Jimma annual project technical report submitted to Technical Consultative Committee (TCC): January 2007 - December 2007

I \ I \. I C()UNTIIY/NOTF: ETITIOPIA Approval year: 2003 Ilcrlorting I'eriod: '[hc Fedcral Dcnrocratic Rcputrlic of Ethiopia Ministry of Health t Fro m : JLu.rriLry .299.7......(Month/\ Pro cct Name: .Iirnm:r Launching vear: 200.{ 'f o ;.....Ds.q.s.lrr.lr.c:.r 1.Q.07 _._ ( Mor lh/Yr-ar')ci1t. ) Proi ect Year of this rcoort: (circlcone) | 2 3 567iJ910 Datc submittcd: 25 October 20117 NGDO partner: Thc Carrcr Center ANNTJAL I'ROJ[]CT TtiCHN IC]A[, ITIiI'OIT'i SUI}MITTED'I'O TticHNtcAL coNSU |_,TATIVE COMMrT't'EIt (',r'CC) DEADLINI.] FOIT SUI}M ISSI ON: 't'o APOC Managcment b1, 3l .Ianuary lbr March ]'CC rtrccLing -t'o APOC Managcrrient br 3l .luly fbr Serrtcmber'I'(l(' ntc,.ring AFITTCAN I'ITOGITAMME F'( iR ONCHOCERCTASTS CONTROL ( {POC) i)lz | .t ' I - " E Tcc.16 rlr -tr 6 6? AHE are rD , It { ) 'lr - i' !\in jho* i AnVttB I !'paal flhFFl, To, {2t}fifi WIlOiAl'(X'. I r \trvcrrrbct'2004 tu*- ( aANNUAL 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: Country: lithiopia National Coordinator Name: Dr t) l1iil Signature: ...... Date: Zonal Oncho Coordinator Name: dtr'7 Signature: .... Date NGDO Representative Name: ..........A.lralst..1 u.t].... Signature: Date This report has been prepared by Name : ..........N.a.;.u:.A.h.r!s1...:..NQ.l.L Designation (. g.u r :r I i t.r.a. !.c:. r Signature Date '-:'. II WHO/APOC, l0 September 2007 / Table of contents Acronyns. Definitions FOLI-OW UP ON'fCC RIICOMMI:NDATIONS SECTION I : Background infbrmation.......... l.l. Gtnt:nnt-tNI:ottMAt'toN............ 1.2. Pot,tJt.nt'toN................ Str(l'l'lON 2: Intplcnrentation ol'Cl )'l'l 2.1 . 'l'tH,tt:t.tNt: otj n("t'tvt I.n:S........... 2.2. n Dvo('n('y 2.3. MoUILIZA't'loN, sITNSI'r'lz.A-r'roN ,\ND lil:ALTI I LDLI('n'iloN ot. A t't{tsK ('oN,l NrLrNt't'll:S 2.4. Corran,IuNt'l'y INVot.vl:Mt1N't'....... 2.5. CAt,n('lt.yuun-r)lNG 2.6. 'l'rrrztrMEN'r's 2.7. OItorntNc, srottACE n ND DELI\/t,tty oF lvEnME('rrN.............. 2.8. CouuuNt't'y st..t.tj-MoNIl'ot{tNC,rND S'r'RI(EIIoLt)r:r{S MsElrNc;.... 2.9. Supnnvtsr<tN................. SECTION 3: Supporl to CD'l'l 3.1 . ligurlur:N'r 3.2. FlNn N('tn t, coNTruBU't'loNS ot,-r ilt: pn li't'NE,t{s n Nr) coMMr.JNl't nrs.. ..........3.3. O'rttEtt IronMS otr coMML.lNIt'y srJl,poR't'............... 3.4. Iixt,tiNut'l'uRta t,t:t{ AC'l'lvl't'y SECTION 4: Sustainability of CD'l'l 4.1 . IN't't:trNnt-; INI)lit,ENDtrN'l'I,AI{'t I('il,n't'oRy MoNl't ()l{tNC; I jvn t.uA I toN ...... 4.2. Sus't'nlNnntLI't'y otr pri.oJltct's: t,t.n N AND st:t.'l'n ti(irr'rs (vnNun t'r)t{}. A'r'. Yn 3) 25 4.3. lN'r r:r;rrn I toN............ 4.4. Ot,t:ttn't'toNAL r{tist:n I(('t I ................ SIlc'floN 5: Strcngths, wcaknr:sscs, challcr-rgcs, arrrl opportunitics.............. SEC'flON (r: Uniquo fcaturcs of thc projcct/othcr rtrattcrs .lv ,.6 ..8 ..8 l0 ll 11 12 t2 l3 l4 l5 19 20 2l 22 22 23 23 23 24 24 25 25 25 27 27 a lu WIIO/r\l)(Xl, ?.i Novonrbcr 2004 f Acronyms APOC ATO ATrO CBO CDI) CDTI CSM LGA MOII NGDO NGO NOTIT PTIC REMO Sr\ll SIIM .I'CC 'f01' UNICEIT LJ'I'G WHO Afiican Programmc {br Onchoccrciasis Corrtl'ol Annual'f rcatrncnt Objcctivc Annual Training Objcctivc Conrmunity- Bascd Organi zltion ('onrrnunity-Dircctccl Distri IrLrto'' Comr-nunity-Dircctcd'lrcaLntcnt with lvcnnccti n Cornmunity Sclf-Monitoring Local Govcnrmcnt Arca Ministry of llcalth N on-Govcnrmcnta I Dovelopn-rcnt Organ izati on Non-Covcrnmental Organ rzation National Onohoccrciasis l-ask Forcc Primary hcalth carc I{apid Epidcrniological Mapping of Onchoccrciasis Scvcrc advcrsc cvcnt Stakcholdcrs itrccting 'l'cchnical ('onsultativc Corrrrr-rittcc (AI,OO scrcntilrc aclvisory gr.r)ui ) 'l'raincr of traincrs Unitcd Natiorrs Chilclrcn's Irund Ultimatc'l'rcatmcnt Goal World I Icalth Organization a IV WIIO/n l)OC'. 2.i November 2004 Definitions (i) Total ulation: the tolal population living in meso/hypcr-endcnrrc cornmunities within thc projcct arca (based on REMO and ccnsus taking) (ii) Eliqible ulation: calculated as 84o/o o1'the total population rn meso/hyper- cndcmic communitics in thc projcct arca (iii) Annual Trea ent Obiectrve (ATO): thc cstirnatccl numbcr o1'p...rsons living in meso/hipcr-cndcrnic arcas that a CDl'l pro.jcct intends to trcat wilr ivelncctin in a givon ycar. (iv) ulri Treatment Goal (UTG): calculatccl as the maxirnum nur.nbcr of people to bc treatcd annually ln rneso/hyper enrlcmic areas within thi' project area, ultinratcly to br: rcachccl when the projcct has rcachcd Iull gcogr,rphic covcragc(nonnally the projcct shoLrld be cxpectcd to rcach the UTG at tht. cncl ol'the 3'd ycar ol'thc projcct). (r) 'l'hcrapcutic covcraqc: r.rtrrnbor ol'pcoplc trcutccl in u givclt yr;ar ()vcr thc total population (this sliould bc cxprcssccl as a pcrccntagc). (vi) Ccogranhical covcragc: rrutnbor olcomrnrrnitics troatccl in a givcrr year ovcr the total nulnbcr of rncso/hypcr-cndomic courrnunitics as idontiliccl b-r REMO in the projcct aroa (this should bc exprcsscd as a pcrccntagc). (vii) lntegration: dclivcring adrlitionalhealth intcrvcntions (i.c. vitamin r supplcments, albcndazole lbr LF, scrccning for cataract. ctc.) tll.ough CD'fl (iising thc same systems, training, super-r,ision and personnol) in ordcr to 1lrximise cost- cllcctivencss and ompowcr communities to solve rnorc ol- thcir he lltir problcns. 'fhis clocs not inolude activities or intclvcntions carricd out l,v comnrunitv tlistributors outsidc ol' CD'l'1. (viii) Sustainabilit-v: CD'fl activities in an arca are sustainablc whcn tlrcy oontinue to lunction cflbctivcly for the foreseeablc Iuturc, with high trcatnrcnt coverage, integrated into the avirilable hcalthcarc scrvice, with strorig "o,r,rrnityowncrship, using rcsourccs rnobiliscd by the cornmunity and thc gt,r crnprcpt. (ix) nlt cmpowcrcd to ovcrsce antl monitor thc bascd hcalth intcrvcntion programnt 'l-hc ploccss by which thc conrnrunity is pcrlbrnrancc ol'CD'f l (or irrry community- c), with a vicrv [o cnsru'ing that the a progranltl.lo is bcing cxcctttocl in thc way intcndcd. It cncouragos tlrc couiurunity to take Iull rcsponsibility ol'ivennectin distribution and mal.c appropriate rnod i [jcations whcn neccssary. WllO/APOC, 2.1 Novembcr 2004 FOLLOW UP ON TGG REGOMMENDATIONS Using the tablo bclow, fill in thc rccomnrondations of thc last TCC on thc projc.'t and describe how they have becn addressed. TCC scssion TCC 25rd T'CC RECOMMENDATIONS Incrcase thc thcrapeutic coveragc in thosc conrnrunitics in which it is rclativcly lorv I{cspect the [rcatment tinres choscn by the comntunities rvhich will hclp incrcasc ther Lltrc ACI'IONS TAIGN BY 7-HIi PROJECT- '[-hc tlrcrapcutic coveragc in all conrrnunitics rvas increascd lt rs rcspcctcd FOR TCC/APOC MGTUSE ONLY Nunher of Recommendutiott in the Rcport 193 6 WIIO/APOC, I tt Septernber 2007 c Exccutive Surnmary l. Background on treatment and population data .limrna Ol)'l'l l)ro;ccr lras bccn start.ccl implclncntirrg (.l.)'l'l acu\'rrv srr.rcc 2(X)4 lrrrl rt rs or, rhc li>r-rrrh ycar lrcatlrcllt routtcl. 'l'hcrc iLrc tlrc totrtI po1'rulirrtons oF tt4tt,67ii rn tlrc 1>ro1ccl lrrctr.'l'lrt' ,\r rtual 'l'rcatntcnt ()ltlcctivc (,\'l() tirr thc I)r(),('ct lrrr tlrc \c,r, ls 712,,9r() r,.,lrrt'ir ,rr.t'tltc s;rnrr".,rs tlrc Illr, rrart' lrcittlt)cl)t (irtal (L-l'l'(i). I"or tl)(' lrc,ltlllcrlt pt'rrotl 70{,1 ti 1>coplc \\,cr'(' trt.rtcti rvrtlr a rlrt,rLpcLruc (', \(,r,ruc o1- [J3t]/,, clistrtl;utt'd rrt { \\'orctlas ttarnclv Nlan:r, St'L.r-(llrckora, SIrcbc Sorrrlrr., arrcl l)r'rlo. Srtr<:t, 'l)c stirrt ol'thc Pr())cct, all thc contlnlrttittcs (vrllagcs) wcrc c()\'crccl rvtth N,lcctrzalt lrcarlltcnt. 2. Background on population rnovemcnts. 'I'hcrc ts ll() l)laJ(rr tt'1>t'ol'ltt.rltullttt<ln rn()\'cn)cnt m thc pr()J(,ct :rrc:r.'i'[rc c()lltnlultrlt(.s ,] (ll)'l'l l)r(),cct al'cas al'c nr:rinly lirnncrs, tritdcrs, rlarll, 1y1,l11i,.,.i an(l clvrl scn,?r.nt\ 3. Training data 'l'rzrtning altd rctratnlng of Ilcalrh workcls, (,ommunitl'srrpcr'\.lsors ancl (,1)[)s rrr c()ncluctcd in tlrc crttirc l)r()lcct arca caclt YCar'. [)Llring lhc trc:rtnrcnr l)('l'r()Ll trarntrrq anrl rctt-irr ng \\,cr.c l]lvcrl [tir 217 Ircaltlt w()rkct's, 192 c()n'l'nr.tnlr\r supcr\/ls()rs lrrrl (),190 (.1)t)s 'l'i re c()ulllultit\, !iul)cl'\,1s()l's irrrcl (.1)l)S lrIc sclcctccl ltv tltt.c()tr.tn1r.ll]ltlcs 4. Challcngcs and how thcy wcro ovcrconlc. Thrcats (Challcngcs): IJigh tLrrn over ol'health workers at zonal ancl worcda lcr cls , ovcrbllrdclting ol-hcalth workcrs in pcriphcral hcalth lircilitics in difl'crcnt lrcaltl prograrrs such as nralaria cpidcrnic.Acute- water)/ t)iarrhea (n WI)). I:lrl , campaigns likc ,rnhanccd Outreach Stratcgics lbr child survivai . nrultiple responsibilitics ovcr cuordinutr,r's ancl shortagc of'worcda hcalth stafl'. l)oor rccording ancl tr'roor cluality rcporting at h..rlth facility levels arc also additional challenges. OJlportunitics: 'l'ltc cxpatrsion of'llcalth ['.xtcnsion l)acl,ugc progranr to cstahi sh hcalth post in etlclt alld cvcry Kobele and thc incrcirscd nLlmbcrs ol'Ilcalth cxtcnsiorr rvtlrl. .rs are a goocl opportunity lbr CD'l'l activitios. -l'hc govcnrnlcnt structLrrcs that arc n()\.v strcl( hilg dgrvn to villagc lcvcl callccl "(icrcc" arc taking thc responsibilitr,ol'rnarnagir)r scvcrir, dcvelopmenl. activitics. in whiclt hcalth is also a nra.ior c()nrponcnt. 'l-his is a rroocl r,lrptlrtunity lbr sustainability ol'('D'l'l in thc pro.jccr. 7 WI lO,',\POC, lt; S.r,.,rlncr 2007 , I SEGTION {: Background information 1.1. General information l.l.l Description of the projcct (briefly) Jittrma CDl'l projcct is founcl in .lirrrrna adnrinistration zone vihich is i ,certcd in thc southwestcrn part o1- Ijthiopia that constitutcs onc ol' thc zoncs in thc Sot,r.hcrn Oromia Regional State.'l'he Zonc is adnrinistratively divided into l8 Woredas. 'l'ltcrc is thc total popLrlation ol'u.lu,6;'ri rrr thc pro.icct rrrca 'l'hc pro.jcct arcir sharc bordcrs with Kaf'la-Shektr CD'l'l in the South. Illubabor Zonc in thc west. SNNPIT in lrc nortlr east. 'fhe Jimnta CD'l-l projcct area covers -l Woredas rvlrich arc Iurthcr strbclir,decl into 137 Kcbelcs attcl 4,123 "Gcrcc" (village). I'hc "(icrcc" (Villagc) consists ol'2: 35 ncarby households that rcsponsible lor all devclopment activitics including health. 'l'hc clirnate of'thc CD'l'l pro.iecl is classilled into thrce gco-cliniatic zoncs: higlr arrcl. mid-land ancl lowland arca. 'l'hs rncan annual tenrp(jps11upe ragcs li'orn I 0 ('C to l(r "C' in tlr. high land, l6 0C -26 oC in thc midland. and 23 "C -33 ('C in k,rvlancl. 'l'hc annual rairlall totals are highest irt the highlands rcaching 2000mrn. 'l'lierc arc trvo rainy scasons. 'l irc nrain rainy scttson is betwccn Juttc and October while sntall rainy scilsoll is liont.lanuary to ,\pril. Somc of thc pcrcnnial {ast flowing rivcrs that cross Jinrnra zone incluclc: Gcr.icb Ghibc, Gilgel Ghibc. Dcclcssa, and Kawa. 'fherc are iilso a number ol'surall rivcrs and strcirrrrs. wliich are tributarics ol'thc largc oncs irr r-r-rnny placcs in the zonc-. 'l'hcrc is a tnain asphaltcd road which is about 340 Kilo luetcrs that connccts Addis Ababa with thc capital o('thc zonc, Jinrma towrr. Each CD'l'l Wolccla capitals arc conn( cted to Jimma town with all wczrtltct'roacls. llowevcr. within the rural conrntrnitics tlic roa( s iu.e only for dry wcathcr.'l-hcrc is also 5 tintcs a wccli flight to Jirnnrrr torvn clircclll, lionr Ari,lis Ababa. 'l'hc zorlc has I rcl-crral hospital, I district hospital. l5lrcalth ccltcps. (r4 ftcalLlr stlti6ps ancl 46 health posts. l'hcrc arc a total ol'17 hcatth facilirics in the CI)'l'l prtltct areas, l'he potcrrtial hcalth scrvicc covcragc lirr thc ,lirnrtra zonc- is 7001,. 8 WIIO/APOC, I tr S"O,.r,ncr 2007 I I Table I: Numbcr of health staff involvcd in CDTI (Plea,sa atld more rov,s if'ncc,'.ssary) l.l.2Partncrship 'l'ltc mairt partncrs involved on CD'l'l activitics are l;eclcral ntinistry ol'lrealth. Itcgional hcalth bureaus, zonc health Office, Woreda health offices, health facilities, health exterrsion workers, tlte conrnrunity. 'l'he Cetrter Center, WI-l( ) and othcr govcr.llutcnt sector ol-llccs. Since the beginning ol'the projcct, therc was strong prrrtncrship dLrring plann,ng, advr>cacy. mobilization. drug distribution. inonitoling aud evaluation o1 the CDI'I astivrries antong all the partncrs. 9 District Number of health stal'l'involved in CD'Il aclivitics * 100B u,B 'l'otal Nunrbcr ol' health Nurrrbcr ol health stal'l' stall'in thc eutirc project irrr'<llvcd in CD'l'l ir Ica tl Pcl , ctrtage Scka-Chckorsa Shebc Sonrbo Dedo Mana 35 7t r5 75 J3 72 .tl 70 00 (;-1.6 tr -j.3 ,)7 'folal ))< 217l ,)(; WI IO/Al'OC, I i Scptcrnb cr 2007 r--O a.l 4) .o u o. rJa O o o. o O tr) a-l I dNPq< U;,iai; 'Eo hQu- 0): -v =o;.F o.= 126r.= ? =/t'+- E tt9tr x(dC OJ9'r, F _\LE.Y !?sy A r]- orJ ;6Jq, J!J ^ v -=^, 0.) vq ts l'r ctr iU *.j =o*!>)'a)/'oi .2a €=Eo:=,F> T6 .'r= ; tr 9) u\w€b0.= = -.'Os.e u a E = tr-c q- ''i'E oo - E -lj tr ^. !-- -ai:E UEk:ao - E.= o t,E E - .gnHbg ee " )'- C.E()o/ € c0'I i y alYe6r()ac-EYE :'.] '.=oH :q?-F ';H5 6:l (s'E <.r or -Y E r-: tr I a9 -E (d ;, (J ,r ?v ", o- a.-JrvF-HL C':1 a 'Ai .:i ,;!-\v-a '!1aL!dJ'- .o = ci " oje O L9,fr+ € Edv#jqin(n!) ;-.= d 0J =-L1- -rjqr0-)-^HAOC:a*;-0.) .- vt - ht\ .ic,^g E-d49ut^v- { (u .F L 2C-P^f'H'-va t-Hs7 E: =aE!cltr.9 F ,.Y !0.)Pdv sA9 i-o *, =;-: v ? -H94. 4dL -E.,ov '=^a-r3 6 = e-goc:(gdH t: o.r E6t^9r =;-o o c9.s F € e =tr E etr Ho '5 o -^ g e l< 0) !L' U) o oU I It, (h C)o '.= 4 C)oL a t( l I I I I I I I I I I\l I l I I I a() 'l c- u) 'q) l-a ili 'L) or'E Pc) Cl -( 'os es o o.lroE O(H0)o 'd o.>L(JQ- r- o,= pO a.n PE6€ c.l j Cd a2i,* 4{ U\) \ c\ q,) AJ i U U p -a o\ ru :v i\ .Y (< :\\c aJ! tt t\ hO' p: \i !r uae::\ -uc L\ cJ! \q, :- qUPF a'\ ci t\ !qr *-c C! L- x-= c () Li U t<o 0) O! a.)ti(o ! 0) (') 2 Cq 0) cq CJq) *5 *i8\\:b,: -a: =bo fv Eg I .. -<.Y iis :b. :w -:'= ild rr* t\c 0) q) 0.) -VU) L o (d '/, tr3O's fltrr!= JEo.HOrlE: N .olN5l . (6l rFt o o 3 !: v .= or L rc t-- c- Ir- F- c.l tF- C...t \c o\a N r + lt rviL L'= - 6 :iE!h *9.-u1ir! o (/ ' *ri. o-\i t! roa .= c-N !\ =j>! q) qr!: @Jiov ?c! Fr'-1 ol CI cl 6l 1 al cl t- al @ J c.l ao r- r- @t c] o. f ol @ t-- a ..l _:l F- ei trr --t a ca at.. 6 =a r) la rn ,ri -.? O e) OI CE O 0) oI o q) Z +_ il IL oN cE9 F -9. a, E:q/: 9s; otr >,o N qrt ! Y.i o:L ?: r-t -1 Ca (.l oo c.l\o al O(\ oo o\\o oo F- c.l al -l- .a cl I rnlna 6\o (^.tN J) c!<c)5ar! '< L Lv --aad 5 eJ.:X 3e, P' a al a.l a.l (-l oo -f CI t-- oo c.l : o\ a.l 00 F- 6 € :Lo) xtrcs - or l'iF-c.= ^eO L )z() O Jua o -o o U) 6) -ou lr) o (.) o (! rl F F r-- O a.l (.) .o o o.oa O () o a. o ar) ') -llt ') ') ) , , C. ') ') a ') :l ^) .l) '.) :' ::- (.) .: 0) ..' a -:E .,o =Cj}i:' -c o o +, +. t) IE b o o tr o E F a F N F o(, h o tr .9{J Gfl tr o Eg q.! l!N - o IF(, ltl o v)q\)U a,) ? U\ I\ o \ Uq q) a_\-_ ! Cdq) 0)F o C) o 0) li a (.) r< c.) ! '+ (n C) o(d qi o 0.) 0) F a., r 6)l -ol -cdlFI r- ol 4) tr a- c\l (J C C,= (J b.0 (r) - F- c! .t) r- ^l r- ol L t-- al z o.5EFEE U F-o ol (,) = F= c.l (.) t-- ot OJE b.0 a- r- ol La t- O(.l =L o. r-- ..l L o. o! o.= tsE Q l-- o c.t L o. l-- ..l L o- a- N r o- dD a- t--C (-.l L o- F- O c.l L o- r- ol t. o. EFEE Q r- (..l L o- r- al .E o. r-- c.] =L o- D.tE& tr- tr-OO C.l L F- al (! tr- c.t L(q o- Q F- O a.l o = a- ol 0) t-- ot (J oq N= oo z o a) (n ) c)I F a0trE a- r-- c.l L CU z. t-- ol L Cg 2 t\ at r- -,3 at L /). r- at u t- al r\OO a.l = o- r- c al '= L o- rc al = t-- el /,. I. O cl t - IO c.l - F-O N (n J q) a< oJus(, :l(Ja -o E a o o a -atC (! ?_ J F 3 2.2. Advocacy State the number of policy/decision makors mobilized at oaoh relevant level durrng the current year; the reason(s) fbr undertaking the arlvocacy and thc outcomc. Dcscribc difllcultics/ constraints bcing faccd and suggcstions on how to improvo advocacy. Onchocerciasis task lbrccs and politicrrl leaclers at Zone, Worccla urrcl Kcbcrc levcls r.verc involvcd in thc aclvocacy nrectings to srr;rport tlrc ovcrull ('l)'l'l aclivitrcs in tltr.cntirc pro.jcct arca. I'lowevcr, thc ovcr bttrdcn of'kcbclc lcadcrs ancl otlrcr scvcral contpcting priolitics of tlre political lcadcrs at high levcls nrakes dilficult to single out a currtrol proqr.am and give attontiorr 2.3. Mobilization, sensitization and health education of at risk communities Contntunity rrlobilizatioti was give-n at cach cornnlrnitr (r,'illagc). I)eliticll lcr,tlcrs apcl Sigh ollicials wcrc scttsitiz.cd in thc crttirc proicct arca.'l'hc llont linc hcalrS g,'erkcr. at all lcvclcs play a great role in disscnrinating health infbrmation anrl lbllow up thc CI)'l'l irctivities .'l'ask lbrces al kcbclc lcvcls and cttnrmunitr supcrvisors hirvc playecl uralor role rrr conrnruliLy nlotliliz.atitlt-t ittltl se nsitizatitltt ol' tltc ri Irole c()ntnlr.lnrlv ut grass root lcvcl ('oplpupity supcrvisors and CI)[)s wcre participatcti in delivering hcaltli infbrntatiol tg t5c cgrlntur.rity 1t villagc lcvcl. l'ltc ctltulltunity Ilobilization ilnd scnsrtization has corirribrrtccl a lot irr au,ar.r ncss crcation. 'fhc awarotrcss ol'tltc ctttnnrunity. thcir involventclit in tlrc ('l)'fl actiyitics anrl rircir intcrcst in getting Mectizan treattncnt has shown signilicant gro\\llr. As a result. thcra;rcr,iic and arnnual treatnlent ob.iective rate have bccn arbove the cxpcctccl runge clr-rring thc pcrigil. t2 WIlOin l,OC. l(i Scprcrnbcr 2007 -tO a\l (J -o 4-) o z$al a o > ca a z 0)a o -oL 4)d Ir)cl c' ,v Q) -qc, -'3.e .iLe L;!! ivL 9\J-tr(!E!.:,^ !y (rA),da o tL)0J=r;v0J ^-aai, .0).5i' >\ cdF= e .' . ! ?r -- re i\ U 'E.65 = o'9dExxAix*XEg=UO:'UqHta0) .! _o '*i-4.<iIr&,; .O'- () o V)ALnoE I .:A L;jJH o_= .d r \ )Ev 63 o =L-(J^^H-LH9.r tr -O.I -o 0() l-'- <.rrJEj -'-cuuii -E 'o o- t)o - <ui o.tE eo'- e su 3Qedt- ts0 rn OZ9 I n ,:>-:= 'H .H u ,rv!P.r- 6 6'tr "OQE=q tr<= u 6_) >HL. Ctro€a.c) o.) at 2r '=u)a = oJ ra))a{) Eal-L-C0 tsoL) =a!6€:!oou rLi €2 ooi.j-o_c 0Ja4X:,J Y'jruu ) l!)i t) -(ra= '4:= -l1 OY>\'E '/. H cia)LJ(J = =Yc, +-PJ-cr,G ---.: 0O 1)UT ru - :1 tru o :-:.:F)AL HLUA= '-(JP)-2 ='e 6 , YE E8.Et E i .=a95 Et< o* 0) c6@H,E e3 E L ,^ , dJk v/- v 9Hg,JLOcddSr:6 '5960i E(€r-O^L o! F.= (.,,aaaES U-L(r= - tr L -C<dQJ,'4);.EEI €9:FE a :;,.Ye .9o ):!c* .F L,''2 a - 'E .HTLLtrHoroX -u^.-trtrtr.di- E n=_.7 a!vv^{)o:trf 9, iE F OP& * ,:E?)o.ta.n o ?,'; t k o rn'<tJ or.Y Eq-UHFAY -l <gX-ri!U-lvUl: tr'- = th >H -or c i€.-E[-rss! <UALi:g:i=E& s 3i c E ,.jjL^o.= . - u t(t-.- - A )? s2.9 - b iiE9U9Od'A =c(ia;OO-E{.8-t'lE,EE bF o-: o-FU< , at a al r- al --l\o , \o ci =t\o h €l .t -- al a N .o (.l =j- c.l co r-. .,1 r\ at o\ln il* co'd E - >.= ? z=?>*! tr: FE trq:o o! o'-: i.: e o=BFtr9tr.- O .I oo at rc F- F- rON .t al - J L H o 4J(, cg)zo a o -o c oa 4) -o CJ a D o d -\ q6 (.) Ca ? o CJ\ \)4 qJ a_ F IJ O 0) o (d o.() 1:. (n C) oU Jr 0", I -oldtFI g tr o E o .: o .s =tr J E E o o 1N co ll * ;ao =io ='=.3 Yrv - r=d =r-z.== + lt o t0 o! F @- H U o ,) .:r, tr a a l tr C -O :I : J1 na a !?il(J iU: . o ?r L ?ilU o ,- + .U \,) UI ,r, c< a< F q,) CI (.) o q) z o a 0)!!^ FF. ar: o c,) ,6) r. c! z N oo o. ..l N ol -f, ot ol (o n at € ; c.l C' € ol @ ol oo ot o\i o\ a \o 6 (ln € I o\ C, q, ql o\ O O O O () E qJ q) \o ?rr U F"Lt U (, o i+ rl ul t LF o< LF q) cELr !Jj UO6O tr:- ze oqJ ol r- (.1 N(a oa at (o a\o -i ol -t .:t @\o \o e)(-t @ \o la t\t r-r- € at rrt N qJ o) ql I \o ct CI c CI at al a.l (.l ar €) o () a \o at J L oJ() (-) :l 0)a -o oa u -o a) a a .E a) rl F F t--OON r(.) -o q) o.q) a O O o H< o <t llo a U a o\ o q p B o q o I 'c t oq. \ o : p a. s -oq s o c .L * :F 2';t 8:o -, .*; .=r.I E b E.ESe ;E:.^s.c9) ^Ei*\= rcl- =: EEc9ol, ? a -, d!{N!i i T.=ir(g6s i :i:i 3e!:! 50 \jePiaci5a=P ;\!Fdu<-,tfiaE = Eocuo -c \,: $ 5i,B -r:a, U n: d^;ji y.. i9s 6- t .bDo = EE aUJ ^ = -r'o u3r.riq.a= o i *E =.:i 9", 4 ,,< O\.Je=:Z t c4 i :<! - 'nQ P?l iB i:t)- IL r =:ocd\ao-iti)::; 5E ?)' :;au-c2.:rq ; s E0 3 ": o > -j =. 1e" -= o :-; 9'i .> </) :co 6'- i\, =b a-N- Ei =, €a? == iO -\-l br- ! F + E:r' EE 3E ;:a. au =i 1:I E= r : 3 q-! c" ;g gq_c, u .?!? V € IE! AV =() L o,.\ ciEoo a (>. ^-o- 5=o qi . = O =; * -X Jt '- aJ L -E!Z !sF 5Ei ; -Y'nNJ.^-.c-:1o ! C ! F,E .1E 3t': -V€E 2iJ-EOr,=tu rn E Er=" i3l; 4 .E 6 E:i ;'.e'i i! : a.-I = = h .: L^i!.vJ=4 '5 h eii zYi ;! q Hea. \E:-. E E g = tF 0"oE ;O 6 FF: tc;. t(E a j-i > z'd= 'ec E lI=E \'a= =l! ; ?.v, S ai'j ,i: ,t ; ! - ;ti' f gt$ :,EE ,^, . V : id -cE = '-.,1ul 3 =Hi ea9 ElN I -, t - tr ii'r, dl oo o) cl cg q,) z Table 6: Type of training undertaken (Tick the boxcs wherc specific training w'us c'ctt'r'iad out during thc rcp<,r'tittg pet'iod) - Any othcr cornnrcnts *'l-raining on community scll-rnonitoring is givcn ftrr cornrnunity lcaclcrs and lrcalth workers at each level. 2.6. Treatments 2.6.1.'l'reatnrcnt figurcs If thc pr<rjc<;t is not achioving 100% geographical covcragc anri a n-rininr.,nr o1'(r5(% thcrapoutic covoragc or thc covcragc ratc is I)ucttrating, statc thc rcasonr and tltc plans bcing madc to rcrncdy this. 'l'rainccs l'ypo ol'trainiug CDDs ( )ther ContmUnlty rncnrbcrs c.g ('omrnunitv s tr pcrv i sors Itcalth Wolke rs ( trl,l I Ir) MOI I slat'f or Othcr l't,t itlcal [.c rrlcrs ( )thors ( spccify) Program managernenr I-low to conduct Ilcalth edtrcation Managcmcnt ol- SAI:s CSM* SIIM Data collcction Data analysis I{eport writing Others (spccily) l5 WIIO/A|'()C, 24 Noven.rbcr 2004 t F-O al (,)p 0.) rIq) a O U o. (-) B \o e) bo!t\ql q\ Et .! $\ 00 u 60 ,I /it \v\ U\{ *)uvs NT9q 6r0)t) 'F 'i. v\as $0)9{ sSdu9 -c .;o i 'Fq!2.Ss i4tradiP dlU .o : $s EEE i ES()YsPi^;Fs i : .t3 !;irH i '$s\9tr E 3.\BI V S 'o '5 E\(') \ pq;E -.* St9' N .= ':-5 s is' oJ I oi -o e SS\\- -Y ! !! cl t ,ginE 3 S+E s is o YtqLi U t :AJbtSr Z cJ GsH i 8-tre * rx '= S' 'Sb .i: G !u3 s :ss Sa -\U 'iIo 3f .:: ss \ qr\ B Ei\ *st ip . qJsS .a\t s:\ l-Ei s;t .s'$ tll\ .r {\E EE s Es rrtt!o stt\ I*a \vv OO x 0.) c0 0-) li o o o C)o L o -o)z o 0) o F \oo\ !.) O O5 o (-) (! 0)LF (g O (o (.) br) !v^6S () F q) c0 0) k o. 0) - a tr.) -o 0) C) cn(g a o o o o C) ()O l^ Ogx _.c v 6:Xots H0) ^Ox0) Ao) cotr oaFZ () 0) oo 0) o (6 'F o\E- cd br) 0) (o ol< o 0) L 0) U) 0) o(-) o EO()O €6x 0.):JO.co o? oolicU a?1' c)H'5 dE cdX o.oOr<o. c) -o(!F o=FZ Oc /. () 0)L 0) o uo o L i-) -a a ,Z ct)q) o{ Lr C) C) (d o (o Lb{ ol()l h4 o (.) l-o o{ o oo L< ,o cC) Eli oi. ::r ,at.,rSJ D = LU - - 'h -oYO- :;OF * / r :J iESAAi F.sl,Z '!: ci. y. o- €? =az-Z !:o -occoJ 7( ltillt1t I,- d\o-.! -o;,=.i =LD--_) fo'I:.r7.u= il o '.= oJ tiod- ooFa oa -a v,Eb56Z 64) .E coju F ,o ,o ^) ai) =u =eua G oF I U ?9o EbL !!oa: ue(, ,! 't, y -N o :O oc 7.6 I €O <y.F- il9r AE{9 -o -aqo +r'E ^= 'o o 1) () oo ! 0) o(-)() ,-: :5 4) o. c.) F O V o\l\t .a 1 -t ol \oaa alI ooal \at- at V. C \aq ,: r-6 al : C = 6 .+\o o o< oo 9 -f, oo C' al co O al -f \o9 O o.r- t--' ..l ]t. .A(a t-- 3 r- r-- O(-- cl -t t-- al o\ € a.l r- !.1 al at .l C @ tct ol ; € l't\o 6 , € (n o oO O _ (.1 @ tr r t- rn(\t tt : ('l U) (\r n _ ot oo ta(\t r,f ! L ,o;a:iu ,!ql) .P oE aa o u o c J F F -:\A V') v1 \lQ\J 6 U\ \)\ o \\ qJq q) E &a 't- U) ol< (! -l o 'F a .o a EI U) (o C) (! q) t<F c-- t orl -ot cdlFI 2.6.2 What arc thc cilusos of abscnteeism? Iu nrost cascs the abscntecrsrn from the trcatntcnt is duc to nrany,iirctors such as work over load and lcli their horne and go somewhore dur.ing thc clrug distribr.rtion tinre. 2.6.3 What arc thc rcasons for rclusals? Surnc individuals considcl tlicmselves as hcalthy ancl thcl,cio not r,cccl Ivcrtnectitt and vcry lcw iurlividuals rcluscri bcoausc ol-l-car ol'nrirror sidc c flccts. 2.(t.4 llriclly dcscribe all known and vcrilicd scrious advcrsc evcnts ISAEs) that occurred during thc rcporting pcriod and providc (in tablc tl) rhc rcquiretl inlbrmation rvhcn avail:r lrlc. In case the projcct did not have any cases olserious erdverse cvcnts (SAl )cluring this rcporting pcriod, plcasc tick in thc box. No SAII casc to rcport a aa t7 Wl'lO/APOC, 2,t November 2004 0) 5t) v i:,:F (JX - >://a U aa o\ @ \ co o\ o CJ) o- o I ll * ll * '.1 'i I, t l) a- ''a ! Eu =aba 4-O-:: o ,2JaasoF .1 cl @ t-- @ co tr- c<; cor- Ir,l ,! il5 -L .- ")q a- co -t =f ,n c- O r- <t r- r! -An'- /!s' FU oo ol$ at6 \d \o ol -l t-- .f,\o oo -l r- ll * lrl l! t! a .,.|d -t9) B6c i u )o - EP -o 2 n.-1)v:-- <t.-- -a D 5Il 99qj i o- c'o O F-r- O r \c N @ @ -f r- F- 9 a- cl oo @ F- .o" oo =l@ q,) c.t) u o() O Q u = !:), 2a,," t-- 9 (-lI t --t t u-a' FU r- r \c r- 9 ot -]- bo6 =a9.... b e - La: c: rl !'! > '- .c=??u :EC =-ocI F- \o a- r*- c.t $ & tr-.] .J OO c.l ol cl 6l -f a.t O a.l \o ON r-- N € 6l a.l ON <foON L 0.)p 0) o z$ .l Q. o o< - @ -q U ! = ') a OJ OI c! ^l.G' q, xv(J \ ri$v\t- ( t I\. .LG v5l9E)aLe-.s96\EFq..=I4qJF -,6= -9 o$L \qlra-9tu \-O0r!.t !v: A-a I Lg q!9ou90)=tr'=Dt9r- Eo.q oJ '=vt L! fi iJ O,)o.tr',qr= F9 trt =iUH€I d 'ji otlF-t5 H F'l -,r 0) !lC!trEl e o)FI LF=l c( ioll P!' -l <) a cJl Ole)ot -tr>lYC)-ol ^!bo= FI6H!4UL :o(Fst (-)9\,IU tEb Irr, c .EEo)!gtr0) t-! Fib(! 'o)aq xE v t\ u'l o)()l q _tHsFl 0. 2.7. Ordering, storage and delivery of ivermectin Mectizan@ ordcrcd/applied for by - (plau.se tick the appropriatc cutstt,cr) MOH V WHOE UNICIiFE NGD(f] Other (plcasr: specily) : MectizanG) dclivcrcd by - (pleu,sc tit'k tlra altpt'opriuta ertts'wcr) MOII g WIIOT UNICt.],Iil NGD(E Other (plcasc spccily): _ Please describe how Mectizan(D is ordercd and how it gets Lo the comnrunitics 'fhc NO1'F rcqucsts Mcctizan frorn MI)P. Allcr thc drug rcaches thc countn it fbllows thc cxisting clrug ancl othcr Inedical ccpripnrcnt clclivcr),s)'stcnt in the countr\,.-['l,cn Lhc clrug is storod in MOll rvarcltousc li'onr which pro;:cts lcvcls rcccir,'c. Irront lhc prol. ct lcvcl (zclnc level) the Worcdas reccive it and distribute to the healtli lacilities anc'l tlie hcalrh facilities to Comnrunity Supcrvisors. It is liom thc cornmurrity supe rvisors that thc CDDs gct thc drug and distribute to thc comrnunities, 'l'able l0: McctizanGD Irrvcntory (Plcu,s'c udd ntore rows, i/ necessory) FIow are the rcmaining ivcrmectin tablets collected and where arc thcy kcpr'.) lrrottr cach comtnunity thc renrainirrg lvermectin arc collected by hcalth lircrlrtics and thcn thc worccla fbcal pcrson collcctcil ll'orn hcalth lacilitics ancl storccl in thc zorr,rl hcaltlr pharmacy storc. [,ist and bricl)y doscribc thc activitics undcr ivcrnrcctrn dclivcry tlrat arc bcrrrg carricd out by hcalth carc pcrsonncl in the pr<rjcot area. . Collcction ol- lvcrnrc-ctir-t ll'ont :tonal healtli ol'licc . Collcctit)n ol'ivcrnrcctin ll'onr the Worcda hcalth ol'flcc . l)istribution ol'ivcrnrcctin ro Ilcalth lircilitics . l)istribution ol' ivcrrtrcctin t() coutntLlnity suPcr.r'rsol.s/CI)l)s . 'l'raining of cclmnrunity srrpcr-visors and Cll)l)s . Morritoring and supcrvisiorr ol'the ovcr all CI)'l'l activitics . Iiccollection of the rcnraining lvcrnrcctin ll.,,nr supervisors . Itccorcling ancl rcportiug ol'tllta Zone Numbcr ol' Mcctizan'" tablcts I F*pi,.Received Lost Wastcd d Jimma I ,919,892 l, 980.(xx) l, 907,4ti r I I,.s:10 0 60,989 1'OI'AL I ,979,892 l, 980,000 l, 907.4 8l r 1,5i0 0 (r0.989 Any <lthcr colnntcnts l9 Wil(),,.\l,OC. I i Novcnrbcr2004 Used 2.8. Gommunity self-monitoring and Stakeholders Meeting Has any training (of traincrs) tbr cornmunity self-monitoring bcen donc in thc projcct arca? Contmunity leaders, Cotnmunity supervist-rrs and kebele taslt lbrces werc trairrcrl on how to cortduct community sell'monitoring in thcir villages. Stalicholdcrs Mecting har,.'been done in cach worcdas arrcl l"l.lll; lcvel of all thc projcct iu'cas. If so, Whcn? March .2007 'fable 11 Comrnunity sclf'-monitoring arrd Stakeholdcrs Mccting (Adcl rctu's i/'trcedcd) Doscribc how tho rcsults of thc contrnunrty scll-- rnonitorrng and stakclrolclcrs u)r'ctings havo aff'cctcd project implcmcrrtation or horv they would bc r.rtilizcd during thc ncxt trcatrncnt cyclc. Cclntmunity supcrvisors ancl kcbclc tasli lbrccs wcre trairrccl on how to concir-rct.()lnltlLluit), scll'rnonitoring sysl.em.'fhe pcrlbrrrancc ol-the CD'l'l acti\,ities ancl thc r,r,ork ol'thc CDDs arc monitorcd in cach villagc by communitl supervisors ancl kcbcle task lorccs. l'he idea catne lrom thc NO'l'li and it r.vas implemented cl'lectively in this pro.iet'r and has proved to bc very clfectivc in nronitoring the per[orntancc ol-thc C]DI)s and tlrc tlterapcutic coveragc at thc cotntnunity lcvcls. Also. stakcholdcrs ntcctiugs havc ttccn conclrretcd at cach u'oreda and hcalth lacilities ol'thc projcct to surpport thc ('D'l'l activities. Artnual progratlt rcvicws wcre also conclucte<l irrvolving ull stakcholdcrs at z.ourrl. worccla and Ft.liF lcvcls. l)rograrn achievcnrcnts anrl weaknesscs \\crc idcntillcd and lutur'. clircctions outlined. Q District/ I-GA 'l'otal # of communitics/vi I lages in thc cntirc projcct arca No of Courmunities that can'icd out sclf monitoring (CSM) No ol' ('ommunities that couduc rcd stakcholders mccl.ing (SIIM) Seka-Chckorsa Shcbc Sonrbo Dcdo Mana 1,053 5 ltl l,-s5l L)31 r .051 5 ttl 1.5-s l e37 l4 I0 r5 l8 T'OTAL 4,123 J,t23 5/ 20 WI IO/n PO(], ltt S.O,",rlOer 2007 2.9. Supervision 2.9.1. Providc a flow chart ol'supervision hicrarchy. NOTIr )ROTIT) ZO'I'F) WO'I'F ) l]ront Linc I Iealth Iracility ) Conrurunr[1, supcrvisors) CDDs 2.9.2. What wcre the main issucs identificd during supcrvision'l . Delay in utilizing anil liqr-ridation ol'lirncls. . I Iigh tunt ovcr ol'hcrrlth worl.:crs ' lnadcqttatc ktttlwlcclgc ol'rtcwly assigrrccl hcath u,rlrkcrs au{ Ircalth extcr-tsion workers . I-ack ol-propcr docurrrent handling and poor reporting ' Dela1, in thc compilarion of treatnrcnt reports 2.9.3. Was a supervision chccl<list uscd? ycs 2.9.4. what wcrc the outcomcs at each levcl of cDTI implcnrcntati,n supcrvision? [)octtnrerrt handling ltas sltown somc' inrpltlr,'ements. 1-hcrapeutre covcrage lor thc projcct is incrcascd arrcl thc participation o('the lcnrales arc alss incrcased. 2.9.s. 2.9.6. Was fcedback given to thc pcrson or groups supcrvised? ycs Ilow was thc fccdback trscd to improvc thc ovcrall perfbrmancc of thc project? 'l'llc impl'ovctltcnt tll'dtlcrrnrcrrL handling unrl lcporting systcnt. tlrc 100%r gcographical covct'zrgc arrrl the ittcrcasing tcnclcncy ol-the-rapcutic covcrage shows pronrising trend. 21 WI IO/APOC, I 0 Scptcmb ar 2007 SEGTION 3: Support to GDTI 3.{. Equipment Table 12: Status of cquipmcnt (Pleasc udd morc rows i.f ncc'essary) *Condition of thc ccluipment (F:Functionrrl, CNFR:Currently non-lunctional but rcprrrrable, WO:Written ol1). How dtlos thc projcct intcnd to nraintairr and rcplacc cxrsting equiprncnt ancl othor rnatorials? Minor nraintctrancc ancl repair ol'thc cxisting pro.lcct is bcing hancllccl by tlrc zonal health office. IIowevcr, the project does rrot. have the capacity to replace and rrraintain capital equipment like vehiclc and motorcycle s. Source 'l'ypc of equipmcnt APOC N'lOll - Zone DIS'|ITICT NGDO Othcrs No ('orrtlrtron N Corrclitron No ('orrdrtron No ('olttltI ton No ('undrtrorr l. Vehicle I CNFR 2. Motor cycle(s) aJ F 3. Computer(s) I F 4. Printer(s) I I.' 5. Photocopier (s) I CNIIR 6. Fax Machinc(s) I [] 7. Overhead proJcctor I Jr 8.25" TV set I I 9. Deiesel Generator I I 22 WIIO/nl'}OC, I () Septcnrbcr 2001 3.2. Financial contributions of the partners and communities Table 13: Financial contributions by all partners fbr thc last three years Ycar 2 2()()5 'ro'fAL Cash I3 Lrdgeted (us$) 1'O'fAt. Cash Released (us$) * C'ontrihution o/'CDDs und c'ommuttils, supet tt.\ors convcr!ecl in ltt ntoni!ory yalut, ** Do not ittcludc /itnd./br cttpttal equipnett! II'therc arr: problctus rvitli rclcasc of'coLrntcrpart funcls, lruu,wcrc thcy adclrcssctl'/ - Additional comnlcnts Dclay ol'n I'}oC'll'ust Iirncl and tlrc nriss ol'sccorrcl irrstallrncrrt frorn AI)OC'l'rust lfuncl. 3.3. Other forms of community support Doscribc (inclicato lbrrns of in-kincl contributions of oorrmr.rnitics il'any) Nonc 3.4. Expenditure per activity Indioatc in tablc 14, thc amount cxpcndcd drrring thc rcporting pcriocl lirr cuch activity listed' Writc thc amount cxpcndecl rn US dollars using tlic currcnt t lnitccl N irti6ls cxchangc ratc to local currcncy. Iurlicate exchangc ratc ursed hero 9.03 i Contributor Ycar l(200.1) Ycar 3 ( )006t Year 4 2007 ) 1'O't'A I- Cash Budget ed (us$) 'l'o'fA [, Cash I{eleasc d (us$) 'fo'fAL Cash 13udgeted (us$) TO'I'N I, Cash Releascd (us$) ) 1'O',l'At_ Cash lludgeted (us$) (2tn4 .fO.I'AI, Caslt Iteleased (us$) MOH (Central + State l-).tt2.l 1.1.9.r3 r7.7135 15.126 0 0 0 3 l .t -.llt 3 (r.736 2'1.135 17.41.5 25.tt()0 I l () 0 0 ) 0 + -s I 187 21.171 I l,4tt6 i I..ltt6 -58.287 (X) .lrrrt.2 I I * 390.2 I l* 129,615 .129.(r l-s* .t3It.964 75+ 16.97 t 10.0(x) 2 9, (r0 (x) 0 MOH (District -t zone Local NGDo(s) ( if NGDO S Communities 37.096 3 5.n2-3 2 5, tl (r() 0 5ti.2ti7 (x) 438.9(r.1 75* 15.0(x) 00 0 13 .290 I7l.(r80* 73.290 l7l,6ti0 APOC Trust Fund .5(r.090+ + 30.0()0 .tOTAL J53,97e 325,736 .l(,' j.,122.50 450,917 52 525.507 ] r,,*.r.,n 1 552.30 t 75 53ri.l r r 7s 23 WI I()/n l'}OC, Ilt S.r,",.,.rncr 2007 0 Table l4: Indicate how much the project spent for each activity listed below dtiring the reporting period - Any comments or explanations? *Contmunity participation and thc contribution of MOI i arc not consiclcrcd as pr.ojcct spent SEGTION 4: Sustainability of GDT! 4.1. lnternall independent participatory monitoring; Evaluation 4.1.1 Was Monitoring/evaluation carricd out during the reporting pcriod? (tick any of thc lbllowing which arc applicabtc) No. _Ycar I Particrpatory Indepcndcnt ntorritoring _ Mid'fcnn Sustainability EvalLralion _ 5 ycar Sustainability Evalr,ratir;n _ Intcmal Monitoring by NOTIr _ Other Evaluatron by othcr partncrs 4.1.2. What wcrc the rccomnrcndations? 4.1.3. Ilow havc thcy bccn inrgrlcmcntcd? Source(s) of MOFI AI'OC AI'OC+ NGDO APOC-I NGDO N POC +NGDO AI'OC+ NGDO AI'OC fundin APOC NGDO NCiI)() m NOTF HQ area to central collection point Mobilization and hcalth cducation of oornmunitics Training of CDDs Training of hcalth stall-at all Icvels Suporvising CDDs ancl distribution Intcrnal monitoring of CD'fl activitics Advocacy visits to hoalth and political authorities IEC materials Summary (rcporting) Iirrrns lbr treattncnt Vchicles/ Motoroyclcs/ bicyclcs maintcnancc Office Equipmcnt (c.g computers, printers ctc) Othcrs Activ Drug delivery fro of community 'fotal number of crsons trcated TOTAL 350.00 3tt,039.10 Expcnditure ($ U 2.500+ 5600+ 8302.6.+ 1 400+404 1 .1 5 1000+2494.5() 2730 4,553 2300 0 7 (t0+L)97 .7 5 r0r0.00 24 Wllo/n POC, l(r Seprcnrbar 2007 t a4.2. Sustainability of projects: plan and set targets (mandatory at Yr 3) Was the project evaluated during the reporting NO Was a sustainability plan written? NQ When was the sustainability plan submitted? What arrangements have been made to sustain CDTI after APOC funding ceases in terms of: 4.2,1. Planning at all relevant levels 4.2.2. Funds 4.2.3 Transport (replacement and maintenance) 4.2.4. Other resources 4.2.5. To what extent has the plan been implemented 4.3. lntegration Outline the extent of integration of CDTI into the PHC structure and the plans for complete integration: 4.3.1. Ivermectin delivery mechanisms The delivery of Ivermectin follows the existing drug system in the country since the start of the program. The request for Ivermectin is directly to the Mectizan Donation Program (MDP) through the Federal Ministry of health. As soon as the drug arrived, the same as all other drugs and medical equipments, all the processes required are handled by a Pharmaceuticals Administration and Supply Service in the MoH. The project, like any other medicines, receives and distributes to the respective project woredas following the existing delivery system. Training: CDTI is integrated with the Primary Health Care (PHC) from its begiming. At the National. Regional, zonal, and woreda levels, the Malaria and other Vector-borne Diseases Prevention and Control Units are responsible for the planning, implementing, monitoring and evaluating CDTI activities. In addition to this, all health professional working in the project areas were trained and retrained each year on Integrated CDTI and other health activities. 4.3.2. t 25 WHO/APOC, l0 September 2007 t Joint supervision and nronitoring lvith othcr progranrs Mostly supervision and nronitoring thc gcneral health activitics alc conducted in an integrated ntattner .llowever, during thc mass Ivcrnrectirr clistribution scparate supervisiott atrd nronitoring are carried out to tacklc ilnrlediatc solutiou . Ilelcasc of funds for project activitics 'l'hc Iuncls fbr the pro.icct activitics has rclcasocl on timc l)'onr parrrrcrs. Is CD'II includcd in thc PHC budgct? Since CIDTI is orte ol-thc priority activities. thc budgcts ilrc inc()r'poratecl into Malaria and other vector borne diseasc unit at all levels Describc other hcalth programmes that are using thc CDl'l structurc and how this was achieved. What havc bccn thc achicvcnrcnts? Malaria control activitics such as on ihe clistribution and Lrtilization o1't,LI]-Ns Dcscribc others issucs considcrcd in thc intcgration of Cl)'[1. 'l'hc expansion cll'health cxtension progranr clcsigned to rcach all ltcbelcs and the existing lower govenurent structure so calleci'Gercc'(villagc )which is conlposed o1'25-35 houscholds is foLurd irnportant fbr intcgration oltcl sustainability o1- CID'l'l ac tivitics. 4.4. Operational research 4.3.3. 4.3.4. 4.3.5. 4.3.6. 4.3.7. 4.4.1. 4.4.2. I Summarize in not morc than onc half of a pagc thc operation:rl rescarch undertakcn in thc projcct area within thc rcporting pcriod. NONI.] IIow wcrc the rcsults :rpplicd in thc pro.icctl { 26 Wl I( ),'n l'}Oc, i () ScPtcn)bcr 2007 , ,l. a + sEGTloN 5: strengths, weaknesses, challenges, and opportunities - List the strcngths and weaknosses ol'CDTI implcnrentation proccss. - List thc challcnges and indicatc hou, they wcre addrcsscd. Strengths: Tlte pro.icct has concluctecl the distribution cil- nrcctizan rvith 100" , geographical coveragc and high therapcr,rtic covcra!c witlr abovc thc ntininrunt stanclarcl rrith in a short pcriod ol'timc.'l'hc high perfbrmance uith 100% coveragc is due to thc activo involvemcnt of health workefs, community supcrvisors und the corrmunity at largc. Wcaknesses: Delay in starling Mectizan distributiorl, P{ror recording. clelay, in getting report and poorquality rcport liorn thc lower lcvel. delay ol'linancial utilization ancl lrrluidation. Opportunitics:'l'hc govcmrlrcnt structtrrc clorvn to villagc lcvcl "gcrcc'' ancl [r.'rr.rg takirrg the responsibility of'clcvelopmcnt activitics as well as health is a goocl opportLrnity lbr sustainability of onchocerciasis cotttrol. -l'he cxpansion o['llcalth [rxtensiorr l)ae kagc progranl and thc incrcascd truntbcrs of hcaltli cxtcnsion workcrs in the ncw builcling of health post going on to each and evcry Kebcle is also anothcr good opporlunity. '['hrcats (Challcngcs): I-ligh tunr over, Shortage arnil overl'rurciening ol'hcalth uorkcrs in pcl'iphcral health facilitics in clil'lcrcnt Ireulth prr\granrs such as nralaria cpidcnrii control, l:l)l .Acutc watcry cliarrhca (AWI)) arrd mcrr.,lcs cantpaigns. SEGTION 5: Nonc Unique features of the projecUother matters , 27 WIIO/n I'(X', lt, Scptcnrbcr 2007