Meeting between OCP and national coordinators :13th -14th April 1998 Ouagadougou

| ---'*o'+ r/oRLD H EALTTI ORGANI ZATION,/OIICH rc ERC IASIS C ON'rROL PROGRAI'I}',1E SITRRA LEONE' I'IEETING BET'^rEEN @P AND NATIONAL CO-ORDINATORS lrTH - 14T1r APRrL 1998 OUAC'ADOIIGOU * , { Dr. Brima Kargbo NATIONAL CO-ORDINATOR 1 COII,IMUNITY-BASED IVERI,4itrTIN DISTRIBUTION Security situation in the country' Inadequate logistics such as transport and stationeries' Inadequate training of Volunteers The inadequate "r"I1"bi1ity of Ivermectin and Monitoring Drugs for adverse reactions. The insufficient mobilization and participation of the "orrrrrity for Community-Based Ivermectin Distribution ac tivities. community-Based Directed Treatment is supposed to be the mainstay of Oncho treatment in Sierra Leone. Due to the unfortunate events in 199?t this mode of distribution could not be carried out. ftre training of Nurses was completed in January 1997. Budgetory approval for ttre training of Clmmunity Volunteers was received' Ttris activity could not be carried out due to the dictates of the security situation in the country. Meanwhile, passive Ivermectin distribution was carried out in 51 Health Institutions. A total of 2Ir89r patients were treated with 2!r728 tablets. 2. SUPERVISION ON CO}.fMTINITY-DIREC TED TREATMENT The supenrision of community-Directed Treatment at community 1eveI will be d.one by the village Health committee and Nurses of the Peripheral Health Units. The Nurses in turn will be supervised by the District Health Team' At Distrlct Ievel, the supervision will be carried out by a super- visory team at the Natioo"l co-ordination IeveI. This supervisory team will compose of: Ttre National Co-ordinator the Medical Officer Three Epidemiological Technicians The three E)I Technicians will be posted in each of the three Provinces - North, South and East. Ttre Medical officer is a backup supervisor at the National co- ordination Ievel. The National co-ordinator wil-I play a more active role in supervi- sion by making on-the-spot checks on the alledged treated villages as reptrted by the District Health Team or the 4lI Supervisors. Now that the Ministry of Heal-th has a }lanager for Disease PreventiongndControl,hewillactasa|watchperson|fortheDirector- General of I'ledica1 Services as the need arises or as reported by the National Co-ordinator. 2.I CONSTRAINTq (i)(ii) ( iii)(iv) (v) 22.2 CORRECTIVE I,IL'ASURES 3 INF'ORI'{ATION ED;JCATION AND Improved security situation Vehicles should be at the disposal of the District Health Team members to effect good supervision. Zonal Supervisors (three Technicians) should be provided with motorbikes for proper monitoring of activities in the affected villages. Stationeries will be soticited from Non Governmental Organizations, Ministry of Health and Sanitation and Oncho Control Programme. Ivermectin tablets will be requested for, on time and adequate storage facilities provided. For active participation of the communities, the District and community Administration will be adequately sensitised to mobilise the community for their effective participa- tion in the control activities. COM]VIUNICATION (IEC) (i)(ii) \111/ (:.v) (v) (vi) Pub1ic Awareness Raising and Sensitization has always been carried out at National, District and Commuaity Levels through the mass media' radio and television news. 4 TRAINING 5 PLAN OF ACTION 1Aq8-2OO2 ,.I AIM After the completion of the training of l.lurses in January L997, the training of CLmmunity Ivermectin DistriUutors was supposed to have taken place in MaY 1997 as Planned. Due to the Military take-over and the subsequent insecurity with the displacement or tn" population, no training of comrnunity volun- teers took place in this Period. Ilor,rever, the Non Governmental organization - -Lunsar Eye Hospital - our collaborators managed to secure funds and trained 94 Community Volunteers along the Roke1 I River Basin from December 15 to 21, 1-997' To eliminate Qrchocerciasis as a disease of public health and socio-economic importance and to maintain the achievements of 6P. GENERAL O&]ECTIVES (i) To institute a sustainable Community-Based Ivermectin Distribution in the Oncho endemic areas of Sierra Leone within a five year perioa (f998-2oo2). 5.2 -t- (ii) 5.3 SPMIFIC OBJECTIVES 1.1 r.2 1.1 1.4 t.5 2.L 2.2 2.3 2.4 To establish an integrated multi-disease epiderniological surveillance system in all the districts for all the diseases in the Devolution Plan within a five year period (rgg8-eooz). To train Community Volunteers in Ivermectin Distribution in all the districts within a five year period' To provide education on Onchocerciasis awareness and on the benefits of Community-Based Ivermectin Distribution to the Chiefs and the PeoPIe. To treat 8ol of the eligible population with Ivermectin in the affected River Basins within a five year period' By the end of 2OO2t 80?6 of the eligible chiefdoms would have been covered with Ivemectin treatment' To update the number of villages eligible for Ivermectin distribution once a year in al-I the districts' To train District Health Team members in the districts to conduct active Surveillance/Evaluation of Onchocercia- sis and the other Devolution Diseases' To ccnduct periodic Epidemiological Surveillance on Qrchocerciasis using Indicator Villages' To organise supervisory visits for Ivermectin distribu- tion ind Epiaemiolo3ical Surveillance activities in the distric ts. To carry out operational research on acceptance of treatment and skin involvement of Onchocerciasis infection' 6. DISTRIBUTION OF IVERMECTIN TABLETS TO IHE COI"I]"{UNITY VOLUNTEERS 5.1 PR@UR-U'IU{T 6.2 Services. STORAGE Ttre procurement of the Ivermectin tablets from I'IsD or @P as tte case mav be rriff U" done by the Director of Drugs and Medical Supplies through the Director-Genera1 of I'ledical. Once the drugs have arrived at the Port, tlere is adequate "fo.rg" laciiities at the CentraL Medical Stores awaiting distribution to the districts. DISTRIBIITION6.1 There is always a prompt, safe and efficient distribution of airg" from Central to bi"tri"t and to the Peripheral Storage Facilities. 4Once the drugs are in the District I'ledical Stores, requisi- tion is made by the Nurse. The Nurses in turn distributes the Ivermectin tablets to the Community Volunteers as the need arises until iv6sn Community-Based directed treatment is fu1ly established that the Volunteers will themselves go to the Health Centres to collect the drugs. r) NATIONAL STRUCTTIRES TO TI'ITEGRA TE IVETU,{ECTIN DISTRIBUTION The integration of Ivermectin Distribution will be done at theDistrict Primary Health Care Level. District Health Team members have already been trained on Community- Based lvenuectin Distribution. Members of the District Health Teams participated in the training of Nurses at the Peripheral Units. thus the lvermectin will be delivered to the District Medical Officer who is the Head of the District Health Team. 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