Proposal for Kano State CDTI special initiative

)*a AFRICAN PROGRAMME FOR ONCHOCERCIASIS CONTROL (APoc) Proposal for Kano State CDTI Special fnitiative 2 t sEP, ?nn? 2 0 sEP 2007 Dambat GezaShano Aiin Lrin Gay Wud RanKara Bebe Tak Sumai Dogu Kano State Nigeria Septemb er 2007 EXECUTIVE SUMMARY Kano State is situated in the northern part of Nigeria and falls in the Sudan, and Sahel zones. However, the endemic areas are generally located in the Sudan Savannah. The terrain in these areas is generally flat or slightly undulating with sandy soil. The State has 44 local government areas with a population of about 8 million people based on the 2006-population census. The people of the area are mainly Hausa/Tulani with few other tribes usually found in urban areas who serve as the minorities in the State. At the community level these ethnic groups (both from within the country and from neighboring countries such as Niger Republic) are more or less assimilated into the local populations. Hausa is the major language of communication. Islam is the religion that dominates the State with a little percentage of Christians, who are mainly found in the cities. The vast majorities of the population of the communities are settled agriculturists, keeping herds of cattle, sheep and goats. There are numbers of pastoral Fulani some of who move according to the seasons. There are fishermen along the river valleys. Craftsmen of various descriptions exist and traders abound. Some of the traders are itinerants seeking markets for their goods and services. CDTI is however being implemented in 18 LGAs in the State with a total population of 609,71 I person living in 810 endemic communities. Community Directed Treatment witlt lvermectin GDTD The African Programme for Onchocerciasis Control (APOC) approved the FCT Project for funding of CDTI implementation in 1998 to implement the Community Directed Treatment with Ivermectin (CDTD. This procedure was meant to replace the system that was used by CBM and the MOFI for distributing Mectizan using the mobile system and later the Community Based Ivermectin Treatment (CBIT) strategy. The African Programme for Onchocerciasis Control (APOC) provided the needed impetus with adequate financial and logistic support to the project to perform. The strategy aims at getting the community people themselves take ownership of the programme, take key decisions on the selection and support of the distributors, collection of the drugs, drug distribution to community members, supervision and monitoring. The Primary Health Care (PHC) system of the govemment is expected to be empowered and to integrate activities into the mainstream routine performed in work places. The project is therefore requesting for the sum of N 6,311,750 from the APOC management to enable it carry out planned activities in this special initiative. 2 N FOR PRO 1) TRAINING: The key to successful CDTI implementation is hinged on effective training and adequate manpower to carry out programme activities. The situation at the moment is that most trained Health workers (LOCT & FLHF staff) are sometimes transferred to non Oncho endemic LGAs, while their replacements are not adequately trained to fill n the gap created. These have been eroding the quality of monitoring and supervision of CDTI activities in the project. The number of CDDs doing the rvork keeps decreasing without commensurate replacement, creating shortage of personnel in such communities, leading to poor coverage of communities and households treated. In this proposal therefore, if key programme personnel are trained and retrained once more in Kano state, they will be skilled and knowledgeable enough to implement CDTI philosophy and guarantee a better quality of service delivery to the people. During this training, other component of Blindness prevention will be introduced as an additional package to bring about motivation and new l<nowledge gained. The training sequence shall be such that the SOCT are trained first as TOT, so that they will in turn train the LOCT and Health Workers so that they will together train all the CDDs to guarantee quality. cd Number of me nel to be trained in the current initiative: * We are proposing to improve the ratio of CDDs (l:250) to be trained per population in each LGA in tlris special Initiative. J LOCT HEALTH WORKERS CDDSSAI LGA TOTAL POP. I Krrra s7228 6 25 228 2 10753 3 3l 43Rogo 3 Ga1,n 29712 4 29 119 4 26468 J 28 106Ajingi 5 Doguwa 80030 6 36 320 6 Makoda 10884 ') 27 44 7 D/Tofa 35013 5 29 140 8 Bebeii 37782 5 34 l5l 9 T/Wada 73421 6 4l 294 l0 Karaye 26036 J 3l 104 411 Kiru 2s603 36 102 t2 G/Malam 39040 6 JJ 156 l3 5 34SLrrnaila 23743 95 t4 Kabo 2r689 4 43 87 15 Crvarzo 2448t 4 34 98 t6 I\4adobi 28570 5 29 tt4 t7 Darnbatta 22042 J 30 88 l8 Tal<ai 372t6 J 38 149 TOTAL 609,711 77 s88 2,438 a 2) TNFORMATTON. EpUCATION AND COMMUNTCATTON OEC). Information dessemination to the endemic communties is central to the success of the CDTI implementation strategy in the control of the Onchgocerciasis disease. Most of the communities have been taking Mectizan drugs for a period of between 7-10 years now. The initial signs and symptonrs of the disease that they experienced at the beginning of the peogramme are no more, giving those false hopes and confidence of not wanting to continue to take the drugs for many more years. This is even more difficult for the programme personnel to convince them when the exact nurnber of years of the drug intake is yet to be scientifically determined. There is therfore no better time to increase awareness on compliance and support to the programme than it is now.The APOC support and initiative is thus a welcome idea. The existirrg IEC materials have been used for a very long period of time, requiring change to confornr 1o current attitude of the people. There is therefore the need for the projects to come together and assess the current materials and review them to comform with the educational needs of the moirlent, and to address specific cultural needs of the people with stronger emphasis on compliar:ce. Sequencc of activities thus includes: 1) Material review and development by the project representatives. 2) Material production for project use. . Posters . Brochures . Treatment forms . FIip Cliarts 3) Advocacy and sensitization of leaders at all levels. 4) Community mobilization and sensitization and the selection of CDDs by the communities to be trained. 4 IEC uirement for the Pro NAME OF LGA No of Com No of Posters needed No ofCDD Brochures needed No of Training Flip Charts needed No of State summary forms needed No of LGA summary forms needed No of Tally sheets Needed. No of Training Materials sets needed Kura 45 Rogo 10 Gaya t4 Ajingi LJ Doguwa 86 Makoda 4 D/Tofa 39 Bebeji 70 TAVada 210 Karaye JJ Kiru Z) G/Malam 41 Sumaila 27 Kabo 46 Gwarzo 36 Madobi 39 Dambatta 25 Takai 39 3000 3,000 150 1 000 2,000 10,000 3 1 68 TOTAL 810 3000 3,000 150 1,000 2,000 10,000 3,168 5 (TIME LINE OF ACTIVITIES: CONCLUSION: The project is quite optimistic that if the funds requested are given due consideration and ap''roval for the implementation of activities, the communities will be more aware and treatment c(,,'erage rvilI be sustained with the community members taking more of the ownership of the CDTI programme to guarantee its sustainability. ACTIVITIES wHo WILL DO IT WHEN INDICATORS FOR SUCCESS Advocacy and sensitization of leaders. SOCT NGO LOCT FLHF Nov. 2007 To February 2008. -Increased awareness -Increased support -Revised & tested IEC -Number of trained SOCT -Number of hained LOCT -Number of trained FLHF -Number of communities mobilized. - Improved coverage Stake holders' meeting Review of IEC material Field Testing of reviewed materials Central production of IEC material Training & retraining of SOCT, LOCT ancl Health workers Mobilization &, sensitization of communities / selection of CDDs. Tlaining of CDDs 6