tick in the box. Not applicable No SAE case to rePort x t4 o) =-oo:r>- 3E b <.s E z *a egE EE# cAtr9EdXnLLUoo z o .'n -OEPao,ioob A z @ u) 0)P!b8 67 ^5:< o o<)q)oE FE =6 z os 0t)Oo->\ ^,'= _=t .:gEFT:8€8gE z COr = 6=v(,(E> d) = o.= t F F.-(5;- oo 6.se z E o €o9or.N(tr-JO.=ofgEtg z U' E o o- E a z 668r.: (U or!] o E Le &(J (,, tr O! z c oNg)6 U, bitr o (5 jo==g z o oorcs:o >o z xo U) z o){o z z a o o s (,, 9El-- >Jo O so o o)a) o^E bs oo oo rr f ui uJ UJ so {= o)fo)o(o Sgs o)O-t(JFo oo rr I- lU lLl lrJ so ! *9oo s0)o.:9aEC rO29. o o_ 1! o u, c0)o ar.> lEoE6S < E:F\J (f, @ ry(o$ rr) o (! f o_ o o- : H., o p E* $$* H, $o o) F-(o o o)C) o^ E eEoo o c, rr I- uJ ul LlJ so .: rr I-5 ur'ui o c, 69 lrJ E o_ G o)oo(, o o)(! (t) oo so LlJ \'E ov'= (1)- E =g€Etr>O2 EE' o ul eq)6 o.> ItrO F E.gT<t6 I o o o) -a Eo o) .E l E E oO So '= J-(,bb9P9 *9f 5I - _s =';E -*.6 ii4dF > o)lgDE EC8o I E. LU (f, roN co oN L o co @ N cf)slr) a(5 B (o G)L(! o o o)E o(,Ff o F iri o G oo o -c o oFf o -c o (E .9!, .E o o Gg o. G o c oL(E =Eo(E96i:o o'6' ccLoo gb tro E: .gL 6 O'rF o.G -oF> .Jo il cclbolE3l e>lo!lEoOE">G .gh!>ooGO eh EOc=Eba-. C bE EO 6F ril E o L o o. t, E o o. o o o)c JE E o oo o G o ul q o c o o o o o E G o o ooa oi;(,,.9o=o*(E=o:: ..o@lz. ol lll olFI 2.7. Ordering, storage and delivery of ivermectin Mectizan@ ordered/applied for bY MoH tr wHo tr UNICEF tr NGDO Other (please specify) The project did not order for mectizan in the reporting period Mectizan@ delivered by WHo tr tr Other (please specify) The project did not receive mectizan in the reporting period Please describe how Mectizan@ is ordered and how it gets to the communities Not applicable Table 10: Mectizan@ lnventory How are the remaining ivermectin tablets collected and where are they kept? Not yet applicable List and briefly describe the activities under ivermectin delivery that are being carried out by health care personnel in the project area. Not yet applicable Any other comments None State /District /LGA Number of Mectizane tablets ln stock from previous year Requested Received Used Lost Waste d Expir ed Remaining Panyiiar 0 0 0 0 0 0 0 0 Leer 0 0 0 0 0 0 0 0 Mayendit 0 0 0 0 0 0 0 0 Koch 0 0 0 0 0 0 0 0 Guit 0 0 0 0 0 0 0 0 Mayom 0 0 0 0 0 0 0 0 Rubkona 0 0 0 0 0 0 0 0 Abiemhom 0 0 0 0 0 0 0 0 Pariang 0 0 0 0 0 0 0 0 TOTAL 0 0 0 0 0 0 0 0 l6 tr 2.8. Community self-monitoring and Stakeholders Meeting Has any training (of trainers) for community self-monitoring been done in the project area? No lf so, When? N/A Table 11: Community self-monitoring and Stakeholders Meeting Describe how the results of the community self- monitoring and stakeholders meetings have affected project implementation or how they would be utilized during the next treatment cycle. Not applicable during this reporting period. 2.9. Supervision 2.9.1. Provide a flow chart of supervision hierarchy. Not applicable during this reporting period. 2.9.2. What were the main issues identified during supervision? Not applicable during this reporting period. 2.9.3. Was a supervision checklist used? N/A 2.9.4. What were the outcomes at each level of CDTI implementation supervision? N/A 2.9.5. Was feedback given to the person or groups supervised? N/A County/ LGA Total # of commun ities/villages in the entire project area No of Communities that carried out self monitoring (CSM) No of Communities that cond ucted stakeholders meeting (SHM) Panyijar Leer IVlayendit Koch Guit ltlayom Rubkona Abiemhom Pariang 00 00 00 00 00 00 00 00 o0 00 00 00 00 oa 0a 00 oo oo TOTAL 00 00 t7 2.9.6. How was the feedback used to improve the overall performance of the project? N/A SECTION 3: Support to CDTI 3.1. Equipment Table 12: Status of equiPment -Condition the equipment (F=Functional, NFR=Currently non-functional but repairable, WO=Written off, NA=Not applicable) How does the project intend to maintain and replace existing equipment and other materials? N/A. 3.2. Financial contributions of the partners and communities - Fill tables 13a, 13b and 13c lf there are problems with release of counterpart funds, how were they addressed? There is no counterpart funding allocated within government PHC budgets to support direct funding for implementation of key CDTI activities. Additional comments - None a COUNTY NGDO OthersAPOC MOH No CondrltonCondrtron No Condttton No CondrtonNo Conditton No Source Type of equipment NANA 0 NA 0NA 0 NA 01. Vehicle 0 NA 0 NA0 NA 0 NA 00 NA2. Motor cycle(s) NANA 0 NA 00 NA 0 NA 03. Computer(s) NA 0 NA0 NA 0 NA 00 NA4. Printer(s) 0 NA0 NA 0 NA0 NA 0 NA5. Photocopier (s) NA 0 NA0 NA 0 NA 00 NA6. Fax Machine(s) 7. Others 0 NA 0 NA0 NA 0 NA0 NAa) metallic cupboard 0 NA0 NA 0 NA0 NA 0 NAb) Bicycles 0 NA 0 NA0 NA 0 NA0 NAc) Radio base l8 F.lr) (f) N @- Ni col@Fl Oit- r-l +ia'\ti (9lO o)l oic) !-: irj ololoo:o to 'i' l' ood oioo:od lcio;o@ i,o I o c @(, o- t- !,trC)f olt rg F <ol olroort olo) n-i olso,i lol@i i(o ii olooto oio oi coicool o):N(oi collrio: Ni(,Ol sllri si coif oq o oq o oq o oq o o o o co oo o oo CJ oq o oq o oq o oq o oq ooLoE o oq o oo o oq o oq o oq o oo ci oq o oo CJ oo o I I ololoqrq:q o:olo oo o lo iolo lo lo lo i I I l I oioioioororo'o o:oio;o oq o I I I olooio o:o oq o oo o oIo .E t =o =oCe o o o,oioo 9r9ooo oo c;oEOq3 'z olo'ojoiooiq,q qrq oo'ooo lo'o l oJO 'O 'O 'ooo o'o lo oo1000 o'ooo oooq'q q ooo oq o c o E ooL .Cl ..2t, 'o L o E(! 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E.E .9t 6El (EEl (,EI <l :Jl - J oF oz E o UJz J F uJ(9 ol @ c, o ,E (E .E, , I'E ilT Ei Hi *,; ol E'(D*tllrI;€Nl <r, YI Q -l-t-rsI I tQ o c o G t4 so ,, s,o, G(rl o !_icb 5rs't, E €3r NS€i .-sq,l€8sl -E3l :{€l Qo G5 G lll 6 .E o o E o otoc lt, : 1O ov' .o, 3, oE' oiI(J:I O: O, oI or .ci .9, .EI .E(Ei(u E; E o! o)clcts .El :Ei =EiEISFiFIS 'ji e.il i "ii "l a U} ci !!it:i : j ci i o.olc '6i .E .oii€i3 #EI E(/); >l ur ii ..il "i(f), ol (.,il (E o aaI alt o\ at, L(E o) o c) LE a(tr oE L o aL oEE(! o- ([ -ct oC .o = _o .E oo EoE(5 .c LL irifit o E G I I I oo 't o G o (! .E E o o otr o o .E .= o GE o E oE '6 oE' c\ otr o G 3 .= o o (E o oIl(\t e(\I ;(, o '6. CL o o E')tr E c o2 oL(tl o ooL .C a(5 oE Lo a ocE(5 o- 6 _o U' o = -o L coo Eoc(E .E LLjj c.) g .cl(EF a o co o'o oqiqrq o:o o oloioololodid:ci oq o oq o oo ci o:oloioo:oloro oio;o;o 'o C)r ol! *z F oo o oo o oo c; oiooio oio oo o oo C; oq o o co oo o oq o oo o oq o oo o oq oq ooL o o oo o oo o o co oq o o co oq o oq o oq o oq o oq o oloo'o o:o oq o oloo'o olo oq o I I I oioo'o olo oo o oo c; oloo,o o:o .E fc,o =.9EEoo oq o oq o ololoqtqtq oio:o oq o oio ooioo ooo oooqoq ooo o'oooo9 ooo o'o,o'oo'o'9 q oooooEOq8 -z o'o o o ooqqq q ooooo oq o oq o I lo Ioio io 'o'o ololooloio o 'd lci oq o I OIOolod'o o co I o!oioololo o'o'o c otr o ?, .o .2E 2 otr L(! o.t u.l !l- o ooo oz I oloolo o'o oloiooloio ooo zzzz zzzzzz zzzz Eot,L = -ooSE zzzzz oooqqq ooo oq o ooooqcc q oooo oooq'q q ooo oooooooooo ooooo oooqq q ooo oIo oooq,q eooo o,o oc q.qooo o'o oq.q'q ooo ooooo;o lO o o,o o o oooooo,o,o.o,o ooooo o co o.o oqq eo,o o o-o oooo o o'c; o:ooooo ooo oo'o,ooo,oo o.o o o o,ooo:oooooo ooooo o eo oo o oq o oq o oq o oq o oq o oq o oo o oq o oq o oo C; oo o I o or6 EtoEF 't o oo 9-o =olE o6oc =oll crlooEtr o =6YO z oo ci oq o ood oo c; oq o oo CJ ooocqqo,o o oq o oooocqc qo,o o o oooqq q o,o o oo ,o ooqq oo (\l o(\I !, o '6 ll d UI (E 'rE, trg (u o o o o oc o o L g o .o L c o(, Fz UI =ztlu o(9 !, o o cr,t, =o oo o oqq q q o,o o .o oq o J F oF oz E o ah C o) .o) .oo o o '(l, ,oE'I3: Oi:oE,oo.-!: 6 o!(I)-or! o) > ei6i\b:Els2i>lo -.NlQ =, =l ,; so Eo B, r!c G E Es G EsEtrloa> 'lo EaE5tr: 'E!()G9o sbo>>o Ib -c o:99: F> * =l E(/j, [rJl o NI Qrj.l a u, oto' s'o,q x'o G s o EE s s o G G : lr.l $ 'f o :s 'o E c o =, .3 s6 ei 3 ai (/)l:{(a; = oo 'o;o :o:(,| C' =:(u' o -oItc:O> '--; .\l 'ffi; .s, ts:f: '.:t-: -:l .! c{. o o)i< o B -c =(5 oI o ci o(,lEa.E.9 r: e E9El s(/) >l uJ .,.t F;Nl(.) <'i, dl c.j;l G o aIt4 uJz J F uJ ool t0 !o tro GN E vt so ut So GO,Eoo>EIs's E' q SE T E ilEES, E H H 5 -iiEt o El ; (U : S:l S El E f: iiSEi: :l : :r t{€l I : iq !,co=olrIE F oioloio:oo:o:ololo ololo,o,o o co oo c; oo o olo,oio o,oioio O ;O ;O'oi't oiolooio o cj io ci ololooro:o o:ci'cj o co o eo oq o9,q, o oo CJ oo o oo o oo o oIo oo o oo o oq o o co oo o oq o oo o oq o oo o o eo oo o oq o oo o oo C; oo o oo ci oo o ood oq o oo ci oo o oo o oo ci .E tc,o =oEe o o oo o oo C; oq o lo !oio Io lo :o oq o oo o oo o oro,oo,o eooa oiolooq'q o coooo o'o oqq q ooo oooqo q ooo oq ooEOq8 'z o o'o,o oO,oOOrO ooooio oq o I I oiooio ci 'c; I oloioololo ooo oq o tr o E o6L lt ,9 !, 'o oEE(! CLt llJ -Fo o oo oz ololololooiolololo o'o'o o'ci olololoololoio o'o'o'o oloiooloio ooo !,oo = -oo o\E zzz zzzz <zzz zzz zzzzzz oooooqqqq q ooooo oooqq q ooo ooooqqq q o,o ,o o oooqq q ooo oooqqg ooo oq o oq o ooooog q,q.q I qooooo .ooolqlq q ooo o-oooq,qrq,q oooo oooqc q o.o o oooqcq ooo o.o'o,o oooo.oo o'o ci o c; o,o o'olo;o ooo oo c; oooq q'c ooo oooooo :ooo o:o oo,o o ooo oIo .9, o o,6 EDOtrF 't -9oa)b.tr9-, ;o a! t,OGoc :o rt cn .noEt o = =l! =c =o zl oo c; oo o oo o oo o oq o oo ci oo C; oq o oo o oo C; oo c; oq o oo c; oo c; oq o oo c; oo o oq o oq o oN E oE '6 -ot UJ G'E g Go o o o!F o tr o E c o(, z UJ =ztlu o(9 !, o o E,,tl tr oo o ocq q qo.o o ,o oq o oq o o,oq,q o,o ooqq oro ooqq oo oq ,o ooqq oo oooqqq o,o o oq o a C o 0) o)o 0) !(l, o) c, 0) U) o c o f .o .oE c oq, E o2 - v, so o o( o E G o o o to o so o EI Gs G E! s G G o a an 6i ss c o,E. d] I r.tJi o Nl o -l ; .4 o ao. o$o E: E .9i 6 'El (tr EI , <l ..Jl - J FoF oz G, o u,z J IIJ(, olo !o s .9 GrN vt tr o tn s(, G(r,coo>E Es: =, .E 3; ,E E 'E: E F.' E,Eti=Ei5*;;sol o ol -o o i:Ecl>@l<.TgSEI:,:l: :r t -:<l I I i i.a o GS G IIJ d 'tr o c o E o tt,t o a. ta 0 o,{i o 3 c' C, o.I: o, o! 'e (E L o. OI c,- .!l -El sFl g o.il d "l ,; oo oo o ot .c; .E:(E: c)i o)i _Erci '6' F; FI Nl I : o! cr !!l l-, .; ci o .E o= rul h lXl O c"il o "l a c o q' (f, ci .9: .q., ei(I)i oJ f: @i rl oj C\ o o .= o G o (U L E o o o c o o .E =(, G o E' o =oo!, oc o(E 3 .= o of(E o o -o o(\t .E (, o .6. CL o o o) .E rc, cf oz o L(5 o o oLE os oE L o aL ocE(5 o- (E -o oc .o f -o c oo EoE(5 .E LL (, al, o tl(! F I a I 3.3. Other forms of community support Not applicable. 3.4. Expenditure per activitY lndicate in table 13, the amount expended during the reporting period for each activity listed. Write the amount expended in US dollars using the current United Nations exchange rate to local currency' Not applicable. Any comments or explanations? None SECTION 4: SustainabilitY of CDTI 4.1. lnternat; independent participatory monitoring; Evaluation Has the project ever been evaluated/ monitored? (Tick any of the following which are aPPlicable) Year 1 Participatory lndependent monitoring Mid Term Sustainability Evaluation 5 year Sustainability Evaluation lnternal Monitoring by NOTF Other Evaluation by other partners a 4.2 Sustainability of projects: plan and set targets (mandatory at Yr 3) Was the project evaluated during the reporting period? -No-Was a sustainability plan written? -NoWhen was the sustainability plan submitted? - No What arrangements have been made to sustain CDTI after APOC funding ceases in terms of: 4.1.2. 4.1.3. 4.2.1. 4.2.2. 4.2.3 4.2.4. 4.2.5. What were the recommendations? Not applicable How have they been implemented? Not applicable Planning at all relevant levels - N/A Funds - N/A Transport (replacement and maintenance) - N/A Other resources - N/A To what extent has the plan been implemented - N/A a 22 4.3. lntegration Outline the extent of integration of CDTI into the PHC structure and the plans for complete integration: 4.3.1. lvermectin delivery mechanisms N/A 4.3.2. Training: N/A 4.3.3. Joint supervision and monitoring with other programs N/A 4.3.4. Release of funds for project activities N/A 4.3.5. ls CDTI included in the PHC budget? Not yet 4.3.6 Describe other health programmes that are using the CDTI structure and how this was achieved. What have been the achievements? Not applicable since CDTI structure has not yet been launched in the project area yet. Explain what are the combinations of interventions co-implemented? N/A How were the interventions implemented? (at the same time?) N/A 4.3.7. Describe others issues considered in the integration of CDTI. This is not yet applicable in this project. 23 () .6(!otr .9 .9, oLG o o o) o oo Etrc .Y E"c L oo ot c Lo= .= Elu)5o = .; t.E =oo , €c .:oo', E g=Ee -o8 .9 IHt E A oooo L o G' tr o E o CL .E EE ho .EEE oa otro.= o E' o E ! o o o- .= o o .E E E o() o tr o E o -zo E cn .E= EO E oq) .= o G a a a a a a tr o E ot o .= o oa F EL c o o o o CL F E oF og (E E ol! og (E = oc o g. OE' cLo oo .(EiE E =z E oF oI(! E oll o o oLo!cLo ES 3s E z og (g E ii oF .E Eq, l! og ooooE E>sOo> .oc E)z og fi, E t,o o(g oG oE3 t= eE =Ezo o !, o o crlL a!F !, oE o a! ot out bE .ctL tso iT t,o o cn tll l- E'l o 6 s.s 8.x"3!8t&g' a a a *.9oE t9 :hLl-O .E oo oEo.tr>oFo I s C.l =e C) G q) oo o e) (o z oL +, o L oE 6eOE o3 .6@ =FoRO \-/EOL-C KPL.- or99; CLE r-EOtl)FO r.=o; t()o -LoI €e]-F a4q) a- E oxq) q5 Q(! (l) a(D oa c 'tr G) ? o +, G+, o E o CL E '5g O'e o) So- 1- t!E9r!l>oEl-z a4.4. Operational research 4.4.1. Summarize in not more than one half of a page the operational research undertaken in the project area within the reporting period. None has been done. 4.4.2. How were the results applied in the project? Not applicable SECTION 5: Strengths, weaknesses, challeng€s, and opportunities Strengths: The project has a number of health facilities that are manned by staff that can be used in the future to supervise onchocerciasis elimination activities in the future. Weakness: These will be reported on in future when activities begin Challenges: These will be reported on in future when activities begin Opportunities: These will be reported on in future when activities begin SECTION 6: Unique features of the projecuother matters No unique features/matters to report. 25