Borno annual project technical report to technical consultative committee (TCC): January 2004

BORNO STATE CDTI PROJECT COUNTRY/NOTF NIGERIA Proiect Name: BORNO Aooroval vear: T6*E-rncn rssa Launching vear: JUNE 1999 Reportinq Period (MonttrtYearl JANUARY,2OO4 Date submitted: NGDO partner: HELEN KELLER INTERNATIONAL ORIGINAL : English ANNUAL PROJECT TECHNICAL REPORT TO TECHNICAL CONSULTATIVE COMMITTEE (TCC) tc( 9o rr/ )tp"s I @14 Grls cI,N CLV Lnr 15r,\ sf'toitl Ac ilo4 v a\ AFRICANPROGRAMME FOR ONCHOCERCTASTS CONTROL (APOC) 70u{ I WHO/APOC, 26 September 2003 IANNUAL I'ROJIiC'I -I ECIINICAL REPORT ,, TO TECHNTCAL CONSUL'IA'ilVE COMMITTEE (TCC) ENDORSEMENT Please confirm you have read this report by signing in the appropriate space. OF'I.'ICD,IIS to sign tlre rcport: I country: NIGDRIA/LIBERIA National Coordinator Namc Sigrtature Date Zonal On cho C oord i n al.or N an e : f.r:,:,.,sr g. r n . . C S.P>.$.r. ftn+c e \1?? i- zvc-ri. sig.aturc' BS.B*a/A...CC Liu: ttrr. rce-- D arc: .?f /.P.:s.f .z $:r).!1... .... This report has becrl preparcd by Narnc . N.1ih. *buto*,r €"L*t,i", Dcsignatiorr . s-l",&r ooc.ho) c,-.r.d,r'h Siurature : ..pitc ...61 ^*:r..1g.?.? -J WHO/APOC, 26 Scptcurbcr 2003 TOLLOW UI' ON'I'CC RECOMMI'NI)A'I'IONS 6 SEC'I'ION l: IIACKCROUND INFOITMA'I'1ON....... ......8 l. GeueRnurNFoRMATroN..................... l.l.l. Dcsuiption of the project (brieJly).. I . 1.2. I'arlttcrship...... 2. I)opuLnltoN AND I Ienulr r sys'r'ritvt.... Error! Bookmark not defined. ::::: : :::::::::: " :! !:!:' "{; .............8 SEC'I'ION 2: IMI'LBMEN'IATION OF CDTI ...............12 2.1 PcRrou oF ncrrvrrrcs l2 2.2. OnosrrrNc, sronACE AND DnLlvEr(y oF tvgntvrEc'nN ........... 14 2.4. MoBlr-tzntroN AND r-rEAL't'lt EDUCAT'IoN or-'A'r'tusK coMMUNr1.rES......................... l6 2.5. CorurrvluNtlrEs rNVor,vEMENT rN DECIsIoN-MAKTNG ............. 16 2.6. Capncrrv BtJlLDrNC.. :.............................:..... ......20 2.6.1. T'ruining... ............... 20 2.6.2. Equipmcnt and lruman resources ...............21 Cor.rortloN ot-"t'llti EeutpMEN'f t PLERsp slATD ............21 2.7. TRen'rvuv1s.............. .....24 2.7.1. Trecttmenlfigures.......... ...........25 2.7.3. Trend of treulntenl uchievenrcnt front CDTI projecl inceplion to llrc currenl ycur 29 2.8 30 SEC'UON 3: SUPPORT TO CD'tl ..................32 3.1. FrNnNcrRr coNTRtgu't'loNs oF T'HE pART'NITRS AND coMMUNtl'l[s.. 3.2. O'ruen FOI{MSoFcoMMUNTT'y suppon'[................... 3.3. ExprHorruRu pER n c'r'rvn.y SI,ICTION 4: SUS'I'AINAI|ILII'Y OF CD'I'I ...................34 4.1. INlenNnu; ttlDEpENDuNT pARlrcrpA'roRy MoNt'totuNc; l3vnlun'rroN.................... 34 4.2. CouvuNrt'y sELr;-MoNl'roRlNG nNu Slnrcnor-DERS MrprtNc ............34 4.3. SusrntNnsrLrT'y oF nRoJECTS: nLAN AND sET Tn RcETS (MnNDA'roRy At'yn 3) ........... 34 4.4. INrecnn'r'roN..... Ennon! IlooxnnnnK No'r DEFTNED. 4.5 Ot,EnnlroNAL RusEARCtr ......36 SECTION 5: S'I'IIIINGT'HS, WIIAKNESSES AND CIIALLENGIrS......... ....37 ..32 ..32 .. JJ J Wl lO/AI'OC, 26 Scprcnrber 2003 APOC nTo A'l'rO ctlo CDI) CDTI CSM LGN MOII NGDO NGO NOI'F PIIC REMO SAE SIIM 1'CC 1'OT UNICEIi UTG WIIO Acronyms Africau l'rogramtnc for Onchoccrciasis Control Annual'l'rcatmcrtt Obj ccti vc Annual'l'raining Objcctive Comn'runity-llascd Organ ization Community-Dircctcd Distributor Communi ty-Dirccted'l'rcatmcnt wi th Ivcrmccti n Community Sel f-Monitori ng Local Government Arca Ministry o[ I lcalth Non-Govcrnmcntal Developnrent Organizat ion Non-Govcrnmcntal Organ i zation National Onchoccrciasis'l'ask lrorcc Prirnary health care I{apid Epiderniological Mapping of Onclroocrciasis Scverc adverse evcnt Stakelroldcrs mccting 'l'cchnical Consultativc Conun ittce (AI'OC scicnti fi c advisory group) 'fraincr of trainers Unitcd Natiolts Childrcn's Fund Ultimatc'l'rcatmcnt Goal World I lcalth Organization 4 WI lO/APOC, 26 Septcnrber 2003 (i) 'fotal ponulation: tl I)cfinitions lc total population living in nreso/hypcr-cttdcntic cornmunitics within thc projcct arca (bascd on I(llMO and ccnsus taking). (ii) lrligible population: calculatcd as 84%o of thc total population in rneso/hyper- cndcntic communitics in tltc projcct arca. (iii) Annual I'reatrncnt Objcctivc: (A1'O): the estimated numbcr of pcrsons living in nrcso/hyper-cndernic arcas that a CD'l'l projcct intcnds to treat with ivcrmcctin in a givcn ycar. (iv) Ultinrate'l'rcatment Goal (Ul'G): calculated as thc maxinrum numbcr of people to be trcatcd annually in moso/hypcr cndcmic arcas within thc projcct arca. ultimately to bc reachcd whon thc projcct has reaohcd full geographic coverage (normally the projcct should be cxpected to reach thc U'l'G at thc end of thc 3'd ycar of thc projcct). (v) 'l'ltcrapeutic covcrage: numbcr o[ pcople treartcd in a given year over the total population (this should bc exprcssed as a peroerttagc). (vi) Gcoqraphical coveraqe: number of comnrunities trcatcd in a given ycar ovcr the total nunrber of meso/hyper-cndemic communities as idcntificd by I(EMO in thc: projcct area (this should bc cxpressed as a perccntagc). 5 Wl lo/n POC, 26 Septcrnber 2003 FOLLOW UP ON TCC ITBCOMMIINDATIONS Using the tablc bclorv, t-rll in tlrc rcconuucnclations of the last'l'CC olt thc projcct alld dcscribe lrow they havc bccn addrcsscd. TCC scssion _ (Plcuse u<ld nrcre ro+r,s d'rtccessary) 6 Numher of Rccommendul ion in lhe ReDort TCC RECOMMENDATIONS Usc new rcporting ftrrmat lbr ncxt Rcport ACTIONS TAKEN I}Y TIIE PROJDCT FOR TCC/APOC MGT USE ONLY l. We are using the new rcportiltg for this rcport ti. I{cach the remaining 9 conrnrunities. 1-he project is trying to ascertain actual no ol'cornmunities. ilt. Addrcss integration attd sustainabi I ity tnore clearlY Irrtegration and sustainability will be addrcssed clcarly. Wl lO/Al'OC, 26 Septcrnbcr 2003 Exccutive Sumnlary l]orno statc of Nigcria is locatcd at thc north-castcrn part of the country and sltarcs intemational border u'ith Cameroon, Chad and Nigcr Itcpublio. 'l'he Statc has two vegetation zolcs, tfts arid - dcscrt zonc in thc northcnr hall'and grasslaltd savanna in the south, suitablc lbr brccding of tlrc Black-Fly - thc vcctor lbr transtnission oIOnchoccrciasis. 'fhc Statc has a population <lf 3.5 million pcople (projcctcd lorm l99l National Ccnsus Irigurcs), 27 Local Govcrnmcnt Areas (LGAs) and twclve (12) ot'these LGAs are Onchoccrciasis cndcmic (5 hypcr and 7 tncso). '['he statc is ntulti-ethnic with varied cultures, languagcs and dialccts. '['hcir rural scttlemcnts arc in largc and srnall satcllitc, which arc olton tltatt ttot along socio-cultural, altd language lincagc. Some cthnic groups include Kanuri, l,lura, Margi, I"ulani attd Hausa. l-lic nraill occupation of thc pcople is larnring, cattle rcaring and trading. It is cstimatcd that there are 1200 communitics in the cndemic areas, i.e.652 mcso and 548 cornmunitics (accurate record on thc total contnrunitics arc yet to bc attend. l-his is ocing donc now to confirm the reportccl number and will be conrmunicatcd to you). T'his number rcprcsents our larget comnrunities. Out of thcse 1099 wcrc trcatccl in the year 2003. 'fhcrc auc 1,020,056 pcoplc, living in thc CDTI communities, which rcprosent our Ultirnatc 'l'reatrnent Goal (U't'G), antl our Annual J'reatnrcnt Objective (A'lO) lor 2003 was 600,000 people out of which 536,290 worc treatcd with l,427 ,406 mectizan tablcts rcprescntingS9yo otA'tO achicvcd. A total of 1,749 out of a targct of 1,801 progriunmc staff wcrc retraitrcd. 'l'hese include 8 SOC't's, 14 Nutrition Officer, 48 LOC'l-s , 174 l>llC StalTand 1,507 CDDs. With this it is estimated that a CDD trcatcd 398 people. Our greatest ohallcnges include getting to know thc actual number of cotnmunitics and rcducing the CDD and population ratio: 'l-hcse are bcing addresscd in the 2004 trcatment activitics by training more CDDs updatc of community ccnsus or rcgistration. 7 Wl{O/Al'OC, 26 Septenrbcr 2003 StrCTlON l: Background intormation l.l. Gencral infornr:rtion lJgrno Statc of Nigcria is locatcd in thc nortltcastcrn part of thc country. It sharcs Intcrnational Bordcr with Nigcr and Chad in tlrc north and Canrcroon in thc ca-st, Adamawa Statc in thc Southcast, Gombe in thc South and Yobe State in thc West. 'l'he total land mass arca of thc Statc is 69,436.sc1. km. T[c Statc lras two notablc vegctational zones with the grassland savanna in the southcm halt and Sahcl - tlcscrt zone in thc nortltern half. Onchoccrciasis is endcmic in the southepr halt, whicft is endowcd with scasoual atrd pcrcnnial fast l)owing rivcrs; t6at rnakc thc land suitablc for agricultural activities, and also brceding sitcs for black lly - (Simulium damnosunl spccies), the vcctor for river blindness. I'he State has tw<l seasorrs, the dry and wet seasons. 'fhc raining scason begins in late May and cncls in early Octobcr when thc dry season cotllmcnccs until mid May. The avcragc rainfall in thc State is 760mm. 'l'he wettest period is around August, Scptembcr an<l thc dricst nronths bcing January, February and March with humidity as low as 12o4. I'opulation : Activities, Cultures, Language 'l'hc state is multi-cthnic with varied cultures, languages imd dialcct groups with a population of 3.5 rnillion people (1991 National Population Cettsus lrigurcs). 'l'hcir rural settlenrcnts arc in large and small satellite groups along socio-cultural and language lineage. Some cthnic groups includes Kanuri, Bura, Margi, Fulani turd Ilausa. Thc rnain occupation of thc pcople are farming and cattle rcaring and trading. Communication Systcm (road): Kanuri, Irulluldc and l-lausa are widely spoken, howcver, English has bcen adopted as the official medium of communication. Othcr forms of communication include lairly good road network from the State I lcadquartcrs to most LGA I leadquarters. Most cornmunitics are difficult to reach due to bad tarren, rivers or rocks. 1'he only lllcans to reach such areas is cithcr by bicyclc or lbot. Adnrinistrative Structurc : I'he Projcct State has thrce levcls o[ adrninistrativc structure. Thcsc arc thc Statc, LGA and conrmunity. the Chicf Adrninistrative Officer in the State is thc Ilxccutive Covcmor. 'Ihere arc tlrrce arms of govcrnnlent that runs the alfairs of thc State (llxccutivc, Legi5lulire and Judiciary) with the Excoutivc Govcrnor as the hcad. There are two arnls of govcntnrcnt (llxccutivc attd Legislative) at thc Local Govemmcnt Level with the Exccutive Chainnan as thc hcad. -l'he community conrprise thc distriots, villages and wards. 'l'hese are headed by the Lawans, Jauros and Mai Angwas. - I'lealth systcnr and health care delivcry (provide the truurbcr of hcalth post/centcrs irt the project are if thc inlbrrnation is available). Ilcalth care is delivered at two levcls in thc project state. At thc State and LGA levels. l'he Statc provides secondary care whore there are the Gencral I Iospitals atd comprehcnsive hcalth ccnters. Thc local level has primary health care cettters, clinics and dispensaries. 'flrcrc are 67 Ilealth districts; 317 hcalth centcrs/clinics and a total ol 2,366 Statl 8 Wl lO/APOC, 26 Septernbcr 2003 Onchoccrciasis is prevalcnt in l2 out of 27 l.GAs in thc Statc. Therc arc l-tvc hypcr-cndernic LGAs and scvcn nrcso-cltdcrrric L(iAs. ApproximaLely 523 couununities \ rcrc rccciving Mcctizan trcatnrcnt bclbrc AI'OC and introduction of CD'I'I. 'l'his has bccn expandcd to covcr 1,191 comtnunitics norv. 1.1.2 Partncrship: Indicate thc partncrs involved in projcct inrplcmcntation at all lcvcls (MOI{, NGDO,- natioual, intcrnational). 1'he partncrs involvcd in projcct inrplerncntation includc : thc cndcmic communitics; LGA Ilcalth Dcpartrncnt (LOC'l's/)rlutrition Ofliccrs); Statc Ortcltoccrciasis Control Unit; and Ilclcn Kcllcr Intemational. Describe ovcrall working rclationship among partners, clearly indicating spccil-rc arcas of projcct activitics (planning, supcrvision, advocacy, planning, mobilization, etc) whcrc all partners are involved : Cornrnunitics: 'l'he Community mcmbcrs mobilizes themselves lbr mcctizan uptakc, sclcct tlrcir distributors ; collection and storagc and safc kecping of mcctizan, distributc, monitor and supcrviscs thc distribution. fhc LOC'ts and Nutrition Ofliccrs at thc LGA lcvel arc involvcd in planning of activities in collaboration with thc State tcarn, rnobiliz-ation oI entlomic conrmunitios, training of comnrunity distributors, collection of mectizan from the State and dclivcry at the collcction points, provision of storage facilities for mectizatr, monitor and supervise the distribution and collcction of treatment rcports. 'l'hc State team draw up plan of activitics to be carricd out in collaboration with the LGA teams attd NGDO partncr (l IKI) ; conducts thc TOT training for thc LGA officials, carry out advocacy visits to the endemic LGAs to solicit LGA Executive support to the project ; collcction of mectizan from the NCDO for the cndcnric LGAs ; tnonitorirtg and supcrvision ; collcction and analysis of trcatment reports, provision of thc nccessary data to thc NGDO for re-appliczrtiorr of mcctizan. 'fhc NGDO providcs tecltnical assisteurcc by training o[ State tcarn as trainers, re- applicatiorr of mcctizan for the pr<rject; high advocacy visit to thc statc MOII olficials and LGA Ilxeoutivcs. Advocacy visit to paranrount conrmunity leadcrs, CllOs and influcntial community mcmbers to solicit thcir supporl. State plans if any to mobilize the State/Region/DistricUlGA decision makcrs, NGI)Os, NGOs, CBOs, to assist in CDTI implcnrentation. 'fhe project intend to intensily advocacy visits to ther LGA Exccutives, espccially now that new oflicials havc been elected into office in ordcr to solicit thcir support tcl thc progrzunme. 'l'hcre is necd to continue with advocacy visits in ordcr to sustain thc good working relationship and support to thc progranlnle lry the statc. 2 aJ 4 9 WI IO/n I'OC, 26 Scpternbcr 2003 ra tN T oE tr 0ts o3 q, J EL I ogl a.l. J o orl o 3 l-t lo)lo' lol- -,aoo c;B ci s.(b(D v1 @ tse s-: o. .o o\Jd A) o5 A) H v)x' '3 (D tD Et (D no tDo !) r!D (D (D tsl (D DDr*t CD t CD DD rD o- o >-t o a-tt 0q (D Ft(D o :1 0q td rDFt oP e(\ N U1 ,(\ Ns (\ o U t (t) o G zE o E = o f 't,Gg. + t" I oE o t o -o IJ o\ tn(D 1f o 3 o-(D I]JO -loFt t X t- P w t- o rr, v)7 P I ED w ? g n c) Ji Uo7 oIoN E!o ED o XXCU(, a' *"; a t4{ 'z + I et' w C B r'8*ALJ E. Y/ J ELHDr rt; P*I'o 3. 3D=tr3 vL-6(D t'='oali + t1\ e b..)e oUIo\ t'J UJ O IJt\){ \o O\c)b o\@ J\O "o\ O N) LltO\oO\o 5I{O Uar {s Llt ool\) CJ\5 '5 IJ(/-) +,O 'i..r O5 o\ L,I o\U)t.) t.J \c) "5 J: J> o\{ 5{ @ ,T, gE FI .3;€ 3 _AgFE P ='3'aD)D o\(,l t.) UI5a t-)e o\ € o\ @ @ UJ oo tJ) 5 5 {O {O oo\o @\o N) t\) aO @ O @ J: o) +\ o\ o\ @ @ l.J\o NJ\o ,z EUBd.5 0 AIE il rg N 5ir .D .< 5(DD,*:lt ils -* CL =6ciig6' rl o(DD !Jt;'3 NO (t,d r!11 I z tr 5 tD ,t o a) t EI E' o(r, D9n tDa E (,l o\tJ 'e -t(,t 5 Ur{ 6 b.J e vto\ t'J (r) OO l.)t-) \tO\o o\o O o\ @ 5O 'b\ o N) LlrP\oO\o 5I{o Lrr 5o -J L,I {{ Llr oo IQ o\stl.JU) J\O 'i-r O5 o\ L,t 'b\ UJ N) TJ \o 'jr 55 t.J \o .A55 o\{ J:\] oo 7ErF d.5 0 AgET;B Bd3. E r.r .d.9 I lc .D r! o.<s;'98 te - =.:G B'."' *3 -lXoo5 \a -.=E N! ='o6, (!l FE o !) o E' o l\.) (/) OO IJP{O\o O\o O o\@ 5o "o. Ot.) L,rO \o \o -J{ "tr, @ l.J o\ +. "5 l.J(,) 5O i.)O5 o\(^ "o\ UJ l-J o\! "s{ oo mlJIe 5{ IJI! o\\o \o oo "@ !O oo\o -J 5O "5 \o(,) 5)J @N .I-'!O{- o\ o\ \J @ r_J\ L'I\t "s 1.)\o +,Oj.-r O (,r oo l.J @\o (Jr \oO L/r Llr\o "o\ O ae olE a "-x Br6 eHo \FG.a! , soclls.,\;\ ,U5 FF#s .8.'? Fgxs 3E 33t= :e T\S-S qd tE(D : =.] F b x.F^_'\ _ GUA -r'.-.1$%0q9:;'a + {E{}s 5 *F -:.^I a itS =.S ia :l\.ha H - -s'\r 3 sisq R i*(s \ X *ts - ri 3 +{\S€ ts i.e'i!:- d R\!l H.^\.$ .o:'.iQ*\ :. i 6'fbUfr 2 13sa. :. Fois a $s<S o- :d\- ' .D UsNS r X=IS 5 PEa-\ t ii,= ,+ =" 6 o='(\;+': - ; Rss ci RE! E s'oLa -+(5 ai S'.=: ;' (\\3. A c{t' 3 dse. + !t ^-(D-IN ^ s--' -:X(b')(\Y6S3 H iiod 3 .;B = F \-il' E. siGid(bs- t? .w\ior-laFtvS.\ / d.lq' ;. S\r\! 6- aa.)(\\ rD *aN -l \R!^QAJS.X- 6' N'r si.s'XE :-Td3sqa1J6 LQ- =56oQrr: rD(\saRNd\- .sA)6\<5\ \O. IS' r+. s, ='5'ttdrDsqEs '^1 '! -UL u - xl \ts6-s.s63 d+$Sah q (D Ft aI A) o ot (D Ft rD U) o Fl o 0aFt F0 !D { l-p TJ o\ t,(D TJ (D 3(r rD l') SIICTION 2: lmplcrtrcntation of CDTI 2.1. Period of activities lnscrt Plan ol'action indicatirrg activitics tly lnonth, rvhich wcrc implcrncntccl YEAR 4 PLAN OF ACTIVITIES FOR THE YEAR 2OO3 Feb MarS/n Activity Jan April May Jun Jul Aug sep Oct Nov 1 State review meeting 2 Organization of Stakeholders meeting 3 Training of SOCTs and LOCTs on community self monitoring (CSM) 4 Community mobilization/ public awareness campaign. 5 Training/ re-training of program staff Update of community registers6 7 Community self monitoring B lllectizan/ vitamin A distribution Monitoring and supervisionI 10 Collation and collection of treatment reports 11 Analysis of the Reports 12 ZOTF meetings 13 APOC Quarterly Reports 14 APOC Six Monthly Reports 15 APOC Annual Reports Dec t2 WllO/APOC, 26 Scplcnrbcr 2003 -lo H I< 7 Pt- @ f.o rr, TD z 'P ln 4 7P e TD g 7 C) ED oX o oN U TE o tp o 7 ,il Ca F a z, :C 1q - UJ C U ttt n l) f'{ o \ rn ftr @ _a 5.+ :f= oa 7r>Lc)OEty ES5+ (DY\ \ \ \ \ \ \ ,11 lr1 @ o oI5 O+r d.D o 1. \ \ \ \ I Y' rr, ED _a dP5.i ==oa ooH5 o; 4(D o -l 't DD oq \ \ 'n rr1 ED \ a. \ 7 F a9 =.}+=' oe o(D tr rrl U, C1,E (D\ \ \ \ \ 7 F oo =39'o -(D o \ \ \ \ \ \ \ \ \ \ rJF r _a =De =.iJ) oa oo =39"o afD ot, U '1 ,q o ta it - o \ <.. \ 'U e - 3g5.+ ==oq (a E(D 7 lr, \ \ \ <\ ooI5 o;r r(D l-l lD)lo' lo h...r ; J rD 5(D o+) p) o (D (n a ts-t o F)H rD FD v) ri(D o) (D a- 5 (D C) tr Ho (D H e(\ a V1(\ S.\ o\(\ -t U a V1 (\ a(\ 4t4 !.1:- I o o J(D U' tr) II o .U o "o IJ o\ t, r01' rD o-(D t.)Oo 2.2. Ordering, storage and delivery of ivermectin Mcctizan@ ordcred/altplied for by - Qrleasc tick lhe appropriuta onsnter)NIOII tr }VIIO N UNICEII' f] NGDO EI Other (plcasc spccily): Mcctizan@ dcliverctl by - Qtleuse tick the uppropriale answer)NIOH tr WIIO tr UNICE,F N NGDO M Othcr (pleasc spccily) Pleasc describe how Mectizarr@ is ordcrcd anrl how it gcts to thc comnrunitics Plcasc dcscribc how mectizan is ordcrcd and how it gets to thc commuttity. Tlrc ordcring of nrcctizun bagitts ./i'om llrc utnunurily whcrc tdiar cotnrnunily rcg,islruliort (cen.sus) lruva bcan conduclcd utul nuntltcr td' illcgiblc paoplc obluinacl. 'l'hcsa urc .;anl lhrough lhe LGAs untl the Slule to the NGDO (IIKQ. IIKI will lhen use lhose inJbrmation to apply fitr lhe maclizurt. l'Yherc dislribulion hus bcen on-going, inJbrnrulion i.s obtained front llrc lraulntcnls rcporls ti'otrt lhe comnnmily stunnrury fonn.s. On tlrc otlrcr hund, when nrcctizurt rcuclrcs thc ytrt of enlry, IIKI will collecl it to hcr .slore. The State now collecls from IIKI slore and laler dislribute lo tlrc endentic LGAs wfut deliver it lo lhe designated I'llC cenlers which ure colleclion points Jbr the CDDs lo collecl fitr di.slribulion invenlories ure properly kepl at all levcls. - State actir ities under ivermcctin dclivery that arc bcing carried out by hcalth care pcrsonncl in the projcct area: Ilealth core pcrsonneI ure involvcd in lheJbllowing uclivitics: - Collection of thc requircd nrcctizunfrom llrc stule - Delivery of nrcclizan lo lhe designaled I'l IC centers which are colleclion poinls - Itrovil;ion rl'sloruge Jbr sufc kee ping of ivermcclin - Muintain propcr invcnlory.fitr llrcm - Collection of lreutmenl rcports urul lc/i over tublels and rcturn to llrc Stalc McctizanrD I 'ettse udd ntore rov,s ,tecessar Number o[ Mectizano tabletsState/District/ I,GA llequeslcd Reccivcd Used Lost W:rsle Iixpircd 145,000 143,552 l30,6lE 647 107,958t29,860 1,095 I I t,354 104,013SIIANI tltu iln wuL 200,000 125,000 KWNYA.KUSAI( 63,562 61,925 367 49 I]AYO 70,412 150,000 143,510 138,332 155 DN MI]ON 190,000 I 82,100 t 73,095 450 GWOZA 282,000 277,523 t80,596 2,908 97,300 365cilttloK r20,000 I 15,534 59,731 70DIKWA E 1,000 66,750 Wl lo/n POC, 26 Scptcmber 2003 BN MA 65,000 t77,962 158,803 958 KN LN.BN LCE 200,000 49,600 39,764 295 TOTAI, 1,1129,412 1,654,127 1,427,4116 7,710 NSKIITA-UBN 201,000 192,820 t75,27 t 351 State activitics undcr iverrncctin delivery that arc being carried out by hcalth carc personnel in thc project arca. Llealth care personnel are involved in theJbllowing aclivities: u. Mobilizulion of endemic communilies. b. 'fruining of CDDs c. Delivcry of Mcclizutt/Vitamin A to tlrc collcction poirtls cl. Supervision of the distribulion c. Trealmenl of reaclions f. Collcclion of reporls. Any other commcnts 2.3. Advocacy and Sensitization State the number of policy/decisiort makers mobilized at each relevant level during the currcnt ycar; thc reasons for the sensitization and outconre. Describc difficultics/cortstraints being faced and suggestions on how to irnprovc advocacy. The number of policy/dccision mukers mobilized al euch relevant level during lhe currenl yeur ure as/bllows: Slate Leyel: Advoctrcy meeling v,ilh (4) senior governnrcnt oJficiuls in MOIL Ilon. Commissioner for Ilealtlt I'ernuurcnt Secretury, IvlO II Direclor, Diseuse Control und l>ublic lleulth Services Direclor, PIrc, Local Governmenl und Chieftaincy l,/firirs. Rcusons: To sustain good v,orking relulionship and ensure conlinuous nrulcriul, lo gii t ics ond fi nunc iul s upltor t. Oulcome: I'he Slale level conlinucd lo releasc her counlerporl financial conlribulion. LGA Level! Iuleeting withf<tur (1) LGA top $ficiuls on lhc nccd to supltort thc program by llrc Stale Co-ordinqtor ond llKI Representalivc.s Jir every LGA. Chairntun C o unc i I lor ./br I lcal t lt l'llC Direclor Dcpuly l'llC Directors 7'1rc supltorl by sonte LGAs lruve been vcry minintul, so , thc nced to cortlinue lo visil und encouruge thcnt to step-u1t lhcir Jinunciul support lo lhc progrummc. a a o a a a a a lleason l5 Wl IO/APOC, 26 Septernber 2003 Oulcome: 20'% oJ'thc LGAs huve respontlcd by nruking sonrc Jinanciul conlrihulitttt lowurds lhe progrunmrc. Communitv Lctcl: o Cornmunily Leaders o Opittion Lcadcrs o llcligious GrouJts o Davclopmenl Association lcadcrs Ilcasons 'l'o cntbrasc lhe progrumilrc Ettcourage lhcm lo supltorl their CDD.s l'rovidc .rloruge and safcty tl'nrcclizan T'o nrunilor und supervise lhe dislribulors Outconrc: Aboul 65% of the conmnmilic.s havc uccepled tlrc pr<tgrcrmnrc und urc giving sonrc loken to lhe CDDs in appreciulion lo lheir comntilment. D iffi c u I t ic s/C o ns t r a i n ls : Most of the ddficulties and constraints are scen ul the LGA and Contntunily Levels. While lhe LGA Executives v,ill ltromise lo .sttltporl lhe projacl through tlrc relea.sc qfJundsforJueling, nruinlcnance of motorcycles, und sonrc ullowunce.s lo LOCTs whcn conlacted during udvocacy vi.ril^s, thcy do nol ulways horutur lhcir pledges. On lhe olher hand some oJ'the contmunity lceders huve lhefeelings lhal lhe projecls should provide puymenl or incenlives to CDDs. Ilow lo Improve on Advocacv: . Apurt Jrom visitittg tlrc LGI Executives, wc would org,anize advocac'y workshop.s for lhem and during the workshops they should visil un endemic contmunity to look ut tlie gruvily of the problents. T'\rc con:nnuities nccd lLt krutw norc aboul parlnershilt in CDTI ond should bc cncouragcd to orgurtize contmunily self-monilorirtg. 'l'his will improve llrcir purliciltulion in lhe projecl uclivitics. a a a o a 2.4. illobilization and health education of at risk communities I)rovidc inlornration on : The use of media and/or other local systems to disseminate information Use of tlrc health workers und C'DDs lo cducale comntunity members Attnouncetnenls are done in lhe churcltes, mosques, end during communily ttssociulion.\ or coopcralive socielies meelings. Use of town onnounccr.s lo dissentinule informalion lo comnrunity nrcmbers Rudio jingle.s and TV spot about the disease and need Jbr lrealment periodically. Mobilization and hcalth education ol'womcn and minoritics - method and response ll/omen and ninorily groups are nrcbilizcd during their fellowshtps, associaliorts, ond olher nrcelings. o a a a l6 Wl lO/APOC, 26 Septcmbcr 2003 l(esponsc oI targct cottrmunitics/vi l lagcs: o Acceptancc of tlrc progromnte v'ltich havc cnsut'cel high covaragc. . Supltort lo the CDDs by contrihulion oJ' belrveen N l0 - N20 by some lruuseholds. Accomplishnrcnt and hcalth educatiott: . lvlobilizalion and educuling 1,099 endcmic comnrunilics . 'li'eulmcnl of 53(t,290 utmmunily ntcntbcrs . Organizulion of stukefuildcrs mceling al Slule und LGA levels. Constraints: a a o Suggcst ways to improve mobilization of targct cornmunitics Even lhouglt PIIC stcff at conmuutity level do nol rcccive ony supportJrom tlrc LGAs, tlrcy should bc made lo undersland lhul nrubilizution of communilies where tlrcy live and work is parl of lheir primary assiq1,nmenl. Supervisittn al commtmity level lty PI{C stqf is vcry mininrul I)rovisiort of supervisory allowancc lo LOCTs almost non-exislanl. Community lo be encourage lo conclucl contmunily-sclf nnniloring. Irrequent advocucy visils lo LGA Chief Execulives lty lhe Slule lea,n tct nIicil for supporl. a o t7 WIIO/n POC, 26 Scptcmber 2003 tiNlO) .ld (Jr16- .ls:oL,' Oe3H3Etr ='r5'H U) rrOEo =6'= tsoi. 5O 5J+o(D= or; \JI -l':e\iOsoxdo :oN.?*s3tsq,ilI: ^);rod (\ a cS Uj V) ut- o E r>F @ r olr, TD ! U x o E ox a 7( P C': TD o 4, /^) N U TD o CD o XCa fr (./) ,z +>r' ct. C U :. rt.t-o TJ 5 \o \o iJo IJO TJO \o \o \o ooo Io- o z 9 o-o ,.oED o TJo o{E E'+ o- s.*TE- 1z *7B*-3di'gs D O LOH{l zE E(t o o 'Eo! o5 lo 0ao ^<E()O - -1 9 o -.8 =il z Eo o (! D9 !o3 j.o i.D ?=: Ig o o U -t NJo \o l9 O iJo tJo o\@ 6 \jo oo\o +- l-.J 6o o oo5 o\ @ N)\o rr:lFli 33 3 =g5I; H'i.etsoi; i i:+ z'di..i;BC+ rE o oo D ,oo o'Zotr =g =6 .?3 =Oo5 Ctro5 Btq< EE-)G 3i aEj {o p a A) o 5 iJ G' ooo o. o5 zo "o oEo \t IJ 65 A 5 N) \oA \o I F). ;td o oo o. z o 'c,Io -o o 1.?'z ^FdE()== =lFr5 [!) f.^6-g + ro oa 6 E o?o o 'u o _o tJ o.(n (D -o .D 3 (Dt iJ UJ zc uGt o o U 7i6 .iD =r:aa+ 6 ao 3 c5 6' o U U -to oF U!oo6' =Z ce=sr 7t-i.^3;i f9 =Jlo3 ^E. ,c) o >dH5(D(D D)O55a) ..(D ot o' p (D o tso'oFl U) oFt (D oo 5p d a? D) J(D o) rD o.to D0 o CD(D oq U) \1 5D)P3oq E: EHTD6=;+P o" -.o,< i: o-5o Hd a? a)H EEs.6Oa o(1 <+d YH a) r:, D) o ot (D'5J D) (D (D d(D H U) oF{) (D() iJ) o(D I,(Ia t, l'o o U *t Vt(A (D a F)r-t(D d(D 0a U)o a U)o v) D) .D o. Fo op o p oFt (, U) o u, s.LG- ,G{>$ \id ='.o\\, FS \N x.R- nJciRlss \q- =(\ (\\ (\ oo q (\ (\ o a (\(\ h :-. (\ \.:io - 4.1 c)(\ A (\. \(\ 6 d\ o\ N \(\ o r: -r a \o a 'u p t.) Or tn(D 'o (D 3 o-(D IJo a :E z TD C U f. .: L- o Fl oH t'{ 7Pt- IE t.o rr, ttr IX € o fEoX tn 57P e @ o{ oN 7 ET o @ o 7( '>I7(' a v t cr' 5 5 z (t (D o Dj 91 (D.)d3 1.. o t, U' D) -o6\ 1'' 6' a! 5t! \oo 5 a A6 5 5 5 5 5 5 A 5 5 5 s s s 5 s 5 i Io .l ts ,? s t: (D .D (D \o ?,r 6t) -I5 s 5 LA s 5 5 5 o\ o\ -Jo '/ .l o D rf' z ct(D o o s) ra D: FT (D E hr -o o\ .) (! l! r! oo l'.) i o h io E z i.jrt!5" 3o'tDa 'aDFl 'rQ+HA,9e'(D t, o t\)5 -J(}Js t) 6' .! 3 a! :: \o{ t,l Urlo (, -t IJ o\ UJ o {o 6 \.1 ooA 5 o\ 5(,) l.J5 tJ 5 @ 5 s @ t'J (,) l.Joo \o oo \o5 o\ 1..) \o .J i o + -jo D z 5 .D o o U U' 't D) (Do lrfo a l-)p'O !- otE 0rHO DFF =:<5Ecoi =c 3o ;El D) 5 D) o a- it(D' F o (D (D u) +) o U -l (D o F) t(\ A w(\ s$ o\(\\o L; I Ri'{ E \ a-6 o D =s. Jr\\o \ o o\f(!\ o $ 0a o o F oF : l\\ o\o o- s o o 0a l-.JO Ga(\ Va U) { o ,o o -o IJ o\ l/)(D 1' (D 3 d(D5 iJO 5 5 J. s 5 5 'frailrees 'l'ypc of training CDI)s Othcr Comnrunity rncrnbcrs e.g Community supcrvisors I lealtlr Workcrs (lrontlinc hcaltlr lacilitics) MOil stal['or Othcr I'olitical Lcadcrs Otlrcrs(specify) Program managcrncnt Ilow to conduct I lcaltlr cducation Managcmcltt of SAlrs CSM SIIM Data' collection Data analysis Ilcport writing Others (specify) 'l'ablc 6: 'typc of training undcrtaketr (l'ick the hoxes where spccilic truining v)as curried oul durirtg lhe reporling period) - Any othcr commcnts 2.6.2. Equipmelrt and hunran resources Iablc 7: Status of equipment (Please add more rows if necessury) *Condition <f the equipmenl (l;unctional, Currcnlly txtit-Juncliotrul bul repairable, I4/rillen olJ) Notc: all llrc cquipntenl areJiutctionul. Sourcc 1'ypc o[ liquipment APOC MOI-I DISTRIC? LGA NGDO Others Conrlition of thc equipment * Plcase state l. Vchicle 1./ 1./ 2. Motor cycle 12/ 2./ 3. Computcrs 1,/ 4. Printers 1./ 5. Irax Machincs 6. Othcrs a) email b) intcrnct c) 2l Wllo/n POC, 2(r Scptcnrbcr 2003 I low docs the project intend to maintain and rcplacc cxisting equipment and othcr materials? 'fhe projcct itttcncl lo ntuinlain utul rcpluce cxistirtg etluipmcnl through counlerparl fitnding. - Dcscribc the adequacy oIavailablc knowledgeablc marrpowcr at all levcls. Almosl ull lcyels of projecl stuJJ.lruvc hacn lrainacl. Dvenwilh lhis, il canngl bc suid lhut we havc uchievecl, because rutl ull tlrc heulth pcrxtnnel ql lhc LGA level lruve been truined. 'l'he ralio of CDD lo nuntber of people being treulcd is very low:Trainers und supervisors al com,nunily level ure inudequule. Where frcquent trarrsfers of trained stafl'occur, state what project is doing or intends to do to remedy thc situation (Thc nrost important issue is what nreasures wcre takcn to ensure adequate CD'tl implemcntation where not enough knowlcdgcable maupower was available or stafloftcn translcrrcd during the coursc of thc campaign). T'here is noJraquenl lransJer oJ'projccl stu/f however, nnre stulf ure bcingtrained lo avoid any evenluality. 1) Wl IC/APOC, 26 Septcmber 2003 N{ a { .l o!t ,.i =Jo :, ..) o a- D)d' c06 6lcp)!1 r Jl.Yod9 A) x.t<a o-I1g9 !o A)5r)tnl dir <1 1 I50c da A)UdO(D\o o\ o0q -(Dnio50qiJ >l(DD)o-!<it3()PA)G. ;-- .o o (DH D) oa(D D) a. i] 5 !1 t5 oH) o\ L,I .o o\ (D Ft F0 -o oE C) FO o (D Ft FD oa(D >.ig) (D ot oo (D F, Fo 0qo >'t FD (D U' og F) gq \i * N ao(\\ Na. ooq(\ (.) \f'-Sa^XR S $s'p>+96'S R .o=<==.:'q s" s ,t *q € s sr\(-J sE-'RiASVOoR\Nd-b(\ s./ q (\qq N-r,!F o R.:\\6 X'=(ru U \tl,i $ ssq e:L= \\.xd'3s 4(\.%tbF-v9t S. s-.\qil !ilS."' d FqO\XX's R Y !!\b AI (SB \.\\S :3 €s$ sS$R {6sos{I.n ="UL\vD. \ N i. tb\N"s R* .yL R -\ =:=' j(\YAs" B\v s.o\(\s q{ \ =&NGc){ *.^ .o q. q -..i :s!s\S\€ NN Y(h ujq Gs-d* f'- (\0\A q\. 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'uJ oo NJ JTJ -IO\o \.cl O o\ @ sI OrOtJ I\c|o\o 5{O { -J 'trt co N) o\5 "5 N)t, 5o l.)o5 o\ b.(r)|.J t\) \o 's 55 o\ -J5{ @ o\Oo Oo 3:>;.:P3E; >'o t 6= UJ o\ ''t'J \oo tJ\o{ LllJ @\o o\ )o\o5 o\ l..J (r) o UJ5 "5 -Jo' o\ -6 \o{ o\t "s \oo I o\o' TJ -oo (r)\o 5o -J t-.J(}J 5s "o, A -.t Aj-J Oro oo ix- r3 f.J ij .o o\ @ rJ oo :J @ o\ 5 @t.) s @P 6(}J bo \o L, @ bo @I \ot.J @ {\o(r, -lpl..J 3+<E x3 m! \ot3.' a l^ o{ N)5 f.J o\ 3\\o o\ 6 o\ -Jo\N @ tJ)\o o\ -lo o oO ,*39" i a.r6adlEE l')@t\) t.) l-.J6 UJo @ \o 6 \o so' 5 (,) 5 s\o N \o\o \o Ot\o oo\ o q tr I I I I I I I I Et iq P n Ba :.& 3 od l-l PlDr {lgL I(D lro -,,toe U,i(!5I'G o5 G&' orl c(D0'o !rp (Drt U'(! 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Aloll a) d(D o- J(rt HN)di/r I\OYo\=l U oFt I(D a-(D 5J 6' F)to A)0 I ='J ='+ J o IE €.(D o d A)a(D A) e -jo v =-cr N.id ts Sllllts sS= D\ A\N{-\x sNX Rqss \ ss sX'R- orN-{ q3e. e,q\' \fiB S1rll'o sYo- =. =(bsts+ 0a\*qij s *\ B\=. e\$+ *x EaL; (\\O]3.> $gN s\] ss,o X'[* qx* $xs *\il t =SAu(aa\?113i. r,as.\ts:=' {INx* sc\h- r! H\ -:. Ci A. =.qt $dss s-r\dv,(\s =N-s $ €.s s *'S \\Ax=n\.>3 -*x i'X(\$x- s a\(\r-Y (\ r) -A\E N s$ I:\ ai+{x.s. E. al(\1.. .BSG '\€\(\d\3 ,o s t-)! t -o o _o t\) o\(, .Drd (D 3q(!I IJoo(,J il ll 7.2 Trcatment If the project is not achicving lO0% geographical covcrage and tuittimurn of 65% therapcutical coveragc ratc or covcrago ratc is fluctuating, state rcasons and plans being made to remcdy this. 'Ihe coverage is fluctuating because of somc oIthesc reasons:- Conntunily registrulion (census) huve nol been update, lhus, lhe accuracy of number oJ'contmunilies in the projccl is yel lo be uchieved. a a lnubility of CDDs lo cover lhe anlire communilies due lo CDDs ullrilion. Luck of adcqualc und elfective supervi.sion at lhe community levcl by health due lo lack of supporl by some LGAs. Plans to remcdy the situation: Arrangcmenls have becn made Jbr updute of communily regislrulion to idenldy lhose communily which are nol being lreutcd. Plans have been mude lo idcnlify und train more CDDs. Advocacy vi.sit ltt lhe LGA Execulive have been intensiJied to solicit their supporl lo lhe progrumme. 2.7.2 What are the causes of absenteeism? Some of the cause.s for absenteeism are as follows:- Sonte calegories of people are cutlle reurers (herdsnrcn) v,ho ntovcJiom pluce to place in search of good grass for tlrcir ceillle. 2. 7'here are seoso,lal communily selllemenls. The members do migruie Jiom neighbouring Slales in seurch offerlile lands for dry seasonfarming and at the end of harvet they migrate back befitre lrealnrcnl commences. Remedy: Arrangemenls have bcen concluded by the projcct lo be lracking these culeS;ories of people und giving lhem llrc drug us .\oon as they lyn around wlrclher lreolnrcnt hqve been commenced or nol. 2.7.3. Briefly describe all known and vcrified serious adverse events (SAEs) and provide in table 9 the required information when available. None has been idenldied so fur. 2.7 .4. ln case the project has no case of serious adverse event (SAE) during this reporting pcriod, plcase tick in thc box. a a a No. Cuse to report 28 E WlIO/APOC, l0 April 2003 o I t.)oo t.)Oot, t.) oIJ l.J o N)OOo \o\o\o \o\o 6 \o\o{ rr,F N)o o t\)oO\o TJoo @ l.)oo -J ]JOo o\ N)oOs t-)Oo N)Oo l.)OO oO -Jo ooo= Bfr s E tn o -.5 r:x'itJ =.-::'/ 3 o :rt HE a 3qBr =DT0a 1.) o \.o \o@ @ o\ o\ o\ t.J o\ oJ- -<r.i P:6's =33E ='o A)o) o\o\o \o \o@ oo o\ o\ o\t.) o\ -<EzH 5=3 =3 * E,,H E T*[i i: oOt \o (h \o \o P oo oo o\ b. oo\o oO rfr 'E \o ii o oo oo oo ooa<)\oG Jt,E o o o o 5E5 (D : A) oa(D 'o TJ .oo o\ {{ ,5Os{ o. o\P o\ o\ 5 5 o{ i.Jo(,J 53 5lao "d5 0 '' =- =.>=iDl oo Z o =.FP.O Y -3$ ; o\o .O oo o\o 'o oo o\O .Pooo o OoO (n oIooo -iFs g93E:'s eroA UJ o\ i.J\oo 6)o @(.) 5 Lro @ 5 ;-J -TUJ 5 s (r) .,N os 'o9.t OE5A@lj 30 airl)O G' o. oo\o \o@ \oI @ @lrJ L^ oo l..J b\ io=rOo s{€vFD oOQtro ='.o oo. \o o ;-ftEo o ru ots o) o o\ UJ o\\o o\5 s\o s6 b. oo^ .s$ 3 oao hJ -J t, -t .! CL o -l t!E (D Da .D .D a! o oU -l -| o(! a E' r) rD! o o (D (a E .' -t a! q .D D l-l lo)lo' laD l= ;>'i(D D) ts(D 5 v) A) o- C)o (D Ftp) oa(D ld t; lD) trDl5lo. IHt< (D p) H at (D (D Ft(! -l o .D .) DEt r! P S(\ G\ NJ\o { o 'uo -o o -d x. t.)Oo 2.A. Supervision NGDONOCP s'[nTE, (socTs) LGA (LOCTS) DISTRICT SUPERVISOI(S CLINICS i/c COLLECTION POINTS COMMUNI'|IES/ CDDs Provide a flow chart of supervision hierarchy. Acoomplishrnerrt and health education. o Mobilizalion ancl health educolion of 1099 enclemic communities, o T'reatment of 536,290 comrnunily nrcmbers What are the main issucs identified during supervision? None provision of allowancesfor LOCTs and other healthworkers involved in CDT'I uclivities by LGA Execulives. No adequate support to CDDs hy many communities The projccl need lo truin morc CDDs to reduce tirc burden of work on some CDDs. I 2.8 2.8.2 2.8.3 Was supervision checklist used? 30 WI{O/APOC, l0 April 2003 Supervisory checkli.st was used by some supervisors during lhe exercise. 2.8.4 What were thc outcomes at each lcvel ol'CD'f[ implernentation supcrviscd? The LGA execulive promised lo by providing ullowunces to lhe LOCTS during field aclivities. 2.8.5 Communities agreed lo sclect nnrc CDDs and supporl lhem. Was fecd-back given to the supervised, and how was thc feedback used in improving the overall performance of the project. The supervisetl tlecitlctl lo correcl areds oJ'tlaJicie nl by resolvetl lo hc more contmitled. 3l WI lO/nPOC, 26 Septernber 2003 SBCTION 3: Support to CDTI 3.{. Financial contributions of the partners and communities I'able I l: Irinanoial contributions by all partners for the last thrcc years lf there are problcms rvith relcase of counterpart funds, how were they addressed? - Comments Problems encountered on the release of counterpart funds are addressed as follows:- . Advococy visil by NOCI' and NGDO lo lhe Executivc Govcrnor. Advocucy visit by Hon. Comntissioner for llealth lo Ministry of ktcal(iovernment and Chieftaincy Afritirs lo solicit supporl from LGA.;. Advocacy visit by Morl und Minislry of Locul Governmuil and Chiefraincy Affuirs to endemic LGAs Exe cutive lo solicit lheir Jinanciul support. Memo /rom the Executive Governor Direcling LGAs to make lheirJinancial conlribuliotrs. 3.2. Other forms of community support - Describe (indicate forms of in-kind contributions of commurities if any) l. Pruyersfor CIDDs 2. I{elping out on CDD./arms 3. l'roviding some CDDs with bicycles to go antl collect drugs 4. conlribulion of cash by euch household to support the.CDDs. a a Contributor Year I (lvtay 2000 - lpril 200I ') Yetr 3 (Muy 2001 -April 2002) Yeer 4 (May 2002 - April 2003) TOTAL Budgetcd (us$) 1'O'rAL Ilcleascd (us$) 1-O1'AL Budgcted (us$) TOTAL Relcased (US$) TOTAL Budgeted (us$) TO'TAL Released (us$) Ministry of l-lealth (MOll) 4,542 'll 27.248 .l -..i l,.i l n,1 65 I I'i. I r,: Local NGDO(s) ( if any) NGDO partner(s) 40, I 05 8,55 r.l3 20,355 9,il5 20,461 I 6,46 t .93 District/LGA t0,862 t 0,862 6,517 6,5t7 45,4 t3 45,413 Others a) b) c) Communities In kind and caslr, which catrnot bc asccrtaincd APOC Trust Fund 148,845 40,894 95,750 20,000 76,tJl I t9,221 TOTAL 204,354 64,849.33 I 49,870 62,880 I 60,050 99,260.93 32 WllO/APOC, 26 Septenrber 2003 r] 3.3. Expenditure per activityr - Indicate the expenditure on activities below in US dollars using the current United Nations exchange rate to local currcncy Table l2: Indicate how much the projcct spcnt lbr each activity listcd below during the rcporting pcriod Conrments Activity Expenditure ($ us) Source(s) of funding Drug delivery from NOTI; IIQ area to central collcction point of community Mobilization and health education of communities 'l'raining of CDDs Training of health staff at all lcvels Supervising CDDs and distribution lntemal monitoring of CDTI activities Advocacy visits to health and political authoritics IIIC matcrials Summary (rcporting) forms for treatment Vehicles/ Motocyclcs/ bicycles maintenancc Office Equipment (e.g computers, printers etc) Others 1,675.50 17,728.16 18,981.25 13,694.79 12,430.23 17,130 MOlt APOC/I IKI/ MOIU LCA IIKI/MOII APOC/TIKI/ MOTYLGA APOC/HKI/ MOH APOC/FIKV MOII TOTAL 99,260.93 'I'otal number of persons treaterl 536,290 33 Wl IO/APOC, 26 Septernbcr 2003 StrCTION 4: Sustainability of CDTI 4.1. lnternal; independent participatory monitoring; Evaluation 4.1.1 Was Monitoring/evaluation carried out during the reporting period? (tick where applicablc) '/ Year I Participatory lndependcnt monitoring Mid l'erm Sustainability Evaluation 5 year Sustainability Evaluation Internal Monitoring by NOTF Inteqration of Vitamirr A i CDTI conducted bv IlKl. Othcr Evaluation by othcr partners 4.1.2 What were thc recommendaiions? 4.1.3 Ilow have thcy bcen implemented? 4.2. GommuniQl self-monitoring and Stakeholders Meeting Table l3: Community self-monitoring and Stakeholders Meeting (l'leuse udcl ntore rotus if necessury) Describe how the results of the community self- monitoring and stakeholders meetings have aflbcted project implementation or how they would be utilized during the next treatment cyole. o The comntunilies/bel u sense of belonging and urc porticipalingfully in monitoring and supervision of aclivities corried out 4.3. Sustainability of proiects: plan and set targets (mandatory at yr 3) What arrangements have becn made to sustain CDTI after APOC funding ceases in tcrms of 4.3.1 Planning at all rclevant levels: The slale und LGAs are fully swore thctl exlernal support will cease in the near future, thus, alternalive source of supporl is being put in placc through sustaining govcrnnrcnt 34 WI-IO/APOC, 26 Septenrber 2003 DistricU LCA 'fotal # of communities/villages in the entire project area No of Communities that carried out self monitoring (CSM) No of Communities that conducted stakeholders meeting (SIIM) BIU HAWUL I}AYO 129 r l8 t0l 5 5 5 5 5 5 SIIANI lr6 5 5 TOTAL 464 10 20 conlributiorts, prominent individuals and orgunizalions in lhe Slalc are also being contacled frtr supporl. 4.3.2 Funds Sensilization and commilnrcnt of the policy mukcrs al lhe State and LGA lcvel will conlinue in order lo increuse theirJinuncial conlribulions and.suslain it lowords the projecl. 4.3.3 fransport (replacemcnt and maintenancc) The State huve starled mukingJinancial ulloculionJitr lhe maintcnance of exisling ones. Some LGAs are also JuelinSg and mainlaining lheir molorcycles. APOC have also been requesled lo replace lhe old vehicle and motorcycles. 4.3.4 Other l{esources IIKI will c<tntinue lo assi,st the projecl wilh IEC and training materials as nruy be required. The communilies will continue lo provide and repluce measuring slicks fitr the new und old CDDs when nceded. 4.3.5 4.3.6 4.4 4.4.t Please provide a written plan with set targcts and achievemcnts for so far No formul ^sustainubilily plan ha.s been tlrawn-up To what cxtcnt has the plan been implcmcnted This will be stuled in lhe next report. Integration: Ivermectin delivery mechanism PIIC slclf now takes re.sponsibility of mec'tizun. Tlrc LOCTs nou,collects nrcctizun f'rom lhe Stute. Also lhe district supervisors do collect /i"om LOCTs and tleliver to lhe colleclion cenlres for CDDs. 4.4.2 Training State Onchocerciusis Co-ordinator is ulways invited to make presenlalion in workslnps for other health progt'an ,nes. 4.4.3 Joint supervision and monitoring with other programs At the districl and contmunity levels, supervisionfor Onchocerciusis and other hectlth aclivilies ure carried out simultaneously. 4.4.4. Relcase of I;unds Rttuline procedures arefollowed in the release offunds just like other projects at the Slate and LGA levels. 35 Wl IO/APOC, 26 September 2003 4.4.5 Is CDTI includcd in thc l'tIC budgct? It is includcd in lhe gencrul budget ul LGA leve[, while ul the Stute il is in llrc Depurtmett! of Disease Conlrol Budgel. 4.4.6 Describe other health programmes that are using the CDTI structure and how this was aohievcd. What have bcen the achicvcmcnts? The CDT'I struclure is being used to dcliver vilumin A to the contntunily nrcmbers. This was possible through communily mobilizalion and educati<tn of comrnunity members lo see the needfor vilamin A sultplements. CDDs were also trainqd on how lo supplemenl. Iligh coverut4,e was recorcled in holh meclizurt and vilumin A supplernentation. 4.4.7 Dcscribe other issucs considcred in the integration of CDTI Through inlegralion, contmunilies huve heen molivuled to carry oul olher health and development activities such as safe drinking v,dler and sanitalion. 4.5 Operational research 4.5.1 Summarize in not more than one half of a page the operational research undertai<en in the project area within the reporting period. 4.5.2 No operalion reseorch have been conducled in thc projecl LIow wcre the results applied in the projcct? 36 WllO/APOC, 26 September 2003 b. SECTION 5: Strengths, wcaknesses and challenges List the strengths and weaknesses of CD'l'l itnplementation process List the challenges and indir:ate how they were addressed. STRENGTIIS: a. Community participation: o Some communities lruve increused their supporl lo CDDs . lmplemenlalion of communily self monitoring have encouraged community members to have sense of belonging, ond has led to increase awareness and c<tmmilment lo the programme. Sustainability: The State Governmenl hus continued lo show commilmenls by prompl releuse of counl e rpur I Ji nanc ial co nl r ib ut i o rt. c. Logbtics: IIKI continuecl to support the projcct with logistics during progruntme aclivilies. Additional vehicle provided by the Slale Governmenl. WEAKNESS: a. LGAs Contribution: Irregular or non-counterpart financial conlribulion by LGAs hqs led lo inadequule lransporl for supervision by LOCTs. CDDs Support: Some contmunilies ore slill nol wiling to sultporl lheir CDDs. Thi,s has resulted lo CDD atlrilion CHALLENGES: a. There is slill lhe needfor conlinuou,s lruining to /ill infor lhe CDTI personnel who have leJi. Some of the challenges/conslrainls of the project include refusal of sonte communities to support their CDDs; high rate of CDD altrition; rutn-release ofJunds by LGAs to supporl the LOCTs. These have heen addressed by intensdied conununily ntobilizalion; and advocacy vi.sits lo lhe LGA Executivcs. a a b. 37 WHO/APOC, 26 September 2003