Plateau/Nasarawa CDTI annual project technical report submitted to Technical Consultative Committee (TCC): June 2002 to May 2023

.W# * * **,:;lii,fu ;,:t,;'ir,,*,il; : y,,,,, i.,1,,"y",, : | ":J,:):t * *t*,*,.g,t:ylJy($gl,tg,*,* NATIONAL ONCHOGERGTASIS TASK FORGE, NTGERIA t;) l-1 * ,.r! / 1 v.? J u).E *f 't ,1 r'l ,l /l I 1 /l .d 'tt & ,l ) .Dt 't .t I F .t /!, t:.iJ /|:j. { \I l /t\ Year being reported: (srt) FIFTH Ur\88 Yffi/rR TEGHNTGAL REPORT SUBMITTED TO: AFRICA$( E)$IGGHAMME FOR ONCHOGER GoNTROL (APOG) Fl'slsI fi.[.JGLrsT 2003 ,i i, t"'; l: ) , II ""'-7) t il i ( :t- l, it ) { ,i$ t:iy) ,.9 ,$$ rr?\t*l rJ)4 ri .z*hvr' l';) ,(* i,J trtJ Ii;} l.rlg(.rl yt iiv\ '\,/ ,,* 'r,J -i rl ,, ii 'Lr r l. " ir '*-ii I i., i .i I -. l 1l 'l t " . ,,t i 'I .:1) : I ,', ; '*ul, *3* COUNTRY/N9TF: HIGERtA Approval year: f ggz P RO J ECT: PLATEAU/NASARAWA Launching yeari 1998 Period being reported: JUNE 2OO2 - MAY 2OO3 Prepared on: AUGUST ZOO3 NGDO partners (s): THE GARTER GENTER. GRBP RECU I 6 stP, 2003 AP r\r'lnl R *.#,b *:) *':v'x| 4',4,r;3;, - - , u i: -', --i)r - ,L;, Table of Contents LIST OF ACRONYMS FOLI.OW UP ON TCC RECOMMENDATIONS SUMMARY SECTION 1 : BACI(CROUND INFORMATION J 5-7 8 1.1 1.1.1 t t.2 1.2 GENERAI. INFORMATION Descripliott o/ the pro.ject (ve11,bnefly) Partnership POPULATION AND HEALTH SYSTEM SECTION 2: IN{PLEMENTATION OF CDTI PERIOI) OF NCTIVI'fIES ORDER]NC, STORAGE AND DELIVERY OF IVERMECTIN NI)VOCNCY N ND SENSITIZATION MOBILIZATION AND HEALTFI EDUCATION OF AT RISK COMMLINITIES- COMMLJ NITIIlS INVOLVE]\,I ENT IN DECISION-MAKING CAPACITY BUII.DING Truining Ecltt iprrtan I and huntatt resources TREATM ENTS Tretttntetr I 'ft'atrel oItreu!tnanl crc'ltie't,etnent.fi'ont CDTI projec/ ittcepttotr lo lhe current year - SUPERVISION Supen,ision of ltculth personncl uchieyetl S'trpcrt,isiott of CDDs oncl clistribLitotls wus crchievetl Qualit.l, o[' records w.as ensurecl 7'he results of supen,ision were utilized 9 l0 l0 10 2.1 2.2 2.3 2.4 2.5 2.6 2.6. I 2.6.2 2.7 2.7, I 2.7.2 2.8 2 8.t 2.8.2 2.6. J 2.8.4 t2 t2 12 t7 17 20 20 24 24 24 28 29 29 29 29 SECI'ION 3: SUPPORT TO CDTI 3.I FINANCIAL CONTRIBUTION OF TI]E PARTNERS AND COMMLTNITIES 3.2 O'I'IIEI{ IJORMS OF COMMUNI-fY SUPPORT 3.3 COST I)IJR ACI-IVITY SECTION 4: S.USTAINABIT,ITY OF CDTI 4,1 INTERNAL; INDEPENDENT PARTICIPATORY MONITORING; EVALUATION- 4,2 CON,IMLINITYSELF-MONITORINC 4,3 SUSI'AINABII-l-IY OF PI{OJEC-l-S: PLAN AND SET TARGETS 4.4 INTEGRz\TION SDCTION 5: S.TRIiNGTFIS, WEAI(NESSES AND CHALLENGES 3l 3l 32 JJ 33 33 33 3s-36 2 APPENDIX APOC CDDs CDTI DHS GRBP LOCTs MOH NCDO NOCP NOTF PA PHC SOCTs SVE SPC LIST OF ACRONYMS African Progranrme for Onchocerciasis Control ' pomnr unity Directed Distributors Commr"rnity Directed Treatment with Ivermectirt District Health Supervisors Global 2000 River Blindness Program Local Onchocerciasis Control Team Members Ministry of Health Nbn Governmental Developnrent Organization National Onchocerciasis Control Programme National Onchocerciasis Task Force Project Administrator 'Primary l{ealth Care State Onchocerciasrs Control Team Members Sentinel Village Evaluation State Project Coordinator J DEFINATIONS i) Total population: The total population living in meso/hyper-endemic communities within the project area (based on REMO and census taking) ii) Eligible pop.ulation: calculated as 84o/o of the total population in meso/hyper endemic comrrunities in the project area. iii) Annual Treatment Objective: (ATO): tlie estimated number of persons living in nieso/hyper-endemic areas that a CDTI project intends to treat with ivermectin in a given )'ear. iv) v) vi) Ultinrate Treatment Goal (UTG): calculated as the maxinlum number of people to be treated annually in rneso/hyper endemic areas within the project area, ultimately to be rcachcd wlrcn the projcct has reached full geographical coverage (normally the project shoutcl be expected to reach the UTG at the end of the 3''d year of the project. Therapeutic coverage: nunrber of people treated in a given year over the total population (this should.be expressed as a percentage) Ceographical coverage: number of communities treated in a given year over the total nurrrber of nreso/h1per-endemic communities as identified by REMO in the project area (this shoul( be expressed as a percentage.) 4 f a, r 'r- te r-:rrt-:r rlerrter J,_,s l.l r tertl Fr_t): t.ll_,. : 2l.i 7:= 4-_,C1Z)r_ Feb,. [1E, 2-]r:14 11 : ..]lHt r RpsPoNsE To TCC 13 & I1COMMENTS ON PLATEAU/NASARAWA PROJECT 1, COST PER PERSON TREATED IN US $ FOR THE YEAR 1998/99 - 2001/2002 YEAR COST/PERSON INUSS APOC CID 1 998/ 1 999 276 3.18 0._i -s 1999t2000 94.516 46 322.71 140.899.77 788 939 0,r8 2000/200 I 90.828 3 8,4 1 8.80 t?9.246,80 961 0.17 200 I '2002 85.069 0.15 NOT AVAILqBLE {.YEAR ENDS 31 MAY,2003 2. NATT]RE OF 9 LGAS NEWLY PROPOSED FOR INCLUSION FOR APOC SUPPORI . These LGAs havc scattered pockets of h1,po-endcnric villages an<i',vith as f'ew as one (1) to tu,elve 111; villages tltat are uresoendemic for onchocerciasis, They have been on CIinic Based trcauuent lpassivc) witlt ivermectin while the tlesoendenlic foci irave been on nrass treatnlent fbr 7 to 8 ycars no\v. l. hesc LGAs arc aiso lyrrrphatic filariasis co-endemic anci have been on urass combined tleatment lvith .A.lbendazole aud h'ermectin for the past I to 2 y,ears, We are therefore. withdrarving the se 9 LGr\s irorn thc Otrcho [st sirtoc they are adequatelr covered und.er the Llmphatic Filariasis EluurnaLron Ploqrarrrme irencetbrth. 3. EXPLANATION OF RETREATMENTS This activin'was necessaty to harnronize treatrnenl perio<l with the "choice tinre" of tlle ctlnurrurrtie: Thev u'ete treated unth a lot oldifficulties sulfered by the clients/CDDs aud supervisols Lrecause tlrc last neamellt was rn the peak of the rainy season. We also thought it wise rather tlmn to clelay'therr treatlrent by six tloths, they rvcre letreatcd six nronths earlier to the date of the next treatn)ent. Drrin! the iiear 200112002 things wcnt quite srnooth in these villages whcn we treated them in the dry scasor. A D BXPENDITURE PERSONSTREATED (B) 86.3 19.41 657,211362 667.41 54.073 90 13e,142,90 917,160 m02i2003^ 1 .50,000 45,949.| J95,949,11 "oN GOING" -5 I GRBP(A+B=C) 64, RI,VISIiD ATO OF T}IE 9 LGAS ARE TO RI,MAIN UNDER APOC LIST In the light of #2 above all demographic data in respect of the 9 new LGAs are being reported to the Lyriphatic Fi lari asis El irnination Program me (LITEP) 5. THE IMPACT OF LF/SCHISTO PROJECT ON CDTI The cornbined treatrnent for Lynphatic filariasis, Schistosomiasis and Onchocerciasis in PlateauA.,lasarawa pr6ject has sliown sylergistic benefits among which are: - Increasing enthusiasm by community mernbers and LGA officials - High level of participation and ownership of the project by LGAs and endemic villages - Irrlprovcd treatnretlt coverage - Integration oi PIIC acrivities and horizontal capacity development of various health workers. ANNUAL TREATMENT SINCE INCEPTION 7. REPORT ON SPECIAL ADVOCACY WORI$HOPiRETIREMENT OF FUNDS This rvas sent to ApOC Headquarters tlirough NOCP Nigeria, immediately after the workshop by Dr. K. Korve. 6 YEAR TARGET ,l VILLAGES COVERED VILLAGES TOTAL POP. ATO POP PERSONS TREATED 1 992 502 502 335,540 271,908 217,289 1 993 888 809 643,234 514,587 484,175 1 994 960 939 665,747 532,598 448,521 1 995 960 951 675,204 540,1 63 536,427 1 996 960 960 735,460 650,000 564,731 1 997 960 960 789,801 650,000 689,254 1 998 885 885 876,250 685,000 653,908 1 999 BB5 885 915,993 700,600 657,211 2000 885 885 986,1 74 699,960 788,939 2001 BB5 885 937,572 711,030 761,690 2002 885 832 1,146,450 1 ,103,763 917,160 98. INTENSIFY ADVOCACY FOR STATB/LCA COUNTERPART FUNDS RELEASE. Several advocacy visits were made to remind the States/LGAs communities to contribute their counterpart funds a s p er t heir b udgets/agreements b ut w ere m et w ith a c onstant p roblem, b ecause most funds went to security maintenance as the trvo States hacl a long period of unrest during the year 2OOIl2OO2. I{orvevet'the communities still supported CDTI with N41 1,822.00 inZOOZas against N517,392.00 in 2001 . EVIDENCE OF INTEGRATION WITII CDTI: . cDDs are involved in other programmes - LFlSchisto, EpI activities ' APOC vehicles/equipment are occasionally made available to other sibter project and sirriilarly other projects do augment CDTI activities at peak time or during brief breal<down etc. o Monitoring & Evaluation oflficers work hand in hand with oncho fie]d staff (LoGTs/DHS/HFS) on collection of field summaries and census up rdating. oncho field staff are also involved in EPVLF & Schisto activitie$. Other health staff at the conrmutlity level helps with health education and mobilization for CDTI during anti- natal vrsits/cl inic sessiorrs. 7 EXCBCUTI\/ E SU J\,I MARY The inrplernentation of CDTI in Plateau,t{asarawa States started when APOC's letter of agreement was signed in April'1998. Tlie CDTI project in the fifth year still maintained the $a tZ LGAsinitially approved by APOC (In Plateau State: Bassa, Bokkos, Jos East, Kanke and, pankshin. In Nasarawa state: Akrvanga, Karu, Kokona, Lafia, Nas/Eggon, Toto and Wamba) with a total of 885 nresoendemic viilages Activities carried out in the year under review are .1. 5'l'year APOC Evaluation .1. Aclvocacy visits to LGA chairmen and community leaders * Mobilization and Healtli education .1. Mectizandistribution * Monitortrrg and Supervision, submission of treatment reports and drug balances. * Training The project treated a totztl of 1,043,572 persons representing33.6% total coverage from 866 villages(97.8%) for both oncho and LF during the year (June 2002 to May 2OO3). This treatment was carried out witlr 3,127,393 tablets of nrectizan out of 4,213,030 received by the project. In addition the project was also able to treat 181,856 out of 367,063 total persons from 435 non-oncho but lymphatic filariasis endernic villages irr both States. (See table 15), A total of 545,563 mectizan tabietjwere used for the LF only treatnrents abo'u'e. Training was carried out targeting those joining the CDTI process for the first time and on stakeholders nleeting (see table 7 a &b) Mobilization was carried out in 866 villages representinggT.S% of our target of 885 villages in the filth year of CDTI. The villages (866) sltowed high level of commitnrent to the programme by giving incentives to l40l CDDs anrountitrg to N1,532,454.00 ($12,259.63) an average of 1,094.00 1SS.ZS) per CDD.Mobilization, healtlt education and advocacy activities were intensified on sustainabiiity effort, owrrership and Stakeholders meeting. Major constraint drrring the period u'as lack of payment of counterpart fund by both the states and[,ocal governnlents, towarcJs the inrplernerrtation of GDTI in the states. (* Populatiott in tlte l2 CDTI l-GAs u'ere not stable during the period under review due to influx of people fi'ont conflict areas borclerirrg thent. In aclclition the combined treatment for Iymphatic filariasis influcnced tlie turn out.) 8 SECTION 1: Backgroundinformation 1.1 General information 1.1.1 Description of the Project PlateauNasarawa states are located in the Middle-Belt of Nigeria and bounded to the South West are I(ogi State & Abuja FCT, while to the North and North East are Kaduna and Bauchi states respectively. Bcnue and Taraba states are to the South and South East respectively. The people of tlie state are predominantly farmers living in scattered rural settlements with most of the roadi leading to strch areas mostly un-iarred, rough aird sometimes not motorable due to flood and lack of culverts and bridges. Also, the rocky nature of some LGAs has serious impediment to effecti ve trarrsportati ort. The state enjoys two types of seasons, the raining season, (May - October) and the dry season (Nov. - April). Most treatnrent/distribution activities in the state are preferably carried out dr.rring the dry season wlren nrost fa'rrners have less to do irr their farrrrs. APOCfinancial as.sistancetothestateCDTIProjectstartedinApril 1998. Theprojecthascompleted its fifth ye.ar (June 2002 - May 2003) of APOC assistance. In the fifth year, the project targeted to treat 1,O83,522persons in 885 villages (Table 6), to train 625 personnel for CDTI activities and to nrobilize and carry out health education in 885 villages. Other activities includcd registration for ivernrectin treatment and village participation meeting. During the year 866 villages (oui of 885 villages) had their l0'l'round of treatment. Treatment surhmary forms slrows tlrat 1,043,572 persons have been treated out of a total population of 1,247,997 persons. The state rninistries of health/LGAs supporled the programme, staff salaries were paid and efforts to ensure that counterpart fund for the project is released is being pursued. Please Note that the project areas population had an increase of 218,263 people from internal retirgees from conflict zones, 1.1.2 Partnership The principal external partners to the project have been APOC, GRBP and MSD. Other partners are, NOCP, Plateau/Nasarlwa States, the twelve LCAs, and the 885 Meso-endemic villages. The States are the Implenrehting agencies and their rnajor roles include Planning, Manpower developnrent, Aclvocacy, Procurernent of IEC materials, Mobilization and health education. APOC/ GRBP provicles [unding/technical assistance to the project, advocacy to high government hrnctionaries, procLlt'en-rent oI ivermectirr tablets lrom MSD and development of Health education materials. Othel partlters irr CDTI are commLrrrity based organizations e.g. Road transport Workers Upion, Churches ancl wonren organization e.g, women fellowship (Matan Zumunta), their roles range fi'om transportaliort of ivermectin to Mobilization of the people. 9 1.2. Population and Health System The PlateauA'.lasarawa States' project operates rvithin two autonomous states with a combined total landntass of 58,585 square kilometers and an estimated population of 4,449,234 persons. The two states consist 30 local government councils (LGCs)/local govemment council areas (LGCAs) (see niap). Trvelve I-GCAs with 885 villages constitute the CDTI project irea. The estimated population of tlresevillagesstands all,24T,99Tpersonsbeinganincrease of 218,263 personstotheprojectareas fron: conflict zones irr the States. Plateau and Nasarawa states, which prior to 1997 were one state (PIateau), have been on mectizan treatment since 1992. The Plateau/Nasarawa states health systern is structured in'such a way that each LGA has five Prinrary healthcare tlistricts usually referred to as referral centers, and is headed by District health supervisors. Within each district are healtir posts or Centers headed by health facility staff (HFS) who oversees the activities of certain number of CDDs within their catchments areas. See Tables 2 & 3. on popr,rlation of CDTI LGAs, l0 -l o b.) !)ta a A) A) !9 o!) (n (D !)aa t? U)(n -lo Fo oI -+)' o i o. a f,. o (u r<o a DJ U)o o. o o o xo o -t -to s -c a t9 N.)5j-J \o\o{ NJ5! \J\o{ z o - U) -l C) a o o (D r1 o o. o -t €. oo, rD --l D) o rJ OJ o +) o -J o J cD U) F,) oaoa -l FJ ;i +) o J o. U) >t o a - q.) a (D F t'n?t>c El CDa a I 0c -oNJ, g' t- 0a (-/) o) o i to o o o- VI o -o o UJ - CN z o -1 ^\ t- -l rr, 2 a F (, (D El !) o SECTION 2: Implementation of CDTI 2.1 Period of activities. This report of CDTI implenrentation is from June 2002 Io May 2003 (twelve months). (See table 3.) The project in the fifth year targeted to mobilize and health educate 885 villages, and to treat 911,278 persons, train 625 Personnel for CDTI activities in PlateauA.lasarawa. Other activities included iegistration/census population, community self-monitoring of CDTI and stakeholder meeting. Most of these activities were carried out between January and June when farmers were less busy. 2.2 Ordgring, storage and delivery of lvermectin Mectizan orclered/ applied for by I\4oH[ ] WHo{ } UNICEF{ } NGDo (o) Mectizan delivered by r\4oH(o) wHo{} LNTCEF{ } NGDO{ } Quantity of Ivermectirr Required for year 200212003 NB: l9 villages havc relocated outside the project area. Mectizan tablets are usirally ordered by the NGDO and collected by the state for the twelve LGAs Mectizan requirenrent is being estirnated based on eligible population from the census figures. When mectizan tablets are rcceived by the states, each LGA is informed either by letters or Radio Messages to corne and collect their allocations based on their eligible population. 2.3. Advocacy and Sensitization The Project Director, Administrator and the State Coordinators canied out advocacy visit to all the CDTI LGAs, TIre main focus was on the issue of sustaining CDTI in their LGAs by,paying their 'ollnterpart firncl, Most of the chairmen promised to contribute their quarter by paying counterpart rnd when thgir financial position improves (see surstainability table I I & l2). ectors PHC at Statc & LGA levels were also sensitized and mobilized to own CDTI as a primary cnsibility. -l-he DFIS and I-IFS were all involved irr the mobilizatiop at village and district levels were always supported logistically and financially to move around from the APOC/GRBP es etc. t2 Cr Number of ivermectin tablets required for the period reportcd 4,213,030 Cz Nunrber of ivermectin tablets received by the Project 4,213,030 Cr Numbcr ol' communities/villages wliich collected drugs froni clesignated point of collection 866 Villages q) >> 6) '>e Oq)9 Ee) .rE cq6 F n FE + il I ral co$ oo \oO (r) o\(-- od$ (r) F- \o cO t-- c\ t-- co 00 ca o\ (r) h q) LIN9s, >rtr ;Ji e) q) (ir o cg o -t I q) '(t q) oo ^N U)q) FTa c.i =l: CO \o rn tr- oo .f, ta)(-- O" \o co tr- r- @ o\ a t) o\\ort q,) - g 5^l .= 3Nt< - ?zti-cq1r.-;! > EH .o;Hll - Eid loi t-- co @ co tr- cO\o \o o\6l qJ c)l=0)36 E^l -E I -F=N] -Li qJl O (t) o) 00 0q) I q) z (J s'E g0)g oc0 > ENo O tr- aO @ ca\o (r- cn\o \o o\6l t-t ca$ oo \oO (].) 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Treatnrent 2.7.1 Treatnrent ligures Tlre Platcau/Nasarawa State CDTI projcct rvas able to achieve the lollowing during the fifth yelr thus:- Coverage '// Total Eligible villages 885 '/ Villages covererl 866 (See table 9 a & b for details) .lB: 13 r'illages relocated outside the project area, u,hile some 218,263 persons migrated into it during tlre period under review. 2.7.2 Cornment on coverage Rcgistration and treatnrenl ligures changed lrom l,OZg,734 population and 9ll,Z7B eligible poptrlaliorr to l,?47,997 populatiorr and | ,083,522 eligible population because of an influx lronr corrflicl areas. larnters itre cxhausted after conring back lrom their farms and therefore, they prefer to be treateJ at honrc either in tlie momings or afternoon. that corrr;lletccl trcatntent Lo ensurc that tlrey are treated. '2.7.3 Trend ol'treatment achievements (See table l0). 24 -l -j l. 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"u. \o5 oa co N) Aa> :.D 3 ;: t :'a D ^l- o5(, Ur{N -IA 6(,l\o co o\ A \o @ t.J 5 \o ! \oo\ t\) Lh "(, N) o\ \o5 v Ji /.6c ,/ =a;r$c € UJ o\ s 0pI5 s @ o\ co o)I oaN) V) oo)J{ coAi, "7Sq! gQq iao> b..)5 z z Z 7 7 Z z z -: ,l--Ciiti= = z! a *X- 3r 4- \o o\{ A -t ! NJ (}J N) NJO A o\ 6 (,{o -l 5\o\o NJ\o oo ,9r hJ@ \J f.J -a,E:.i F= E E ia* a-n4a -Iaa3o a l'- 0= a^ z t z z 7 v = z = z z c-!6;6:Z IO, q E.E: ==fl.;.-=.=-nEet':3:i : =rlEva N) o\ N) NJ N (JJ N.) N) NJ NJ N) v\o\o N) \o\o oo \o \o o -t co @ @ oo @6 @oo o 3 rD(a) A) (r, ^ (J :i- +*. j -i '-:u,-.)a I Y -:-o)o J+<- ^- 17 = -- :llp J 'r 4 -u-4, .DTDlJ:t)AUi@o q ,o- .d > a=) oi:l;=C7Ac) r)OryaZ- -21--i i.< =lD'lD c = ^'oa = ;iX r! -.-i o:q ?.oerD 30a D^i n+ rc O a\ A) -<Pt: rtJ rJ iJ L.,0a ? .T. l! (, + * @ oo 6@(Jl @ oo(rr \oo\ \oo\ oo @(.rr @ oo @ oo(-r! 6 @(/l @! N) oo @(-h oo @(Jr 6@ \o oo (J, s O o\ '.oo\ 90 s \oo\ \o6\ \o \o -J5 "o. O oo -J! @\oA U.) 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() f) ri r) A' z td (, 0qoo o o !, t!o o o do l,i( o zt,U) A, ''l D9 !9(/) D' (D r (! o o o At t.)o c (,) N) -J Fi l-aa \-) 8Eilu, ua =' '7d o-oloc 5eaO) ^a aO l,/) o o = o -J >z q N('! o- >z ia N rD o- ! 1 Ut s.* ->z =o 9r N o- lP /- N o o- N ll ,f 3\ '=' z Z.a a'a J.L r!c =q@4 :oa ft; A) .D !9 oa (, >z N o >z N .) tJJ (, \o >7 ts N o >z .z' N o o- x A II tJ\ UJ o * I -t | -r- I a9 lc a'aE;9 a-e dg=. -- i; o< q= r.DZoe o, a @ >z N cD o- >z N .DO. e) O @ (^F (, ur(, o >z N o- >z N o o- (J 3Z k3 = X6 {It b.J s >4 !J+q No o- >z N o o- { i.) s -J II o, + -I (D 6 A b..)@t, >z N CD 5 NJ @ >Z N cD o (D G CD €(,r >z N CD >Z .T No @ D) 6 rl - i FJ z a >.l A' (! o l! A9 o A' o. o o A9 o o (D(, a o ot) tDt, A' t) z - D) (? (D 'l D9 oa(D o D9 Fl oq11 (n (, (D tD D9 N(D El o a D) (D V) l..J@ 2.8. Supervision 2.8.1 Health Staff': LGA Level The plateau/Nasararva CDI'l project is so designed that at each level there are experienced staff to carry out supervisiorr. At the state level, the SOCTs supervise the activities of the LOCTs rvhilc the LOCTs supervise those of the DHS and HFS. All the LOCTs are provided with Motorcycles to lapilitale supervisron. Communitl,Level Tlre DIIS arc nssigncd Fivc P[-{C centers, rvhich serve as collection centers for Mectizan and thcsc collcction centcrs arc lrcuclcd by HFS rvl-ro supervises the activity of the CDDs. During supervision Community regrsters are checlced to ensure proper recording, drugs are checked to ensLrrc that,they are adeqrratc, also questions are asked about CDDs incentives. 2.8.2 CDDs Each CDD collects Mectizirrr 1l'onr a Health facility of his choice after Community registers rnust Irave becrr updated. trligible population multiplied by three estimates total Mectizan required. Each CDD has cornnrrrrrity rcgister rvhere information on households are entered. Conrnriurity leaders/Health Conrrnittee nrenrbers nronitor/supervise the CDDs on daily basis. 2,8.3 With close sLrpervision at cach level records were properly kept and mistakes were avoided Results of supcrvision are Lrsetl rn addressing problem areas to prevent future occulTences. 29 Nq o\ o\ oo^(r)\f, u9 q-, a7)9 o\ |. c\ N @ O O\n ea q) IA c(OA v." at- F J z oo \f,, o\ a.l 'qo\v @ aa aaF 6 cn ta) C-l N a, rn N\o^ ca\o(A m o6l 6l Orl 6l 2 0) lr') (! q) qJ b!^ PCtaa 6l oF O c1 O. aa I-* a \J t-- o. c.l @ o\\o t', co @ ! q,) 6l c,)- ?a (!v ,oF J z q aar- .t a, C! 09 @ (A \o F- A c..l FA o\ ,r1 \a) oo @ q o\O. a r/-) ca o\ (A C.l a). co (A a.l e al o 6l dt ?- 0) v GIq, q) 0)o0^E@ =ar0= 6t oF C\l @. @ v1 (A co c.] oo^ o\IA \o n\o c-l .1 EA O oq oo t oo (f) U a? \o .a (A ra)q o\ t--- \c qa O r.n 4 6l oq @ tr) QO \o o\\o 4 c, GI :a9.u) d- oF c) q,,0!^Aqlao G oo od @ @ oc .\l oo +\l 6l A rn filq) E ft a/F L) a , 0)t Ld o- o t-J O Z. q-) F a OJ () l- tn tn 4) () L L oQ (s 0-) o Lh* =e t) t) ta c! q) o t,q) o(J E G t, q) c, qJ o t, o ,o oa C! o (g lr 6l q) 6lF a z ldF J SECTION 3: Supporr to C'DTI. 3.1 Financial contributions of thc partners and communities. During the period uncler'ret'iew anri the past years, Support to CDTI by ApOC and GRBp has beenquite satisfactory. But the Statc and LGAs are yet to release their counterpart fund due to lack offtrnd, In Plateau State. a merlto of 2.5 nrillion was sent to the Govemor for approval but this is yet to be done, while in Nasarawa stale govcrttntent has taken steps to deduct at source counterpart fund forLGA. A total sttttt of N729,230.00 was contributecl by 866 communities to support l40l CDDs in the twelve CDTI LCAs. (See table l2). The projects need strong advocacy to the governors of the two States by Nocp and GRBp for theState to releasc its counterpart funcl to tlre project. 3'2' In botlr States ntost of the incentive lor CDDs are in Cash except for some communities who dtrring tlre distribution period provicled food and some drinks to bDDs. 3.3. See Table l3 3l a.l DI I oq) O. c0 d, O U o O" u< cq O cq& ()(J r a cq r',(, U o 0- cq d.(,(, - lJi O. cq d, O l) o A. cqc(, \,c or (,) cor- @(A a C) ) E O No o o L' N z. Z E 0)o o o ri 'e lL2FE z5 4ot(*oo ,:F a59o C).Y .5 308 o3 r- ca ca(A [n a'l v €(\r ro c.) v7 J F F .f, r- (n th o a d O o- d 4) U) tt O o aa r\ oo" oltn tJ') C) O ot Fc b/) d r 0) oo(-- i @ ol Lh l- '5 = -o i o E a L-.] I-] a o a '- o a cn$ s(A rn6 0) (! (d Cd a q) o o0 LF (h L.] o(-) o o0 tr ,= t-F () Lq) q (, i, Cq U) z D F J ll. SECTION 4: Sustainabilitl, of CDTI 4.1, Monitoring and Evaluation. Tlre prolect is nral<irrg steady progress toward sustainability. This is indicated by the commitnlent o[. vartotrs cotlllltLlnities e.g. provision of incentive to CDDs, collection of Mectizan lrorn collection pornt of their choice and selection of cDDs Tlte evalrtation of the Project in the filth year to determine its sustainability was held between Febrtrary' 1-5 to March 3, 2003. Reports of the evaluation shows that thi project is moving toivard srrstai nabi I i t1,. 4.2. (-'omntunitl, self-monitoring Most villagcs itt'c )'ct to carr'\'oLrI cornnrLrnity self-monitoring of their programme, however cottrlltttnity nlembers especillly'r'illage cleveloprrient chairmen uni uittuge heads do sultervisron on regulal basis Stakelrolclers lreetltlgs were hclcl in 522 t4llages cluring the year. The attendance at such mcetings were quite encoltraglng. 4.3. I'}r'oject sustainabilitr'. 1'lre pltrteatr CDTI projcct is irr its linal year ancl plans are in top gear for the 6rh - 8(h year,s budget to enstlre that the prograrnnle will continue after APOC funds cease. These plans incltrcle high-ln'el aclvocatcy by the NGDO and NOCP to persuade the govemment to releaseftrnd lor programltre activil.rcs at both state and LGA levels to thii end a mbeting was sclledrrled wrth LCA chairlre'tt b1'the Conrrnissioner Ministry for Local. government and clrieltaincv al'ftrirs on horv to gg[ 6e1l11teqtart lund deducted from source. 4.1. I ntegration l:lre CDTI programrrc is ltrlly'irttegrated in the health structure of the state ministryof health alrd that of thc Local gor,'crtrtlent, This is eviclenced by the fact that all staff involved in the Progratrttlc cottrbitte othcr aclrvities u,ith CDTI e.g. immunization and treatment of minor cliseases. attcl provisiott irt tltc hcalth budget are madJbut not released due to lack of funds. 33 !bo 0? .o) zu) N o\ o\ r-.f Nt-- Nrt (Jo 500E'o.Etr0,)tr ^L=ULE Z J z ,.] z 'lz '.]z t-l z .l z -l z J z 6.J q) 00 15 *\9- E'rr^,c.9 >rtr!siF-O.-C " '3q J (J aa (..l o\ 3t- V (--. sf o 'lzoV Nr\ (dJ oo o\ o oF rn @ (c .o u o\ € lr.) '] F t-r rf, t U) Z D E]F o) o o E I =oa .E E E oo C') =G oa o. rt o E(!l- !0, a '!:'i '-c)E U UT Z 't' .{' F- st N r- a.lal IG '980o tr E'l- =oo EE'E STE E(J Z J z J z -.1 z J z J z '-]z ca @ t-- U)(., . OO :1 u) r-- +0JO= >,L * >E cq -qoad. u q'=!E9ts;'; ts* ' =orIE i5 a,' (J U) t-- aa c0 a vV c0 co v F(A El(n o rr.lv z u Z U)V z. aa \o N J F F SECTION 5: 5.1 STRENGTH, \},EAKNESS AND CHALLENGES: Strengths ;[:?JIffll;X';,:';#]ff;:]?;fl:ff;Ie wishes to observe the rouowing srrengths or dcspite the stril<e actiotl ancl lack of payment, oiruiuri., for months by their LGAs. 5.2. Wcal<ness / Constr.aints posed a sc'ious treat to cD'il s,stainabirityin trr. rirt.. 5.3. Assi.stanceNeeded a. Statc Government/I,GAs il]::;" attcl governors of thc states to press for the release of counteqpart fund in the years b. NOTF/ApOC Managernent : Advocacy r,isits to state go,er-n,tc,t a,d MOFI and LGAs. i. I{eplacenrerrt ol2No 4 \\/D vehicles ancl l2 motorcycles. C. Challenges: ' l]n,tl,ijl"r srare*'icrc srr.ii<cs thar srorved suppries and commencement of drug s1'mpathizcd with the cotttnrunities needs. bccasionaily state staff had to communicatedirectly u,it, co'rnrunities to a'oicl r*."*iu.i.;;;""*,' -15 d. Conclusion/Future Plans:- 'i Conrmence cornnrunity self-nrorritoring to 30% of villages. 36 a E]F ri&t- o z U) td O F-$ ( O \o m € tn \o l,n € € z F J D O O $\o $ v\o !+ ?a\o 6f-\o m at! IJ lr z rn rar+ .l cd b0 JZ LV o V (0 I (.dJ o a0 bo E] z op oF d ,? 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