Preparation of countries presentations to JAF 12, 13-22 November 2006, Addis Ababa, Ethiopia: mission report

1African l'rograrnrlre for onchocerciasis control Programme Africain de Lutte contre I'onchocercose Preparotion of countries' presentotions to JA F lZ L3-22 November 2006, Addis Abobo, Ethiopio MISSION REPORT Dr Noma Mounkaila, Chief of Epidemiology and Vector Elimination Unit, ApOC & Mr. Yacouba lssaka Niandou, lnformation System Offtcer, APOC/EVE November 2006 1Worltl Health Organization African Programme lor Onchocerciasis Control MISSION REPORT Submitted by / Pr6pare par Dr NomeMounkaila & Mr. lssaka Niandou Yac.ouba Date: 02 11212006 Authorised by / Autoris6e paq Direction/Apoc Duration / Dur6e de la mission : incluant les jours de voyage / inclusive travel dates: From./De To/Au tt/rt/2006 23nU2006 Co-travel ler(s)/Autres membres de la mission Preporotion of countraes' presentotions to JA F tz t3-17 Novenrber 2006, Addis Abobo, Ethio Purpose/Objective of travel / But de la mission Pro Visit to / Lieu de la mission : Addis Ababa (Ethiopia) - 13 au 22 November 2006 Brief summary / R6sum6: 1. Objectives and Expected outcome r.1 a a a General Objectives To provide answer to the request of JAF 1l on ivermectin treatment in APOC countries To provide answer of the query of Donors on Governments' financial contributions to CDTI activities To prepare countries' presentations to JAF l2 Specific Objectives ,,/ Collect and cornpile data on Govemments' financial contributions to key CDTI activities Collect and compile ivermectin treatment data of each CDTI project (2003-2005) Standardize and harmonize the total number of communities and the total population in meso and hyper endemic zones of each project Check, complete and validate data on Govemments' financial contributions to CDTI activities Prepare counfries presentations to JAF 12 on Govemments' financial contributions and treatment coverage v. 2 1.3 Expected Outcome At the end of the rvorkshop countries' presentations are finalized on: . Governments' financial contributions to key CDTI activities o lvennectin treatnlent: total population, total communities, communities and persons treated, therapeutic and geographical coverages. o a a a a 2 i ^e."-I-r,,F 2. Results reached / Rtisultats atteints : Trvo APOC nrarlaqcrlrctlt menrbers lacilitated the rvorkshop that took place rn Addis Ababa, Ethropia from ljthto 22nd November 2006. The 8 participants at the workshop on countries presentation came from 5 countries namely Ethiopia, Malawi,Nigeri4 Tanzania and Uganda (list of participants in annex t). r' The agenda of the workshop was revised to address identified needs of participants. (agenda in annex II). The objectives of the workshop were reached. 2.1. Implementation of the workshop The workshop was chaired from begin to end by the national Coordinator of Uganda, Dr RichardNdyomugyenyi. Mr. okoronko chuku was elected as rapporteur. " ,.,' ' The workshop was conducted in two phases: hase I was devoted to countries' financial contributions to CDTI activities and phase 2 to Ivermectin treatment data in APOC countries. In each phase, a review of the data was carried out after the presentation of country data. working sessions and plenary sessions were carried out. 2.2. Review of countries' financial contributions to cDTr activities o Except Tanzania and Nigeria, funding of CDTI activities is decentralized in all the remaining countries and it is the responsibility of the districts. The countries' representatives were well prepared to attend the meeting. ' Tanzania: communication had to be carried out to get additional information's in order to not under report the national level contribution to cDTI activities. ' Nigeria: the data was incomplete, only the contributions of the states were available for 13 projectsfrom on set' Federal and LGAs contributions to CDTI activities were not available. The meeting urgedthe representatives of the NOTF of Nigeria to put effort to provide complete data on governments, contributions at all level: Federal, States and LGAs. ' Participants agreed on the format to present countries' financial contributions to CDTI activities.The representatives of the NOTF of Nigeria noted the importance of having a centralized database to compile the governments, confibutions at all level. 2.3. Review of Ivermectin treatment data Each country presented its treatment data by project and by year (2003- zoofi: Then the meeting carried out cleaning treatment data, mainly correction and validation of the denon{inators for computalion oftherapeutic and geographical coverages (total population and total communities). Basic statisticalparameters rvere discussed and adopted for correction and validation of reported data. Countries (Nigeria, Taruania' Malawi) noted the importance of having treatment data at the NOTF le'elto fbcilitate immediate response to ApoC request at anytime. o a 3 n Conclusion : Govemnlenls are contnbutlng annually to key CDTI activities; horx,ever the Contributions from all levels need to be reported by the NOTFs in order not to minimize countries' financial support to CDTIactivities. ../ The meeting was welcomed by the palticipants and was the beginning of improving data quality through peer review of data. Uganda and Ethiopia can be facilitators for training others countries in the importance a proper management of data, The data provided by the countries should be published to add value and to secure the data. In 2007 , APOC Management should consider to carry such workshop in gathering in the same venue the francophone and Anglophone countries. 4. Recommendations-Action to be taken / Recommandations-Actions a prendre : o to centtalize and check Governments' financial contributions at all levels ' to have a centtalized databases on ivermectin treatment and Governments' financial contributions at all level a a a a a Action to be taken / Action i rendre By / par APOC Management to identiff a focal point to monitor the Governments' financial contributions CEV and ISO to follow-up with NOTF Nigeria to collect Govemments' financial contributions for all levels from 2004 to 2006. // o a APOC Countries 4 -- _= ,?. -frflEr Anneres l. List of participants 2. Agenda 3. Minutes of the Pre-JAF Workshop) 5 Annex I List of participants I Mry Qgbu Pearce NOTF Ni 2 Mrs Zakiq Mugaba NOTF Ugqq4a 3 yomugyenylDr Richard Nd NOTF U 4 Mr Oscar Kaitaba NOTF Tataanta 5 Mr Chuku Okoronko NOTF a 6 Mr Woubshet Dinkessa NOTF 7 Dr Square Mkwanda NOTF Malawi 8 DrNoma Mounkaila APOC 9 Mr Issaka Niandou Yacouba APOC Manageme4t \o \onr & Prenonr Titre \tl rcssc 6 --.F-\-:.--'.S--l-:* Annexe 2 PREPARATION OF COU).T'I'RIES' PRESENTATIONS TO JAF I2 .A.ddis Ababa, Ethiopia, l3 to l7 November 2006 Provisional Agenda 8h:00-l0h:00 WHO Country Representative by the facilitators of the Authorities of the M Briefing ofthe the facilitatorsB of Health b th:00-10h:00 Setting of equipment and working material l0h:00-10h:45 - Welcome address of the National Coordinator of Ethiopia - Statement of the Representative of the NGDOs' Coalition - Statement of the Representative of ApOC Director - Statement of the WHO Country Representative - opening of the meeting by the Representative of the Minister of Health - Introduction of participants - Objectives and expected outcomes of the meeting - Adoption of Agenda - Election of counties' focal point Opening of the meeting to CDTI key activitiesof l lh:00-11h:30 Presentation of Ethiopia Govemment's Financial activities - discussions and conclusions contributions to CDTI 11h:30-l2h:00 Presentation of Tanzania Government 's Financial contributions to CDTI acttvttres - discussions and conclusions l2h:O0-l2h.,30 Presentation of Malawi Govemment 's Financial contributions to CDTI actrvrties - discussions and conclusions l2h:30-l3h:00 Presentation of Uganda Government 's Financial contributions to CDTI acttvities - discussions and conclusions ffi l4h:30-15h: l5 igeria Government's Financial contributions to CDil activities - discussions and conclusions Presentation ofN l5h: I 5- l5h:45 Presentation of Sudan Government's Financial contributions to CDTI activities - discussions and conclusions l6h:OGl7h:00 - design of template ofpresentation of govemment financial contributions to JAF 12 l7h:00- l 7h:30 Closed session betu.een Ethiopia and Congo facilitators Jlondar l3 \orclnhe r 20(l(r 7 data on Ivermectin treatmentPresentation of 8h:00-8h:30 Presentation of treatment data ^ discussions and conclusions of Ethiopia CDTI projecrs 8h:30-9h:00 ofPresentatlon datatreatment Tof CDTIallz,anra ectsproJ stotrsdiscus and conc lusions th:00-9h:30 conclusions ofPresentation dataEeatment ofMalawi TTCD prolects anddiscussions th:30-l0h:00 Presentation - discussions of Uganda CDTI projectstreatment data and conclusions vermectin treatment (Cont)of data on I l0h:00-10h:45 Presentation of treatrnent data - discussions and conclusions of Nigeria CDTI projects I lh:00-11h:30 - discussions and conclusions of treatment data Sudanof CDTI ectsproJ l lh:30-12h:30 - design of template of presentation of ivermectin treatment data to JAF lz 12h:30-13h:00 and treatment data by country teamsReview of financial l4h:30-l5h:45 Preparing countries' CDTI activities presentation on Govemments' financial contributions to l6h:00-l7h:00 presentation on Governments ' financial contributions toPreparing countries' CDTI activities l7h:00- l7h:30 Closed session between Ethiopia and Congo facilitators 8h:0O-10h:45 Preparing counuies' presentation ' financial contributions toof Governments CDTI activities l lh:00-l3h:00 Preparing counuies' preserrtation on ivermectin treatment l4h:30-l5h:45 Preparin-e countries' presentation on ivermectin treatment l6h:00-l7h:00 Preparin-e countries' presentation on ivermectin treatment l7h:00-l 7h:30 Closed session benveen Ethiopia and Congo facilitators Tucsday l{ November 2006 \\ ctlnestlar l5 \orrnrbcr 2006 8 8h:00-l0h:45 Presentation of Countries fi nancial country tocal poirrt contributions to JAF l2 by country elected ^ discussions l lh:00-l3h:00 Presentation of ivermectin country focal point treatment in APOC countries to JAF l?by elected - discussions l4h:30-l5h:45 Countries financial contributions to JAF l2Review of Presentation of l6h:00-17h:00 Review of the Presentation on ivermectin treatment to JAF l2 17h:00-17h:30 session between Ethiopia and Congo facilitatorsClosed 8h:00-10h:45 presentation on govemments' contributions by elected country foCal pointFinal 1lh:00-13h:45 Final presentation on ivermectin .treatment by elected country focal point 14h:45-15h:30 Closure of the meeting l5h:30-16h:30 16h:00-17h:30 meeting facilitators and presenters to JAFEvaluation of the 'Ihurcda1- I6 November 2006 Frirlar l7 \or cnrhcl' 201)6 9 Minisurytheof of AuthoritiesHealth andDebriefing WHo country b andfacilitators elected Annex 3 iVI in utes of Proceedinss for l4th N ''ember 2006 (Pre-J AF \\'orkshon) The rapporteur gave the minutes of the proceedings of yesterday. A few additions were requested to be inserted to reflect the outcorne of discussions. Countries worked on their information, summarized by the 4 major/key activities. [nformation on salaries and capital items can be added as foot notes. Presentations Tanzania presented. Issues Raised t The amount539,492 for Distribution of MectizaninKilosa still need to be investigated. It was agreed that this might bias the data collated, and has to be eliminated until clarification is given. a It was also explained that at HQ level the low budget and release in 2005 was for routine training, while in2004 and2C[l6 training was targeted. o It was noted that in 2004 about ll2% of what was budgeted was released, and the meeting needed an explanation on this. Participants noted that amount released for CDD training for 2004 and 2006 were higher than what were budgeted, particularly for 2OO6.It was later found out that these were due to computing errors. a Why there was no budget (and release) for Morogoro for 2005. It was stated that there was no distribution in that year. However, participants noted that there must have been a plan & budget for 2005, only that there was no release. Ethiopia prescnted lssues Raised t It was noted that rnoney was budgeted and released for integrated programme management, and only percentages were used to compute figures required. o Except for one district, there were little details from other projects. o Two projects are yet to report. a On an aggregated basis the amount disbursed was higher than budgeted for 2OO4 & 2005. It was explained that for some districts the amount disbursed was reported but not for the amount budgeted. . The meeting was of the view that the Ethiopian NOTF does not plan & budget for their prograrnmes. It was suggested that the Ethiopian team should get the strategy plan, and use it to compute the budgeting aspect. . It was presented that funds used are SWAp money, just like Malawi. The meeting was divided on whether SWAp funds are govemment funds, and should therefore be ieported as goverrlment expenditure, when some of the funds are brought in from external sources. lt was agreed that in the presentations at JAF, the countries using SWAp will need to highlighted with the problems associated rvith collection of informarion on government contribution for CDTI. Malarvi presented lssues Raised o The summary for 2 projects \r as presented. but details for each project were nor avai lable The presenter prornised to send the details when he goes back. Hou,ever. Dr. Noma said l0 thc idca \\'as to finalizc the presentation beforc leaving this nteering. If the details are llol avatlable h)'this rveek, then the tnlbrmatron from \{alas'i might bc lcft out ip thcprcsentationtoJAFI2 Itrvasagreedthatthemeetinguseu,harisayailablcg'hile*arti.q for details. Any changes from the details wiil be effected on the summary and appropriately communicated to the partners concerned. The footnote on budgeting for 'outbreak of blackflies' should be taken out. Uganda presented Issues Raised t The Phase [V project, it was noted, was getting more funds released than in other projects The explanation given was that the area is unstable and a lot of donors are making nrnas available to the goverlment there. It was stated that the funds said to be released are essentially donors' funds. o The amounts budgeted are consistently high compared to actual disbursements, it was pointed out, as planners are always hopeful that more funds will be released. Nigeria presented Issues Raised ' If we do not get more information on Borno and FCT, they may be excluded as details areyet to be provided. a No funds were released in Anambra for 2005 due to political crises there. a The upsurge in disbursement in Benue State for 2005 was due to receipt of funds from health systems funds for training of health staff. o Yobe has 100% disbursement of funds budgeted. Statistically, this might not be true. It was explained that these are State allocations, and the LGAs; contribu-lions o It was noted that some of the States do not have the LGAs contributions yet, and it might be under reporting. It was agreed that the data so far received can be utilized for the presentation as long as the details are complete. The format for presenting at JAF was reviewed. It was agreed that the percentage releases should be reflected (in parenthesis) per budget line. Minu of for lSth N r 2006 (Pre-JAF W hop) Tanzania The Tukuyu population figures do not reflect appropriate grouh rate. This needs to be checked, but in the meantime use the national growth rate. As a basis, the census in thefirst year can be used for projection. In the interim, the increases in the number of communities/villages will need to be adjusted to original numbers in 2003 since the 100% geographic coverage has been maintained over time. N{alaw i o o o Should organize the data bl,project, not bv district. ll Ethiopia a It was observed that there was a sharp increase in total population for Northe Gonder from 2004, and the presenter could not explain the reason why. It was stated that it could be that a good census was not caried out in the initial year. On the fluctuating population figures for 2004 - 2006, it was explained that it could be due to population movements. o There were sirnilar population fluctuations in Illubabor & Jimm4 which could not be adequately explained. a There were no treatrnents in 2005 in East Wollega due to management problems. For Metekel & Gambella" no treatments were done due to conflicts. Dr Noma Save a brielpresentation on how he monitors population changes and uses the base year to calculate population growth using internationally acceptable growth rates for each country. He suggested that NOTFs could adopt same strategy after discussions on it. Nigeria a Populations changes were not systematic, and it was suggested that the above method be adoptedpending outcome of the collection of community data exercise. o Where there are nomadic movements rx'hich affect total populations, studies can be carried out to track treatments. o The rates that are above 85% need to be corrected. a Where, as in Gombe, there was a comprehensive census update in2004 or 2005, the data can be used as baseline to work backwards; and correct accordingly all the data using projections of populations in definite CDTI areas from GIS. Uganda a Decrease in communities but increase in population observed in Phase 2 between 2OO3 & 2005 not thoroughly understood. o The drop in coverage in Phase tV in 2004 was due to conflict. It was noted that denominators are problematic in most projects across all countries. Participants agreed that these should be corrected in the course of the meeting. As a way forward, participants were requested to identify for each project when they have the most reliable population data. Dr Noma will then provide the appropriate rates and formulaes to be used for correction of data for other years. He highlighted two ways of doing this viz: . Use population data of the year with refiable census and simply apply the growth rate to get an estimate of population a Calculate average population per community of the year rvith reliable census and multiply average with total number of communities. The first option is preferred. But to be able to use eitherof the options, he said, there is need to get the right total nuntber of communities. To get this, one can take the highest nunrber of communities reported since it is expected that by the third year the project should have reached full geographic coverage. Thereafter, countries contnrenced cleaning of population data. t2 --!-".-,.F-?".G. : Minu of Proceed inst for l6'h Not'ember 2006 (Pre-JAF Workshoo) Dr Nonra began the da,v rvith thc prese]ltation on ,qo\.crnntent contributious. Issues o There might be need to have a slide by activity by countries and govemment contribution summarized for the 3 yeus ' Percentages of amount disbursed to be included on slide on summary of government contributions. i It was noted that JAF is a political meeting and the shorter the presentation the better.t As a recall, a slide reflecting percentages of disbursements by activity for the entire 3years for the countries should be added. ' To ensure that government contribution and treatments are properly presented, a sample size will be selected (the number of projects whose information has been included pei country). ' The title on cost per treatment must reflect that calculations were based on governrnent contributions on key CDTI activities. ' A slide or rwo can be added to reflect additional activities using the CDTI structure as well as other govemment contributions to CDTI such as salaries and capital items/maintenance Dr Noma was requested to tidyup the presentation given the above suggestions and to make use of appropriate colours and fonts that will enhanie readability Presentitions on revised population figures Malawi Issues The presenter should watch the terminology used. Rather than use the word .adjusted,, he should use 'comected' which was what was done. It was later agreed that the wird 'estimated' will be more appropriate. The data should be presented in one table to enable quick comparisons between the reported and the oonected population figures. o o a Tatuania Issues The treatment coverage nationally still above 650/o withthe corrected population figures. Uganda Issues o The appropriate number of comrnunities per project to be done, and included Ethiopia lssues a ylth u corrected population, the therapeutic coverage in 2005 in Bench project rvas abor.e 90Yo and still need to be cc-,llected r3 --1s..!. ( .? .aYw .a The corcrage rates in Thrlrhe Gond project for 2003 ri'ill nee<! anorher look. Same applicslor 2()()4 in Illtrtrabor A sunrntarr- for all (lre projects by year to be prepared. Nigeria Issues i FCT may need to be visited and the population correcred o The national coverage is increasing though they have gone down. Dr Noma presented a template for the presentation of treatments in APOC countries. [ssues i List the countries that have data being presented t The titles of some of the slides need to be amended t Situation per country should be annexes to presented if time permits or where requestedI Because there is partial data for 2006, the tables on summary of Ivermectin treatment(persons/communities treated & therapeutic/geographic coverage) should not reflect 2006 data. o A slide on number of cDTI trained by year by country should be added. The presentation to be finalizedby the Apoc Management team. Minutes of Proceedines for lTtr November 2006 (pre-JAF workshop) Dr Noma presented the draft presentation on treatments. It was obvious that some data still need to be rechecked, and the percentages rightly calculated. The draft presentation on government contributions was seen. It was observed that overall government contributions are increasing. But percentages need to be reviewed. A slide on add-ons was updated. One slide rvill be addid to reflect other government contributi ons (salari es, c apital i tems/maintenance ). IJ