Kano State: year 3 CDTI activities report

04 AFRICANI PROGRAMME FOR ONCHOCE,RCIASIS CONTROL(APoC) Year 3 CDTI Activities RePort t i t I I f?n- ,1. r,-4 U: f-rL-- -- - I To: (sl) C ev. coP f,: i'l f. i-; For lnfcrmction Tor 3ri Eur+- LA rL.CL :l- ';lrr IrloL Dambatta Bichi Bagwai Shanono Ajingi KaboGwarzo Gaya Wudil Rano Bebeji Karaye Takai Kiru Sumaila Tud Doguwa Kano State Nigeria December 2001 EX VE SUMMARY Kano State is situated in the northern part of Nigeria' The State has 44 Local Government areas out of which l8 are Meso endemic with few hyper-endemic foci' The State falls in the Sudan Savannah and Sahel zones. However, the endemic areas are generally located in tlie sudan savarurah. The terrain is flat or undulating with some major rivers such as I{ivcr K1rro, lliver 'Lungur and Challawa and theil tributaries' There is obtained a large irrigation scheme in the project area (the Kadawa scheme) which covers an extensive network of irrigation channels. These provide suitable breeding places for the black fly' Iverrnecrin Distribution Programme (IDP) started in 1996 with cBM assigned by NOCP to assist Kano State in the control of onchocerciasis in all the endemic areas of the State' 'l'he CD'l'l approach began lully in January' 1999 with the arrival of APOC funds after tbrmalapprovalinSeptemberlgg8.Theprojectistherefore,initsthirdyear. _t tlelow arc thc troatment figurcs for the period of 1996 to 2001 Sum ma rY of M ectizan treatmen tbv Year YIinl{ 2001 Theprojectlrasanultimategoaloftreating390,000ruralPopulationwhoareeither knowntobeinfectedoratriskofinfection.Thisgoalcanonlybeachievedby cstab'shirrg a, ellective and sustainable community Treatment progriun in all the endenric areas of Kano State by the year 2003 I'hc lrl lc systcnt of the Statc and I-ocal Government Areas have pr()qramlnc.andareirrvolvcclitrsupervisionandarealsoservirrgasthe o1' thc Mectiz-an drugs for collection by integrated the chief custodians the CDDs ?b .IREATMENT 108,837 209,1 35 1996 l99l 241,518 l 998 250,097 1999 340,497 2000 368,29 SE ONI BACKGRO NG INF RMATI N l.l CD l-here are approximately 775 endemic communities identified in the 18 targetl,ocalGovernmentAreasinKanoState.Thesecommunitiesare determined by households under the leadership of a rccognzed village head andorwardheadwithanestimatedaveragepopulationof1000to3000 persons. The households in these communities contain an average of 5-10 personsperhouseholdbutwithsomeashavingupto20-30members. 1.2 Eu The following are the treatment rounds for each endemic Local'Government area DISTRI BUTION ROUND MENTLOCAL GOVERN AREA NO 6Do waI 6Tudun Wada2 6 3 6Kura4 6Garun Mallam5 6 Ga6 6 7 6 Takai8 6 5 Sumaila Gwarzo () l0 5il 5 Rot2 5Kirul3 l4 5 5 Madobi Dawakin'fol5 5Dambattal6 5 Kabo 5 Makoda t7 .> lli SECTI ON II CDTI TABLII I [)i strt ct lt.G A 20 to IIMPLE ENTATI N No. ol' Comm/ Villagcs No. of Comm/ Villages paying CDDs in cash or kind. No. of Comm/ Villages with trained CDDs No. o[ Comm/ Villages that dccidcd on the mcthod of treatment No. ol' Comm/ Villages that dccidcd on Month(s) of distribution No. ol' Comm/ Villagcs that collcctcd [)rugs No. ttl' Comm/ Villagcs 'lhat sclcctcd CDI)s 3l S/N 808080808080Doguwa 74I 188lE8188l8EI lt8lE8TAVada 30z 373731373737Kura 293 353535353535(i/Mallanr 2447474't474141llctr.lt 6l5l5l5t5l5l5(iaya 9.i, l l4l4l4t4l4t4Ajrngr l61 3l3l3l3l3l3lTakai 2'18 383838383838Sumatla 409 5l5l5l5l5l5l 28(iwarzrll0 474747474'l47Kabo 29il 535353535353Karal'c l4l2 2323232323 2337l,] 373't3731 23 JI K rru Madobtl4 l9393939l939 t0l)/l olar5 2727277'lz7Datnbatta 3l6 7't 1'l 2Ilogo 6t7 6666 39sMakcxla 775llt 7757757757751'OTAL SOURCE: KANO srarE OXC HO UNIT -l'hc Comrnurlities in our project prefer receiving treatment during period when there is Iess thrniing activities, and this has been carried out according to their wishes' making the cornpliance rate for the choice of distribution period of 100%' .I-his table however we think, requires review by APoc management to fashion out htter i,dicators tliat could allorv prcrjccts share expcriences in divcrsity' Atrvhatpcriodwillaprojectconsiderthistablcappropriatelyansweredbytheproject, bcirr.inu. in n-rilrd that this rcport covers a period ol-one calendar yoar, which could allow c(),,rnities that could not conlply initially do so afler some education and mobilization' { 14 7 6 7'15 LE o ST v L INTNG O D IMPL MENTA ION 2.1 T ra i n ing o bi ect ives/ach ieveme nt In this third year of GDTI implen'rentation, different training activities took place.'IheassistingNGDO'NOCPandtheMOHofficialcarriedoutthe trainingofthesoCTandtheLOCTwhilethestateandtheLGApersonnel trained the CDDs at the various training centers close to the communities' Thetablebelowshowsthetargetednumberofpeopletobetrainedandthose actually trained during the period under review' PBRSO NNE L TRAI NING IN PER AGB.CDTI o//o COVERAGE ACTUALPROJE CTEt)PERSONNELS/N ro0%99SOCTI 94%4851LOCT2 93%348373PgC STAFF) 97%40711,453CDDs4 96',h1,8L21,886TOTAL ( J 2.2 'fhe matcriat used during the training and retraining were the training manual for CDTI' ODD guide. brochure translated into local language (hausa), Oncho flipchart' posters and lonns that were provided by APOC funds. The use of hausa as the main local language of comnrunication has been fully utilized in the training of the cDDs' 2.3 Performance of CD,DS The pertbrmance of CDDs in their respective communities indicated a good increase tn thc levclof understanding, of their roles in the program' More cDDs were trained this year particutarly fiom satellite communities. This reduces workload of the distributors' 2.4 ,l.hequalityoItrainingneedstobeimprovedupon,withnroreemphasisonthe communitiesrolesandresponsibilitiesandcorrectregistrationbyCDDs.LOCTmembers shouldbeencouragedtoassulnetherolesoftrainersintheirLGAs.Thoughtheliteracy levelisvery[ow,differentapproachesshouldbeemployedtogetCDDstocomprehend tlre recording forms. It is inrportant to note that maintaining quality of training may be difficult because of the caliber of cDDs selected by the respective communities whose literacy level is low' 6n Development of lraining material used Table II t"ltAl ING DI R LE LS TOTAL SOURCE KANO STATE ONCHO (JNIT ST lI.rtheycar200l,fflzuryoftliesatcllitecommunitieswereabletoselecttheirCDDstobe trainedtodistributeMectizandrugstothem.Thisaccountedforthehighnumberof (.1)l)sr.ccorctcdintlrercport.grcaterthaninanyofourreportsinthepast. .l S/N District/ I-GA Doguwa T/Wada No of training urrdcrtakcn (LOCT & CDDs) 3 No. ofTOT trained (socr & LOCTs) 6 No. of District or LGA stafftrained in CDTI No. of Health centres/Post Staff trained on CDTI No. ofCDDs trained. Target 4 Actual 4 4 Target Actual Target Actua I l6 28 2l 23 236 206 r90 I 206 2 J Kura 4 4 l5 l6 140 140 4 G/Mallam 4 4 t7 23 t8 23 108 157 108 157 7 8 Bebeji Caya A Takai 5 3 3 4 ) 4 --) 2 2 ) 4 2 t7 l9 23 t0 l9 24 29 34 39 46 75 34 5l 75 9. io t2 l3 t4 l5 Surnaila Crvarzo Kabo Karaye Kiru Madobi D/Tofa J 3 3 J 2 2 2 4 3 ) 2 2 2 4 l8 t6 t4 2l t7 30 22 20 l8 t2 l6 31 l4 55 63 34 88 4t 62 50 55 63 34 88 4t 57 50 l6 t1 r8 Dambatta Rogo Makoda 3 3 2 2 /) 2 2 2 5l 2 2 2 48 20 20 l0 354 l8 t2 346 7 t2 I 453 7 t2 1407 r 4 5. 6. ll MO II,I TION ND ED TIO OF TA CO 2.2.1 Tha use ofmedia ln M The state commissioner for health and other officiars of the ministry carried out advocacy visit to sorlic l,(jAs during the period under review and such visits were given media publicitl'.llcwasalsoinvolvedinacommunitymobilizationcampaignforCDTI inrplcnlcrltat ton 11', Ot h e r Mo b il izatio n e ffo rts' Commurlities wcre fully mobilized using the following strategtes: Traditional and religious leaders Face- to -face d iscussio n with co mmunity members Town criers mobilizing community members 1)7 Mobilization activities have been quite satisfactory resulting in successful acceptance of responsibilitybycommunitymembersandunderstandingtheproblemfromtheright point.ThisisexpectedtomakeCDTIasustainableproject.Thereactionsofthe conrmunities were favorable and positive to the CDTI strategies' This was noticed by the IevelofitrvolvementofcommunitiesinCDDselection,decidingontimeandmethodof clistribution and high mectizan intake by eligible people. It4 llcsltonsa o-{' lhe communil ies TABLE III MOBI LIZATION SOIJRCE: KANO STATE ONCHO UNt't T 3 involved in Mobilization. No. SaffNo. of MOH $affinvolved in Mobilization No. ofAdvocacY Visits to State or Rcgional Dircctors of Health Commfy'illages that rcccivcd Hcalth F/ucation about the imJnrtance of cxtcndcd trcatmcnt No. ofTargetNo. of Communitics and Villagcs mobilized Distrrcl,/ r.(;n 54 54 80 r88188 80l)ogttwa lTWa<il SN 2 543737Kura3 543535G/Mallam4 I44747Bebeji5 IJ4l515Gaya6 I54t4l4Ajingi7 343l3lTakai8 I343838Sumaila9 J45l5lCrvarzol0 344'747Kaboll 245353Karaye12 242323Kirut3 )43737Madobi14. 243939D/Tofal5 242127f)ambattal6 2471Rogot7 2466Makodar8 87277s'7'75TOTAL Yf I I I I I 3.0 A 3.1. Treatment coverage 3.2. Total (census) PoPulation : 449399 3.3. Etigible PoPulation = 391456 -- 368292X100 =80%o 449399 2001 TREA RESULT FOR TE LCAs l. Kura 2. 3. Makoda 4. D/Tofa 5. Ga 6. Kar 7. Takai 8. T/Wada 9. Madobi No. of target villages treated 45 r6 6 3l t5 33 40 206 3'7 Total Pop. of treated comm. 45485 18296 7325 26334 9l0s r r789 21606 53676 l8l I4 Total people eligible for mectizan 40680 I 0005 67 14 24096 8050 r 0573 19t97 44667 16264 No. of eligible persons treated 37738 9461 6342 21513 7648 97 t7 18274 414'12 I 5545 Percen- tage coverag e. 83% 52% 86% 82% 84% 82% 85% 77% 86% Cost per person treated N/A at a, No. of comm. ln which CDD is a health worker 0 0 0 0 0 0 0 0 0 0 No. of distribut ions supervis ed by health workers 2 2 2 2 2 2) 2 2 2 No. of treated comm. With summary forms 45 r6 4 3l t2 33 40 206 33 86 10. D I l. G/Malani 12. Dambatta 13. Gwarz-o 14. Sumai la 15. Kiru r6. 86 4l 2'l 36 38 23 52 41 1 7rt6 69456 36227 12710 19373 14667 23640 40803 r r543 9250 449139 63404 31564 l 1330 16981 13525 20550 3648'l 9716 1 651 61705 29819 10412 14374 12923 19214 38854 848 I 4800 3(t11292 89% 82% 82% 74% 88% 8t% 95% 73% 5t% 80% a) a) N/n 0 0 0 0 0 0 0 0 0 2 2 2 2 2 2 2 2 3 6 4l l5 36 30 23 52 35 7 745 17. Kabo tlT-.,g,, i9 I 456 SOTJI{Ct:: KANO STAl-lr ONCI{O OITFICII w - lrt STRE NGTHS .l The participation of the LGA has improved tremendously due mainly to the increased advocacy visits that were undertaken' .i Training of cDDs is at close distance to the cotnmunities' cDDs and the communities quite appreciate this development' -i" Training at centers close to the communities has encouraged community members to watch as observers' +Morefetnaleworkersarelrowparticipatingintheprogramlnearrdas selected CDDs .1. Increased number of cDDs that were trained this year reduqed workload of the CDDs. .l The state Oncho tearn tnembers are very effective and have been handling the challenges of CDTI implementatton' .1. The project was able to reaclr more satellite villages, and this accounted for the high treatment figures' .}Cornrnunitymemberswerealsoinvolvedinthemobilizattotloftheir peopletotakemectizandrugsthroughparticipatorylearningandaction (PLA) strategY w ll 'tTlrelackol-supporttoCDDsinsomecommunitiesisahindrancetothe successful implementation of CDTI in the state' .i.Toomanysatellitecommunitiestrndertheleadershipofonevillagehead rnakeadequatemobilizationandeducationdiffrcultonthepartofthe village head' .}Payrnentofmonetaryrewardstolocalguideswhoparticipatedinother communitybasedactivitieslikepoliovaccinationhasanegativeeffecton sustainability' This is lowering the morale of the CDD WEAK AREAS FWEAKNESS IMPR VED .l.TlreprocessofconceptuatizingCDTIandpracticalapplicationofthe strategyinendemicareasbyLOCT/PHCstaffisquiteencouraging. *Thestatehasreleasedthesumof:N750,000.00ascounterparttothe .,. l"ff;Jprovrde monttrry imprest of :N 3000.00 to the local oncho units in the state' ' rg commturities' 'l' Breaking larger communities in to smaller reportu .l.Conductofanupdatecommtrnitycensusinalltheendemicareas. .t.I.lrel,GAPHCstafflravestartedasstrmingtheroleoftrainersinthe programme' n rL AREAS oFwEAKN ESS IMPROVED *.theprocessofconceptualizirrgCDTIandpracticalapplicationofthe strategy in endemic areas by LOCT/PHC staffis quite encouraging' * The state has released the sum of :N750,000'00 as counter part to the programme l.lrcl,GAsproviderrrolr(lrlyirrrprestof:N3000.00totlrelocalonclro units in the State .l Breaking larger comrnunities in to srnaller reporting cotnmumtres' .l conduct ol' an update cotntnttnity census in all the endernic areas' .1. The LGA pHC staffhave started assuming the role of trainers in the programme w r:' WBAKN ESSBS .}TlrelackofsupporttoCDDsitrsomecommunitiesisahindrancetothe successful implementation ol CDTI in the state' "}Toomanysatellitecommttnitiestrndertheleadershipofoneviltagehead makeadequatemobitizationandeducationdifficultonthepartofthe village head' *Payrnentofmonetaryrewardstolocalguideswhoparticipatedinother communiry based activities like polio vaccination has a negative effect on sustainabiliry' This is lowering the morale of the CDDs' vl t4 REC NDATION .}MoretrainingshouldbeorganizedforLGAPHCstaffontheCDTI aPProach; *.l.r-:-Lr,. *AdditionaladvocacyvisittobotlrStateandLGAofficialsishighly required; 'l More tirne shoutd be devoted to the programme by LGA staff; *Freqtrentandintensifiedcorununitymobilizationisquitedesirableto nlove the Programme forward; .tAdvocacymeetingwithLGAofficialsatbothStateandzonallevelswill increase support to the programrne by LGAs' w ! /", >. 9, Eda-CHEObuo4 tro)L .oo(gL .=H o9Fi oJ t< € ar7 !a 0) o L< o. 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