West Wollega CDTI project technical report submitted to Technical Consultative Committee (TCC): January 2010 to December 2010

-ORIGINAL : Enslish Fe.de.t-o,l Derrroc.r-atic p..e;=rr-rl>t -c of E-l-l-r-o3>-o, AA i n - s t r-;z of l-4e. a,l f- l.r Launching veat: 2006 Reporting Period: From Januar\' 2010 to December 2010 I\'Ionth/Year I\'[onth/Year 1\1'!)E l'unding r e:rr: (circle onc) I 2 I 4 5 \lr( ) ' I 'a,) ue1 lrn llcrncnt:rlion I e t; (circlc onc) 7 8 9 l0 lr t2 l3 r t-c ! 2 I -l 5 E 7 8 () l0 ll t2 ll Date subrnitted Partners: \Iirrislrr ol'Ilcallh .\tlicirrr l'rogr:rnr rrrc lor' ( )nchoccrci:rsis ( ontrol (,\ l,O(') IIcclizlrr I)onrrIiorr I'rogr-urn (\Il)l'.y l.ighl lirr tlrc \\'orlrl l2 99 COUNTRY/NOTF: Ethiopia Proiect Name: West Wollega Approval year: ANNLIAI- PROJECT TECHNICAL REPORT SUBMITTED TO TECHNICAL CONSULTATT\/E COMMITTEE (T DEADLINE FOII SUBN{ ISSION: AFRICAN PROGRAMME FOil a)ccl tl :t tD I I F.lr Action :o: Ljr'tI i'{/. \ 'Yr 1r ri-trirL l'o .APOC' Managcrnent by 3l J:rnuarv lor IVIarch'f('C' nrectrn ?J -l'o ..\POC'N{anagenrent bv 3l Juh, tbr' Se tenrber TC'(' rneetin ri! lr.{ For lnfrormot$o'f'r To.Lrii i -t ,. -,_'_.,r r '. ,-'.\ t/ lr ONCHOCERCTASIS CONTROL (APOC) u \\'tlO,',{POC'. I J Scptcrnbcr 20()9 I I I i I I I i I ir ANNUAL PROJECT 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: Cou n tn,: E th iopia National Coordinator Nanre 'a'l.'-1.11;:, : :i i .., ;. {ia.l,,; t:.' 'U,r;;:''' i :i : : ;,:,'.i'i', .. .,'! , ,art l . :i{',f ! E{ | iJii curur Si c.rratLrre : . .4.,t.,.1= .'. _i- l_ . '- i1 ;-' , ti ) 7| .:. Date- Zt-tnal Oncho Coordinator Nan-re: Mr Alerr"rtr Bi Mr se Wak Signature: .l Date: ,wfiilrr NGDO Representattt'e Narre: Dubiri,ak Getnccla Signature Date 'l'his report lias been preparecl bv Narne: Dubiu'ak Genrcda Desi gnatit-rn : I)ro gran.t O 1'llcer Signature Date 'ill151 ,.1 .ri ll WII(),APO('. l-l Scptenrbcr 2009 I 'j t! Table of contents ACRONYMS ...v . \/IDEFINITIONS FOLLOW UP ON TCC RECOMMENDATIONS EXECUTIVE SUI\INIARY SECTION I : Br\CKGROUND IN I.-ORN'IATION GrNunet, INFoRNI,\'noN ....... I ) c,s c' r' i 7t t i Lt rt o I t lt t, p r oJ c (' t (b r r a fh' ) l)tt t'l ttt't'.t lt i lt PLrl't l.\ ll( )\ ..4 I .T .t1 i EIurcx! IJ<toxlr,rnK Nol Dct, I NFtD. 0 I 2 tt 1: I I ) Sl,lc'l'lON 2: INIPLENIFINTA'IlON OI,- CD'l'l I I 'l'ntt t INI ()t .\( IIvul:S 9 I I --\uror.\(\'.. .. . . .Emou! Booxll.utk\o't l)trl.'t\t-t). Li 'Nl()BII Il.\fl()N.st:NSIltZ,\t'toN.\\DIIE.\t-THlrtx,rc.,\t't()NoF.\lt{t\h(()\t\1lr\ttlt-s llluron! llooxir LrnK No't' Dht,-l NIlI). 2 -+. Ctntirtt Nt't'\' l,\\'ot,\'ht\1trN I .. .. Ettttolr! IJooxlt.rRK No't' I)t.-titNlit). 2.5 Crt,.rc't fY utru.utNc .. .. Ennon! BooKNLTRK No'l' I)I-FINEI). 2.6 l-Rl,.r t\lt:rr- fS Eturon! BooHlt.rnK No'l l)DIrlNEl). I 6 I 'l-t't,cttrttt'rtt.figrrrr,s Error! IJooknrark rtot defirted. 2 6 I ll'lrtrt Ltrc tlrt'c'rtrtscs o.f ob.santt,arsrrt2 .Error! Bookmark not dcJirted. : 6 -l ll'ltot ut'r, thc'rc'o.sctns for rcfrtsuls) Error! Bookmurk trot deJined. 2.6 1 llrrr,fl_t'dcst'nba ull bntrn urttl vcri/iatl .rc/-ror1r adt'ersa ('r'r'/1rr fSIl:s/ tltut Error! B o o k m u r k ttot de.finad. 2 6.5 Tt't'rrtl of'traatntattt oc'hiat'c'ttt<'rtl frortt ('D'l-l prolacl tltc'apltotr lo tltc'L'ut'ran!.\a(tr Error! Bookmurk rtot de.fincd. 2 1 . Ottpl,tuNc;. s tr)tL.\cE ,\ND Dtit.tvt:tt\' ()F tvEl{xilr(' ilN . . . .. Enu<lu! Il(x)K}IAIIK No't' I)Et.'tNriD. 2.3. ('olt\rUNrr y sELt -NIoNIt'oRING ,TNI) Sr.\KI-uor.DI:l{S Mt,E'rtNc Etrnon! BooxNr,r.nx NO'I- DI'IIINI]D. 2.9. Strpr,Rt'lstoN... .... .....Ennon! BooxuanK No't'DEl,'lNFlD. I 9 I l'roytda a /lotr churt of sultct't,tsiort lticrarch.t' . .Errur! Bookmurk not deJined. 2 9 2 ll'httt tt't't'c, tltt, nrout l.r.!r/(,.s rtlenri/iccl clunng supervisxtrt') Error! Bookntark not deJined. 2 9 -l II''us tt suytct't'rsiott c'ltecklist usccl'.) ... ... . Error! Bookmark not deJirted. :9 4 l['lrut y'L'r('lha oulc'<trrteJ ul L,uL'lt lct't'l ol CI)'l-l itrtplc'trtc'rt!tllt()n.sttpL't't'rsrort'' Error! Booknrurk not defirrcd. : 9 5 ll'o.s ft,t'dbuclt {tt'ctt to !he parsott or groups srtp,tt'r't'r.sarl) Error! Booktnurk rtrtt de./itred. : 9 6 1/orl ilrr.s thc lt,cdback usad Io unprovc tltc'ot't'rull 1tt't-for-rttrtttct'ol thc prttlc'c't') Error! IJookmurk not defined. SE('1'lON 3: SLTPPOR'l'l'O CD'l'l ..... ERRORI tlOOK,\'1AI{l( N(l f DEFINEI) i.l. Hr2tiu,trrr--N t. . . .... ....EnnoR! IJooxrtrtrK NO't-DI.ltNuD. 3.1 FtxaNt l-.r1, ('r)N lt{urLrrtoNS (-)F I-ttr p,{R't'NEI{s ANI) ('()\tNI(TNIIIES . EluroR! BooKlrlrR-t( N o't' DEIit Nu D. 3 i Ot nr,rr. FOrlNls ( )F c'oNfNft rN I'ty sr rppoR'r.. ... . ElrRon! IJooKt\L\RK No'r' DEI.'tNIiD. \\/HOTAPOC. l-1 Scptcnrber 2009 3.4. EXPPNOINTRT PER ACTTVITY............. .ENNON! BOOTMARX NOT DEFINED' SECTION 4: SUSTAINABILITY OF CDTI........ ERROR! BOOKMARK NOT DEF'TNED 4.1. lNreRNnl; INDEeENDENT pAR'ncrpAloRv MoNIToRINc; EvnLunTIoN... ...... Ennon! BooruaRx Nor DEFINED. 4 t.l Has the projec't et,er been ct'aluatecl/monttorcrl'? (Tick ant' of the /ollctv'ing t'ltich arc rtpplLcable) ..Error! Bookmark not defined. 4 I 2. lI/hat x'ere llrc recomntutdcttions'? . .Error! Bookmark not defined. 4 t 3. Hov' hat,c thel' been implententcd'/ 3l 1.2 SuslarNesllrry oF pR9JECTS: ILAN AND sE I TARGEI's (N'IANDATORY AT . . . Ennon! BOOTUaRK NOT DEFINED. jpi,,|,,,|,,ttitttgt,ttctllt,lln,jjn,,tl,","r, I [:ttruls Error'! Bookmat'k trot deJined. -i 'l'ntrtsytgt'l (rcpltrc'r,mattt Ltrrtl ntrrtntt'ttttrtc'a) Error! Bookmark not deJinel. 1 ()tht'l-r-L'i(,rrl'c'('.t Error! IJookrtturk not deJinad' 5 'l.tt ttlt(tt r.\-t(,nt hos tht,Ttltrrr ltt't,rt rrrrltlatn<'rrlt'd Error! IJookmark not de.fitted. .1 I\ I l.t , tt.-.t I l( )N .., I lvcrrttt't'tttt dt'ltt'L't'l tttL'('lt(tttlsttl-\ ) l'ruitttttg -i .lttttt.t sttpL't'\'tstott (ttld nt()tttt()/'//lg 11 ttlt otlttr Pt'ogt-utlts Ytr 3) 4: t1 ,f 1: l: -1 -l -) _l -) _) -l 1 ll'-'lattsc' of .littttl.s f ttr ltrr4at't (tcltttttr-\ l) li I -l t 1.s CD'l-l rrrc'lurlr'cl trt tht' l'llC btulgr't'' I -l 6 I)t,s<,t-il-tt,r-ttfiar ht,altlt ltrr-t.qrttrtrtrtc-y tlttrl (tt'c ttsttt.q tha CD'l'l 5tt'ttc'lttt'('tttttl lrtttt 1/rt.s rt rts Ltc'lttt't'atl ll'ltol huve bc't'rr tltc ut'lrtt't'ant<'trls) J -l - Dcsgrilta orlrcr.s 1.!Jac,.r t'orr.stclert'tl ttt thc ttttc{t"uttott ol (-l)'l l + + OPElr-A.t't( )Nr\l- RliSEr\R('H 11 I Stgttrlctt'i:t, 1t tlot ntort, lltun ottt'httlf of tt puzc tlt('()p('t'(ttt(,trttl t't'.scrrr-t'lr ttnclartttlian rn lhg proJaCf ttre tt n ttlttrt tlta t'aportrrrg partrtd 11: Iltttr ttc'r'c llrc rc-sulls ttltpltt'd rn lha prrtlac'l'? SEC-tION 5: S.IRENGTHS, \\/EAKNESSES, CTIALLENGES, I\ND -) -) -) -) l(, i6 16 O P PO R't U N IT I ES........ SECTION 6: [INIQUE FI]A'I'LIRES OIi'[IIE PI{OJECTiOTHEII NIA'I-'tERS .3(, 36 \\/l IOi.,\POC, l'1 Septcrnber 2009 Acronyms APOC ATO ATrO CBO CDD CDTI CSNl LG;\ IvIOI'{ NGDO NGO NO II- Plt(' lt E\1( ) s,q, t: SLI\1 1'C'(- 'fo t I.JN I('E IT LI-I'C w'Ho Afircan Progtamme for Onchocerciasis Control Annual Treatment Objective Annual Traintng Objectr ve Community-Based Organizatiort Community-Directed Di stnbutor Cornmuni t,y- Di rected Treatment u' i th Ir'ertncct i tt Cornrnunrtt, Sel t: N'lonrtort ttg I-ocal Govenrtnettt Area N'hnrstrv o1'Healtlr N o n- Go vet'n tn cuta I f)eve I tllttltcll t Orgall t zat t tl tl Non-Gor ernntetttaI C)rgattt zattott Nlt ronal C)nc[tticerct ltst s -['ltsk Irtrl'ee Prrnrarv hcalth citt'c l{aprrl Hptclentto lor:,rcaI N 1altpttl g o 1' Otlehtrecl'ctasts Scvcrc aclr et sci cr cttt Stakcholclcrs lncett ns TccIurcal Cttpsultatlt e ('otlttt'ttttcc (.'\l']O(' scictlltllc tttlltsorr qtoup) -1'rar ner o l' trattters Llnrted Natiorts Clttlclrctt's []ttrltl U ltrniatc'lrcattnetrt Goal Wor lcl I Iealth Oruatrtzattolt WFIO ,\POC'. l'1 Septcrnbc'r l()()t) Definitions (i) Total population: the total population living in meso/hyper-endemic comnunities u'ithin the project area (based on REMO and census taking) Elieible populatron calculated as 84ok ot' the total population tn mcso/hyper- endernic communittes in the project area (iii) Annual T Obtectrve (ATO) the cstitnated nutrber of persons lrving rrr ntcso,/h1per-cndeutrc arcas that a CDTI project rntcnds to treat rvitli ivenricctin in a gr\ cll vezlr LIltrn-urtc -l-r'eat t Goal (Ul'C) calculatecl as thc nlAxtttlutlt t.tutttbcr tll'pcoplc ttl be trcatecl itnnuailr rn me so'hYpcl crtdcnrtc arcas rr tthtt.t the prtr-;ce t are a, rrltinratcll'to [.re leaehcd u'hen thc prti.;ect hits reaeltctl lirll geograllhte eovct.age lnorntallv tlte 1tro.;cct shtiulcl bc crpectecl to r.clrclt thc Lll'(i irt tlie clttl ol- tllc l"i r cal til'tltc pro.lcct ) fhcrap poprrlattrlu lthrs sh-otrltl ltc erllt'essccl lts a llet'eelltagc) (rr) Ge ogt-al.l (otal nuruber o1-ntcso lirper-cnclcnlc eonutttlrtltlcs .ls ttlerttrllecl llr lLllNI() rrl thc proJect arca (this shoLtltl tle exllrcssccl as a pcrcetrtitgc) (r,ri) Inte gratrttn clclir elrng acldrtional he alth lntt: l'\'clltlons ( I c vltal't-ttt.t A sullple tlretlts. albcqc'lazolc lbL LF. scrccnuts lbr cataritct. ctc.) thror,rsh CD-['l lusrng thc satrlc svstcllls' trallllllg' sLlpe rVlsl()ll ancl pcrstlutte l) Lt't ortlet 1tr trlaritllisc e Llst- e[['ectrr.clc-ss an<J empo\\'cr col]lmutrtttcs ttl solrc t.t.tttt-e o['tltctr health llrobletlls This clocs nol rncltrtlc actn itres ol' lntcr'\'etttlotts e arrlctl oltt bv cot'tlt.uutittY d tstrtbutot s tlutstdc o1' C D-l-l 1i'r ir ) Sustainabrlrt) CDTI actrr ttle s ln an itrea al'c sustlllltitble u ltctt thct cotltttrue ttr luuctritn c-l'f ce trr e lr lbr- thc tirrcseeable tuture . u rth hrgh trcatlllcllt e o\ crllsc. rplegratcd rnttt tlte ar arlablc hcalthcarc scrvlcc. u'ttlt stt-tltrg col)llllLtllltv t,rt tlcrshill. ruSiug restturccs t.uobtItscd bv thc C()llllrrunltv allcl lltc Utl\'crllllle llt (rx) se l[--rnonrt N1 'l'hc plocess bf u'htch tlte cottrtrtutlttv ts cltpr)\\'ered to overscc and rnonitor tlic pe rfonr-lilne e of CDI-I (or auv collllnulllt\'- based hcalth ll'rtervcntlou pl'ograrnlnc), u'tth a vre\\' to cltsurlllg that thc prograllllllc is berng executcd in the u al, intcncled It eucourttgcs the coltllllul)ltv to take full rcsponsrbrlrtv ol'ivcnnectrn distributton and tnake appropt'tatc rtltltlificattotls u'hetr IICC CSSA T\/ (l\') (r ) hical cor et.aqc t.ttttttbcr ttl' e ttl.tttltulttttcs lt.e .ltetl ttl lt eLrtle c()\ crage tiuttttre t' trt' vl pcrtple tr catecl rn il gl\ e It \ cllr trr e t. thc ltitlll gt\ e 11 \'elll ctl cr tllc WllO APOC. l-1 Scpte rnber l00t) FOLLOW UP ON TGC REGOMMENDATIONS Using the table belorv, fiIl in the recommendations of the last TCC on the project and descnbe horv they have been addressed. TCC session Nuruber of Recommcndution in tlra rt TCC RECOlV]I,TENDATIONS ('ornpletc tables l2 crpupnlcnl and li lirndrng (repeatcd) FOR TCC/APOC LIGT LrSE O!\tLl' () Both tables are properlv tllle'd or letcd l{cr clsc .tltcr,ttrtrrt sort tatrlc Il rs rer cr sctl I I I l I l ACTIOIVS TAKEN BY THE PROJECT' (Plt'ttsc udtl ttrrtrt rou s rf tlc(L's.\arl) \\,'Fl() ..\l'(-)C. l-l Scpte rnber 1009 l Executive Summary The total population of Kelerrr Wollega and the present West Wollega for the reporting period is 2,399,405 out of which 985,801 is at risk of Onchocerciasis. As usual, West Wollega CDTI project includes Kelern and the present West Wollega zone.ln both zones there are a total of 3l districts of rvhich 12 of thern are undertaking CDTI project. The CDTI districts are sub-divided into 311 Kebeles and 4120 villages. The restnrcturing of the zones lias affected the project in that the equiptnents given to the prel'ious West W'ollega rentained thcre. l'he Annual Treatnrent Oblective i r\TO,,for the y'ear \\as 788,641 out o1' ri'ltich 8ll,53l pcoplc \\'ere treated. On thc'other lianr], aboLrt 198,863 people \\'et'c trot trcatcci antottg ri'hich retirsal antl abscrrtccisnt \\'ere 2,303 and I1,046 resltectivelr. IIt sonte cirstricts. thc peoplc nr()\'c tl'onr rrnc pluce ttt ancrtltcr ri'ithin the clistricts tirr lurnting u'ltich inct'casr's the nLrnttrcr t)l'absenteeisnt inelLrclrng CDDs. llonctcr. thc ttvet'all thcrapcrrtie ctircruruc has rncrcasecl [l'trnt 79.9 ",, to 82 ",, u'[rile rl ir bclrr\r S0",, in sonrc rlrstricts. l]clirrc tlistributing thc rlrug. Training o1-tt'atncrs u'as given lbr health uorkcrs ilt zor.rc anci districts lerel..At both levcls 'll ue\\' \\ere traincd uhilc 9tl9 \\'erL- re ll'cshccl. -l hose nho Itavc l"rained at districts level havc trainccl 7l.l ncn'C'Dt)s and rcfl'cshccl I1,822.]'hc ailn of incre'asing the nunrbet'ol'neu' C'DDs rs trr reltlace tltose u'lto are not u'illing to cot-ttinr,re u,orkit'tg in the prrlcct and u'lio have lelt the villagc clue to several reasons.'l'he average nuurber ol'CDDs per village is 1.8. Bcsides. on.;ttLr training u'as sir,'cn at (r health facilities fbr 20 health u'orkers. Ou the trainin_u, district fbcal persons and supervisurs ol'health extensiort s'orkers havc parlicipated. l'hc hcalth extension supcrvisors are those u,ho ncu'lv assigneci to supervise llve satellite health posts. At the end of each trairrin-e sessiou thc near b1, comnrunitl' leadcrs \\'ere inr ited to participate on the llnal discussion. '['he aini \\ias to strengthcn the participation ol- cornrnunitv leaclers in the implemer-rLation o1' the project and creatc good rrurking environrnent. I'he training r.r'as sir,'en on hori' to prepare plan at their ler,'el, the need of integrating Onchocerciasis rvith other prograrns, and docur-nent rnanagentent. In addition. the rolc of cotntnurtitl, leaders in tlie irnplernentation of the ltroject ancl methodology' of CDD training \\,ere included in the training. \\ihe'rc the health posts are close to each other six or rnore llealth Extension u,orkcrs \\rere trainecl at one rvorksite. On thc other hand. health education ri'as carricd out at dil'ferent places in the villages. Advocacy,, settsitizatiort and social rnobilization \\rerc conducted at all levels to obtairt tlte necessary; sLrpport fl-onr ofllcials, political leaders, partners. conrr-nunit1, leaclers and 1r'ont the conintunitr it's sel1. The pro-iect faccs sinrilar cliallengcs evcr\' )'car, such as lhe tr.rrn over o1'hear] district health offlces anc'l C)nchocerciasis control prosraltl coordinators. 'l'he fiecluent Iurn o\/er of tlie health lrersonnel especiallv the coordinators can seriousll, affect tlie project. Because u,hen one u,ho has exper-ience lcaves his position it takes tirne to replace and orient the neu' one. Due to being late in receiving nrectizan in 2010 tlie treatment u'as under taken in the rnonth of Jr-rne 2 \\/llo,'AI'}()C. l{ Scptenrbcr 2009 and July when the community was busy and left the area for farming. Above all, it is the time when some health workers leave for summer course and malaria control activities is carried out. From year to year the health service coverage of the zone is getting better and the number of health extension package workers who live in the community and service at the grass root level is increasing from time to tirne. The health extension workers train, and closely supen,ise CDDs. Likewise, they cary out health education and social rnobilization in their catchments areas. J \\'il() APO( . l-1 Scptcnrbe r 2009 SEGTION 1: Background information 1 1 General information l.l.t Description of the project (briefl1,) West Wollega project includes kelem and the present West Wollega zones, located in the Western part of the country. They are close to each other and bounded by Benishangul Gumuzi regional state and the Sudan in the Nofthrvest, East Wollega in the east, illubabor zone in the South and Garnbela in the West. Still one has to know that the majority of the CDTI districts are located in Kelenr Wollega rvhile tliere are trvo in the present West Wollega zone. Both zones share the satnc topographv ri'hich is donrinated by, hills and Gorges that range in altitucle frorn 600m- 2100rn a.s.l. l'herc arc uranv big rivers in the zones narnelv Birbir. Keto. clabus and Didesa. Besicles, the're are man\; snrall r-ivers ancl streanrs that drain into the- basin. Both zoncs arc charactcrized bv distinct rairtr and drr seasolls. -l'he nta_iot't'aint,seas()n is 1l'onr June ttl Se'lttcntber'.'l'hc llealt annual rain fall raries fl-ortt one at'ea to anollier ranginu ll'ont fi00rtrnr- 100[)ntnt. rihile thc Inean aunual tetlperature t'angcs 1l'onr l0- i0c. -l'he total poltLrlation rtt'thc tu'tt zont:s is 2,399,405'rnillion out ol'u'hich abou( 3,5",, live in rLrral Llrcas. largelv clependirl-q on subsistencc larnring. []csicles. cot'tce is the nrain cash crolr lor bolh zorles. Out of the total popLrlation aboul 985,801 arc at risk tt1' Orrchocerciasis. Male to t-enrale scx ratio is I to l.l. \\iornen in the rcproclr,rctire age groult ' l5-49r' cortstitute ?2.99'i, of t[e total popLrlatigti. Inlant ' . I ]'car,,'. urrder-llvc and uncler l5 years children. account l-or ).62",i'. 11.169o ond -15 -129i, of the total population respectivell'. 1'he zones are clirided into 3l districts or,rt ol' u'hich l2 ol'them are liyper and rneso-cndeuric areas. l'he CDI'I districts ilre again sub-divided into 3ll kebelesr the lou,est adnrinistrativc uniti.,.\nd the Kebeles are lirrther sub-divided into 1120 cornmunities/ r,illages'.'fhe villagcs are arranged in such au,a), that they can consist 30 tcl 40 lroLrseholds. \!'est and kelenr Wollega zones are honie lor diversified people ri,ith nrulti cultural and multi-lingual richness. Over fir,e ethnic groups and languagcs are belicved to cxist in the zone. Sorle of therr-r carne fi'our diffbrent regior-ral States of thc country and of Oromia Regional State in the last three decades lbr resettlernent. Christianity and Islarn are the tu,o rnajor religions. 'l'he rernaining are fbllou'ers of other religion including the tradrtional ones. All CDTI clistricts have all rveather roads except yernalogi Walal. J'here are 310 health posts. 47 clinics and Il hcalth centers in CDTI areas u'ith 1030 health personnel of all categories. As the avatlable inlirrmation indicates. the nrajoritl,of public health problertrs of the zonL-s ir-rclude among otlters, rnalaria, tuberculosis. Ill\/iAII)S, chilcl hcalth illncss and reproductive health problerns. Sirnilarlr'. parasitic infections anci othcr vcctor borne diseascs like Onchocerciasis and Lynrlthatic lllariasis are among the serious public hcalth problcrns especiallf in Kelern \\'ollcga. Onchoccrciasis is very cornnr()r1 in other scvcn clistricts of the prcsent \\rest Wollega rv'hich needs REMO reflnctnent. -+ \\;lIO/AI'()C, l4 Septernbcr 2()09 Table l:Numberof health staff involved in CDTI (Please add morc rov's if necessary') District/LGA Number of health staff involved in CDTI activities Total Number of health staff in the entire Jrroject area Numbcr of health staff involved in CD'I'I Br B, Pc rce n tage B:=Bz/ Ilr *100 Antllo D Satlr D \\'.rhcr.r (ittl.u tt r (l Kcbc [{ (i,rl.rrr I II,rt, 9t 90 99 9l 8J 9l Ill I0{) S9 r)S ss 9() ,)5 \() \\ llr) tt\ SI (l\ ,J ,)l l- Krlc (r- ()' Sct,o \r )l-l lr)() \''\\'llal .() -i() I ttt) Crurbr lll sl Horrr.r -+o lf I () -l l'otal I 016 921 92 1.1.2. Partncrship Indrcate thc llaftners lnvolvcd lu pro.lcct n')rplcurt:utation at all lcvels [\lOII. NGDOs (natronll i intcrnatrc'rnal). contntr.lll tles. local organl zatious. ctc. l Deseribc ()\Ierall \\'orkurg rclatronshrp am()ns purtncrs. clearll' indrcutrng slleeltlc areas ol pro1cct acti\ rtlcs (plannrnq. sLrper\ lslou. advocilc\'. lllalllnq. ll()Lllllzatl()n. etc) u,here all parlners are iuvolvcd Statc plans. il' any. to uroblllze the stateiresrolrdrstnct,l-GA dccrsron-nrakers. NGDOs. NCOs, CBOs. to assrst rrl ('Dl'l inrplementation 5 \\,'llO -.\P(l('. l-1 Seplenib(-r l()()() PARTNERSHIP Building a broad base of participation and support is critical to the successful implementation and sustainability of the prograrn. Accordingly, Onchocerciasis control prograrn requires the parlicipation of ser,'eral partners from the country and abroacl. Thus. the key paftners are: . APOC and light fbr the World--rvho support the project b1' proviclitie firnd. logistics and assisl tlic ('DTI r()r.rcs in inrpleurenting the prrograut. . Thc C'at-ter C'c-trtcr Ethiopia- Pla1,5 r.r nrLUol role ir-r ;lror iclinu teaching utaterials. rcporting fornrats ancl othel' thinss thun . another ()ne r'lse . MOII supports bt, t'ecluesting mcctizan fl'onr N4erck C'o. ancl clistribute to the rcspective zones and also concluct superr isiorr and submit plan. . Merck Co. - supply nrcctizan fiec- of charge. . Orotnia Health Bureau. Zone Health departrnent and clistrict health offices participate in conducting training and revieu' rneetings. collect rnectizan frorn MOFI ancl clistribr-rte to districts, plan. organize and in-rplement the pro-ject. . Thc colnrlunities at large- rvho participate in selecting CDDS. monitor and assist he'alth personnel in rmpleurenting the project Since, Most of the district adrninistrators are newly appointcd and do not knou, ven' u,ell about tl-re project there is a need of rnobilizing thern ir-r the month o1' December 2010 to insist parlicipating in problem identitlcation ancl solving. 6 \\;HO APO('. l{ Scptcnrber 20(,)() t-\ OO(\ o -o o o. oa $ j o o. o I CJ c s* \J :\ g: ! I !: ,. el:-< -F: :-v =^ !> =_l :-: \l -a a't :- iJ -i: !: .-tr :\ ll : irt NJ a7 aiJ U iJ ? I iJ c iJ ,. s U o_ 'o o ,tr 0) c. cI] r c O L (:) :IJ ! *r ! i) ! () ! -tc)E u a) c)l- o) t c) c)() j ,'r c c so .9;+.= a! c3 =9O. .=o=rl a(t .;t N orl .7t F '=l FI t--$@ \o o\ tr- s $ ca ce$Fp )o- :cd = *9 @ aa1 tr- @(r) c.L \o v-) \o .'l n a- -t CA aa N c.) ro^ \o ca ^Jca c\tr) t-- \o o\ \o N !C\o € €r- -=a) rv!L A.u-- 4 4>,! o o r= t-! Z. + il ,q, -q/o .= o,N - ),q cn -E.r r ()E c.lNo\ oo co t--\f'I a-r <r t-- -t 9 -t -t oo oo oo^ CO x o.,\ ca\. NN oo^ c\@ :/- ,-! - -t .l-a o al + -t 9 -t N ca $ o. o\ co c- oo oo v rt -al C o\9 o|) alr t\ -t o!O\ -t 5 cl t-- al t s c.l c\ tr) \o c.) c.l C..l 3\ -l r a-l c- $(r) tr- t\ cl al a.l O$ rJN €r: tr) t-. i t-- ON oo <1- tr) c,) ,-l r al '/a l. Ovq cO @ c-) .\c a-; .l r- r-, -/a -t (-.l co \D1 o. -t ,-,. l € ra € o\ Vt t r- (\l lfi a 0x6 O 0) a o Z ., L Y!L >,! ,rr 6 N 4. +_ il 1. o ON clo ,- ioq/ oi! 2, .c \o Oc a..l :at -t-a =f -t(.I o -t -tf J -t -t (-l(-] a.l al o al r- -t \? -f al \o clcl O 3 c.l .o CI € ..l cl q. c .c y) C] C] al : u) \t J : -f cl c?if =f € (..l 1 l/.t r- c.l a{ VIt@ : + O -t? t-- al a\lj. :n -t ,<- -f. 7) \r) cl a rn 00 ;: !._6re: -tv €r9.- E 3: l. t! ^- ^ cl C.I iU' c1 C1 ca- cl aa cox 71 cl + o, oC ,-: t- 7a- lfi -r : $ -..1l I: u ? !) a - - _a - -=(, = E aFetY-a-Lit -o/Ah-:- 1u6 = - tja, o t n -:) o ! _c9I O 6 c I O c.l OJ -o E o o. a$ U o o. o o() '= t< o. 0) (* o o taU= =, ja -a),.- i-!a) ,-: a t, aJ) O a) <')-- =ta 2'J',J -- --a'oi I Fq. O, (J Oe= ')q: OIJ Eq)G) AA u=7 =>t U --. - - .YJ /t u:>:- =U,.. c) O- OJtrUfE- ; ;'q,a l^ =!n5 ,=at7eo) -!7, L- a(r Fv aa7 ae ,J U ='-L*!ucr.C v!= -.A ;7) -t) -w 9 L9 -'J: >'ai E IL CJ Z, 7a a .J 1)(.) =o Lq) E -) I I I I I I I -7 I I I I o !(, 't a () .J c 2 ; .J - A/- --), (t 7) )C a.!) a .J 1) -o !) - 0) ,') ! c !J a .J c .Z : o t' Ua :IJ tr o c) o L t-) o -E O rD =La a) L .a a tn c) U 6 o\OON (.) -otq) c/a -j- c- !. C q, a *o trE U L(J -oo o o oo a- o. L }I oe o.5 (, :! 't- *o I i o _o o o U) a z. = L rJ -ou d u(, OI t OI .a* oe (, 5n 'J) - Na t) co ra- J L o,ri 4 a) _o a) ,J - -o O - O Sad o d I a o f b IA u J J :a G =a) I a : ; ! :; =i ! : \\ I Oio; Its y,Oz 4) -tlL.ioi .-E+r:G:+rY '.:LtO'.?'iFuLoi -O=aro* -= -at':E.t{ rara (r: c:c,itl -o'l3.EEo I2 -E=Fi:;(, '; lll . zlEF-lU?--oiFl (, 2.2. Advocacy Advocacy u,as conducted at all level to stakeholders, governmental and non- govemmental organization, religious Ieaders, and district political and civic leaders to ensure different support. When conducting the advocacy, the magnitude of the problem, program objectives, implementation strategy and the required support u,as discussed. The support given b1, political leaders and local government has helped in improving the CDTI activities especially in organizine the cotnmunitv and developing strategies. -l'he nurnber of dc'cision rnakers rnobilized u'as li front each district ancl 7frour e'ach Kebele r.r,hicli makes a total of 2333 peoltle. Conlnunrtl' leaders, Developnrent r\gents and Scltool tcachers \\'ere the nta-ior plavers in nrobilizing and sensitizine thc comn-r-rnitl, 2.3. Mobilization, sensitization and health education of at risk Conrnrunities C'ontn-rutiitv nrobilizatiorr ancl eclucational activities \\'erc conc]r,rcted at e\ er\ village bl,orgattiz.ing cc'tnmrunitv nreeting, at School and rcligious placcs..,\s results a total ol' 4120 r illages \\,ere mobilrzed befbre nrilss treatrne'nt \\'AS startccl. As liealth eclucation is an essential lool and an integrated part of health sen'ice. a total ol' 4120 cornmunities \\/cre targeted and all o1' thenr \\'crc educated. Health staff.s ir-r Health Centers, Clinics and I-lcalth posts \\ ere responsible in conducting health education by using posters and brochr-rres. Mobilization, Ser-rsitizatiorr and health education have a lot o1' cor-rtribution irr a\\/areness creation anrl providing supporl. l0 \\'HO,'APOC. I-1 Septc'nrbcr 2009 GommuniQl involvement Table 4: Communities participation in the CDTI (Please add more rov's if nccessory) C'tinunent ot-t' - Attendance tlf fcntale meurbcrs of thc comntunlt)' at hcaltli ctluclttttitr tneettngs - In general. horv do you ratc the parlrcipation olt'ernale tnctnbers trf the cotntnutlltv r-r-rcctrr-rgs *,hen CDTI rssr.rcs are being drscusscs (attenciancc. particlpatit-rlt tn thc drscr,rssion etc). - Incentrves provided by con-tnrLtnitics fbr the CDDs - Attntion of ('DDs Is attntron a problem fbr the prolcct'.) If 1'es. Itou ts tt itcldressccl') - Othcr issucs It rs clcar that tltc paftrcrpatron o1'tcntale is crucial ftrr thc ttnplentclttattotts attcl sttstatttabtlttv o1'anv prrUect llou,erer. the par1rcrpatron ollbmale in tltc pr(Uect area is strll verv ltlu tlr.te ttr tradrtron ancl ri'rtrk loacl rn the housc. A trral u,as tnadc tn tnvtttttu l'erttalcs to thc'tlleettt.lg ittlcl dccision ntakrr-rg. Ancl also they uerc enc()uraged to parlictltate rn distntruttng the clrug as CDD But duc to the above nrcr-rtitlned problcms thc nurtrber ol'lctnalcs partte tpattllg rrt ('D-l-l ls nrrc .Hori cver, thcsc nunrbcr has rncrcascd contparecl to tlte last tuo trr three vcars N4trst of tlie ('DDs are tunners busv rn tlnrtne, harvesttnq. and lookltg aficr cattlc CJII thc othcr hanri. they clo not gct artv rncentrve h'otn thc cor.t.tt.t.tunttt'tltat ts tvhv thcre ts attrtttotl District/l-CA Number of contmu nities/villages w'ith communitl' members as supervisors Number of CDDs and thc conrmunities i nvolved l\{ale CDDs Femalc CDDs l'ota I IJ, Il8 Br: $-+$t Number of communities /r,illages rvith female CDDs Number of cornrnunities rr ith fenrale C'DDs I Percentage lJ ', llrr= ts ro/Br* 100 Total no. commu nities in the entire project a rea Bl Number rvith communitl' members as s u perviso rs B5 Percentage Bo= tsJ Br *100 An ll lo D S.rtlr [) \\'.rher.r ( r tLi,t nr t ( i Kcbc II Galan -l (r -l -l tr-l 100 J( rtr -1(r(r I(X) -.ll I T- LlE - lll I0() l.ls -i -15; I I )(-) -1-i- l0r) J(r0 -1(rt t t l0r) 6() I ,5 I -1 -i llTe 6lS I9l -r l-i -l Ilo-; sl ll)()l .1 Il I +0s 6) Il I l8 lor ) .l ()() lo Il-r-1 Ilr5 9-i l 9tI . ()9J .l [{tiro lol l()2 I 1)rl l-i{) ()ll s L Krlc l0o l( )6 l0n -s9() lll 7r)l a5 Sevo l-i f)i I ()0 I lti5 9-l I273 SI r6 \"i \\/alal l-ls -2.1 8 I ()0 ll7 t7t -18 3 I(]I t) Grurbr l0s .1( )8 I00 l]02 i4 t)16 )-1 li Horna rrr I t{i I ()0 t7l l()0 i -17l i fotal { I 20 .lt20 100 t 0.{5{ 7 082 r 2.516 6()() It,5 l1 \\'l l(,) AI'}OC'. l-l Septr-r))b 9() i5 iI 2.5. GapaciQr building Training is given for all categories of health personnel every year at all level. Thus, there is no shortage of knowledgeable manpower at all level. However, frequent transfer of trained staff is occurring any time, especially head health districts and Oncho Focal persons. On the other hand, during the course of the campaign solne health rvorkers attend surnmer course. Holvever, there is an opportunity in using health extension rvorkers and their supen,isors u,ho are available all thc time. tt is believed that those sLlper\/isors can solve ntanv problents b1'assisting health extensiou u'orkers and Oncho. focal personas. Due to delav ol'ntectizalt ever\'),car thc cartrpaiurr is carried out in the u,inter ri,hen health ti orkers attend suurmer coursL' ancl the cr-rr-nmunitt, inclLrding C'Df)s are vcn'bust in farnrinq. Iloricvcr. there is an opporlLrnitv in using hcalth c.\tcnsiorl tirtrker supcr\ isors u'ho \\'erc nearlv assiqnccl to supervise llvc satellite health ltosts eaclt. It is bclieved tliat those sup.er\ rsors can solve tnan\/ problents in assisting hcalth ertension ri'orkers ancl Oncho fbcal persons. 2 WHO,APOC. l-1 Septc'nrber 200!) OON q) .o {J o. oa =:t C o. 'T' 2 O c- Or- Ot- {-- -f \. r- € -t\c .o \c ,c N\o r- c! r- C cl\ct\ (- ral t C] .c cl O .c) \c t- t @O$ rc =t- O -t t- ,.: I - t -f = C I c '1 o.l O c.l C .l 't 7- t cl r ON 6l c- -t C] t\ J t -l I -l c a1 X x -f -l € t-- ca O T € T c - r n c 7 7 -l l o\t.- Ct .t (-.l -t OC : -f J 1 a .J: J r-- t\ 7 r- (-- C t-- o r- -t -l \. =lq x tt t-- rc @$ o] tr- =l \c) OO @ a- a.l O a1 a .o OC -I c-(\ O rc aa c-$ r.-$ O r-t (.)ln 6l 6l GT@ tt r- 6l c?) a/ l/ ! ^\ t- -1 Z ct .l --f] ? + r -t .c f! 'a -*f O -r- r <f .c al -t :, al t -, al cc ca al J -t al -t \or cl c- .t r I 6l r/.it ca ca al o o \- Grr U ctl+ - I, U - J Q0) Z O br- 6l J (, -.1 a .f : - o ! s:!I -: I a a !. -l c c (i l- V] : u c a a 5{ : a { : -: l : :' ? : a v i a) (D u L- !(, c q u (!) .) L u -J) = ! ,1,1 ,Dl -lal dl FI .azF- ,-) .J ol- 7 il: U v F q s e) c( U q) Z ; L -l .o6 a) E z. vl 5L 6)u ,. (, F cI C frt- Table 6: Type of training undertaken (Tick tltt' bo-r<'s v'here specific lratnirtg tt'rts c'orrtcd out during thc reportirtg 1t<,r-rorl) A nv tlthc'r cor.t.ttticr.tt s Tra rnees 'lypc o l' trarnrng t'DDs Other Conrmunrty nrcmbers e g C'onrtttunrtv sr.l llcrvrsors I Iealth \\;orkers (liontlrne hca ltlr l.rcrlttrcs) N,lOII sta fI- or ()thcr I)olrt rc a l Lcaclc-rs Othcrs(spce t1'r ) Progrant rrlanagclne nt IocaI NG( )s IIou ttr c()n(lLlel IIcrlth e rltre lt I t ott N Il rrugcrrrc n t trl'S.{l-s C'S ]\ I SII\I Data collcct rou [)atu anulr srs Report u'ritrng Others (specrf_r ) l-+ \\/HO.\PO(., l0 -\pnl 1003 o\OON L o -o !_) o. oa : ti o o.4 .: o a:o q! !l( o - dZt^ "= q u v- i I> o 9 ii€U9T-Jd c i- aod o>uaOL a To o o -o E =z O O O O O O O O O !tr cl! =42i; O O o O O O O O O 2_! ,c--::) --=-.L! = a L <=) - -1='a-e !- \. t- ., \a t-- al <l- O r \, <f =:;: a ? t) =,' ,)r'): Z ,t-- --/t= --/')= L!OO =at' -'t s t ! - C c3 c- A)(-) cll 6 0) = tr o(, \o6 ol CI t-- ca C'r c-r C.) a.l c.l Iar tr) a-r C.l aa aa \o c\ Nc'.1 C..l tr- ...l O c.l -j- v al C] (-I o t-- \o :n (-.l o (-- c al rX r,) cl C' u) alar T 7a cq (-.lL C.la/a <tv a/) /)t\ a.l>a N* :a \t c') tr- aa c-\c, \c (.I ?a -t. t-- c r- -t a t--r- (-.t(-I r- ;(.I -c\ \c A -=$ =tr- ra -t =t r-r- fr- r- CIt :t \a t\\o €. g -l V, € v) tr- a rn a.l \D\o O \?O a.)(r) c- r-va. .o <f c; O) tr-q Osf $n c.)$ c.l ca .o- O \, ca o c..l \ -o\c o\ C. \o(-.l $ @ cor- (-.l N a oo oo CI c.lU) C..f oo U) U) n oo C] aa + o. o.O n t--U) oo $.. \D $ o..l a.l r- + r/.) $ tr- c.l ON o) @$ Osn C. U) c.lC. @ tr) 00 O? OO C c = O? OO c OO \c) ca \c =t $$sf oo -tt (-- v a\c sf N\o c..l UO ..1 ...1(-I CO c..l q) a =f -f r.l -$ a.l n aa .o \' ,ct =t -t -t co =t -t t-- -t c .o -f c..l\o(.I \oC(.I (-.l6l .t) ca c.l xct it c'r\D \a.c -t =ts -t tvJ sf -t t-- -t O .o -t c.l\o CI \cO c1 (-.l cl an c.l uac :f 3 a.l t a =IEq a -a a Us C -a(, ,:)! Y O - (, :tr c o :E; D Ij 0)a CT 5Ic -: a :a aF ..\ - ?- aUU :\ ? p P O N U V)tU a_ .Y ,J) l- a a) - E tr r'1 J O q'p OJ oo.? tv) o ?=flL! LdO eE +,8GAO*IL ir-Fxr_l . c)l(9 -ol . -lNFI =! -=t ;!- t o =9u -1) J != ottl -ii ')c .--:,) F =- ! zat =! =\2 -= /.2 la L.- t/ '-,- = )= a ! '---= ---,t,uu t.*j OO(\ () -o E(, o- O U) -f a o o. o : (- = OJ oL oq) c c C) -o = =7. '9 a) E O - cF) oi- , ,') 0) -, O = 1-) L 4. t :J a) t^' tJ L- G 0) O u =, c- i)E = /t- i! la -= t , ; q .J ) o t) O U -o O= D-..- F -,= U= oJX CO -c F ,Z- .) -! a) aJ) L "J ') '^- a-- L alJ 1) :) ,) ,! = ') = = = T, 2 = 7 t) --oa) -o ^) .t 'a -4 -t -t r, !. =l rD lt -l a :i .-t'- .! --lt i. al- = -.1- = --l-lLl-tdlz 5 ,t- *l) ol o c LI UL ojl o- iu -.1 _ -o )tu ,Z.I - Z c) ! a) C(J .J o € U. o a.)b{ 'o ,J a :J. E) ! CJ r o LL a c: ! a_) al) L! ) ')^ -a =.u 'r) c- 2.6.2 What are the causes of absenteeism? Some pcople move from place to place for farming 2.6.3 What are the reasons for refusals? Sonrc pcoplc think that thcv do not havc thc tliscasc. 2.6.1 Bl-icllr tlcscribe ull kuuurt and verificd serious advcrse ercnts (SAEs) that occurrcrl rluring the rcporting period anrl proridc (irr l:rblc tl) tltc rctluirecl in lornr:tti<.ln rvhclt availirblc. . [)anrsitoltrtr:I lr,ullCtl'' No o [-'rrsLencc tll rnre ro\e()lre '' l'ltcre is in thc g()\ cllulle nt ltealtli lite ilrtres . Ila. tlrc |11,lee I rr'lr\)Ltetl lrll \ \l s trr \1ee Ltzittt I)r,tt.tlttrtt I)rttr]t.lrttr r\il)l') ' I'1..t:.'1ttl. (rne ffi x-,, t-l r.I l)ut ht case the ltrtllect drd not havc anv cltscs ol'scn()Lls aclverse events (SAE) clr.trutg thts rcp()rtuls pcrrod. please trck tn tlic box. No S.\l: e irsc to rept'rrt l1 \\'tl( ) ,\1'}()C. 1-1 ScpterrrLrer 1009 tr o'OON O E(-) o- a)a --r a a- C. = e) o0 () q) oc c) o a q) a <) a rt (, Z q) Z tE = =t I a Ll-.] a I ! -;,1 :l FI c o _E XYE <E5 :a d= rj- =, 2at ! :: -:1 -= a; -t-', a V -c =!:- = t : af 41 il c =a 1 C I c - a = 1q - 1 I i O o!(, €^ L ;-i \o "t>-- l) o.@ "l; C{ s o. t'- o. c\ :l .l :l ll * ,.i bJ k) a 42- o. ol sc' $ r o. tt o. C\ Q * Ei kl t! ! L- . l: =) - r r-t\ r Nq , 1- =/ 7: I l ,a --T t J t- .l t - r- -f ,,' rl==) -t 1 -f. ,. )I f ( ( : '7,/, r- f- at- : t 1 € r r! 5l d , a7' t-a.'41- ct -l t- .l -/- .l (_ al CI l 1 ] -l r tr al) = '! =a - =Z a a -9 -={_ !--a = ==')1=--/,cr, r -t c -t al cl .i -f tr -f -t .1 T d I E] =t .. L; t\ -f.., + I 1 -1 I 1 -a el a f 1,' = = - -. a 'r ' r I == '---; a={r't - ) )- =!:: r : -t ,:, 1 l .l -l J t- +T al -t n c <f- J-l t a\ o:- c l al cl cl .l ol -a al -l € = -l t al .< .l 3. .t o\OO(\ 0) -o O o. q-) U) =j- o o-I C c t :J ! a L u a L L \ !: t ')- =O C^ :L )u ,)E a-L.: L Ft , Ll - -ol at : -11 =-l, tl ?t a- =! =-!a =' --t= -! -! !* ,:- l tal 't -Ll -r ;l 2.7. Ordering, storage and delivery of ivermectin MectizanG) orderediapplied tbr b1, Qslease tic'k the appropnate ansvcr)MOH WHO tr UNICEF tr NGDO Other (please spccify): _lt is order b1' the I\'IOH Mectizan@ delivered b1, Qtlease ttck the appropriatt' cutswer) MOH E WHO E UNICEF tr Other (plcase specify): Dclivered hy NGDO NGDO tr Plcasc descnbc hclrv lrlectrzanl-('ls trrdcrcrl anil htlu rt qets to the cor.r.rr.r.rur.rrtrt:s Zone health trl'lices collcct lionr NlOII iuirl cltstrt[rLlte t() tlte respectrvc cltstrrcts ueeotrltr.tr] trr thcrr nccrl 'l-hc'n thc tlrstncts tlrstntrutc to 1l1a ncur'[rv heulth tr.rcrlrtrcs tirrnr uhcre rt rs r,.rrcn to ('DL)s le e orrltuq to tlte t-csLtlt ol'llte sltrr cr tr l-ablc I0 Nlectrzalt l{ ltrr ctttttfr' (l)lt'Lt.sr' ,ttltl rrtt.tr.r' l rttt: tl /r('('r'\ s.1i 't / Statc /District /I-GA Nunrber of Nlcctizau' tablcts vctl I I IIleq uestctl Ilccr:i I rctl i Los( \\'lr I I e tl Iirpire tl lte rtra i ning I Antiltr D Satlr D, \\'abcr,r Gtd,rnrr C, Kcbc 0 0 0 .1907 l0().()lX ) 196._i()() I7 9. -i0t) I 16.50(_) l0l.-\(.)0 l!-lL!1, 10.r.-106 0 ll(x) I9 I ,6+l le l .062 t) -i ()l ) I7q. -s()0 I79.006 .19+ t?1111 I I ii .+62 r) 37(l l(_)0._r4 s 20()..+ I 5 1) 623 () 0 0 0 () s()0 l0 () l1 -1-)" I l5l H (l.tl.rrr I ()6 28.1,000 28.1,000 2 82. .l 90 0 t2l6 0 .100 J'Hot o () I 22.500 122.2110 l2 I,339 0 t7 0 8.lJ L,'Krlc- 582'7 120,000 120,000 121,218 0 I 579 0 0 Seyo 0 293.000 292.171) )o', ,r1 0 2.17 0 (.) \'/Walal 0 I 12,500 I I 2,500 112.012 0 128 0 0 Gimbr 1753 202,500 t 95.196 I 93.799 0 I 599 0 2'7 56 I lonra 1 560 82,(XXl 72,896 75,966 0 -190 0 0 I rrtJl ll1.-llrl 2.-1 16,500 I 2,30.1,{88 02,-3 0 ,0()0 I 9528 0 5,29{ 20 \\/LlO,,\tr()('. l.l Ntrrr'nrbcr. l()0 1 Horv are the remaining ivermectin tablets collected and rvhere are they kept? ,At the end ol distribution, the reniaining Mectrzan tablets are collected bv fiontline health facilities lror-r-r each cornnrunity supervisor by checking the alnount received, used, wasted and the remaining and give back to district healtli olfrce. After collecting frorn each health lacility then the district Onchocerciasis control proqranr coorclinator gives back to zonc pharntac\/ to be used again List and bricflv tlescrihc thc:rctivitics under ivernrcctin clcliverv tltat arc being carriccl out br hcalth c:lre J)crsonncl in thc projcct arca. . Irlcntil'r gaps ancl trainccs o l)re'par-e training proposal o tt'ain healtli pe rsonne I aI zor.rc ancl clistnct ler cl . -f rain CI)Ds and corlrnLrnitr sLrpe n'isors . condLtct nrobilization. sensitization atlvocaer ancl Itcalth erlucation o assist CDDs auc'l con-rrrrunitl' supen'isors in CensLls Lrll datine . Check the ar-r.roun[ anc] collect thc o\/ct' leli N'[ectizan liorn coltllt-tutlitl' supel isors and C'DDs. o distribution of the clrug . conduct intensivc supen,isittn beflore. during anc'l a lter clistribution . collect . analyze and send a report 1o the concernecl bodies . conduct mccting u'ith stakeholders O CitI'D'OLIt CSM . conduct revieu' nreeting at all level - Anv other cornments \\'llO .,\I']( )('. l-1 St-lttcnrbcr l()(.)t)21 2.A. Gommunity self-monitoring and Stakeholders Meeting I{as any tratning (of trainers) fbr cornniur-trtv self'-nronrtoring been done rn the prur.;cct arca') 'fable I I Conrnrurrrtv self'-nronitonnq ancl Stakeholdcrs Nlccting (.,|cld rovs tl rrt'aded) Describe httu'thc rcsults o1'thc eourrnunrty selt- nrottttorttrq attd stakcholders tncetttlgs httre al ctecl project rlnplernentation ttr hou'the1,u,ould bc utrlrzed dr.rrirtq the ttcrt treatttletlt ctcle NOte: Training lvas given to every health \l'orker on ho\1' to conduct communitl,self- nlonitoring and stakeholders meeting, holl'ever, due to time constraints and shortage monev it lvas not conducted. Iior the next treatment cycle the concerned health personnel lvill be retrained to mobilize the comnlunit), to carry out both CSN'I and stakeholders meetings based on thc experience gained from Comnlunity conversation progranr. Drstrrct,/ I-GA Total ;r ol contrnunrtrcs'r'rllage s rrt thc e ntrrc pr'().lecI arc.l No ol- CortrrtrLtrtrtres that cllr-1-rc(l out scIl' nlr)u rt()r'lug (('SI\t ) No ot' L'omnrunrtres tliat conclrrctecl stukelroItlcr s rncctuts (SIINI) ,\rt ll I, r [) \,rrlr [) \\ .rlrer.r )(l l -+66 -+-1+ ( ) (.) r) (.) ( ) (_) Cr.l.rnrr -+-1S 0 0 C Kel.e 151 0 0 H (l.rl,rrr -16() 0 0 -l I{oro ?.62 0 0 [- Krlc 206 0 0 Seyo 225 0 0 YiWalal 238 0 0 Grmbi 408 0 t) Ilorn.r 1,13 0 0 Total 1t20 0 0 )) \\/l{O,iAP()( . I -l Septerrrbcr l(X)() 2.9. Supervision 2.9.1. Provide a flow chart of supervision hierarchy 2.9.2. What u'ere the nrain issues identified during supervision? o In sorne Health F-acilities there is poor handling of registration books o Some Ilealtlt Facilities clo not train CDDs properly . Poor reporl u'riting antl census upclate are the rlain ri'eakness ide nti1lecl. . ln sonre districts the rclatitinship betu'cen healtlr fucilitics antl corlrlLrttitv lcadcrs concentirtu Ortchocerciasis ctlntrol pr()granr \\'ils vert' u'cak . Giving attention to thc f'eed back qivcn is rlininral . I-ack ol'1air mectizun rlistribution to Llcalth lracilitics . [-ack of super-r'ision lltrnr tlistrict I Icalth Olljcc to Hcalth I:acrlitrcs and fr-onr Ilealth Iracrlities to villages. 2.9.3. \\'as :r supervision chccl<list userl'J Yes, it rvas used at district and zone level but the health I'acilities do not use as such. 2.9.1. \\'hat nerc the outcornes at cach level of CDI'I inrplcnre ntation suJrcrvision ? o Registration books are properlv fltled o Report u,riting ancl censr-ls updatlng \\'ere itnproved . The rclationship betu'cen I-lFs and corlr-r-rur-rit1, leaclers u'as irnproved 2.9.5. 2.9.6 \\/as feedback given to the pcrson or groups superviscd? Yes Hon' u'as thc l-ccdback uscd to improve the overall perlornrance of thc project? 'fhe supen'isces havc learrred fronr their nrrstakcs. and thcir knori'ledge ancl skill havc increasccl too. i\s a resr.rlt. thc ri'caknesses identrllecl durine supen ision \\ ere irnproved anc'l thc therapeutic c()\,era-ge n'as incre asecl. 23 \\IHO ,\P(X'. l-l Scptr-nrbcr l(X)t) SECTION 3: Support to GDT! 3.{, Equipment ]-able l2 Status of cquipnrcnt (Pleosc add tttorc rotts t.f ttcccssLtrl') *C'onclitron olthe equrllrient (F-liunctrona[. L'NFI{-currentlv non-luttctttitial bLtt rcPlttrallle \\/O:Wrrtten oft) Note: o The Vehicle is vert'old and nceds repair . Alnrost all thc N'Iotor cYcles are brokclt alrcl tron functional Hgu,docs the project intend ttl ntarntairr ancl rcplacc exrsting cqutltntetlt atlcl othct-t.tlatcrtals'' There is a need of maintain, but the proiect lacks budget. 3.2. Financial contributions of the partncrs and comnrunities - Frll tables 13a, l3b and I 3c - If there arc problcrns u,ith rclcasc ot'ctlttnteqrarl lunds. htt*'u'erc thev adclrcsscd'' - AcicLtionitlcottttttc Source 'l'1pc of c(lu rl)nlenI APOC N{OH DISTRICT' LG.A. NCDO Othcrs Ntr C \)rl(irtlr)r) N C'r,ndttt,rrt N ( orttittttrn Ntr ( (rt)(iltlrlt) \ C t ,il(lrI l(,il L Vchicle I rrld C'NFR 0 1 Nlotor clclc(s) (.NTT Ii () (.NF R 0 -l ('orrputer(s ) I ( Nt--t{ I0 I Il -1. l)rrntcr(s) I c Ntrlt l(l I lr ) Photocoprcr (s) I rtrrt ltttt 0 (l (r. l'-ax N,laclirne(s) I T NI.'I( () 0 7 Others a) b) c) 24 WH() APOC'. l.i Septenrbcr 200() o. O(\l o -o il o- O tJa f o C :i 6oo(\ c '6 ! t trJ (! ! It! o lcl6, IEto g II o !, oL 0, E .E CL t lIJ -Fo oaF;C)rotr o- OO 6| so @ s @@N (0 @ o --+ (o(o oo(o(o @ooo @€ o@o@s@@o GI o)r, F-_ o e o o -oo @ - o o O(aNOOOooot@ -o0@-mT@ ooOO tD@ oo o o oN(O O r <. --N t9 N- O^ CJ OJ N o o =c E E o(J oEOq3 -z o o o(, z -o o\' o f 'tr c oo Fz ul =ztlrl oo ! o o f o o\ I, .; @ @ @t(l No(o I <t oor .i oo 6_ No @ cot N O6 OOr N O @ I I f, I vr - o @ o @ o a r a ;o al O @O I6 o, o \to .(l_ .(f OOO oio@(oo)o l O $ fO _co o-l @- N O oo N. N oool N O O N N OO c! r N oN N oN aN N. NN @ OO O o O O O Io- >Gs6 g1F 't o Oo '. o! -@io(! !o e Oo)ulc =o-Na c o-co E Gz Ns o_ N N N or, @ o$@ F o @6- ! o 0) r0 u.l z =F IIJ oo f(D pc dr O :6U\ ri o;r!Ooi -ui c ::i oo o !Lccco 60! 6i,.: >:o 6q q- a o 6Q ;F iE + - no d NaJ q= lo l'\l6 l* C o; -o 6i.:uo \^.tv=- .9 6 b 3 Us6>a<rg 3 - N o vo !: a(n $ o 0.) o G N o \ o B o o 'o o o a N a o E i q o o a_ Otr .. a :.oo .Ya== !ad6!q-No o O'g ouu)i.a* cqsyrtro !! oo \Loo: tso = 9 Qc il .. 'io : oe> @ , .9o a tr 'b"' - O SI i, EXP o o>di E P:Er 6 6 Sil _ * I .\.otrJ <q (, c o l\ !u (t uto o-Q 5l u.) E OO ac Zo O= oE 1Oa2 -Nmo J F oF oz t o el , I c F i -l o @ o Ntso ct N sfNo ftN OOOOO NN OO(co o @ NO @@ NO- NO NO r@ r o- OOooo, o) o)oooo, o@(ooN@NOOO) oo o.O L() -o O o.(.) a =l- U o c. o 6 c_i O o0-O6T OO ^tN O tD OOO O OOO O N O .a .z o @O o)o @oo(o@oOO o) o)6ql O \c -l ro)oNNOO@ oo@cl og r o- N o_ ) F oF o z t O I a -l O. 6 Z o E s)o l.t.i N s o C -0) 0) E q o d s o !) c o a) o o ! o o LO 9> =olA a :oa a* c -cO-d)o oc-r r - () O - A6 o o- 6 q\cOl-LbEEl66 n\ a (u Nt o a-Z OOU) 9--oi-oss l- on A> = o o !) U) o o o o: u E 0)o G =a t ! C G c 9) -tr q ! q O 0) E qJ o)c E' OG =)c; J?>2LU NO oo C o a - €,)o) m ofIu 'ccrfolr o. NO(oo NO N o oNo o(o N OO) - -r; (o (o st r-N eq) o =c E E o() oo oEOq3 -z c o E o e5ltIE e oct(Eot u,IF o o o o oz (c(D a O N @ O- N c o@ @6 o N @ i E 0) -g tr -oo o\E I0r- >(!s6 061j-c .; o oo e.=efrao(o :o o e .oooc "No o-FGC- 'a(! z o:ao(\ s(! o\ q) ,t (.) o a.g o)tr o o) o) '6 -o tr uJ 6EcI(u o o o .9 o o. (g o o o c o f .o c oo Fz UJ =z d. ul oo o o ul! o OOvo Os @, o OO s- @ oo @ @ o o$ @o N ONN TC@ t--@ _@o OTTO [!zl F 111 oo l dl !rc;,o :c -G o;ruOo. vrc *o -o '! o o) .1:ccc c=o 66L 6t)q.;; .e o, E !=3F::\r .: o o oii .s : ; Ed o:fi - - €., N N Ji = (/J= C o -o 9l : >- - {) r; -=- oooi:(4<r! NOs-Q - -- f U) { G o o o a o i G o o !GC -o .9 li ac= .No; QG4 OQ +i_ <o -u - a c o - = a = E C L ! F o o\OO al o -o E o 0 0 st o a- a r-(-1 8q: o-if <F1! o) oroo @@ od N N cr! @ N oEO o o @_ o) O OO- r) NO@N N(OO) o_N .E =Eo:o tre oo t uJ T,F o o oo oz (E o oJ o oo(9 z oo - @o ^ aN < oo @+$ NN oaO J) No F N oN oN o O- O (00 OO$O dN oo OO -@ gOl-tg r@@O ooN :-ol @o o_ o C) o) a ; o oN @ @ v- N @ N ts- : N o^ 9.o->Go: u)Fc;o Oo5.Eei :oo a,q) g, -O q)oc -No EJo-E(! E6z o oc{ Q) 6 t UJ (! 15 o E o o oiF c .9)ll tr oo Fz TUEzt UJ oo 1' o oq) E dl @ @ o aO O T € @ oo 6_ o @ @ o o; @ OON $ O O O. O N @ N, N @ N $ at3 o N c2 N o- OO N @ @ oo @ @ @(o O O) € OOOO OOn'9 o o$@ I I o o@i @l N $ oq O @ o f T OOOO$@ o o.i OOs(o SN OO OOf@ @ai t!z =Ft! oo =ro a o q) o a N t4 o s1 io G oo>t .o-o e cX o - o:- l : ;i!Yo d-) .Y Nl:Q cc=ao=:N^=L>\: l!o! oi:iE >U)< r9 €S -ruo w-d<'b --- - 5 <o q qe !G }B {SuJ obiPOI: L:;o oo: !!o EGN::--e9 6inE ; o, F E= E F : =\': 6 6G X .: E io :F:U)i- - N -Q iNNJ= =q o C coooEo ULE b 6 +=A\ = I ;'\Y-!l; s ;G ,i 5 i #5 r N O SQ ooo63 (r) o o a_ og ,^o6:1 C Ud (uu 'D(nlr;o UI ooo Ig() o o o ! o o o:o>qOTtc O=E\uo!u o o> o 6 6so ? 5og - N€ OJSJqu) o o 0) o)s a tr o a V, o o o J ) F oF oz E(, c a - tr = t = 9_ =l - : Other fonns of commuruty support The communih, does not support either in kind or in cash 3.4. Expenditure per activity Indrcate in table 13, the amount expended during the reporling period for each activitv hsted. Write the arnoultt expended in US dollars usrng the current Llnited Nations exchange rate to local currency. Indicate cxchange rate uscd here 13.5 Note. Wlien the llnd \\'as received tlle exchangc rate \\'as li.5 Birr/ ltlcal curreltc\'. buI nori'it is 16.-1 Birr. IIou'ever. tlie arrount expendec] during thc reporting periocl is calculated as lLlS dollar fbr 13.-5 local currenc\'. ,,\ r-tv c tl r.t t r r.t et.t t s o r c r p I a tt lt t t o It s',' It rs nttt clcal rr hr rr c are .rskccl to rrse thc e rrrlent [.] nrtecl Nattot'ts crchltttgc. bee ltLtsc rr lte tt thc firnrl \\ ils rce L-rvcd I t lS tlollrr tvlts ll -5 rll loe ltl e tll'rcllcy SECTION 4: Sustainability of GDTI 4.1. lnternall independent participatory monitoringl Evaluation .l.l.l Il:rs tlrc pro.icct crer becu errlu:ttctl/tttoltitttrctl'l (-l'ick irnr ol'thc lirllowing rvh ich a rc :r;rltlicltble) --\'car I Parttcrllatory Indcllettcletlt lllolllt()l'lllll N4rd'fernt Strstarrtabi Ittv EI'aluattot-t - 5 r'c'ar Sustarnabilitv F-r'aluatiotl hrtenral IVlrrtrttortng bv NOTF Othcr Ilvaluattott by other pafttrcrs 4.1.2. What u,erc the rccorntnendationsl 'l'he recommendations $'ere on; Pl.r\NING . C'DTI should be integrated into the over all ri'ritterl plall. . 'l'he plan should rnake provision lbr all key activities IVlectizarr suppl\,. targeting training. targeting I ISAM. targcting nlonitori rlg superv is ittrt. . \'ear plans shoulcl be drau'rl up in participatorlr 1,'rr'. . \'ear plan must take into accoLrnt e ()rnntLrnity reclLriretttettts lbr thc tin-ri ng of distribution. 28 \\/llO/APOC. l-1 Septcnrbcr lo09 3 METIZAN PROCUREMENT o Mectizan supply should be controlled rvithin a government systern o 'fhe system should be effective, uncomplicated and ef tlcient. o The system should supply sufficient Mectizan lor the needs of all the projects concerned, in good time. 1.1.2. what w'ere the recomnlcndations? The recommendations *'ere on; PI.,\NING . CDTI shoulcl be intesrated into thc ovcr all ri,ritten plan. . l-lie plart shoLrlcl nrake provision lur all ke1' activitics It{cctrzan supltll', talqetitts trairring. targetinu IIS,,\N,I. targeting rnonittrrrnS super\ isirrrt. o 1'c-cr ltlans shoLrlcl be drau'n Lrlt in particiPat()r'\' \\ l\. . \'car ltlatr tur-lst take into accr-runt conrnLrrritv rcrlLrirt'lnr'nts lor thc - tirning o1'tlistribution. NI E-I'IZAN PITOCUITENI ENT . Mectizan supplv should be coutroiled ri ithin il s()\ e ntntent systcnt . -l'he systent should be elfective, unconrplicatecl altcl el'llcient. o l-hc s1's1ern should suppll, sufficient N'lectizan lbr the needs ol'all the pro1ects concerrred. in good tirne. TIIAINING o There should be an objective need lor each eprsode of training. . -lhere should be evidence that stafl'to be trainecl lack knori,ledge and skills to perfornt thelob and the 1r'aining should then focLrs on this deflcienc)/ only. . Resources lor training / hurnan, transport etc..,/ should bc e fflcientlr used. CD'TI SKILT,S WHEN A TRATNED PERSON NIO\/ES A \\/AY . Staff at all level should remain in one post forat least flve ],ears. o l'here should be irnmediate orientation ,, in CDTI/ of neu,. unskilled 1tro.j ect staff mernbers. BUDCET FOR PLANNED ONCHOCERCIASIS C]ON'I'ROI, ACTTvITIES . 'l-he cost lbr each Oncliocc'rciasis control acti'u,itl'in the vear plan should bc clearlv spelt out in a budgct. . Proicct managcrsllrPi shoulcl liavc a clcar cstintale ol' the firncis that w'ill be available to thcm lbr Onchocerciasis control in thc comins year. 29 \\IllO ..\t'}(l('. l-1 Septernbe r l()0q SUPERVISION . Supervision visits should focus more on FLHFs where there are proven problems. . each supervision visit must be justified . There should be evidence of action taken based on reconlmendations in previous ntonitoring exercises . Successes should be noted and reporled. . leed back should be given to the sulten isee. -1.1.3. IIorr' havc thev been irnplenrented'J J.2. Sustainabilitv of projects: plan ancl set targets/ nrandaton' at Yr 3/ Was tlic prt-rlect cvaluated clr-rring thc rcltortinu lrericlc'l'.) No Was a sustainabilitl'plan rr'ritterr'.) NO When u'as thc sr-rstainabilitl,plan sLrbnritted'.) .lune 2009 \\'hat arrangenlents have been made to sustain CDl'l after APOC funding Cesse in tcrrties of; 30 WIlO,/AI'(i('. l-1 September 1009 4.2.1. Planning at all relevant levels The Ethiopian health sector planning process is redesigned under the policy planning monitoring and evaluation /PPME/ core process. Though the PPME is a part of the new Business Process Reengineering / BPR/ the planning process with the principle of "one plan, one Budget and one repofl" has been exercised for the last two years ivith the top- dowtt and bottorn up approacli in order to align priorities and targets rvhile addressing local priorities too. "One plan" is the idea that all the n-rajor actir,'ities happening at various ler,els of the health sl,stent are incluclecl in onc joint plan. "One plan" rrearls that all stakeholclcrs (gttvernmeut. doncrrs. NGOs and the comnrunitr') agree to be part of a brooclcr sect oral plan. Where i.rs "()r.re buclget" ideallt'nleans alI firnc]ing lor hcaltlt licti\ itrcs poolecl and channelec'l through sovenrnrent chiinnels. Iloriever, all lIncls lirr health activities reflectecl in one plan artcl one clclcr.rnrentecj buclget, btrt aetLrallv disbLrrsccl throLrgh separate cliatnels. 'fliercfore, thc plan ancl lirnd.fbr Onchocerciasis etintrol l)rograrlr catt nrrt be erclLrrlcd. -fhus, tlte arriiugcnrents that have becn nrarlc to sustarn CDl'l alier z\POC ancl other NGDOs tunding ceases is as explainc-d abor c. -l'lie vehicle ancl rnotorcr,'cles used by'the ministrl'of health at all levels arc proviclecl by'clifferent donors such as UNICEF. WIIO, ancl others. Therelirre, thc chunce r'rl- reprlacing is lou ri,hile it can be uraintained bi,'zone and ciistrict expenses. The hunran resources required fbr the realization of the strategy w'oulcl bc lirllllled through basic in-servicc training activities. -fhe budget fbr material procluctron. technical supporl and actual vu,ork at cornmunitv level u,ill be incorporatecl in thc re,eular budget o1-districts. So far it is irnplemcnted to some extent.'l'he crrsting Vehicles and N4otor cvcles and otl'rer resources \\'ere usecl fbr Onchocet'ciasrs control program too. 4.2.2. F unds No budget u,as aliocated fbr Oncliocerciasis control alone. because all health Progranrs are ri,'ell integrated and carried out sirnultaneouslv inclLrding Onchocerciasis control program. tdeally rrearls all funding fbr health actrvities pooled and channeled through government channels. However, all lirncls lbr health activities rcflected in one ltlan and one clocurnented budgel, but actLrallr disbursed through separate channels. 4.2.3. .[-ra nsport (repla cement a nd nraintena nces ) While there are lerv Veliicles at Zone Ilealth Deparlnients sonrc of tlrt'distnets hare no at all. 1-he-y ltavc fleri'N4otor C't,clcs u'hich are \/ery old ancl nectl N{aintcnance. Besidcs. no iirranscnrcnts made to replace the old n'ith the ncu onec tliarr rnairrtuirtinu. 4.2.1. C)ther resou rccs \\'llO,'r\P( )t'. l1 Septe urLrer l()0t)3t 4 .2.5. To what extent has the plan been implemented? The plan has been implemented by integrating the project into the existing health programs. 4.3. Integration Oirtlrne the extcnt of'rntcgratron ot-C'D'fl tntti tltc I)l-lC structurc antl the plans tirr courplete r ntcgratr tl r.t {.3.1 Ivernrectin delivert' nrechanisnrs I'hc l\L'r'mcetin tlcIivcrv sr"sten'r rs vcr\/ ri'elI rntcgraterl in ttr thc N'IOII strLrcture right lionr thc onset. -l-here has beer-r nr) scl)arate Ir ernrectiti tlelircn's1,stenr than lbllori'ing thc eristing cleliverv svstcnt in the coLlutr\ Wlrcn the drurg arrive ti'tlm a broad the prolect zonc-s are notiljed to cctllect tl'ttrn thc central point ancl clistributc'to the clistricts artcl Flcalth ftrcilities fiom u'liere it is tiistributcd to the conirttuliities. 1.3.2.'l'raining Every y,ear All health professionals in the entire project area trairl altd retrair-r on Comntunity Directeil Treatment With Ivert-uecti /CDl'ti The project is ilttegrated rvith the Prirnary Healtli Care /PI{C/ particularly to ntalaria and other r cctor bome diseases from the beginning. Therefbre. CD'l'l is a parl and parcel of the health care deliverv Systeu at all ler,'els ,1.3.3. .loint supcrvision attd ntonitoring rvith othcr progr:lms Pnrnary Health Care activity in the project area are sLlpervised arrd nror-ritored in an integrated nrauner, o1'rvhich.Mectizan distribution is one. Supervision check list is developed irt sucli a \\'ay that it cottsisLs all health programs including Onchocerciasis control prograrn. When returning back 1r-oni supen'ision the supervisors discusscs on it artcl send leed back to the districts. +.3 -+. Ilelcase of lLIrds lbr prr4ect acttvtttes Durring the reportirrg pericrd the fund vr'as not released ttu timc 4.3.5 Is CD'l'l includcd in thc PHC budgct'r Yes, it is included but not separate budget lor CD'l'l alone. il \\/l lO/AP(lC. l -1 Septenibcr 20(19 4.3.6. Describe other health programmes that are using thc CDTI structure and horr' this w'as achieved. What have been the achicvements? . Fill tables 14 and l-5 and provrde descrrbe other programmes that are usrng the CDTI structure and how thrs was achieved What have been the achrevements? e For each tnterventton ltsted in table 15, explain what were the roles played by the CDDs (census, mobtlizatton, distributron, data collectron, storage, collectron of drugs, rcfcrral oI SAEs, etc )? ! ixplarn r,n"rlrel arc thc ccnrbrnations of rrterventrons co rnrplent,l,rlc(J ) ilorv v,",r,rt the tltervcntrrtrrs rnrplernenLrd? (at the 5arnc tlrltc ))a {.3.7. [)escribc otlters issues considercd in the integration ol'C'D'l'l J-1 \\III( ) .\P( )('. l{ Scptenrbe r l()()() O a.l o -o tr o o. OI U o o- o :a -t t- u =C N - al) 1) = 'r, (1J -o a frl .= a -a U tr O ., sr bJ) o L oi- o .) .J) .Ja )t-q) .J C C - Zl.al> o a! o o L o L E Z ( F 3( E all q 6 2 ? o o on L L t -t vY !- Z 7c ! ? :_ i, -I f -l a ! 5! L - \,\ !-s t L , L -a^ L; a6>a ! 5L 't7 oi a t a o\ O C\ -o 6 o- Oo <1- l, o o. o aq c! co L o co aa= =ua aL-. ---J i-/t ao !'; !r ,= ? O ? q) ? t )T '= ?. d ,Ja aq, <) o o I ! t a CCa Q)6 >.= a a ,. ! u .J-- ,xo o c e €c PC ^- ao U! .t 4d =6>€ o cly9o l(o!o s A.) Oro a t a - U o- J OoJ e^ oN '-o 601OE a :EF U) q z =) o C 9 f -o - q o a ,) z. a a (.) Cq d O a 5 a U F - 9 (E C <orCE - urO- a I l I C z c OJ - OJ oo rg C mO C5 OJ rEC-L' osT a = C() CJ tr cJ z aaa II I I I aaa d, - oota q 0) C a I . - F i, - ! ? ! :\ lJ - C a\ a\ ! v) ! tl.) (-) l- .lJ O L<Pa t-..1(, oo (n a(.) !r oll t- l-(J ]J o t/.t q) F a 4.4. Operational research 4.4.1. Summarize in not more than one half of a page the opcrational research undertaken in the project area within the reporting period. 1.4.2 Not done, becausc, there lvas no allocated budget for this purpose Ho* ucrc the rcsults applied in the project'l SEGTION 5: Strengths, weaknesses, challenges, and opportunities Strength DL'sl)ite erccssivc nteeting, slunnrcr cr)LrrsL- trartiing antl ritlrk loacl on thc ht'alth personnel and lack of inccntive lirr C't)Ds cithe'r'tronr the projcct or tlte ct'unntt-tnitv the perfirnnance ri'as fbuncl ttl bc good \l'eakncsses . [:r'en though. intensive training atitl supct-r'isiotr \\'t-' re cotrrlr-tcteci, still tltct'e is poor record keeping. . Poor censLrs up dating . I)ela)'rn reporling . inabilitl,to increase lbrtrale participation in ('t)'f l ancl thc t.tt-ttttbct'of ('DDs . LacktlI'supcn'isiott . [-ack ol-preparing inlegrated plan u'hich inclucles bLrdge't. Challenges During this clistribution period, rnost of the health rn'orkcrs u'ho are trairtecl artcl have 'u,aluable experience irr underlaking CD'l-l activrties \\rere settt to diffbrcnt colleges and institutions to be up gradecl fiour health assistancc to tiursing antl frorl nursing to Health Officer. Besides, tnosl o1'the health staff rvorking in zone hcalth deparlrnent and district health o1'llces are atteltding sutt-ttt-ter coLlt'se. l-hat is u'hv therc uas dclal,'in subrnitting tlie rcp()I1 trlt tit'ttt' Opportunities . 'l-hc cxpransit-rtt ol-healtli facilities . .['lte nuntbe r of healtli extcnsicln package ri orkcrs has iltcreasetl . '[-hc neec] clf conrn-rur-rity rs rncreasing fl'onr ycat' to vcal' o the abilitr of the drug to erlrel dil'l-erent intcstinal puritsites o Il-tc reductiott of rnectizan sicie effect i6 \\ H(),AI)O('. l-1 Septe nrlrer l0()9 n On the other hand, the health policy of the country is developed based on the critical examination of the nature, magnitude and root causes of the prevailing health problems of the country of which Onchocerciasis is one. In addition, there is good relation and support among the partners t SEGTION 6: matters Unique features of the project/other a What makes this project unique is that it is managed and carried out by the community with out any payment. \\'ll( ) ..\l'}()C'. l-1 Scprtcrnber 2(X)t)