Yobe CDTI annual project technical report submitted to Technical Consultative Committee (TCC): January –December 2006

YOBE STATE PROJECT , li U E l E F E r1' I I I I I I I I I I I I I I I ORIGINAL : English #h ytraR ANNUAL PRoJECT TECHNICAL REPoRT ST]BMITTED TO TECHNICAL CONSULTATTYE COMMITTEE (TCC) For To: To APOC Management by 3l Januart for Marc! TCC To APOC Management by 3l Julv for SeptgErbef TCC Tccfh for To, \iR J{l on 0 8 FEV 2007 AFRICAN PROGRAMME FOR oNcHocERCrASrS CoNTROL (APOC) -l Pfri rl-A*fLlrh I --r-_ COUNTRY/NOTF : MGERIA Prqiect NflIne: YOBE STATE Approval vearz 1999 Legncting vear: 1999 006) circler th one I( , 43) 5 6 7 9 I0(8) Date submitted: JAIYUARY 2OO7 CBM JOS ,l_ : I ! ! I I I ANNtll\t, I'RO.rH(.'I' I t-('l INl('rt l, f{EP()R'I' I'O I'llCI lNl('Al. ('ONSt,l, I A l'l VIr ('oMi\41 l"l'l:l: ('l'(.(') ENDORSEME,NT Please confirnl you have read this report by signing in the a l,lrr'0lrria te s J)ace. OFFICERS to sig n the report: Country Ni National Coordinator Nattte P*r*r._r A e6a Sigrrature Date: .7.a/i{1.12*=z ZonalOncho Coordinator Narrr",pgp-,q4 ft CC*BU -fl€Atce Signature, ..@o**- I)are: Sq[r ]-z*=t This report has been preparecl by Narne . E.l Sara (Mrs) I )esigrrat iorr : Coortlirtatol Sigrrature ft}rie=-.* [)ate g'r' .lAN 2t]()7 ,A- L E Table of contents .,.,............ v DEFINITIONS......... FOLLOW tTP ON TCC RECOMMENDATIONS.. ... I EXECIJTIyE StirvIMARy .............. 3 SECTION I : BACKGROUhTD INFORIVIATION 1.1. GTNiERAT rNFoRMATroN.......... Description of the project (brie/ty)........ Partnership 1.1.1 1.1.2. 1.2 PopulnrroN.... SECTION 2: IMPLEMENTATION Of,.CDTI 2.1 - Tfr'tgrrt.IE oF ACTIvrrrEs................- 2.2 9 2.3 Aovocacy Mostr zerroN, sENSITIzATIoN AND HEALTI{ ..9 10 102.4. CorwrrrNrryrNvoLvEMENT 2.5- CapacryBUrLDrNG.. 2.6. TRsenrcN-rs. 2.6.1. Treatmentfigures- Enor! Boohnnrh not de/ined.2.6.2 What are the causes of absenteeism? . 192.6.3 Whot me the reasons for refusals?.2.6.4 Briefly describe all lmown and verified seriow adverse events (SAEs) thatError! Bookmark not deJined. 2.6.5. Trend of 2.7. Onoannc, sToRAGEAND treatment achievement DELryERYOF fro^ CDTI project inception to the ctrrent year2\ IYERMECTIN ........212.8. Corvuurury sELF-MOMTORING AND STAKEHOLDERS MTTTWC 222.9. SuprnvrsloN 2.9.1. Provide aflow chot of supertision hierochy. . 23 2.9.2. Whatwere the moin issucs identified furing sulxrvision? .-.. ..24 2.9.3. Was a supervision clpcHist used? 242.9.4. W'lut were the outcomes at each level Enor! Boohmarh not dcllnedof CDTI inplementation superttision 2Enor! Boo*nark not defncd2.9.5. Wasfeedback gwen to thc person or grotrys supervised? Ermt! Boolaturh notdetined 2'9'6' How wos thefeedback used to imprwe tlu overall performonce of the project?Enor! Booknark not dcJincd. SECTION 3: SIJPPORT To CDTI 3.1. 3.2. 3.3. 3.4. 25EQupt'tE^IT ...........-.........25FnqeNcrel coNTRrBUTroNs oF TrrE pARTNERs AND coMMuNrnEs.-............ .......-.....26Onren FoRMs oF coMMt Nrry strpFoRT Ennon! BooKuARK N<lr DEFINED.E>eeNolrunr pER AcTrvrry............. . Ennon! Booroanx Nor DEFINED. SECTION 4: SUSTNNABILITY OF CDTI ..4-._.-6e..a.,,.r.r...4,,..........,.....2E 4.1. INTCRNNI; INDEPENDENT PARTICIPATORY MONITORINC; EVAIUET,ON ......... ...........2g4' l ' l was Monitoring/evaluation carried out duing tlu reprring period? (tick any 4.1.2. Wlut were the reiommendations?... . . -. -.... ..:.... ..... ."' .' .". ...... ............29 ^_ \ L 4 4 5 7 t t t I E E E t I E E E r L 1.1.3. How hsve theybeenimplemeilet? .........-..........Error! Boo*norknol defined 4.2. SusrarNnsrlrry oF nRoJECTS: rLAN AND sET TARCETS (MANDAToRv AT........ ...-....29 Yn 3) 1.2. l. Plonning at all relevant levels...... ..29 ..29 .29 .30 .30 .30 .30 1.2.2. 1.2.3 4.2.4. 4.2.5. 4.3. Irurecnenotr 4.3.1 4.3.2 Funds Transport (replace me nt and mointenctnce ) .. . .... Aher resources To what extent has the plan been implemented. Ivermectin de I ivery me chanisms Training... ......30 ......30 r 4.3.3. Joint supervision and monitoringwith other programs .................30 4.3.4. Release offunds for project activities... ........... 314.3.5. Is CDTI included in the PHC ktdget?................ ..........31 4.3.6. Describe other health programmes tlrol ue using the CDTI structure and how this was achieved What luve been the achievements? ....-...--... ....................31 4.3.7. Descrtbe others issues considered in tlre tntegration of CDTI......................... J/ 4.4. OppnarroNAl RESEARCH 3l 4.4.1. Summarize in not more than one hdf of aryge the operational reseoch undertaken in the project ueawithin tlu rcporting period ...-....31 4.4.2. How were the results applied in the project? .........-... SECTTON 5r BII.TXGTHS, WEAKNESSES, CIIALLENGES, ANI) OPPORTUNTTIES SECTION 6: UMQIIE IEATIIRES OF TIIE PROJECT/OTIIER MATTERS. ERROR! BOOKMARK NOT DEFINED. ........ 3 I LU r Acronyms APOC ATO ATrO CBO CBM CDD CETI CSM FLHF LGA LOCT MOH NGDO NGO NOCP NOTF PEC PHC REMO SAE SHM SOCT TCC TOT UNICEF UTG wHo African Programme for Onchocerciasis Conucl Annual Treatrnent Objec tive Annual Training Objective Communi ty-Based Organizati on Chri stoffel Blinden Mission Community-Directed Distri butor Community-Directed Treatment with lvermeclin Community Self-Monitoring First line Health Facility Local Government Area Local Government Oncho. Control Team Minisry of Health Non-Governmental Development Organization Non-Governm ental Organi zatton National Onchocerciasis Control Programme National Onchocerciasis Task Force Primary Eye Care Primary healthcare Rapid Epidemiological Mapping of Onchocerciasis Severe adverse event Stakeholders meeting State Onchocerciasis Control Team Technical Consultative Committee (APOC scientific advisory group) Trainer of trainers United Nations Children's Fund Ultimate Treatment Goal World Health Organization v Definitions (i) Total population: the total population living in rnesoAyper-endemic communities (i i) within the project area (based on REIVO and census taking). Eligible population: calcularcd as 84ozi, of tle total population in meso/hyper- endemic communities in the project area. (iii) Annual Treatment Objective: (ATO): the estimated number of persons living in meso/trlper+ndemic areas that a CDTI project intends to treat with ivermectin in a given year. (iv) Ultimate Trearnent Goal ftJTG): calculated as the maximum number of people to be treated annually in meso/hyper endcmic arcas within the project area, ultimately to be reached when the project has reached full geographic coverage (normally the project should be expected to reach fte UTG at the end of the 3d year of the projec|. (v) Therapeutic coverage: number of people teated in a given year over the total population (this should be expressed as a percentage). (vi) Geographical coverage: number of comrnunities treated in a given year over the total number of meso4ryper-endemic cornmunities as identified by REMO in the project area (this should be expressed as a percentage). (vii) lntegration: delivering additional heahh intcrventions (i.e. vitamin A supplements, albendazole for LF, screening for cataracL etc.) through CDTI (using the same systems, training, supervision and personnel) in order to maximise cost- effectiveness and empo\f,Er cornmunities to solve more of their health problems. This does not include activities or interventions carried out by community distributors outside of CDTI. (viii) Sustainability: CDTI activities in an area are sustainrble when thcy continue to function effectively for the foreseeablc futur€, with high heafinent coverage, integrated into ttre available healthcare service, with srong community ownership, using resources mobiliscd by the community and the govemment. (ix) Community self-monitorin& LCSM): The process by which the community is empowered to ovcrscc and monitor thc perfonnarrcc of CDTI (or any community- based health intcrvention programrne), with a vicw lo cnsrring drat the programme is being executed in the way intended- It errcourages the commmity to take full responsibility of ivermectin distribution and make rypropriate modifications when necessary. !i E t.I. IT t I FOLLOW UP ON TCG RECOf,I}IE}IDATIONS Using the table below, fill in the recommendarions of the laor TCC on the project and describe how they have been addressed. TCC session 2l This is diffiqdr lreffisc comnnunitiss see a bunden of sr-ppqil;ng even ooe CDD trrll lvss of increasi"lg their number. Communitier wsre mobilizod rosdecl I I I I I .r,. ).',, (\//. a, lr_. _+L-_ ann, Number of Rcanncndolion in thc Rqort TCC RECOMMENDATIONS ACTIOT{$ rAralr iy ?:flE PXOMCX FOR rcC/APOC MGT USE ONLY The Therapeutic coverage and involvement of health staffin CDn The ysment of health staffis gadual however, all healtlh staffwill lbc inriol're after their tlaining iir CDTI Involvement of women in advocacy and mobilization. CDD/population ratio is still low with poor supervision This is still maihteirnod It is difficult to chmge CDDs ratiobecause comnrtmityselect ard sug)ort thelr CIDDs; however, the project has embarkon intensive mbil ir zatifu 6 of mr this. Train all staffon CDTI Integrate drug delivery into PHC to reduce cost and ensure sustainabi Drugs delircry will b€ firlly integlded by 2007. Continue sensitization, health education and mobilization of commrrnities to improve awareness on community roles and Sensitizati cl was done and will cortiurc. Comnrmities tre mrr/ awareof their rq,le$ snd responsibiliries. Review training objectives for CDDs to attain a ratio of 2:250; esellect and train additional CDDs. A_ rpre CDD! ro h The project ha,s mt achieved th:s lhere is aplan for training aJIl health staff bynexl year. t, r az- t I t t t t r t. t EI E I I I I I I I I (Please add more rows if necessary) to tneet a ratio,rlat least l:250. Improve integrated supervision At the course o PHC activity, hedth staffdo supervise the L)Ds and trtake nec$rsirry intervention. TLe sornetimes help in collecting results fmm CDDs.. Update census in 6 LGAs with therapeutic coverages over 84Yoto ensure correct denominator. Although Ceosrs has been updated uring CDDs census update. There is still inr,orrect population figure in sorne LGAs. This will be address nexryear. Continue integration of CDTI into PHC. Already plan bas been made to tythe distibuti on of mectizan together with Immunization campaigns in some LGAs. \l ,r t/trA fvri a. \r----_L__.M. Executive Summary. Yobe State was created out of former Borno Stare in August 1991. The river Yobe is of particular mention as it cuts :rcross six (6) LGAs and i serves as breeding sites of the black flies. The project is in its I 16 treatnent round but in its 7CI year of CDTI implementation rrrder APOC. A total of 247 communities are undergoing treameil in 12 LGAs' of the state out of whichT are Meso - endemic & 5 hlper endemic zones. The population of the communities under treament is &6,3?6 people. The ultimate treatnent goal for the programme is 520,000 persons In the year under review, a total of 465,1l0people were treated using 1,126,386 tablets of Mectiza Slving 77 % therapeutic Coverage, l00% Geographical coverage andS94/o Ultirnate Treahnent Goal. Most of LGAs have Nomadis f'rrlani cattle rearers' qihose movement is determined by climatic factors. Also, in Bade LGA there are populations of fishermen who move in to settle towards end of rainy season and move out in the drier perts of the Jeirr Targeted refresher training was conducted at a[ levels to various categories of staff. 370 CDDs and 184 health workers were hained and rehained respectively. With this, the project achieved 77Yo arrd 9O.5oA of its ATOs for CDDs and health workers respectively. Ratio of CDD to total population is l:1081. Major chall6ngsr include lack of zupport by LGAs, which led to decrease in monitoring and supervision at that level. Also community support b CDDs is low, this led to high rate of CDDs athition. The project is encouraging CBOs in the various communities to support especially where there are indications that the CBOs wilf be rcsponsible for giving CDDs some stipends. With respect to LGAs support in tcnns of cormtagt contribution plans are put in place for LGAS to increase their conkibutions for Chcho/Blindness prevention activities . The project will identif few women grorrystbatwill resist in the mobilization and health education of women and bring some degree of pessure to bear on the male dominated traditiond stnrctures to allow increased participation of women i,n CDTI, especialty women participation as CDDs. CDTI is inrcgraed into PHC stnrctue in Yobe Stae. In tle rqorting yar, A total of 400 persons were operated for cataract freely, and 38 lid stngery cafiied out. Free Canract operations were conducted by the following organizfions; M Patients by the hoject in collaboration with CBIvI Diamond bark 100, Machina and Yunrreari LGAs carried out 100. Already, the State Government has ernpowered FLHF satr through caryir,y luilding using health system development funds, to improve tbe performance of f,LHf, The State approved and released 3.2 Million Nara for yea 2006. Yobe sute project vehicle is obsolete. Therc is need for its replacement. lrrt trl, a lra\- aa Lr^.-^-L-- ama SECTION 1: Background information 1.1. General information l.l.l Description of thc project (briefly) - Geographical location, topography, climate Yobe State lies in the Northeastem region of Nigeria It was carved out of the old Borno State in 1991. It derives its name from the river Yobe that runs across the entire State. It occupies a landmass of 47,153 sq km. The State shares National boundaries with Bomo to the East, Jigawa to the Northwes! Bauchi and Gombe States to the West. Yunusari, Machina Yusufari LGAS lie along the international boundaries with Niger Republic to the North. The metropolitan city of Damaturu is the administrative headquarters of the State. The State is characteized by savannah vegetation with evident desertification that makes most areas sandy (and muddy in the rainy season) as a result of qfuich the terrain is mostly difficult. The topography is varied with hard-to-reach areas in Gulani, Yunusari, Geidam, Yusu&ri, Karasuwa, Machina and Jakusko LGAS. Fika and fime LGA are hard to reach during the rainy season. Yobe state is in its 7th year of CDTI implelrrentation in 12 LGAS of the state. Machin4Yusufari, Giedam, Yunusari and Damaturu LGAS are not endemic however, passive treafrnent is given in these LGAs. Populetion: activities, cultures, hngurge Yobe state has a population, of 3-2 million, with rich cultural activiteis among which are farming, fishing and animal rearing. The major languages spoken are: Kanuri, Bolewa, Ngizim, Karai-karai, Ngamo, Bade, Manga,Bura fuiani and others. Most of the endemic ssrnmrrnifies are multi-ethnic and multi-lingual with population speaking several languages. Poshral Cattle herders such as Fulani groups Koyan and Shuwa Arabs live interspersed with settled agricultural communities. The State has 17 LGAS and 129 health districts and 178 political wards with suuctures for health care delivery services at all levels. - Nrrmber of health staff in project area and number of health staff involved in CDn activities. ) tirlt^r^ tff -r Lt^-,^-L^- ^Mr T E r E r, r t t t t t E t E I Table l: Number of health staffinvolved in CDTI (Plea,r- add nore rov,s dnecessary) DistriGULGA Nrmbcr of lce ltl strfl irvolvcd L CDTI rctivitics- Totrl Nurber of lcrlth st!fiin thc crtirc projcct rret Nuabqof lcrltt strfiorolvcd it(]DTI Br F, Perccntrgc B.=BJB, rl00 BADE 32 2l 65 BURSARI 32 t9 59 FIKA 3t 20 53 FUNE 45 40 88 GUJBA 3l 2l 67 GULANI 29 t5 6 JAKUSKO 2t l6 51 KARASUWA 25 l3 52 NANGERE It 9 50 NGT'RU 42 29 69 POTISKT,IM 5t 33 57 TARMUWA l9 9 47 Totd 397 245 6t 1.1.2. Partnership The Partners involved in CDTI implementations are MOH, endemic LGAs, NGDO (CBIO, NOCP, and local CBOs. These CBOs include 32 Community Developmental Associations in Fune LGA and 3l in Fika LGAs, 6 in Bade, 8 in Jalrusko LGA 7 in Gulani LGA' I in Potiskum LGA, and 14 in Gujba that are assisting in CDTI irnplementation at community level. Others are Drmagum Development AssociatiorL Fune development Association both in Fune LGA, Bubaram Gakoko in Potiskum LGA Relationship with pertners There is a very cordial relationship betu,een the NGDO (CBM) and the State Government. A Memorandum of understanding was signed in 1995 between Yobe State and Christoffel Blindness Mission (CBt 0 to last as long as the Partners ry@ & it was also renewed at the end of the Project's 56 Year for Post APOC Years. Thr NGDO (CBIO usually assist in advocacy, provision of IEC materials for raining provision of fitrds for various activities, and in training of State teams where necessary. The State perforrrs such funaions as training and re-training of LGA health workers, Mectiz:n procurement and saryply to LGA5, rlrttn ra tff aa \r-.,--L-- 1Ma B' r t r) monitoring and supervision of Mectizan distribution. forrnulation of operational guidelines in order to ensure good implementation of the programme. and community mobilization and education. The LGAs are responsible for training and rc-raining of health facility staff and CDDs. Mectizan procurement and supply to comrnutlities. comrnunity mobilization and education, monitoring and supervision of Mectiran disfibution. The endemic communities collect their yearly Mectizan supply from the health facilities. ensures dishibution of Mectizan to eligible p€rsons, selects distibutors and deterrnines tirnes and methods of distribution. They also minimally monitor and supervise the distribution exercise. The NOCP through the Zo.'aloffice provides technical and moral support to he programme, suprvises the activities of the state of Oncho Control Programme, and pays advocacy visits to policy makers to solicit for support to prograrnme implementation. The lrcal CBOs assist rn advocacv, support of CDDs duri4g disribution and community mobilization. Mobilizetioh There is a plan for an intensive mobilization in some LGAs and communities that are yet to prove evidence of ownership of CDTI project. 6 rtrf tn rriff 4a tr^..--L--aM, l-l -l$. lsP h.->;t9E =trJ- =o =--s.O9,4 $ \ o\(\ d (; (\ a!\ D' o. 1J oEc A' o !,+ B ta ,r (D CD E rt TD E5o (D a Dr! (D 19{ (Dd @tst (D F0E(D E(D D) raA oFl o a.C1 0a (D Fl(DEo :1 0a E CDFt o * -l F? 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E4()7 E{o Bg ? o4(a7 z IEa .lit -(a =E =.isE' o tD Eo ao 1,E IDF}(D zo (!i 6o zo (! d(!I z. o o5 C (.DI zo o 3doI zo o5(t @E zo o E' ct(! 5 zo o5(r(Dt zo (r 36(!n zo (D 3qr(D! z o o doI zo tD eC r'D4 zo tt3C(tyl o 5EEgi+(D 0 3 E a) p Ho Bo DD o lg C) Eo ptc' ? !c e ? D B:t 80 of ? ro4 ta7 3!E a TT ETE.+ sE' n rer O rt E o E' z o o 3 cr(! zo o (t(D z o tt 3q o zo (l 5C'(D 2. o (f d(!I zo o d(a z o o d(l z6 d cr(,t I z,c (D 3t(Di z o o5 do zo1o 3q r! t- .t adGt o 3g ABer3 o q oI E C) 7 to o Eo 7 E .l Dh a) zl E6:, 7 i eu ? b (>t Bo/ ? dt 2 7 E c9,ED ^-isF o c) o(t(D o a) o(,(D a o c) o cr(l oo oq ('D oo o cr(DI oo oq (.D oo o €(l - 86g a> 9{ oo oaoI od d .3 aq egai *,,cla i, r IJP O E* ts;J'{ -lr-HB Or= z3d N :3o r!H{iB i E EE ---a+ o +B 3sorrro)P-.;oottD) -rFOPI - *o6IrEOdtrt*{ (D DH e(\ a4(\ $ o -r G\ t aa GaGt-1 E .\ trE oDoo E oE ol it 19 Da (D ao{orl (D Borl t0 t,D p o E E EI E'(Da tc Ea l*l E'o E oDoo oxE D E' g oc oa a)o o aD{oEt o o B'HT.(D o- od o (n o! Ho Io (, 5o p r{ o (n A' o. oo (D rn o IDHH (D o- ot it(D Ft F'o (!t) p tn P3(D rD 3E o 3(D =p ;,{ o) U) o-o (D att F TD (D od V) p p (D r{ o U) o -u o -o N)A z o (D q r! hJa3 r tI t I I t t E E E E E E E T I I t t I \o o t lDI lD o 2.2. Advocacy AII chairmen of the care taker committees and the district heads in each [-GA were nrobilized. Mobilization was done both at LGA and communiry levels with dilTerent targel groups. Chairmen of the care taker committees were advocated to gasp CDTI and release their support. It was clearly explained to them that CDTI is rhe LGAs' project and it their responsibility to keep it going. Although all chairmen have shorxn commitmenL some of them failed to execute their responsibility of supporting the project in terms of cash. Advocacy should be done at state level where all stake holders will be brought together and be sensitized. l.g Mobilization, sensitization and heatlfr education ol at risk communities A targeted mobilization was done in all the LGAs, having in focus those communities with difficulties in CDTI implementation. Community membes were sensitized and Local NGOs were also educated on community self monitoring and supcrvision. Posters were used to disseminate information. Most commrrnities se€m to be aware of the projects however, it is still difficult for them to support the CDDs in ternrs of cash or kind. Intensive mobilization and sensitization in all the CDTI communities will be of paramount importance by use of mediq and film show at community levels. {5 rlnt/rra h/f -a \r-,---L-_ 16rr, iUJBA 2.4. Gommunlty involvenent Table 4: Communities participation in the CDTI TPleose add more ro*s if necessdry) Comment on: - Attendance of female members of the community at health education meetings - In general, how do you rate the participation of female mernbsrs of the community meetings when CDTI iszues are being discusses (attendance, participation in the discussion etc). - Participation of female members of the comnunity at health education meetings and other meetings related to CDTI has been difficult in some Muslim dominaled communities. Despite the health education mobilization doue efforts proved abortive. Efforts will sti[ be made next year. DistricUlGA Numbcr of communitics/villegcs with community ncmbcrs es sopervisors Nuubcr of CDIh Nuobcr of comnuni6cs /villegts with fcmrh CDIh Totrl no- comncniti6 in tbe cntire projcct erce B. Numbcr wittr community ncmbcrs rs supcrvisors & Pcrccrtrgc BF BJB. rlm MrhCDDsi I i Fcmrh CDIX D, B Totrl Bl=BzrBr Nuabcr of comuuuitics *iti fcmrlc CDIX &r Pcrccntrgc Btl= B'/BrrllX) BADE l8 ll 5l 26 0 26 0 0 BURSARI 4t 9 22 55 0 5s 0 0 FIKA 3l 5 l6 47 0 47 0 0 FUNE 45 28 62 59 0 59 0 0 2l 5 23 2E 0 2E 0 0 GlJLANI 36 t7 47 47 0 17 0 0 JAKUSKO l4 6 43 29 0 29 0 0 KARASUWA 5 5 t00 t5 0 l5 0 0 NANGERE 9 4 u ll 0 il 0 0 NGURU t 3 38 l4 0 l4 0 0 POTISKUM 9 4 M t9 0 t9 0 0 TARMTTWA l0 3 30 22 0 ?2 0 0 Totel 12 247 100 ,10 370 0 370 0 0 rtL rlnjli,A 1/{. aa lr^,,^-},- aml H l ! I I l, Incentives provided by communities for the CDDs Incentives provided by the communities to CDDs i;; not sotDelhitg to talk of since some communities claimed that the CDD is their son. w incentive is rtrt necessary fbr the CDD. This has brought about a high CDD attrition rate in the pruj,-vt. Attrition of CDDs. CDDs attrition has been a problem for the project howeverl there is a plan for all CDDs to be incorporated in some of the health intervention progammes, e.g. IPDs and NIDs. Moreover bicycles will be distributed to some CDDs wift lhe aim of tying them to be committed. a_ Itrtt.'ar^ lulr ^a \r---^-L-- 1M. 2.5. Gapacityrbuildlng The project has enough manpower to carry out the project activiry at all levels o CDTI implementation. A targeted training was organized to utdate the knowledge of some staffand also to train those staff that were transferred newly to the project area. New CDDs were also trained however this does not meet a ratio of 2:250 The project has a plan to tain all existing health workers on CDTI activities across the state in addition to the frontline health statr(in charges of health clinics) that were previously trained. This scheduled to hold next year. 4+ ll/lrr'\ra ry\n aa rr^.,^-L-- 1rt \2 h h I E -lo -.1 t- o t, o\ s a .' lD (! \ot, s IE IC 'uo -l aXC7 zoCFC lz z o rrjF tT, lr lraC xCa 7\ a cp o -t- z Y' C2 at 'tl n lrrCF(A b cd Ufr, Y ta ?, F t, l,- (A o ztr (D -l o U a rt ft at F o L a E B rl ID e(Da I l* ; o F---- t o o tj) o L'T (,r o (^ o o (2 Ur ts---- o (, ; G- h\ fg l- l>la tat (D B atE'] -l -l\Ol sl t,(, o o o\ o\ tJ o Nu) o\ l.) o o z elorl o r.l(D D to !0 -l Ilc l,(Da e '- !.)c t\)e o 6 @ o o o o \o o o\ o\ o o\ ----t Ot o \o \o ---t o \o \o o a 6 lo I I -l----- o\ 6 o ;o $.)o o o o o \o \o 2 s -to D o I s, I o + o s lD (D .t E t,D!' 66 s a @ o.t o 2 H(DDn 6 ,-,(D0art -lq Y,tr-l !c97(D a o o -l -t o -J -J $F .{ + () =-ard+i-o a\la 3 o s (i (l lt (! €\o s 5\.,o hJIJ hJo 5 o (, N l-)@ -lN x5 o\o\ (,l.) z r a, o o vvu ;I T & -; 6 t- Frr' -.6rE (ra (,(a -t (ra{o o hJ 1.) t\) i.J o ;o l.Jo o 5 i-- E o o o o o N)\o N)\o (, ! .5 ! .J ;- € t"- L l-)l6 o hJ --l l9 h)t,) {- +. a -.t (, IJ(, l)(r\ l-J lD)lcr lolu ;Hg. oop tD a tD'Ho (D o U ot+) o U -.1 (, (D 3o ss o5 \d(\ S a s s N o R\o (\ o!\ t;d s.. o t s\r \ s E. s o a s Fo n'\ o s Go tSt ! 0o o s oI :< i il >s s. n so saei- o s :t :qe z -, tr, c oa o o) !r !oo u, to EB Et trt (D o. D]r-t(!p (r) o -loF(t {(D (D Io o trroE (} a do o'+, -lo -j o o c 5 tJ t0d o tD o to o o.rc -o o l9 o P .) o tr :,5 Ot t, (D o'it o o d doFt o r-{) a oo -Jt) SD Fl(D o(D oo. t_t 9) 0c -l o F(D (r) E FD o Ft D) o{ ru o{oFl ,r(Dtt, A) {(D r-t(D EIo o o U -l soo (! x o .s)n E T E I l t t E t (, T I E EE T tJ5Ii -q' lE I I T t I \o 6 Trainees Type of training CDDs Other Community members e.g Community supervisors Health Worken (fr,ontline health facilities) MOH staffrr Other Political Leaden Others(specifu) Program management V How to conduct Health education / Management of SAEs v CSM J J SHM J { V Data collection { ^/Data anatysis { { Report writing { J Others (speci&) PEC V Table 6: T1,pe of training undertaken (fick the boxes v'here specrfic training wtrs canied out during the reporting period) 46 ll,fJA, L rYA./- a t \t^..^_L_ 1rt t, E r t; t<lc l€ .1, o -t(, x z oCvC lzl>lzo rr,v rD JxI>lv (t, C Ix IClalxo ocr Z lslulwt> r.: , :r IEDCF cr) E tD U rr, -E754 >6' tJ5 --r \o @ \o 5 c\ l= + 5 0a t\,5 -l o \o I6 \o l* 5 o\ ).) - 5 6 h) .}{ o \o @ \o 5 o\ N) .5 s 6 oo oo oo oo oo oo oo oo oo (2<2 oo oI <>o 3 a J.R $39=* EE i[* ll I ^-lFE Tc3E ='o lc o* .824 43 E afr 1r o s8 8EE(b=ro6' EL o\o ch(.){ o\ 5ot) o\o u)(,) 5(l)\o (,(/) o\o hJ55N)N hJ\o NJ n) 5o nJ@ o\@ N)\o UJ o\6(.) \ooI -a o\ -.ro o\6 -lt, o\sN) s \o J9r 9. EE ^ P.SEBE6'.y 9EHE'Ttof 5(a oooo t,oooo N ooo r,oooo 6oo6 (4) oooo h.) ooo lJroooo s ooo oaaaa o\oooo oooo (, oooo (, S g'rg3E =.C ELo= 56t, o u)IJ(,)o o\ b.J}J (rro hJ (, -t h.)IJ(, o\ 6t) N) t, t, tJ -J \ot) o\ u)oo\l') -{6+f\)6 (, -J\orOt o\t,) ol.J N)\o\o5N) t ssa -r -t 6o o\o\ o\5 \o o\(, {\o @-t -I -{oo Qi..) @o\ -lt\) 6\ (, F -r,rll 66 j o=loa 6.8FO(FC o ='.f) -t -t o hJOi t) 5 o o o o o -Jo o o\rr) [P.rf A *eB I!d 6o -t NtJ o\ o\N)(r) 5\o L9o\ h.)N)5 o\ { o\o\ tJo ts) (, w hJ6@ (! t-) 9Z6C o=],Cr6q9o o o o o o o o o o o o o 17 a4 >a_rrE P P {t o or; 3 otr}o -])-t tD D) tD D) a O lrj U) lo. U) 5.o r{ o A' trrt(Dp U)p l-t U) ,f s * so\G\o €a, '!, a90 =d z $ s i v?33. €.ea74t?g 7,2 i oI oaI' o .cCp (!Eo +oo. o L,I{ rOo\ () o (D r-t 8o oa JD @ oot o d(D St Fl.dd o o. o irl(D ol(D1 U'1dtU'I lfi oadtst o{ o l'(D !Ft e.(D o q, (D tP (D x otrt 7 o (D tt)I {(!p (D (D E(D FO 3o OQtrt(D o'Et o E.d D) o o- o o to.o (D oE trtcl H(D v1 !-+ -l o p 'c, IDcf.o() o (Dt at 0a(D aD (D ll tzlc l3ld l(a t;I+r tt:loloE lol*Irn ls,td t(Dlo- lxt-lola { { o -u I t.)5 z o (! g(! FJoo5 I E r t t E t t t t E I T T T I I I T I t oocoooooooo h.) -.to J.D/ioe0qqts vsa s= s -Dj v[3 r(p-tD1^; iOlD-aq F) 0a(D ts a $; 5 5Elt ! -.1 €f $ dri i x E$ $ r ss i B vS 5 r* t tR .g ,,tss giY E S$ i dF $i $ itr $F$gB I$[EE 5t B *l=$$ s F\$ s =ES5 HES6s t€ ,ES'OirE\GIEgst! E$sts86'FJ ErRgRYVl *r=.8r. s EliE 3$l EFE .{+ s.pBA rDG^s-ar) L->-)Ecj * Oe s € = sfI G 5t @ { o -o tJA z o (! C(! N) o5 E I I t I E t E E t E I 3 T t t I I T I I >lz ltz tSlc Olc o =13 FIE sF lr ;18' ; ,l-t r l-t o =b =lo !,6 l+, e- l+, EBIH E18 E'dE slE q'i 13 =.lE = E IH 1|fr ,EU.la ti> E';E EIF ;to iti6 (Dlo (Drd a3lh sJO- la .)gE ii =B Elg r'81z. gill- O. =lo (D3 a =L a+.)a'8Pp5 IA ;J o-=ta=. 'aO ohFa *- .?* irJs!fnd o .a. ='(D)o aerqEB €.(DIp Eop I lt a2.6.2 Whet rre the cluscs of tbsentceism? Absenteeism is as a result of travels and farming activitJ, 2.63 What are the reasons for rcfrrsals? The reason for refusals is still not very well known. However some still claim that it is for fiamily planning. ln case the project did not have any cases of serious adrerse events (SAE) during this reporting period, please tick in the box. No SAE case to report u i llrlt.'r, a (V\/, ^t rt_.,^*L__ aM, N)oo o\ t\)oo t)ooA IJoo hJooN) N)oo hJooo ;3 \o\olE o\o{ tftbfi N5 -J N)s -l N)5 -l N)5 -J N)5 -J tJ5 -J N)5 -I h.J5 -J }.) +! l.J5 -J lnlola5LI JI f E iJtFi'35 3:a $I r3{ "F l.J5 -l N)5 -l nJ5 -l N)5{ ].Js{ 1..)5{ N)s(, \o (> l.Jo €ilrg3v ,'o D o= r, N)A\t l..J5 -J hJ5{ |..)5-J N)5o\ N5(,,! t.)5N) E6 (,6 l.-) 6o!-c-39g =3 as.€ 5. ii6 f-oOS F] oo oo oo oo \op(, \oI \o-Jio \J9 OiqJ!c 5 90\o F:aOE-6{' !rs$ a$E.l:t oo oo oo oo \oI \op \o90{ \o90\o o oI@ oo- ^< D\co ieEo o tt: c_ ,!a.Frtl t 6o o\u){ o\ 5\o5 5@o\ AN) .:- \o -t 5 t\) -J{hJ t,\o 5\o -J t, O'{ t'J\o tr)(, hJ \ooo l-)\o .9\ UJ\t\o N) o\N A\o @)ou -ls.) *a EI O -=-Jt!l:.>+!c o "BH"g.s 5 oooo 5 "9ooo tJ)l/rPooo t))(,Pooo (j) t, -9ooo iJ) hJ -oooo t\){Pooo N)(rr Pooo N(j o ooo \otrt ooo .n-l -c,. .i PE.E P95E ='o !L{D3 F, 5 o\(, o 5f)){ o\ -lh.J t.)6 -65{5 u)(, lj hJ5 t-) s \o\o rJ) (JJ }..) @ .9oU)o N) o\ s65 N(j -u \o\o € o\ 5\o t,9z s5be. Itoa{- ts, Ii --) -l € 90 696 @9 @-lio 6 :j @ io 6t\) 'tt, a6 ie \o 90(, il8d 5*QCo3. a) ,P ttt r_ FF3rI o \o{ i.) o o o5 \o-t o ? oob \o b' 66^ -c fi 1-*€c EIt* uF] "', B €\o t) { o\ @ o\6 o\o o 5A c\ o efie .h 'o tU l-l t!)5' EL o\8l*i^g- I'o i9.6s55E' in o-3BgcD5_' *(D'rYASt, i+c,!arts .lXg /-rB*5€ r -t(D=.tlts9Ets0 Et3ggIFB EEE;lE'oPUU(DFt(.TNF-i 19EIH(, l.r XbH€.CrdO:B'3.tri(D!J818 ='Elt .d 3.ts.(,Ex l.a) FtE.+0a;.oCtD+FI.lTT .D c; i.DEtool.idrlgHH'g o.E;+I SEEqEGE' :hDS *i. ttEa'F Er =({/S -(*; tHs-ON 8$lltE€FqEI .D aD a a n 6'g t t t t F r I t t t t8 E E E I lepl; =tI J| T T I I I l I : E t t E E F E E E E I I I I I I t 2.7. Ordering, storage and delivery ol 19166sffn Mectizan@ ordered/applied for by - (please tick the apl>ropriarc qnr$er) 0 MOH f] WHO f] I.rNICf,F tr NGDO E Other (please specifu): Mectizan@ delivered by - (please tick the appropriate answer) MoH 0 wHofl uMCErn Other $lease speciff): NGDOf] Please describe how Mectizen@ is ordered end how it gsts to tte communities - Mectizan is ordered by FLTIF to LOCT to State Ministry ofHealth. - The State compiles all LGAs requirement and orders throu$ I'JGDO Partner. - Ministry of Health receives Mectizan from NGDO paffEr. - Ministry of Health dishibutes to all LGAs - LOCTs deliver drugs to FLHF. - CDDs collect drugs from FLHF. L .trt t'1,, n/V\ ^, lt_-___L-_.Ma Table l0: Mectizan@ Inventory (Please add more rows dneez.s^tt41, State/District/LGA Numb"" of M"ctizenutrUlctl Number in stock Rcqucstcd R.cccived Uscd U*d/Pcrsootrt cd lar \trstcd Erpircd Rcmeiniog BADE 70000 70m0 68t06 1 0 0 0 ll94 BURSARI 145000 r45000 140752 I 0 576 0 3672 FIKA 150000 r50000 t42194 I 0 357 0 ?M9 FUNE r93000 193000 1E9949 I 0 1495 0 r 556 GUJBA 8t000 8E000 87000 , 0 r000 0 0 GULANI 140000 140000 r3t400 , 0 376 0 1224 JAKUSKO 70000 70000 65s58 I 0 830 0 3612 RASUWA NANGERE 40000 40000 3v2m I 0 310 0 490 64000 64000 58026 I 0 67E 0 5296 NGURU 65000 65000 63721 I T 0 473 0 806 POTISKUM 65000 65000 54128 t 0 0 0 10272 TARMI.]WA 85000 t5000 78052 t 0 232 0 l7l6 TOTAL ll7qno ll7flno ttz63x I 0 63.27 0 37297 Mectizan are kept with the LOCT in charges of varbus IGAS after colection from the state office. At the cause of mectizan distribution, health do itentifi' scune patients with cataracl. Other activities include health education on general conditicm of living. Other activities carried out by health care persomel arc sport checks on distribution of mectizan. Some include PEC activity e.g. screening of cliem for cataract surgery. During mectizan delivery, health workers carry out a supenrisor-v mles and make necessary correction to CDDs, they also mobilize and educate tlc comrnunity on need to support CDDs. NOTE: Mectizen is elweys stock et state lcveL 7)u\- rt,l r._r, A ftatt- -. Lt-..--^L^- iMr l ti E 2.A. GommuniQl self.nronitoring and Stakcholdens tcet{ng Training for CSM and SHM was done in all the LCAs- However not all communities carried OUt CSM. Table 1l: Community self-monitoring and Stakeholders Meeting (Add rows if needed) Community self-monitoring and stakeholders meeting has contributed to the project as many policy makers and community members are aware of their responsibilities. District/ LGA Total # of communitieJvillages in the entire project area NoofCommunities thar carri€d out self monitoring (CSllO No of Communities that conducted sakeholders meeting (SEM) BADE BURSARJ l8 4t 3l l4 l2 I t4 t2 FTKA 9 FLINE 45 t3 l3 GUJBA 2t 7 7 GULANI 36 t4 t4 JAKUSKO l4 8 8 KARASI.IWA 5 5 5 NANGERE 9 5 5 NGURU 8 6 6 POTISKUM 9 5 5 TARMUWA l0 4 4 247 97 97 a rlrrtnr. tff ^, Lt_.,^_L^_aM, I 2.9. Supervision 2.9.1. Provide e flow chert of supenririon hiererchy. DIRECTOR DISEASE CON-I.ROL IvtOH I PROJECT COORDINATOR CDTI I SOCTMEMBERS I LOCTMEMBERS I PHC YC / FLTIF ICBO COMMLINITY \/ \/ CDDs 2-9-2. what were the main issues identiried during supcrwision? 1. Improper documentation of heatrnents data 2. Inability of the LGA to play their parts as needed- 3. Late distribution by some CDDs sometimes due to unsteady support for CDDs by some Communities. 4. The supervisory checklists are notproperly utilized for all supervisory visits. 2.93. Was e supervision checklist used? Supervisory checklists were used at all levels of zupervision- 2.9.4- Whet were the outcomes at erch lcvct of CDTI implementation supcnision? On the job training to the first tine health facitity staf on the proper way of documentation was carried out. Communities were also reminded through CBOs to assist the CDDs. These intervention measures resulted in ensuring coverage of all endemic communities and maintenance of high therryatic coverage rate for the project. 2.9-5- w.s feedbeck given to the person or grcups supcrvised? There is feedback of information at state tLGA levels dwing supervision. 2-9-6- IIow wes the fccdbeck uscd to iruprovc thc occrlll per{ormuce of the proiect? Feedback of inforrnation are used for future planinig. cXher informations are used for corection during subsiquent trainig. atrlafttrrVt/, 4t r!^. ^-.L---Maeu t t I t , SEGTtOil 3: Support to GDTI 3.r. Equipment Table 12: Stattrs of equipmen t (prease add more ro,,s if nccessuy) of the equlpment (F=Functional, non-frurctional hrt repairable,WGIWritten off) fflJ"'fi the proiect intend to maintain and repreee cxisting equipment and other The 4grewrent signed with a consulting firm, which mainrztns all existing equipment usingState counterpart funds is still in place. At the LGA level, some fimds are being released formaintenance of motorcycles. In terms of replacemen( efforts ae still being made to secure abudgetary provision from the State or LGA'- Moreover, the hoject is still expecting NocpManagement to arrange a date for the collection of the equipment donated by Apocmanagement' Meanwhiler' the project vehicle is obsorete The project is especting itsreplacement soonest by ApOC management. Materials like; IEC materials, flip charts in local dialects & grioorial tally sheets wereprovided by the NGDO parrrers (CBlv!. 11"t.',ta tv^v\ ^a rri. ^_L__ aMa I source Type of equipment APOC MOH D LGA NGDO Others No. Conaitim- No. I 0 0 0 0 Codition No NF lNo. lcoffi- No. Coridi6on 7. Others a) b c I F 0 H = 0 0 7q I. 2. J- 4. 6. Fax t I I Vehicle Motor F CNFR F F NF NF 4 I I5 4 0 0 0 0 0 6 0 0 0 F 0 0 0 0 0 t r I 3-2- Financiar contributions of the partncre ind communlties Table 13: Financial contributions by all partren for the last rtnre years Released of fimds is not timely and difficult by all patrersespocirlly Apoc management. The is yet to be addressed. Additional comments APoc management to please release all outstanding frrnds albcaed b the project from its inception to date. our NGDo (CBM) ust'ally assists the project alunays with vehicles during mobiti.etion, distribution and supernision- MoH rcleases counGrpart cmhihrtion excltding personnel cost' The l-ocal Ncos are the CBos like Damagrun Dtwlbpment Associatiorl Fune Development Association both in Fune LGA" Bubaffir Gaeoko in potiskum & others newly identified that released the amount above interyrsoftrhbiljzatioa Srryervision and E Contributor Yan6('20M') Ycer tTOTAL AMOT]N T (cASH) Budgeted TOTAL CASH Released (us$) AMOI,JN T (c,qsH) Budgeted TUTAL CA$H Raleased (1rss,) TOTAL AMOI.]N T (cAsrD Budgeted TOTAL CASH Released (us$) MOH (Central + Provincial/State) 20,000 It,000 20,00t 2r,Nl 25,m 25,(X)0 MOH 20,000 r8,5lE 20,m0 7,m ?,m 7,500 Local NGDO(s) ( if 1,000 I,m0 2ffi t,000 250 NGDO parrre(s) 5,000 3,000 5,000 3,000 5,000 3,000 Others a)Communities 600 600 7,{m 7,W 7,W0 APOC Trust Fund 0 0 70,000, 0 t50,m0 99297 TOTAL 45,000 4t,l l8 I 15,000 37,000 t95,500 142,U7 rt.r r.'rra NV ^. \t_---_L^- aMa payrng stipends to the CDDs _ Ycer 1 ('2fr5')l 3.3. Other forms of community support The commrrnities support to CDDs in kind by g"ing thern some moasures (mudu) of grains or units of other farm products in appreciation of their work is still encouraged. During farming some communities assist their CDDs by mobiliring some members to work on their farms. Some of the communities simply pray for the CDDs and wish them well. Some assist them with loans for their private business or enterprises. Some comrnunities support the CDDs in running for political positions e.g. councillorship. Some communities make available transport (bicycles or motorcycles) to CDDs to enable him pick Mectizan, attend training in a nearby community or submit reports of treatments. Some others govide refreshments during CDD training. Few LGAs stil do employ some CDDs as a means of motivation to others at \r,t i/rrl alf -a \r-_._-L^_ ama G E I t |/ I . 1 Y. Expenditure per actMty Indicate in table 14, the amount expended during the reponing psriod for each acriviry listed. Write the amount expended in US doll,rm using tle curent United Nations exchange rate to local currency. Indicate exchange rale used here I$ US = NI28. Table 14: Indicate how much the project spent foreach activity listed below during the reporting perid. The project is spending close to N2 million to take Mecti:.rn from Lagos to the communities. This could be due to over expenses on part of the stzrte and LGA. Thsre is a plan for the integration of drugs delivery into PHC. a Activify Erpenditure ($ us) Sourc{s) of funding Dnrg delivery from NOTF HQ area to central collection point of 15,000 MOHJGA,CB M Mobilization and health education of communities 14,0(m MOHIGA/ CBM of CDDs J,000 MOH of health staffat all levels 38,M7 MOH, APOC CDDs and disaibution 10,0(m MOHJGA Internal ofCDTI activities 10,000 COMMI'NITIES visits to health and authorities &, 35,(rc0 MOH, APOC IEC materials E,000 MOH forms for treatrrent l,(xx) MOII/CBM VehicleV maintenance 7,000 MOTYLGA Office etc l,(xx) MOH Others o TOTAL 71tut7 Total number of treated 465,rr0 f!rr a.-rl^ JVf -t \t--,-_L-_ ^,u. r t E E community SEGTION 4: Sustainabiliel of GDT! 4.1. lnterna!; independent parti,clpatoryr monitodng; Evaluation 4.1-l Was Monitoring/cvduttion cerrird out during tte rcporting pcriod? (tick any of the following which rrc epplicablc) -Not applicable -Year I Panicipatory Independent monitoring _ Nor applicable_ Mid Term Sutainability Evaluation Not applicable_ 5 year Sustainability Erraluarion Not applicable_ lnterml Monitoring by NOTF Not applicable _ _ Other Evaluation by other partners 4.1.2. Whet were the rlecommendetions? Not applicable 4.2. sustainability of proiects: pran and sct targets (mandatory at Yr 3) Was the project evaluated during the reporting Was a sustainability plan written? when was the sustainability plan submitted?_last fouryears What arrangements have been made to sustain CDTI aff:er APOC funding ceases in tenns of: 4.2.1. Planning at all relwant levels The 3 year sustainability plans developed based on basic CDTI activity earlier are still being followed up. The plans were fine tuned and draft submitted to the policy.makers and was used in the execution of the 2006 CDTI activity. 4.2.2. Funds The State & L.G.AS have accepted ilfy eeir roles in CDTI and have dernonshated this in the release of counterpart fimding. To e'nhance continrrcus relcase and improve the level of firnding at $e LGA level tbere is a policy to ccntrally deduct funds from Minis.y of LGA Atrairs for CDTI implernentation Meanwhilc the State counrerpart contribution has been on the increase sirre inception of thr project. Thc State released the sum of 3.2Million for is counterpart ftrxling. .la L* rlnrr.tr, fvtar at lr_. __l_.Ma E t n4.23 Trensport (replacement end Erio,cnrne) Funds from the Counterpart contributions are slill usoJ tbr maintenance of equipment as has been highlighted in previous sections. Hcwevsr. ,rs stated earlier the project expects APOC to arrange for the collection of nerv capital equipments allocated to the project.. The state received approved phase II budget frorr APOII but replacement of Vehicle still not done. 4.2.4. Other resources other resources like motorcycles belonging to other prugfiunmes in the pHC departrnen! were used during mectizan distibutim. 4.2.5. To what extent has the plan boen implemented About 85% of the planned activities of the reportirry year hus been implemented. 4.3. lntegration Outline the extent of integration of CDTI inro fte PHC shrcture and the plans for complete integration: 4.3.1. Ivcrmectindclivcrymcchrnisns Mectizan is being delivered through the normal Healtfi centers. Also mectizan is delivered through other PHC activity e.g. routine immuizdion and distribution of Vitamin A supplementation has been a good means of Mectizan delivery to some LGAs and communities. 43.2. Tnining Targeted training was done in all the LGAS howewr, frw cornmunities were targeted. Health Staff do give some on the job trainiry dur-ng &eir supervisory roles on other PHC activities e.g. Immlnization. This is not fulh inpgratcd. At the @urse of GDTI trainin& some comFonems of pFICare also discuss. 433. Joint supervision end monitoriug with otler progamr CDTI activities were also zupervised by other health offiiros from witrin the pHC deparrnent of the ministry during other health ativities. r !art!.'.r^ tUtf -. !r-_--_L^_ a,ua b E r a t E E E sEcTloll 5: strengths, weaknessell, chailenges, and opportunities STRENGTHS Yobe State Government has been financially committed to the Programme The Project has dedicated soCT rnernbers implementing the programme a o a The Project has enjoyed tenendous suppofl of the assisting NGDO and NocP. Their back seat sulrpot system to the state is highly appreciated as it makes the Project to tate full omership of the programme right from the onset. Acceptance of Programme by communities is a success indicator. The project in collaboration wiith her counterpart parmer was able to conduct free cataract surgery to people that are catanctbtinded (400 eyes were operated). WEAKI\IESSES o Lack of constant and regula frmding fromparhers o Untimely financial support from ApOC management. o Poor supervision by Locrs at community revel due to lack of adequate frrnding. o Unable to meet the dateline fo,r the submission of result and annual report for TCC meeting. CIIALLENGES . High ratio of CDD to poprlafion o Non participation of fernale in CDTI activities CHALLENGES ADDRE,SSED Continuous health educatiou mobilizaion_ o a o 3t_ tarrla\t t tW aa rr^. __t-- ^Ma G t sEcTloll 6: Unique features of the prorecuother matters Dedlcatcd and commltbd rtrlf et stttr lryc!. Gontlnuous support lhom llre grovemrDcrrt end other partnerc. Ability to t htaln tho Ptrof.ct vdrlctr fbr ovcr t{re O ycars Thls needs utgpnt rcplaccmcnt fior gnooor runnlng of th. profec-t THAIII( YOU FOR TAlOilG YOUR TIIE rO READ. L a Lat tlrtt^ra r -. at_---_L_ aMa tE