Extension-Phalombe CDTI annual project Technical report submitted to Technical Consultative Committe (TCC): January to December 2011

!tC {f I \t RESERVED FOR PROJECT LOGO/ITEAD (including e-mail address) ORICINAL : Enslish Ut_lt_tggliqi rer-g': (r'ilcllune) i I I { 5 (: 7 lJ 9 (lll} Il ll lJ ..i i'{ )t ' l'r'r llttncttlittiUtl \ r'irt' r'! rt't cilclcurr.') I 2 .) l 6 ' ti ri l(, ll (12 { t I I J It ( t3 ANNUAL PIIOJECT TECHNICAL REPORT SUBMITTED TO TECHNICAL CONSULTATIVE COMMTTTEE (T DEADLINE FOR SUB N Pa rtners: i linistr)' of ilcaIth tl)'ican I'rogrirrurtrc tirr ( )rrchoccrcilrsi'. i tirrlr',rl i il'(X'1 )r !rr Ii.ran l)oltrrliorr l'rogl'iurr (]llll'l sl(;ll I'ri.\\'t,){s. \\ ()til_t) Iili.\t,'t tt (}ii(, i.1,tt.11'to\(): ('{)\lNIl \ l't'l I,.\ CC) 5o ir,:r i'*t t f"p p ArtL,r: 3i e*^ n4tfo AI'OC Manasement by, 3l January fbr March 'I'C(' rneetin.siI I I fo APOC Managenrent by 3l July for Sente mber l'CC rneeti lv1fi" AYo I "l lr,t{+ I I I \e Horm@ttc.'h io, frR AFRICAN PROGRAMME FOR ONCHOCERCTASTS CONTROL (APOC) n-{ii J RECU LE I J ,.,. !. 2Al2 COUNTRY/NOTF: Malau,i Proiect Name: Extensio,grltE3:r From: January 20ll...To: December 201I Launching vear: 2000Annrov al year: 1999 Reoortin s Period: Month/Yea MonthfYear Date subrnitted: WI l()/'Al'}()(. lJ Scptenrber 20()9 # I \ l-, ilr\l ,\l tr'i{{}.Ei'.('l g'1.i li"'!{ il !{f ('{}i{ i itt il(ll\.i(\l(i;"rllll\.il\i'.ri\r'l"llllliiii [iNlX]H,SI!]l['-N"[' I)ltlrse COnlirnl \ott lulrC l'til(l llrit r-tpot't !tr sigrlirtg irl tlrc :r l) [] r{}l)I't lt t r r l)1lc(" ( )l'l l( l-tl.\ trrigrt titt' t t'ltrrrl ( (rl.iiitl\ '\ llll.r\\ i I)l i( | l)[.] l( .] \,:1,,. '' t i\ iill ir\ '\:t!t,r. .\ il'lltiil i . t.' 4T \trli,,tt,il {')(\l'(iilllll,rl \l:i':tlLtit I i rl'. \,.tllt. l 'r;i,t, \,).lr l.:l l Ii ( \ 1) ,ii +t .l,) ' l.\\ l ltt. t;i',rl'l it:is lrcttt l'rt'l'.1r;tl irl '\'lillt ( "ri 'rr I i r ' I \ l)r;rir:l',:lil "l J)t t( \r:ll.;ltll'L I ), I 1,,. . ,1, t a'l ;i .'r:., 1,. : r i:_ ;ti" il \ r.'it. ti l, i ! t. I Table of contents ACITONYN,IS DEFINITIONS FOLLOW UP ON TCC RECON,{MENDATIONS EXECUTIVE SUMMARY ............ SECTI ON I : BAC KGROUND INFORIv"I ATI ON........ l.l. CtNl-ttnt.tNloRtvtA'iloN.......... 1.1 . I Dc.s'crrpliott of the proyc't (ltrrt,flt') 1.1.2. Partner.;hip 1.2. Poptrr-,.\l'toN SECTION 2: IMPLBMBNTA.I.ION OF CDTI 2.1. Ttptr-t-tNt, ot. ,\ct-tvll'n-s .........6 2.2. ADvo(',rc'r' ....................8 2.3. I\1oBn,|l,|'toN. sENSI'ilzAt'toN,\NDIIt:,\l ltt I)tr(',\ttoNot A-t'I{tsKCoMi\4uNtTtes..8 2.1. CoH,rlruNrr'\' rNVor-vnM8NT............ ...................8 2.5. C.\p.\cn y IttJILDtNG .............,..........9 2.6. TRu,t-tMLN'fs ............... I I 2.6.1 . 7-reatntent Jigtlrcs .. .... .. .. . . . ... I I 2 6.2 lilhut rrrc lhe cattses of ubsuttccistrt') .... , . . 13 2.6.3 ll/lrul urc lhe renson.t' for rcf u.t'ul;'' I 3 2.6.1 Ilriaflt'cle.sa'ibe ull knotrtr rttrtlte rrf tetl .tarious orfigvss arent.\ (SAE,';) that .. . l3 2 6.5. Tratul of lreatrrtenl achievuttcnt frcttrt CDT-l projec'l inceplion lo lha ctrrrenl yearl5 2.7 . ORUL-trtNc, st-oRACE AND Dlrt.tvtrt(\' ()F lvt.tuvrt.c I'tN............. ............... l6 2.8. Cotr.lirrttNtfy sEt-F-tvloNlt'ot{tN(; z\NI) St AKt,nol.t)trtts Mer-r-tNc; ........... l6 2.9. Sr.;r,r.nvrstoN...,........... ..................17 2.9. 1 . l)rovtclc u.flotv chorl of .s'trltcrt,r:;iott ltrerurc'1n,. . . 17 29.2.II/holwerethentatnl,\'llt(,\,tdentifieddurtng,sttpen,i';it'ltt 2.9.3. ll''ct,y u :;ttpervr.sion c'hcckli.s't tr.s'ed'.) ............18 2 9 1 l,I/hctt were lhe otrlcrttrrc.s'crt crrch lavel o/ ('DTI itttplcntentalion.supervi,sion? l8 2.9.5. ltr'a,t feadbcrc'k grven to llrc person or groupssupcn'ised? . 18 2.9.6. l[ov, tvtr,,; the fecclbuc'k tr,serl to intl,tt"ota llrc ot'erull lter/orntonce ofllrc proiet't') IB SECTION 3: SUPPORT TO CDTI l9 3.l. Et2utlH4r-.NI'................ 3.2. FIN,\NCt,rt. c'oN'fRIBtrnoNS ()t I-uI I)AIil'NLI(s,\NI) ('()t\4MtJNl-ilES 3.3. Ot't tt.tr I:ot{N4s ot- co\4t\lt.rNn y siit,t)ott't'................ 3.1. Ext,t.NI)t't'Ul{t:. I,EI{A('l'tvtt\' .............. t9 20 25 25 SBCTION 1: SUSTAINABILITY OF CDTL... 25 1.1. INt F]ItN,\r.: rNDEprrNDhN I I,AI{'r 1Cil,,\r'()RY r\4oNIr'()I{rN(;l Ev,,u-U,t-r'roN ........... ........25 1 I I Hu.s the pt"oject ct'cr bcan evrrlttolctlintontt()t'cd') (T1t'k rrny o/ the follorving'rhich ttt'ctrpltlit'<tltle) ...... . ................25 I 1.2 W/hot y,ere lhc racontntertclution.s'? ... .. . ... .............25 I 1 .3 Hotr hut,e lhe.t, been trrrplartterttccl'? . .....25 4.2. SLts t,\tN,\uil.ti Y OI pR()[-.c't's: I,t-AN ,\NI) sl. t t'.\t{(;t] rs (ntzrruon-l ot{y r\ r ...............26 Yrr 3).... .............26 1 2.1 ['luttrtirtg ul oll relcvunt lcvcl.s . .. Error'! Booknttrk nol ele/irtetl. I 2.2. Fttnd.s Error! Booktnurk not de.t'ined. \\/llO/,APOC. l.l Septcnrber 2009 ..................... \/I I 2 3 .Ennon! Boorrtlnx Nor DEITINED. . .. Error! llooknrurk not de.fined. ........1 , . . . . . . . . . . . . . . . . . .. . 5 ,......'..'...'.'..''..6 1.2.3 Ii"ttrt,sltot"l (reltlrrc'enrattt unrl nt(titttL'n(tn(t') .Error! Boolorturk ttol la./ittel, I 2.1. Otlrer rc,\'()ut'('c.\' ... . Errot'! Bttolirturt'li rtol de./inel. 1.2.5. To trlrot a.\taut lru,s tlrc plrut bcen itttplctttan/ed .Error! Bortlitttrrrk nol lc.firtel, 4.3. IN l't-tctt,r t't()\ .... .. .................26 1.3.1. lrcrtttactrtt tleltvar.t' rrtcchtrni.s'trt.t . . Errur! IJoolitttttrk nol le.fittctl. J.3.2 Ttuitrrttg. Ert'or! Boollrturk rtol ile./ittct[. 1.3.3 ./oit'tt ,strltat't'i.stott uttd rtrottilortttg vitlt olltct'ltrogrctrtt.s' Error! Bookttturk ttol de.fine il. 1.3.1. Releer.se o/ /irnds for projact uLtit,itic.\' Error! Boolltrurk nol deJirrcl. 1.3.5. Ls L-D7'l ittltrclctl trt tlrc PIIC btrrlgat'! .Error! Bookrtturh rtol de.fined. 1 3.6. De.scribc otlrcr hcultlt progt'ontnte.s lhol are using lhe CD7-l ,\lt'u('lttre crnd hov llti.s tlos uc'ltict,acl- ll'ltttt ltuva lrcut llte rtc'htevetilanls?. ...... . ... ... 26 1.3.7. De:;c'rtba otltat',t /,!.v(,.r c'ort.sidare d rrt lhe inleg;rolictn oJ'('D7'l ..... . .2'7 .1.4. Ot,t,.tr,li'toN.\t. I{t st \t{('tt................. ....... ..........30 I1.1. ,strttrrttrtrt:t'ut n()t ntot'( thon one lrul/o/ e l)uge the operuliorttrl t'c.sattrclt rtttdertokatt in llrc proyt'L'l (tra(t tltlhirr llta rcltot'ting pertotl. . ... 3() 1.1.2 Hotr trt'rc tlrt't't'strll,s trpplicrl in llrc prc1ccl'.) . . .. ... -l() SECTION 5: STIIENGTFIS. \\/8.\I(NESSES, CHALLENGES, AND OPPORTUNITIES... SECTION 6: UNIQTJE FEATLIIIES OF THE PROJECT/OTHEII MA'ITERS.......... 30 30 lV \\'l I()/,A IrOC. lJ Scptcrlbcr 2009 Acronyms APOC Aliican l)roqrartrnre fbr Orrchocerciasis Control ATO r\nnual -['re-atmenl Ob.jective ATrO Anntral 'l-ruinirre Objective CBO Conuruuitl'-Llasccl Organization CDD Corrrnrunitr'-Directed DistlibLrtor CDTI CortrrrrLrnitr-DirectedTrcatnrclttu,ithIvernrectin CSM Corlrlunitl Self'-Monitoring LCA l-ocal Corcrrrnrerrt Area MOH Vlinistrr ol l-lcalth NGDO Norr-(ior,ernnrcntal Developllent Orgarrization NGO Non-(jor,ernlnental Organizatiolr NOl-F Natiorral Orrchr-rccre iasis -l-asli lrorcc PHC Prirrary health care REMO Rapicl Iipiderniological Mapping o1'Onchocerciasis SAE Severe adr'else cvent Sl-lM Stalieholdcrs nreetirrg l-CC 'le'chnical ('clnsultative Conrnrittee (AI)OC scientillc adl,isorv groLrp) TOT Trairrer of trainers UNICEF LJnited Nations ('hilclrcn's Irund IJI'G LJltirnate Jreatnrcnt (ioal WHO \\/orld I-lcalth Organization DC District C'onrnr issioner DE(' DisfriclErecLrtil'eC'olrrnittce DflN'lT DistrictIlealth N'lanagerrrcntClonllittee I-l.S.A. Healtlr SLrrveillanceAssistant MDP Mectizarr Donation Progranr CHAM Christian Ilealtlr ,,\ssociation ol- I\4alarvi DIP District InrplentenLaLion Plan NOTF National Onchocclciasis 'l-asl< Folce WI l(),/Al'}()C'. IJ Scptcnrbcr 2009 tlefinitions (ri) Eliuible poptrlation: calcrrlatccl as 84% ol the total popLrlation irr nreso/hyper- endenric corrrnrrrrrities in the project at'ea (rir) Annual -freatnrent Olrjecti_ye: tATO): the estinrated nunrber of pelsons Iiv'ing in nreso/hvper-cnrlenric areas thal a CDTI pro.ject rntc'ncls to treat rr'itlr ircnnectin in a eiven Yeirr. [.] ltinratc l-realnrent Goal (U-l-C ): calcLrlatecl as the nraxrnrrrnr nr-rrrrbel o1' pcoplc to bc tlcatcd anrrr-rallv irr nrcso/h\/per enderlic areas ri,rtlrrn the project alea. ultirrratelv to bc reachr-cl rvhelr the pro.iect has reacherl firll geoqraphic covelage(nonrall\ the project shoulcl be expectcd to reach thc' Lll-G at thc end ol the 3"i vcar o1' t lre plcr.;ect) (r') llrqlaperrtrc' Qo\ c4qq nr-rnrber ol'people treated in a given )'car o\/er the total popLrlation (this slrorrlcl be expressecl as a percentage ) Cqq_qralrl1g4l gqr,erage : r'ru rlbe r ol cour rlr-rrr i ti es treated i n a given vear over tlre total nLrnrber of rreso/lr1'per-enclerlic corlnrr-rnities as iclenti Ired bl Rl:MO irr tlre pro.jc'ct alca (this shoLr ld be explessed as a percentage) lvii) Intc'{r'ation: clelivc'ring additional health inlerventiorrs 1i.e. vitanrin A st-tpplertrents. albcnclazolc lor L.lr. scrc'errir.ru lbr catalact, etc.) thror-rgh C't)'ll (Lrsrng the sanru' s\steurs. tlairring. sLrpu'n'isron arrd personncl) in ordcl to rnaxintise cost- el'f-ectrvcness ancl enrl-lo\\er conrlunities to solve nrorc ol'tht'ir health pro[llenrs. 'l-lris clocs not incltrcle lctivities or intcrventions calricrl orrt br ctlrt.tnrLrttit\ clistlibirtols or-rtsidc o1' CDl-1. (r) (rr') (vi) (r'rir ) (ix) 'i'otal popttlatiort the lotal popLrlation living rn rlcso/hr pcr'-cnclenrrc e ornrnurrrtics ri ithin thc prolect area (basccl orr RITNlO ilncl censLrs tal<ing) Srrstarnabilit-t CDl'l acti\ities irr arr area lrc sustainable ulren ther continue to lirnction c'1}'ectii,ell lbr the lbreseeable lirtLrrc, rvith hrgh tri:atnrcnt covcrase. intcgrated irrlo the available healthcale service. rvith strong con'rn.tur.titt, ou rrcrsltip. Lrsing resoulces rrrobilised b1'tlre conrnrunitv and the governnrent. ('onrnrLrnit.r' scll'-nronrtorinq (CSlVl ): 'Ihe' process [ry rvhrclr thc conrrlLtnitr is enrpori,erecl to overscc arnil n.ronitor thc perlbrrlance- o1'CD-l I (or unr cor.trn.tLtr.tit,r- blrscd hcalth inleIr'cntirln l)r'os|anrnre), rvith a vierv to errsLrring thal thr-'pr'ogranttre r: b.'ing execLrtet'l rr the \\al intcrrclecl. lt errcoLrrages thc conrnrLlnrt_\ t() take firll responsitrilitv ol'ri,'ernrc-ctin clistribLrtion and nral'e applopriate rlodilicutions uhcrt llcccssa l')'. vt WI IC)/r\l']OC'. l-l Scplenrbcr 20()9 FOTLOW UP OhI TCG REGOMMHNT}ATISNS Using the table belorr. flll in fhe rcconrnrendations of tlre last'l('('on thc projcct arrcl clcscribe hou, Lhev have bcc'n acldresse cl. TCC session httt ttthcr oI Rec'otrtttte t tdulio tr irr llta N.\ TCC ECOMITEAIDATIONS ACTIONS TAI(Ei\'I I]I'TITE PROJECT FOR'TCC/APOC ITGT LISE ONLY -l l^ I li I --lNA N,-\ I I I .l l- ( I' I e r r,sc t t t lt I t t t o t'e to tr'.s t f n c (' (,.\.\' ( t t'_)' ) \\/l iO/,,\ l'OC . IJ Scpte nrlrcr' 2009 Executive Sumrfiary ('l)-l'l progrant in l)halonrbc startccl in thc lcar 1000 ri itlr I I villagcs [hc' pt'ogranr is ttotv lt.t the I I y'ear o1-treatrncnt. Phalornbc has 62 orrchocelcizrsis cnclcnric villages and all the 62 lillages \,vere c()\'ered u'ith MDA representing 1000,o geographical co\'er.lgc.-l'hc total poprrlation olthe irnpacl area u,as 40,318 oLrt ol'this 33.]42 ncre trcatecl and oLtr covet'age is 83.luh.Onr AT'O r,ras -13.867and \\,e nranaqcci to treal 33.742 popLrlation.Ll'[C tirr oLrr distl'ict rv'as still33.867. 'lhe larntcrs go to lhlut irr lteighboring MocarnbitlLre. Lil<ervisc otlters go to worl< itt estates lrrtd lhrrus irt otltct' tlistricts. l-he clistrict lras -l(r0 available CIDDs irr uhich 6() ucrc not arrcl -100 olil ('t)t)s arrcl '14 health riorl<ers.'l'hc ratio ol'C'DD to the;topLtlation serrecl rrasl ('DD to 97. l'he rlain challcrr-qc laced bi'the prograrr u'as Ihe n']ovcnrent ot'peoplc to itncl tl'orn I\'lalairito Nlozanrbiquc dLrrirrg the clistlibLrtion peliocl. -l-he sccond challenge rvas C'DD clrop or,rt.CDD clrop oLrt solLrtittn, u,c selcct nerv CDDs replacing those w'ho left tlrc prograttt. Movetlent of 1;eople tlrc scilrrtion is rre distribLrte the clrugs befilre nro\/emerlts bcgLtn. Alstt. rve are facing a challerrge of lue I scarcitl' lcacling to inacleqttitte sttltert'isioll . ) \\'l lO'\l'()C'. t.1 Seplcnrbct 1009 SECTIGF{ { r Backgraund inforrmaticn '['lre clistlict borr]ers rvith I\4ularrje to the south. Zonrba [o thc u,est. N{ulan-jc lVlorrrtain to tlrc north ancl l\lozlrrlbiqLrc to tlrc cast. -l 'he urcir has [*,tl tvpes ol'clirnatc'-sr.rnrrcr ancl rr,irrter'. 'i lre irnpact arca is to the east ol-thc il istrict arrci covels trro lrcalllr centct's (Nl'htr Iantbe and S u lia sa rr.jr') -['he people ol'this arca are l-orrruc anci I(ol<hola tribe ancl tlro, speal< thc fbllon,ing languaues; C'hiclreu'a,[-onr\\e arrd l(ol<lrola.l-lre nrain tracl itiorral clanccs anror.lg thesc peoplc are rrerinlt L-ililata and [cltolttt. l'hc rrairr occtrl'lation lirr'tlresc people is farnrns on srnallscalc leve ls.'fhcr urcrr clill'erent crol)s lil(r-:-nrai/-e rs therl nrain stalrlc lbod. others inclucle cassava. rice. pcas. gr()Lurdnuts and pigcrlrr;;c'us. llrc district t'oatl rtctrrorl< is corrrprised ol'thrcc rrairr roads:-one ll-ont N4trlarrfc boalder tltrouglt Phrtlonrbc to C'lritaliale ancl tlrc scctmcJ road is liorl ['lralurnbe to Zonrba throLrgh Jali. thc thirc'l rtxtrl is lionr Chiradz-ulLl [hrotrqh N.ligorrito Chiringa. Roacls lcccssibilily'dLnirrg the raittl season is nearly irrpassablc cspce iullr in thc oncho irrr;tact are'a. J-he clrstrret is bcing rttn Lrv thc District.,\sscnrblv hcatierl b1 (he District C'ornnrissioner'(DC). Thc- [)istrict LrecLrtive Cornrnittee (l)l:C') is looliccJ b1 the DC'as the lcade r ol' Acltttiltisl"r'it1ion.[)EC'is cotnprisec] bv hcitcls ol'sovcrrrnrr-nt scctot's rrnder the t)C r\pa11 {iorn thc DEC. thcre arc alsrr tradilional .\utholity(1-A).CrouP Vrllaqc [-leadrnan ancl \/illage Ircaclrlan. -l'hc Irealth svstcnr in the ciistlict is bcing lool<ecl alicr b1 tlre District Ilealth Oflrccr'(DI-lO) ri ito is Ihc Icaclcl of- District I-lcaltlr N,lunugcnrcnt -l'canr (DIIN'll'). 'l-hcrc alc thlcc hcalth cerlter s in tlte' irnpact itrca and in total tlrcrc arc I-\ health facilities in tltc clistlict out of'tlrcse 4 are('ll;\N,l lacilitics ,\ll++ lrclltlr stirl'l'ilr tlre irtrpacl alca \\,crc irtvolvcrl in the CD-l-l actir itics -) \\'l IO/Al')O( . lJ Scplcnrbcr 2009 'fable I : Nrrrlber ol he altlr sl.al-l'irrr'oli cci in ('Dl'l (Plausc trrltl rttorc rrnr,s rf trcc'c.ss'rtt't') [)rstrict/1.(i \ \unrlru ol ltc:tltlt sl:tl'l inrttlretl irr ('l) I I :tcltr ilics. Iol:rl \unrlrcr ol Nrrnrbcl ol ltcaltlr hcirllh slulf in lltc stirll inrolrr:tl irr enlirc J)r'olccl ru c:l ( l) l'l l'c rcc rr lit gc I|, llz llr=l]r, tr' -t,,,, P hul o ntbc l,l l4 lll0ol' '[ota I H .ll I (l()"i, 1.1.2. Partncrslti;r I'hc pa;trrcls irrvolr,eci in thc C'l).1 I rnrlllen.lcutatiotr irt orl'clistl'ict (Phalorltrc) \\'cre the lbllor,r,ing:-MinisLrr ol l-lcalth. Sisht Sar,crs. \\,"orlcl Ilealth Ol'ganiz-atiotl,'l-l'atlitiotlal ALrthoritl,(TA).Village Ilcaltlt C'ollntrttccs- ('l)Ds and the er)llnlLntit\. Itttcrttatiilllll paflncl\ arc,{POC lbl tcchnical and llnancill strpptrrt ancl l\4DI' litl l\'lcctizarr clrttg clorlation. l'hc lbor,c partncl's \\'crc illl irrrolve'cl in thc planrting. sttpcrvision. aclvocac\'. sel.lsitiTatiot.t ttnd rliobilization ol'plojecl activrtics rrl thc ('D'l'l itl;lact rttea. .AIltlre partners \verc lnostlv irrvolvcrl in strpcrvision olC'D'l-l activities i.c. betbl'e. dLtring and aftcr N4ectizan altd .\lberttlaz-ctlc cl istribtrtiort. 4 Wl IO,/,\ l'}( )( . I -l Scprtcnrbcr 20()9 cl IL =! C. ! J ^ .= = =E a '_)) -a nO.) LJ .Jtlv ?. 1) =- .c 4" -:)- a) 'J -=, -i a!) s?7 .) =-=>= ') '- a-= o1 =a =-J=a*,)= i3 '.u!-, !.= "h (-- == .a .J -n; u tnu .)J a) /\ =:)/.) .) -= i- /. -o o '= a) o_ cJl ='5 L oo 4)L .JE or.) =:- -o oE Lc -c a) a)L C)! -q L a) -c (J .C I () = .= - = o-: 6^t -c\ i I I I I I = a) o- d ,2 =a ,n L us I l I -/ I I o o(, c Z. q() iJ .9 L c- at) u oo)4)LE(,,) (3s (J alt '.C ='rc =- Ot 'o =O'*oc '4,, ,t)(f-L -= LO .os o-= 2z = =4) '-) = = .2 1. u O ! L -l)|./) /- I ! s 5n ar, lrt:): : : (r- u- E^ Jl- F\ ,9 ^: c ..il v .rl < -l ! -,1 :J -l \ ' t\rl ! tr .9 +,g I o, o L. .i f. I\ t- *i 1-. \l4 {, ";%1' q o00 '\\ :-L!,;!-u/ .. a ! a - N= + il U- 4i ,' .= e-N - l. O .L - L lri 'ai?N: a_ -l ?) =O -t cr) co c9 ,a t raa rt) 1/:t .e 0a a.l ,! a:\ br.i _ =cl 1r ! r,i r, L:_s Lr v; ! ^t i , -v x.= -. N z.te= - itu q<! ;-- 9 a?:'t _-:C'lt:5 u.: s i--. a' ..J: --JF-L^-^ T- c.) -t a.l .o al r') tf a..l v (..l tn qP ?a'J 2-ii't _-i:, ,-) v, .4.J - -a = I F F I SEGTION tr lrnplementatien of CDTI 2.1, Timeline of activities Irill irr table i. lrttrt,lutt'of trr'ln'rtrt't for ut'(,u\ trctrl<:tl tn ('urrattl t't'rrr'. itltlietttirtu ttltetl lhc I'c) actiyities rrc;c iptplclteptccl [rr thc nrontlr tltcl begarr and tltc ntottth tltcr ctltlccl 6 \\'l I() \l)( )( . I I Septcnrbcr l()09 -l .)t: =, c-u 'tl -t 1 7 I I l ---.'l_ --r --t-- l I I I / : = :.1- I I -i I i + I l i I I I I l I l I I I l -iL I -'l I I ! I I l I l ala =! 2! ! 2 Z 2 2 = I = 2 al) I 1+ at tt- 5' 'u- cl. J) ,' q, = NF z J 9 .2 2 l F :r ? ? -rr ? = .'r ! = lJ? ! e_ ! cg 'Zt 1) t) a) -c , ! uL s L ,c ,^ ,2 .= t) C) .= u = r't I -lal L-- l =a) = =a(t I I I I l I I I I l 2.?. Advoeacy Drring lrlvocac-r'\\'c Lrsc clrarna irncl banrl to cl isscrninatc C)ncho rttcssages l() thc [trrxrclel cr'lnrntLlrritt'.'l'hc1 ;rcrlclnrr br trsinr.t sr'lngs. tc-stinronics b1 thosc trlto tool' Nlcctizlrn in tltc plst _\'cars.'T'hc nuntbcr ol'polrcr ntrl<ct's nrtttriltzccl trclc I00.'l ltcsc Inclrrrle tlre'Local lcarlcrs. 1;olitietrl Iclclers. ehLu'ch cltle'rs uncl otltcr inf'l LrcntiaI ltcoplc in tltc conrnttrnit\'. \\'c tlrrtctcd the'r illagcs u itlr lorr co\e lagc rn rrrclct'to botrst tltcir ctl'clltgc this \cat. Pcoplc trrrrretl u;-l in largc r.rtrrnbcrs cspecilllr rvonten rtncl chilclrcn in all ltreas r isitecl. 2.3. Mobilization, sensitization and health education cf at risk communities \\'c Lrsc ntegaltlrorres ancl nrotorcvclc ttl scnsitizc and ntobilizc tlre colntlurlt\ cl ttrrtrg i\4ce tizrrrr distrit.rrt itrtr. -l he Ct)l)s giie ltealth tall<s lrclblc lr'lcctizarr clistribLrtion to Ihe ir'[rtoaclcr conrtttunitics. -l'hc ctrrnnttrnitics resperntl [rr, ttrrning Lrp rn llrlge nrrntbets especiallr \\on]ert arttl chiltllert. In tltc rrc'rt ilrplcnrcuLirtion pcriorl. \\'e are planrtirtg lo r.rsc a vchtclc tr tth lt lttrblic,ttlcltcss s\ stcnr so to rclclr lartrc tnasscs ol';leoplc. _!'ablc.l: C'onrlttltitics pal'ticipalion in tlrc CL)'l'I f ['jlaust trthl tnot('t'()v'.\ tf na('(.\tut'\') l)irl lrcl/l-( i \ ('onrnrertt tlt: Worlcn tLln ul) in larqc rrunbc'r's clrrrrng nreetings Ihan nrctr bccattse \\('rtttc-lt at'c ttsttally avlilrble rn thc villages. N,lcn go cltrt irt scarclr ol'lbocl lirr thcir ltrrrtilics (lsttallr'\\olrell ilt'e nt()tc ae tiYc irr tltc 1t|og|arn irr te|rns of-irLtcnclarrce arrcl ;lat'ticipal.ion citrrinq tlrr:ctitlgs lhc C Dt) attrititln ll.rtc is vcr'1' lc,rr, tlrarr the lrlst l() )cars.-l'his rcat'ltttt'itirrtt t'iltt'\\ls at I().f (1,,. 8 \\'l lO, \l'( )('- lJ \cptcrrrhcr l0()() \urrrhcr ol colrrrrrrrnilics/r illagcs rrillt crrrttttttrililt rrtcntltt't \ il\ \il1)cr'\ i\{)t \ \rrrrrbcr ol ('l)l)r :ttttl lltc ttttttttttttiilits ir: r olr ctl \l:rlc(l)l)r lert;tlc Iol:tl( l)l)r \urrrllcr ol cornrrrrrnil ier /r illagrr rr ith lcnritle ('l)l)s I ol.t l no. t out rtt lt rti I Icr in llrc cnlilc l)r r)i('cl :il eir \rrrrrhcr rr rlh l'cr ccrrtaqc \ urtr lrtl ol eontrrrrtttilicr rr r(lr lcnrllu( I) l)s l'crccnIagc ({}ntiltltrtrl\ lllcntllt'r'r:tr \ul)cr'\ t\ol \ t], ll. llr'= llr/ llr'100 ll, llt li,,= li.+ll" li ,,, llrr= Itro/l!11 l()0 I'lr,tlorttbe () 0 l(rl (rl) 96.7u/o 0 I -l ri t- ,l I 'i (i (.) 0 rr)l ll ltl ) t)(t l'' , I ola I I 2.5. Gapacity builtJEng Io strcngthcn tltc caltacitr trl'all llurtncr.s in ('[)'l-1. thc Ploglurn nranilges trr [rLr ilcl r:itltacitv ol' rll piu'ttlcls in lttntr ol'training tll'its nrcnrbcrs, Fol crnnrl.rlc. tlre Pt'olcct plitnttccl ttt ttairt I I tlistrict stlrl'l'i.e [()'l trarning. rt irlstr tririnecl -]3 II S .\.s In acltlition thc plogrurnt trarlrccl 460( l)l)s. $'c also trainccl 2l I eornnrtrnitr n.tt,rtitols. For tlansl'el ol'stall. the ploglanr tlains tlre ncrr stal'l'that ltas.iust.joirrcd (hc ('l) l-l intpact it tclt \\ e .rlsrr se rrsrtrz-ctl anrl nrotrilizccl l(t0 corrrnrrrnitl' rne nrbe rs rn thcir te spectir,c t rllagcs \\'llO/,\l'>OC'. lJ \cpte n)licr l0()()9 f x ! a2 a_ -+ 1 ! .L at, \ > -? 1, ? ^: :J? iJ e_ =C '= =a) =E = (J ta a) .) =, ,4) =-o .) E :l) = =L L \r'l !l -=l L ,a: J - .\ ! ^\ I i l I I -t .\ J :] ^\ x ct cl I I I I C] I i I I I I -l N al 6l ^l c. ,-1_ I i I I I I l I I I I l I I I I I i x l t. i I I l-- l 1 I __ F fi:- J ::- r? L Z (, -/_ -li - + a|- :- 1)r z - -v a -f -J. I 9a <)- ::! -L L9Q4_ !: - ri v ! I I I l 1 i I I I I I l cJ = l l l ; i tl il I ll ll I i l I I'lrblq 6' I r pe ol'lrairring un(le-r'tal\e n (-/'ttk tlte btt.ret' trltt'r'a s:ltct tf t<' tt'uuuug tt rrs r'rtrrt(tl ttttt rltrrtttg lltc t'altrtt'ltttu lrcriorl) I ).rlir r, o lle ct rorr [).itu rrnulr sis I(epolt rr r rtr ( )t ltct s ( : pct r I'r )Scns tlizrrtion & rrrotrilizal,itr n \rrr othcl' c()ilntents. n Irie ld t'csttlts llicr activity itrplcnren(lrtror intl re ilte s clrangcs in lhc l\no\\ lcdge gup. i.c lelrlrrrrrg lras talicn I)lacc. ?.6. Treatments 2.6.1.'l'rur(rrrerrt ligrrrcs It'thc ltlo.ieet is lrttt itchict,irtr. l()09rr uct)trlrphicirlcovcraqc alrcl a rrrininrtrnt ol'(r594, tltcl-apcLrtie c()\/ct'i,lqc ttt tltc co\cr'{rgu ratc is Iltrclrrirl.itrq..slirlc thc tcus()ns arrcl tlte ltllln: bcing r:rlrclc ttr lcrnecJv tlris, 'l'ntittt'cs lrpe ol llurrrins C DDs Olhcr' C'tl nt ttr rrn r tr nrcnrbe r s c.e Co nr n.t tr rt rlr s Lt1-lct't'iso r-s Ilcalth \\'o rk crs (llorrtlure' lrcaltlr lircrlitrcs,l Ntol1 5llrff'or- ( ) tltcr l)olrticirl l-circler: ()lhels( rlronrtor \) l) 1'lrgltnt nrl nlrgcttl cn I I loii to co rttlrrcI I I.'rtltir ccltrclrt rorr >lr -! \ llttltgcrncnt rrl'S.,\ I 's (.SN1 I l * sil\l J- ,i< >t: )i. l .i< )l< ,I >i. a. :F .t ,r I \\ l lO \l'O('. I I \cItcnrlrcr l()(tt) Fr !L =, a- o 1 J 1 ^ (.l .) ,) c 1 2 = ,= /a ::J cl -.o -a c) '= =u =tn 2 .= = = = =c U = -c =ua .r =lI .i'' .t J ')--, ':! .) :,J -t( -')- et -l -) ='-'J = al ,-:l _l - = .)t -= .) - - aL-7<t v. (-) 1) 11 aO -= - '= = .v .= = = = -C t) ! =O,J- -a it -,u -6 al;t ". .) -i ;i al/ --t: -ai.- ") ^,, {'2l '-)t ^ t t>= -= =,-) =D=O - (1, oi- c) ,\ - 1it7 tl -.1 _ -oiila-l -1t -rl/-- - ?- .o .I - .) ) = ') =i ! at al, - c: .2 =)l -t ] a?- - eJ - iJ c* '/t L t L = = l a); -c _c il-.1 .1 '{- = = C 1) a 9) L -a , = .) ? ta ,-l -,1 -) zl =iz.i -a ") '! E t) F) c , ,c ) , al) ?c a = D - - 4) o(l = 'F o =- t,l ) oU(, t "t) .J a) U: foi 1IU --L ,J = al 2 r - clJ f\ (\ T c-, q ct at\. a .': .: '','l : - = ! --= -- '-') 't *'; r;,- t -_=a.aa -= - = ^- )'J - -- -!-1,= t - =-ar= zt= =.1) =) - 4 != -=') ==/- -= = -i- t -!u - a)) a', :! ==--ti/* z-= a-.! !* / =/ 7-tt /a =9 = = q C) .ts C (-) al i. r 7 CI -t r .;, r Z 2 -t cl a .l .l _a = = =1 F I2.6.2 \\'hat itrc tlrc cirrisos ol'ltltscrrtccisnr'.' Fiu'nrttrg iu I\,lozantbirl Lre C'ltangcs ln thc sclrrrol cllc-rtrlar ancl sclcctrorr ol pLrpils to rrationalschoolsl 2.6.J \\'hat arc tltc lcitsons lor rcl'rrsirls'l - [{cligiorrs backgrorr nrl 2.6.1 Ilricllt'tlcscribc rrll l<norr'n antl lcrilrcrl scriorrs atlvcrsc rvcuts (S.-\lis) lhat (,ccur'r'c(l tlrrrirrg fhc rcportirrg pcriorl lrrtl provirlc (in tablc ti) llrc rctprirctl inlbrnr:ttiorr rr lrcrr avrrillblc. l),tl.trlt,,lrrr,is1 [lil'l',]ri" ') tr. I-ti',lirrc.l l1l I l!r I ri:lCllr't ttl'tllie' ()\-,'l'! )\ i I li\.trl't[llu ln case'the pro.icct cl irl not harc ant cilscs ()l'scrious lrlverse c\,ents {S,\l:)dulinq thrs rcpolting;rct'toc1. plcasc (icl' in thc brtr.. Ntt S,\l: citsc' to t'cpolt o r3 \\'l I()i,\l'()( . I J Septenrbcr' ?()rt9 a cl ! I =O c- !t, l ,J 1 T $ 3 ! a .- ! ! -a , a_ at) = t , -C al) = - =: J t a) 2 a) - ^o = ,) a n _l II .:t -/-! = = '/_ a;') ;-.- -rt'i =2 1'J- a-, z .r. 7) al) 1 J- 2 =' --ta: 2;:-' al) ) al) .- ) --: -)t- =-- -t-) =2a ?=) --t) =- rL - -)= = a1) -+= /-, = ct 2 =.J C, ,) '-r- 1 -r -,1) --- \2-- co N N N ro I- t\ @\t o) C.(o co NO t\ C!(o ro$ F- LO N @ (\ Nt\ ro s f-- Lr)O oo co N O) v (o CO f-- O o) Lr)Ns O) N O) c) co I\ co C) l\$ (\l O o) o) (, COv(\() O) o) Y ?. Lr)$ t- ro N @ r \ ciCI cl r CI ., cl ., -t al -t N NN ro v f.- = -t I\ c -l alT -et .l -a ol -l @ C\O r.- N(o T alJ "fr at al CI -:Zr al ') = ]. ct cl @ co N N t- LO -t .l -l I\ al ) f. al .l F-t\ @$ O) co(o --r t\ a c-l al --t --r - .l -i- al Ir-= ,;Li r: a)) - =,,a -=-=l- ,- = = , , -, -- = | 2'i =, a) ^ 5l) 1-- -o =, = at, ===l- -, = 1) -t -)= =) - a- ai =J )Z: 1 -)- '-,-- - l_' :1 = t /!a c- u al) i: .: ,, '! .= = = = = LO O @ co N O) c.) s C\l() o) o) .a I r t- .I Z € ct ,a r) CD f\ G)(, a1 '- ir f .-t l! I\ (\ O O-) o) at T I: r = -t/ f I l I l I I l .l LO N O) r\ O) T J -/_ at 2 ; at r- at .c .f (o c.) N O O) at at a -.at .c at C ct ]\ r , T ,, al ct -t r- -l cl -cl \, , - -T -t -t - CI .a al at ., at rt al .l CI\' CI .a ct\' al -t al ! .l CI CI .a .l -l.l -t at I cl i I .l9 ct ct \. at r ct ct 'a al CI .l 2.7. Grelarilrg, storagr a:td delivery of ivemnc"ctin i\,lectizrrtt tt trrtf-,11/trpltlieci lirr bt - (1tlctt,s'a lrc'k tlr' ul)l)t'ol)t'tut(' rntsttar') NIou I I r' \\,n(l! tiNICI,lfl N(; D(D Otlrcr' (ple asc spc-c i l\ ) N,'lcctizan tl clclri erctl l-1,rt - (ltlatr:'<, /rck tlrc (tl)l)t'opt't(tt(, (ut.\'lt ('t'l N{OII tr I, \\,IIO! [iNI(.I.]IE N(; IXT Otlrcr (plcasc spccilj I -l'lrc cornn.rrrrrrtic. tr llcr clrrirr!.1, ecnsus up rlutc. thc\ or-clcr tltttg: tlrt'otrgh tlrcir t'cspcctirc hcaltlr lle ilttics. tht'f,re ilrtics scncls tlrosc o,rlcr': to tltc [)istrrct ('o()rtl inatot'.'l'hc cl istrie t scnds tlte f ucilitr olr.lcts to thc' \lttional ( o,,lrtl ittatot'. 'l'he distlicls errllect tlrugs accorcl ing, to (hcir orrlcrs/ alloeatitrr 1r'onr []lantyre [)ll() [)lltrrtrac_r 'l-lrc'cl istricl tlrr llrr'srrrnc Io the lrcaltlr cL'r]trcs rt'htr scntls tlrcrr.,r'tlcrs ttt Iltc rl istrict [-irsllr llte lrcalth lacilitic.' rltstt'ibLrte the cllLrgr to thcil rcspectivc villagcs accot'rl ing to tltcil ot'clcrs. 'l'able l0: I\'lectrzairii Iirr,cnton (l'l<'rr,sc crtlrl tnorc rrnrs'rf tTcL'('.\\ut'\') l(r 'l'hc renrurning i\,'lcctrzrrn (ircrrncctirr) alc tll\cn b1, 1;,. ( l)t)i an(l ilre lre ing sttrtcttclerccl to tlrcir ncarcst hr:itltlr lae ilill arrrl lastlv thc laolitr'scnci tlrc drtrgs Lo thc tl tstlict l)h.tt'tt.trtcv u'lrele tlte cirLrgs arc l\cl)t Ilcallh u'orkcls lolc rn ivcrnrce tirr clclivcry anrong othe r'\ incltrdc. " Rcptiltirtg ol'.1 t'ttg Ltsitgc " C'or.ts,.rli,-lating rcPtrt'ts t;rt tt'eatlttctrt covet'itl,c o Fltlrrt lrncrs in nr()l)rlizing ('l)Ds to collcct clltrgs ll'orrr lacilitrcs to r illatles 2.8. Gorrrnrurrity self-rnonitoring and Stakeholders Meeting Ilirs artv tlainirrt (ol'tmincr'r) lor conrrnuritt'59lf'-11111;1 itot'ittg hccn tlonc ttt tltc 1tt'c-r.icct ttrea') II'so. \V'lrcn'l It ri'ls in .ltrlr llrrs r ciu \\ ll() \l'O(. l-l Scptcnrbcr 2()()9 ll.cnriri nrn .Stutc /l)istrict i t,G.\ ).'u rrr lrc t. 0I' N'l cc liza rr I l{et; rr lirpircrl tl I L's l c(l Ilcccir ctl la blcls I ise tl ' Lo:l I \\ :tstc 2116()9-1.()00 )( 0) + if_._l---- I 60.tI)lte Ionr hc 60Je0, r 50 9J,000 0 0 2216f( )l',\ L 9 l.i)()( ) 9J.0 00 I l i I I rrtrlc I I ( t,nrnrLrnilv scl['-nronit()r'ilrg ilnr.l Stll.elrolcle rr \,lcclltg (,1tltl rott's rf n(,((l(,(lt [)rslr rct [ (i{ I-otal l/ o l' corttnrrrni I rcs'vr I lascs in tlre crrtrrc pr-otccl oleu I No rr l- Conrnrtrnities th.rl c.rr r-rctl orrt scll' nronlt()r'rr)s (CSNI) No trl C orrrlurtitres tltat L ('n\l u\'le\l :tlrl' clto]rlo's nrce lins (S I-l Nl ) l)h u lonr llc 6) 6 ') 62 'f (x'.\ L 62 62 iez I)e:e lttrc horr thc t'cstt lts ol'tlte cor)rnr.uriLY scll- nrcrnitorrng ancl stal<choltlcr'\ nl('r'trngs ha\'e lI'lce tctl projccl irlplenrcntlrtiorr or. lrorv thcv rr,otrlcl bc rrtrliz,ctl tlrrring thc nert trc.llnrcnt e r e lc. 2.9. $upervision 2.9.1. l)rovitle a llol clrart ol'supcrvisiorr hicrirrclrt,. N,\ I'tON:\l_('oo tt t)tN/\l'ot( t)rs ft{t("1S t.rI'IrIt Y ISOIt S IlL r\l- I II Sl.,1ii\/f ILI .\N('E /\SSIS I,,\N I.S C'O\,I\,II NI'I'IIlS ).9.2 \toNl'lorts ( l)t)s \\ lr.rl rrt'r't'tlrc lrririn issrrcs rlcrrlil'ictl rlrrlintl strllcrvrsiotr'l . \trltcrt l\r()n \\'ll\ r)o[ .111g.11111g S()nte rcgi\tcrs tlicl nLrI Iravc'eolLlr.lr lirr albcntlirzolc \\'l lO ,\l'O( lJ \cptenrtrcr'1()09t7 2.9.3 2.9.1 I}EFOIIE I) tiR tN(; .\ III'lill e c a \\/rrs rr .sr.rl)ct'\'isiotr t'hecl.list lrsc(l'/ . \'ts \'\'ha( u'crc llrc oritcorucs nt cilcll lcvcl ol'('l)'l'l irnltle lrrcrrtation srtpcrvisiorr ? o Ccnsrrs rrp rlltc rvls (lonc r-tsing ne\\ r'cgisters r [)r'trgs \\,ct'c tinrcl\ orricl'crl I)rugs rr"cle tirrul.. tlcltr ct'ecl rn he ultlr lircilrtics l)rLrgs \\clc linrcl., r'oljertucl b-r ('[)l)s 'l'ltelc \\'ils I)r'()l)cl rloe rrrlcrrtatton ol'all rcle vant statrstieal rlata Mass cllug cJistribution \\'a\ tinrell rl()nc Mop trp \\/as lcinlbrcccl irr conrrluritrcs u ith lor covcrage Statistical cale ululiorrs 'srrrnr.r.rations u'cr'c tintclr anrl cillrcctl\'(lone l'irttelittcss nas clbscrr crl rn lc1'lolt irrt l{cnrarning rlrtrt:s rr clc re (trrrrcd or.r tlntc \\/:ts i'cctl bitcli gir't'rr lo tlrc I)crson or group\ supcrviscrl ? c \''c.s IIorv n,lts tlrc f'cctlllacli rrserl lo irrrllrrlvc tllc ovcrlll pcrfilrnrirrrcc ol'the 1l ro.icct? r 'J'hc lccclback rr us irrrnrccl iatelr sivcrr to that lcl'e I ulrlcl strpcrvision. nristal<es e ollce tccj unrl ort.iob tnrilring rras clorrc . \\/c ltrrthcl cl iscLrss thc rvit\ lbru'ard for the llast ycar clrrrrng C I)Di I Icl I th ir,rtr'l'cls ltlirrrn i n g ntc-ct i nss. 2.9.5. 2.9.6 \\'l i() \l'()( . lJ Scptcnrber'2009t8 Str$TI*E$ 3: $r;6:Bont ts> SBTfl 3.{. Equliprnent I'trlilc-l 2: Stirtus o1'ct1rr1-rnrcnl tl)lt,rrtt'rtrltl ttttttt'r'otrs rf na((,\\'(u't') Strrrlcc I r,pe ol' ct1tti;rnrcnl ('tlrlcliliorl ol.the eclttiprrtcrtl (F'Ftrrtclional. CNIrll L'rrrrerrtl_r rron-lirrrctional [rrrt re puil'able \\'(-) \\'r'itren ol-l) lltlrr cioes lhe lrrtl.icct itttcncl to ntaintain irrrri rcplacc crrstint: ccltril-lnrcrrl irntl trllrul rnatcrials? \\'l l()i,\l'OC. l J Scplcnrbcr ?009 ,\ [)( )(' Nlorr I)IS I-ItIC"I-i t_(;A N(iD( ) Otlrers N (-L,nrlttr,rn N. ( ()tt(lttr\,I \\, (,, rrltlrLrn \rr ( trtttltlrrrtr N Corrtlrtton I \/clr rc lc I \lotolcrcI C(S ) i CorrrltLrlcr'( s) 0 IJ I 0 -; I 0 0()l lr l 1 I,' I I -1. I)r'rntcr(s) I i. I'hottre ,.r ltiur'(:) (r. Iilrr. tVlrchr nc(sJ 7 Othcrs -l_I F' t- lu)( icncral.or' I I I Ij lb) IJicr clcs c) _-) lr () l9 l- 3.2. Flnanciat contrEbutio,rs t:f the parlners and ccmmurritit:s I ill tirblcs lia. l.ltr iuttl l-le ll-tltcte alc ltloblcnts ri rtlt rclclsc rrl eottt.ttctltlltt littrcls. ltttu uet'c tltcr ilcltlrcs'cd'' . FLrrrcls rvcrc clclarcti t,., lrc re lcasccl tltre to ncu Ilnanctal s1 ste ttt at tlrc tl isttrct coLttlctl ancl tlti,, \\'as aclclresscrl br rrrplenrentitis thc inte nclctl irctii'ities ott ltlatl hll'is.ttld pi.l\in'rcnts vvc|c nrAclc lutct'. ,\clditiona I con.rnrertts . in ljrtrrrc.. ploltosal t'cr[!e\t Iiil lirnrjs tvill hc nuttlc in atlt'atlcc priot'to ttlllrletl.tr:tltirtitrtt o{ rclivities \\'l lOi,,\l'O('. lJ Scpte nrbcr' 10()9)0 ] ct !) E ! c- , .t -+ ? /a OO oooOOO oOooorsoo(oo6(O9o r)@lr)N\il N al o H? -J, co ONiII o v(c @ ro N oooOOO$ot(ovo(o@to(r)so NC.ttn o OO (o @ ro N tn c) V) o a_x*(JC _^ 0) :EO'U6 = = 19 !(,uJo!tqNa Loof o ;.oOY.( tr[;= <FI.L O()OO o-) o) NN co tr! o EB,JZ 0) tr o) o .9 t, O) G t llJrF o too o oz Ea Oo oOo$ @ co o c) <t o ca oOOt\ t\O$ o O o o O o -l 1 O O a O O O L- C) oooo ac)o OOO')O OOOO CC)O 0(:c-)Oa)O OOOOO OO()O OOO oo!?o@-HNFssg oooo aooo na UJ 6 (: o O C (a =o; a) o 6 cr N o t- o N o \ d C) a- ta i) C ! o o I o) t = O)E G ! O) o .9E o o E 0) OJ m o 'c o o F IU =zt UJ o L, o (! z rc 0) o th ;eE ii oF o .; .9. o E a .9 C) olNfi o Nr o O 6 N N o oOo N O C) C)N () oo C] N OOON O c)oOt\OO oO(o oOOv ao $N (a) O O OOO Lr) <f C 5 o () O O O O O O O O OOOOOONN t-- I I l l lO OO A O C I- C) >QOOO "ooo ^(O(, (() .i r-Y NNUUe co co OOOO O:-OOOO ooO NC)OOO sqlNS NOC) oO ONOON(oOs I\ON() caov Ooo _(UUq)OOOO c!NOI\ OO$N t\N CO OOO oc)oc)oooOOO l\ co c, O rO <t OA C)OOO oofO tr) oOO(oO I\OI\ LO coov OoON : i9 x e 6,Uql IDUtroc)GOa !piCl0$o 3e b E ':tr! o:o: a Lv!U|i or I .:onc 'tl\-0J E>ii 'i:9oo> X'eE6\ : ar t^ c >Fbqr s {9>=9 z Y -6r:OtO:E=g' ; c) .a! *O)(!r .Nb r\UoOEotn - r) ' il e'oE=c!o occ9,69oE=s E- c .o o ; =a! s 6 9 : I m -9 0 : J C) X Ec; ; ?; i ! : Y o) .E:\ S N E 9 P E,: ;i! , E ; o ; .S ; E - ; =O 9 o r 1, 'i:.: :" o = i.j -:- - t <o.-:\clN: i S ctr + (\ U) TUzf F tu(, of, m ii ot :0i >i A) U) I COo)E o9o = IUG >Q NC/)A o(Dof (/) ') n) = .) 'a a) =: =c: _a a = = !- ') :: '-) C.: art O O @ I o E o o .9 ^o 0) ts o. v IUIF o I ; L _t .! .C .) u O a o o(, z O O o -l- c O O o O o O O o O OOOOO OOOO OOO OOOOO OOOO OOO oooOOOOO OOOO OOOOO OOOO OOOO OOO OOO OOOOOO@o-_(o ON o o) Of otL =o({f F OOOOO(}O)O-C)OC,. LOOr) N OOOOO=O o-$K@. $co.^-N$crxl@ OOoo olo-q? F-N OOOO = E.: O ? O-O oEO Ll o -z OOOO @ o q@ o N o, r Ol o- m m f.- O) o o a.l e] o Ni G o o C) o 0) o) 6 u. UJ 6 =O) o a6 o o) ; =o o) E (! o) o ,9 a = E @ v N o(o @o o o '= tr o Fz I.LJ Ezt tU o o o N c{ CD(o @ rn o !t N ooo c.l @ O C)(o I I o N N O O) ca (f OOsl l -l --- -) ,J @ N O DN OoON oOON O OoO ONOO co c1 v N OO O E c r:(! z oo\oNgo) o)o(Cr? NO (.)Sso OUUOI\N ;?srO;?r> o) c) o;(o !o (ooo(D NOU) col\N oq) o f, o ;eE ooO:fP& OON$ O@@ o.)tr)OO\i o)of\ O)$NCOO OONNOO o) c,) OONN @() v o O-) co - o- i o co O) OO o.)oI\ O)$NCT)O OOOoooOLo1., ^.NNc")- OOOOOLOcrvo OOOoo(r) E F .9 .9 o E ,9 oo(o t-' v J F oF o z E o Elo4 o!J !,G- cq)(!pr E o-t!i \(U auJ ^ o k oJ!i =.q ? 'io.ts 6 tr(^o .9; D E (EH. I X leoo>X o^. tr : o ,u* >o -O N a q\'q s $ 5 1 l 1 I II clo Ol :G as - 61 o=tulOo:iOI 9) '-loo3qqa.r L L : Fl ccio o 6 c trl I I I cl o o) c >Ft :i gEEP==P=Si E€E=: r" F EE b +EEE SN.-iri-'-N(.d .NNJi'ocacof =NU)=v) o oiql! (, o L1\Q a(JC OC' b- c IaX E o :j': Y = > i( F + (U ;\ Y o$ l! ru X u >or\=)\-;: = ; X i{! ! - ; s ^-\O I oi o o, iJ S; r\ c, v e<o; : iS 'J) uJ z J F r.u l(rl o l co E ^0J cJt: -o ooiYaL!s c.l a U) O r.- N .f o FO O so oj t3 N lo C,a$(I)(o u) N --)O ct !O f) f) C) c) J F oF z x D C) ! c3 1) u to Ls -c L ,a L u L = _a =2 = -a'- a Ct) = I = .= Li- ; .a F c GI , !) =, ! ',: = oooooo-g(o@LO rO OO OOC) LOOlr). LOSO) o@mCO 'd' OOO=Oo0:or\(owf N:O) (\ -T tI r--$@ <t@w otr)o) n ro)N LD OOO o$ O) ?sO); @(ro ss N;€;€N OUU@@(o o9:ooo)NB;3,A(i :' o O o) O)N roOO O)N u, @ co cl F* co N r'- o @ o N (o +p o VOC'O tr) OO : V,o N 6 OOO an alLO I\ c.) O v LO COO oO) $ o)Os co @ t\ @(, o () C] (JOOI I i I l aP 336oo(') coi:: of o r.L =o<{ :J F oL OJ o o o oooJ oz CO :C)tre o o E 0) o -o .9 'o o) L(! u IUIF o o oo oz o)o c)N n c) a 0) q o r: o 0) O) L '6 -c u. UJ a! o O o a o (J .l! o O I o I ; o O) G q) @ -o ,9 E o o E !f m o! .E o o t-z ui E zt UJ o(, ; c o oz o o ! o G oF c ,9 o E c ,9 a) 2 o "o ^.) -:: U = a) = -c _c tJ t) ll .a F O .r. t\ m\, C)(o @ co(-) r)OO OOOOO(o$$o C) o)N O C)c),c)oo L.C)OLOIOr) ONAIe OOOOoa)oc)(o (oON O OOO v oo(o cr) LO o) r)ol OO oaHE6i c0i a!,tsg!i,traQoJ !o ! ruU>i:C .: ot of,o : a q,Q> +!.. o Lv()!Eg E E 3.tr\ - @ X -:o : tr o c .S: ii il > a a *E 6 i, > S 6, E -trc)\:io-, d=Shorrc.;3.=..o.l: >9 :b s ar ; J (, .o fr COo)c iico o=l o-!o; rNcaa croof u) o G a UJ o o o U) I CJ o; ,^-a um*OoiH(_) r ai oo) 9q)-LL]seEspE 0)0X o)oo cn==?= .==6 r:::r-;dFFPSieNd NN('i =Nq c o N t6uJliZa) -,1 vl FiuJi:oi!Olo o ;i! - 6 0 *GiC^U \!*64,'OF P rJ X @ '-9r'r=:\- N:E -o Z < oSc, o 6 6 d P Si N (,) " oiC U) I I I I l a-l ! - ! c- , "r. -1 1 .,,] f- oF C) a.(J -t c.t 3.3. Other ierms af cotrritrurrity strppci^t | 'l-lrc cotlnturtities sr)nrcIrr]cs givc bicrclc ttr tlrc ( l)l)s to Lrsc to collccI rlrtr{.rs fiorr the hcalth lircrlitr t() tllr'il v'illages. ,\licl clrrrg rlistribtrtron thc\ trse thc srrrlc Lrier,e les to deliver thu rcr.nitinrng tlrLtgs thc hcaltlr lacilitics -l 'he_r Lrsc \anle [)ic\clcs lbr tiving ort lcports. 2 ,'\lso c()nlrrrur.litics gir,c lirocl [o C'Dt)s rltrring tlrror'to clotrr clr-trg cl istribtrtirtrr -l Sclection rrl'( [)l)s -l [)rLrg stol'ilsc 5. N'lotriliz.utitrn itntl selrsrtization(t. \[lrs: rllrrr: lrtlrrrinistrirtitrn 3.4. Expenditrrrc Fer activity Irtcl icitLe' irr lirblc I3. the ilnr()r.rrI cr;rc'nclcd rlrn'rrg Ilre. r'cpoll.irre ytcriocl fitr cae It ilctivit_\ listr-cl \\ ritc thc anr()r.rnt c..penclccl in US tlollar.s rrsrnq Ihc cur.r.cnl L]rritcrl Nations crclrangt iatc to Iocit I e rtrrencr Irrcl iclrte exchanr,c l'.ttc usc(l hcrc ltjS.S:150 ,,\ rrr eolr.r nrerit s itr c-rpIaniltions'J SESTIOH 4r Sustainability ef GDTI 4.{. lnternal; independent participatory monitoringl Evaluation -1. l.l ir ' ,t . ",i __- _ \'car I I)itt'tie ipirtorr incle pcrrclcl.rt nrt,nitor irrs | .' I l r' . , \\ II()/ \l,O('. I I ScPlerlbcr 2009 Nlirl'l errn Sustuinatrilrlt Er,alrrarion 5 r car Strstarnabilit-r' [-t,alLratiorr _=\_ Intcntal Vlttnitoring tr1 N01'1: t Othcr Fr alutrlrt,n lry othcr nar'1 n(.t'\ - cpiclcrniologrt irI e r alLntion -1 .1.2. \\'lrill rr e rt' thc t'ct'onnrrclulirliorrs? r \'1'tl't''.tttu tltct'c is ctlttttl cl tstltbittton ol'Llrrrgs slr-( ()tltur ilrcas c\l)ct'icrrcc clrug shortage , Clrcclr ltrr ltlalrl' sJ)itccs in legtstcrs tlirr.ing srrltr.r.r isirrr.r e N'lrrkc srrlc ('l)[)s lL'corcl tu'o [hrnilies Pcr'parc in tlrcir rcgistcrs r \'litl,r,'srrre ('DI)s Iear,'c sl<i;l pages lil'rccorcl inu, trl subsctltrent l\4Dr\ l. I l. I Iorl lrirr c thc,t, llccn irtrlllcrrrcntcrt'J r i\ lirilotr ttlt sLt;tcrvisitl.t \\as rl()ne clrrring arrrl .tlicr tllLrg cl rstl'itrrrlitrn " -l lrcre is trrr rnrl ieation ol'rln1-llovcntcnt in nrrrrl oltl t'l)Ds li 11..? Sustain*bilitSi of 1:roj+cts: pEnrt and set targets imant{atory at Yr 3) \\ rrs thc pro.icct ci,alLratecl rlrrrins tlrc rclrorl.irre pcritrrl') NiA \\ ls l strsl.ainabilitl plarr rr'r'ittcrr') Nr',,\ \\ lrerr rras the srrstlinabilitr lrlarr sLrbrnittcrl" Ni,\_ \\ lllrt arrurrgcnlcnts havc [--ccn nratle to strstitin ('l)-l I irlicr AI'}O( lirrtcl ins !'cascs in lct'nrs ol-: I'hc distlict rvillsustain thc ('l)'l l progrirnr bi incltrclirrg thc ('l)1-l actr\,itit's rn the DIP (Distriet Inrpluncntation I)lan).Frrrrtling u'ill [rc obtirirrcr-l thloLrglr that plan. 1-hc;rroglunr rtill usc lransl)orl. lionr the DI-lO's pool .ll ivrll also bc irrtegnrtccl rvith I-lrrrphalic l-ilariirsis;lrogratl rr hich ltas thc slune e ()nccpl as to C'l)'l-l 'l he plln is lrcing Lrscrl cvcr_r' r e lt'. 4"3. integration Olrtlirrc the extcrrt rrl- inle gi'utiorr ol'('l)'l'l into thc l)lIC' strLrctLrrc arrd tlrc plans lot'coirtplete in Lc g t'll lron: ( l) I I [rtrtlgct is bcirrg irrclLrrlcrl irr thc I)ll'. Ivurrncctir] \\irs ()rcl.--rc'd b-i tlrc l\4inistri trl'Hcalth hLii(l!iuiu'ters bl rrsint rlisLrict orclcls. l)islrictq ect it liorrr NO'l I"and clelit,cr tltcrtt ltr heirlth cetltrcs \\ c trsc an),tlansl)ort avarlablc to tlilnsl)()r't thu rlltrgs. I.vcrr,r,cal bclbre rlrtrg tl isti'ilttrtiort. llrst ri'c it'tl cslrl'tluin the C't)[)s. C'cllrrluct loc:r I lcuclcls nrcctings in lrlcl itrtrn [o colr.rr]rLrnilv lirrule rtcss abottl ('D'[-l corrccpt. l)Lrrirrr: sLrpc-r'r,ision \\L'r'()r](lLrct tr.joint strlrcrr"isiort itnd nrotriL,.rring rvitlt olitcr l)r-()gluurs e.g. cltrrirrg CIll)s activitics. \,lal.rriir riecli cte . \\'c intcgrate C't)'l'l rr itlr I I)l acttvrtics. J.3.6 I)cscribe otlro'lrc;rlllr progruunnrcs llurt urc usirrg the CI)'l'l sll-ucturc ittttl hort' lhis l irs achicvcrl , \\'h:rt havc llcen tlre achicvcrne nts'l t il,l 'iL.)i-l:' ir ir , /''; ,'f)1, l'Cr:' t1';'' 1 ,l 1 i:'n'llll ,'1'1,5,-,,1 : , | -l 1 i'rr) )t; ,': lr:i,,1'l,jt,i (\ t t ,li, r I rl .r i :. {\l \\ II()i \l'()(' I I Scl ,lcilr[.ir 2t)0r,t A number of tnterventrons were Integrated wtth the CDTI activttres 26 av Also, CDDs were also tnvolr.recl trr tlre drstrrbLrtion of vrtantrn A and Albendazole for chtld and rrartenal heaitlr Durrng the exercrse, CDDs also gave health edrrcation and nrarraged the crowcj These activrtres were irnplerlerrted not at the sante tinte J.3.7. I)csct'ibc o(lte rs isstrcs corrsirlcrctl irr the intcgrirtiorr ol'CD'l'1. Ottlv thosc ('I)l)s thut itlc llctr\,f u'e ul\err prirrlitr Lr-r plal ltllcs rr.r othcr [)l lC ;rrrrlrrrrns so tt; ntotivatc'tltcrn. \\ I I( )i'\ I)OL l-1 Scple ntlrcr 2t)f)tt27 at _c =! c- o -t T ! =t /7 ,& a_ ei co u ! a c! v\ l\ a\ a:: cl =! =i ==/. a,h i'! -aL =a /_ ,-, c L3 =a +r Yr IJ .. = a.l ! _a = c- ! ,,/) -t 1 = cl ^! \ a = ., ,j ct) tl) rJl !J = at) i) rft a) .'* 4 -4. 0perati+rrxl research LJ.l. Sittttntarizc itt t.tuf nrorc thirn orrc hrrll'ol'il tlagc tlte opcrirtionirl rcsearclr tr,ttlct'litkctt irt tlre projccl urca \l itlrin tlrc rcpurling pcriorl. Nrrt tlcrnc 1.1.2. I lorr rr crc thc rcsrrl(s lpplicrl in thc ptro.jcct? N,\ SHCTION 5r Strengths, wefikriesses, clrallenses, and opSrortu ]t i tEes - [-rst thc challcnge s irrrcl rnrl ical.c horv tlrcv u,crc aclclrt-.ssccl. s IRt,.N(;'fils c I 0()0.,, !ctrur';1;l11rcll I cr)\/c[agc c l-rcalntcrrl e rrr cml:.c is alrovc ii0%, in tltc plcvirltrs r e als . C'ool.rct'irlion lrclttccrt thc inrl)lr'nrcnting lllr.tr.]crs ie lrealth rrorl<crs zrrrrl cornr.rrttnities \\'Ii,,\ IiNESS/( I I.'r l.t. n N( ; I'lS r L'l)[) tlr,,p rrtrt . ()t iqtn rrl'1, rclilrorts urortpinu l,.rrlticlc]rn:, its rrrcnrt,crs ll'orl tul, lre iln\ clr'u!l . Strrlltur.n i,\el . Ftrc I \e ilrc I[ \ ( ) t,t,ott't'[] N I't I ti,s . Stlrf-l'avliilrhilrtr , ,\ l)O(' ILrncls o DII() Iirnrls $HSTIOS" Sr rrtatters Uniqcr{i features elf the project/other \\ I I( ), \l'()( l.l Sc|Lcrlll.cr 2ltr)t) -) (.1