Progress report on the implementation of transfered activities to the national onchocerciasis programmes: 1st January –November 2002

Onchocerciasis Control Programme in West Africa Programme de Lutte contre l'Onchocercose en Afrique de I'Ouest COMITE CONJOINT DU PROGRAMME Bureau du Pr6sident COMITE CONJOINT DU PROGRAMME Vingt-troisidme session Ouaeadoueou. 4-6 d6cembre 2002 CCP . JPC JOINT PROGRAMME COMMITTEE Office of the Chairman JPC23.8 (d) ORIGINAL: ENGLISH November 2002 Point l0 de I'ordre du jour provrsorre PROGRESS REPORT ON THE IMPLEMENTATION OF TRANSFERED ACTIVITIES TO THE NATIONAL ONCHOCERCIASTS CONTROL PROGRAMMES (1't January - November 2002) GHANA t t i? t I JPC _ 23 ON ONCHO CONTROL A JANUARY _NOVEMBER 2OO2 Introduction: Following the closure of the last OCP operational base, the country took full control of the Oncho Control activities. The emphasis was on the integration of the activities into the decentralized health delivery services into the district health services administration. This was however beset with problems as a result of the ongoing Health Sector reforms. Ivermectin Distribution : The year saw the LF control programme being extended into several areas of the country. This had an impact on the oncho control programme as in some cases it was the same CDD and health workers who distributed the Ivermectin. As in the previous 2 years, the country ordered the drugs directly from MSD. The supply was delivered to the Central Medical Stores of the Ministry of Health, on February 2OO2 in collaboration with UNICEF/Ghana. The CDTI strategy was used in both savannah and forest areas. There was passive distribution in the big urban areas as people who had moved from the endemic areas sought the drugs from the health workers. The distribution started at different times in the endemic regions despite the recommendation that they should be carried out before the rains started. Each region planned and carried out the distribution according to their schedule. They collected the drugs from the Central stores for distribution to the districts when they were on Regional trips to the capital. This really affected the retums on the Ivermectin distributed throughout the year. As at the end of November, incomplete returns have been received from three out of the nine regions. Reports indicated that even though the retums had been received from some of the communities, they had not been collated at the district level. Subsequently, Regional data has not been complete. Achievement: 1. The district health management teams coordinated the Ivermectin distribution. 2. There were very few areas, which reported drug shortages during the year. Issues: 1. There was no coordination between the LF and Oncho Control programmes with regard to the times for distribution and the mode of data collection. 2. The data on the CDTI were irregularly submitted 3. Monitoring by the District team needs to be improved. 4. The Distributors need incentives to motivate them as other programmes do it. I Epidemiological Evaluation/ Surveillance : This could not come on as planned due to the several factors. They included the following: 1. The distribution of the Ivermectin to control LF in areas under surveillance as a result of non- coordination of activities between the LF and the Oncho Control programmes. 2. The erratic and unpredicted rainfall pattern during the year. 3. The presence of several health activities which were regarded as priorities. 4. Inadequate logistical support to implement activities. The evaluation has been scheduled to start during the last week of November 2002 in 13 river valleys in 6 Regions Entomological Control: - This was intensified in the Asukawkaw and Pru river basins where there was active vector control through' aerial and ground larviciding. - An entomological post control surveillance activity was carried out in some areas of the Asukawkaw basin with the active support of OCP between May and October 2002. Trouble Spots: These are in the Pru basin, Lower Volta Basin at Bui and in the Kulpawn-Mole basin. With exception of the Pru basin where Ivermectin distribution was intensified by way of giving 2 doses to some communities and intensification of ground larviciding, nothing much was done in these areas apaft fi'om the normal ivermectin distribution. Issues: It is quite expensive to carry out the entomological activities by the nationals through national budgets. Information, Education & Communication (IEC) As part of the strategy to create awareness on the disease and its control Helen Keller International (HKI) supported a workshop to develop IEC materials for both audio and visual in six local and English languages. The materials for radio and TV have not been released fully for lack of funds. They are as follows: 300,000 copies of leaflets which contain basic facts about Oncho Audio cassettes which contain radio jingles in six languages (English, Akan, Hausa, Ewe, Wallo, and Dagbani) Flip charls to provide basic information about Oncho. I 5-minute Video cassettes. Financing: 2 It is mainly from the national budget. Others are from a number of NGOs Conclusions: The year did not see much of the Oncho control activities; as a result of the integration of the programme into the regional health activities and the non-prominence given to the programme by the health managers at the periphery. Some of the problems have been highlighted and it is hoped that as the programme gets fully integrated the surveillance and ivermectin distribution will be improved. ) Region Total Popln Iverm. Supplied No of People Treated by Dose Total Popln Treated Total Tabs Used Iverm Distrib. Cov. (%) No. of Communities Geogr, Cov. (%) I 2 J 4 Target Treated Upper East s0990 170000 6108 9789 9625 11223 36745 37545 76 95 95 100 Ashanti 19997 I 12t554 1492 9683 13982 7 562 387 r9 8877 I t2 Brong Ahafo 309306 496158 10877 t4117 22940 5794 54388 340932 46.2 360 240 67 Upper West Northern Volta Central Western Eastern Total 560227 787712 24477 34251 46547 24579 t298s2 466388 23o/" 455 33s Summary of Ivermectin distribution through the CDTI in Ghana,2002 Comparison of Ivermectin Treatment Coverage for Ghana 2001 and 2002 Region Total People Treated 2002 2001 Remarks on Iverm Cov. Iverm Cov. (%) Geog Cov. ('/'\ Iverm. Cov. (%) Geog. Cov. (o/o) Upper East 36697 100 76 80 Increased Upper West 28s43 76 Northern 76389 46 70 B. Ahafo t24536 67 46.2 45 No change Volta t067t5 s3.1 Central 94709 4t.r Western 36847r 96 68.4 Eastern 89r29 58.2 Ashanti 19080 t2 75 Incomplete Total 944,891 44 56.4 4 t