Ogun State CDTI annual project technical report submitted to Technical Consultative Committee (TCC): January to December 2006

OGUN STATE CDTI PROJECT a Ol{lClNn L : L:rrglish Proiect Name: OGUN STATE CDTI PROJECT Launching vear: NOVEMBEIL, 2001 Reportins Period: From: January, 2006 To: December,2006. th/Year Month/Year ANN UAL PROJECT TBCHNICAL ITEI'OII'I' SUBMITTED TO :. TECHNICAL CONSULTATIVE COMMITTEE (TCC) "l;*1*-,, . -_r Acticn ,lirol' Ii qr' .fM*b "'l'G'" , ,-:L Ii' . rivl1 i b;nli qeql pEApLTNE FOR SUBMTSSTON: i t;*; I; At: I To APOC Management by 31 Januarv for M:rrch TCC mect,"*,]ffi To APOC Management by 3l Julv fbr Septernber'l'CC rneerrn-ei Tor #" { Jr r+A llWltul i I ii:**,'r;-Ttel J -_a,.fri-r+,rr AFRICAN PROGRAMME FOR , ONCHOCERCIASTS CONTnOL (APOC) l j l 2 0 JU|L 2007 COUNTRY/NOTF: NIGERIA Aprrroval year: FEBRUARY ,2000 Erokgtvearofthisreport: (circleone) I 2 3 4 (5) 6 7 8 g l0 Date submitted: December ,2006. NGDO nartner: IFESH/UNIVA. Wl-lO/Al'}Oc. 24 Novenrbcr. 2(X)4 :, I : ,t 1I + II * a: : t I{ IlE II t E ! E AI\I\ruAL PROJECT TECHNICAL REPORT TO TECHNICAL CONSULTATIVE COMMITTEE (TCC) ENDORSEMENT Please confirm you have read this report by signing in the appropriate space- OFFICERS to sign the report: Country: NIGERIA National Coordinator |rJam€r Mrs. P. Ogbu Pearce Signature: .. Zonal Oncho Coordinator Narne: Otunba A. Jaiyeoba Signature: Date: 3* f.*q NGDO Representative Name: Dr. R. A. Aderinoye ).. This report has been prepared by Name : Mr. V. O. Osikoya Designation : Project Coordinator Signature: nate: . )L ...t:*..J.:,i: -f'{-. L \- \-/it' 2-0t7 .,.Y..o . 7-"P7 Signature ,e-*::Lf; ;1^ t Date ..2.......+.w:,!-.. ?-c-=,]1 Table of contents ACIIONYMS... DEFINITIONS 1.2. .........5 6 1.1 SECTION 2: IMPLEMENTATION OF CDTI ......... lJ2.1. Tttvtt:t_rNt,olAcrtvu'ttis............ 2.2. ADVoCACY 2'3' Moull-tzarloN, SENStt'lzAl-toN AND FTEALTT-UIDUC^ TIoN orr A.r-r{rsK coMMUN2.4. Conavururry rNVoLVElvtENl............ 2.5. Cnt,nclrygurLDtNC... 2.6. TRt.Ri-vgNl-s ..........,... 2.6.2 l4/hat are the causes of absenteei:srn,? ..2.6.3 l{hul tre. thc rca:;on:;for re.f tr,utl:;,?...,,... 2 6 1 llrrcJly describe all known ctdveriJied;ierious,urlrrr,r, evcrt.\. (s:.4t,.,y) r/r, - I 6'5 T'rcnd of trcutmenl achieventenrJrom tDTt pruyrt,r trtc,eprion rp tlta c,trr.t.attt2.7. Ottt,l'RtNC, s1'oRACtr nND DE.tvtit(y oF lvtit(Mtrct.tN2.8. coHauuNrr y sElF-rvroNrroRrNG AND s r.AKrrr-roLDEns MeulrNc2.9. SupERVrstoN...........,.... 2 9.1. 292 2 9.3. 2.9.1. 2.9.5. 2.9 6 oJ tlrc pt'tt1t,t't ) _i0 FOLLOW UP ON TCC'RECOMMENDATIONS BXECUTIVE SUMMARY SECTION I: BACKGROUND INFORMATION Gt,NrtrnL lNI.'oRMn't'loN .....................,.. Description oJ' the project (brieJty) . Partnership.......... Pot,ut.n't'toN SECTION 4: SUSTAINABILITY OF CDTI....... Provide a fl ox, chart oJ'supervis ion hierarc.hy. llhot were tlrc nain is'sues itrenriJiecr crurirtg sr.pervtstott.) Wa.r a supervt,\'run checkli.tt u:;ed?..,...... LI/lrut vvcrc tha ottrcorues ttr cttc'h lct,er o.f ('D'l l rtttltle ,tcrrrtt(),.\ LI/us feeclbcrck givcn to lhc per.ton or groltp,\. s,u1tcrvt.sed., Hov' t+'tt'\ thefeedback u,vecr ro i,tprot,e tric,ve-r.rril 1te tfrrtrtuttce SECTION 3: SUI,pORT TO CDTI........ 3. l. EqlrrlvuN'r. 3.2. FrnnNcral coN-rRruulroNs ol r.lrE pAn.r.NEr{s AND coMMUNl,r.rLS3.3. OlueR FoRMS oF coMMUNrry suppon.t. ................3.4. Ext,ENt>n.uturpEILncl-rvt1.y ........8 l. I I 2. ...9 ,9 .9 l0 il .,.', l:j li t't tt.s I 7 ut , J 30 3t 32 -)_ .l .t 4.1. INtr:nNeL; TNDEPENDENT pARlrCrPAl-ORy MONn'OI{rNC]; Ev.rLurr r.roN...,............... 341' L I lf/as Monitoring/evalualion cqrrie cl out durirtg rlte rcpurtittl4 1te rrrcl? (ttL k t,ttoJ the fitlloruing whichlrc ultplicultt")...... .. . . . ....... -iJ1.1.2. Ll/hut were thc rec.omntendotion.y,?. . . . ..,..... .,..... ......... ,...,. .r.l 34 3 Wll()/Al'()('. l"l NUr urUlrur lt)0.1 27 2e le iu E 1.1.3. How have they heen implemented?.............. ,..,. 344.2. SUSTEINEnILITY OI.- PROJECTS: PLAN AND SET TN ITGEI'S (MANDAI'OI{Y AT...... ...,..,..34 Yn 3) ,.,., l+1.2.1. Plunning at ull relevant levels..... .................... jJ1.2.2 Fund:;........ .......... -r{1.2.3 Transport (replacemenl and mainlenartcc) .... . _i-,1.2.1. Other resource.\ . _i-i1.2.5. To whut exlenl has the plan been intplentented... ...... . . . j-i4.3. lN'r'nc;nn'noN............... ..... j51.3.1. Ivermeclin delivery nrcchanisrnr................ ...... Jj132 fruining..... ...-i_i 1 3 3 Joint .supervi.sion and moniloring wilh other progrctm,t ,.......... . ..... J.,1.3.1. llalau:;c oJ'JiutdsJitr prqjcc,t ttctivitia:s.... ..,......... .. ...,... _jj1.3.5. Is CDTI inc'luded in the pI{L. btrulgat'?...... . . .i.,1 3'(t. l)a:;c'rilrc otlrcr ln'ultlt l)n)grututuali tltttl ttt't, tr.sittg llrc ('t)'t't \tt.rL,t,t.(,trrrlltrtr thi:s tytt.s uchieved. ll/'hst have bcen the achievement.y?.......-.. jj1'3.7. Describc othar';i.v.vrre.r con.sicrercd in rlrc ittre grcttio, o/ (,D.1,1. .. jj4.4. Opnnn'floNAt_ RusEArrcH ...... 361'1'l' Stttttttturize in rtol rttrtrc lhutt onc lurl/'t2f (t l)uga tltt,oltt,rtrtrort<rl t.t,.satrt.t,lt rtttdc_rtttkan in the prr2ject ure u +uithin tlrc reporltrtl4 pcriod. -j61.1.2. I lttw tvcrc tlrc ra.ytrlt:t eqryliad irt tlrc projc'cl/............. ....,. j(t SBCTION 5: STRENGTH S, WEAKNBSSES, CFIALLBNG IIS , ANI)OPPOTTTUN ITIBS J6 SBC'IION 6: UNIQUB FEATUITDS OII TI{II I'ITOJIICT/OTHIIIT VIAI"I'IIITS J6 4 WII()/n I,OC, 24 Novcrtrbcr 20()4 I Acronyms APOC ATO ATrO CAN CBO CDD CDTI CSM ITGN FM CCCC IFESII 1,G LCA LOCT MOH NCDO NCO NOTI? NPI NTA OGBC OCRUMED OCTV PHC PFIC & DC RBM Rt]MO SAE SI-IM SOCT TB TB/L TCC TOT UNICEF IJNIVA UTC WFIO Aliican Programme fbr Onchocerciasis Control Annual Treatnrent Objective Annual Training Objective Christian Association of Nigeria Cornm urr ity-Based Orgarr ization Cornrnun ity-Directed Distributor Cornnr un ity- D i rected Treatmen t w i th I vernrect i n Conrnrun ity Sell'-Mon itoring Federal Government of Nigeria Frequency Modulation Governrnent Caslr Counterpart Contribution International Fourrdation for Education & Sell--l-lelp Local Covernment Local Covernment Area Local Covernnrent Onchocerciasis Control Teanr Ministry of Health Non-Covernmental Deve lopment Organ izart i cln Non-Governmental Organization National Onclrocerciasis'lersk Force National Programme on Immunization National Television Authourity Ogurr State Broadcastirrg Corporation Ogun State Rural Medical Schente Ogun State Television Prirnary Health Care Prinrary Health Care & Disease Control Roll Back Malaria Rapid Epridern iological Mapping of Onohocerciasis Severe Adverse Event Stakehulders tlecting State Onchocerciasis Control l'earn Turberculosis Tuberculosis and Leprosy Prograrnme Tcchrr ical corrsu ltative conrrn ittcc (APOC sc icnti llc acl v isor y gr.ou p) Trainer of trainers United Nations Children's Fund University Vi llage Association U ltirnatc Trcatnrent Coal World Flealth Organizatiorr 5 WHO/n I'OC. 2.1 Novcrtrbe r. 20().1 * Definitions (i) Total populatiorr: the total population tiving in meso/hyper-endentic comnruuirics within the project area (based on REMO and census taking). (ii) Eligiblp poqrrlatiorr: calculatecl as 84o/o ol'the tottrl popr,rlariorr in prese,'lrypcr.- endemic conrmunities in the project area. (iii) Arrnual Treatmerrt Objective: (ATO): the estimared nurnber ol'persons livipg irr nreso/lryper-endentic areas that a CD1'l projcct intends to Lrca[ willr iver.rrruel,rrr rrr a given year. (iv) [.lltittllttc Tt'ctttrrrctrt Ctxrl (.tJ-l'O: calcr.rlirtctl as tlre rn:rxilrrlrr rrrrrrrlrr;r..1';lu',le t,bc trcated atl.rlually itt tttcso/hypcr cnclertrie alcas witlrrrr rlrc pr.ojce[ .tr,L,i,r, ultintlrtcly to he reacltcd wlrcrr thc projcct lras lcachcd lirll gcogr.agrhic covcr.irgc(trortltally thc projcct should bc cxpcctcd to rclclr tlrc U'l'C at titc crrcl ol'tlrc j,,, year of tlre project). (v) 'lherapeutic coverage: nuttrber ol'people tleatecl irr a given vcar ovel tlre [.t.rl popr"rlutiotr (this should be cxprcsserl as a pcrccntage ). (vi) Ceographical coverage: trumber of comn.rurritics tleatecl in ir giverr yca;rrvcr.tlre total number of meso/lryper-endernic communities as iclentilj"a Uy nSnz1C) rrr rlrcproject area (tlris should be expressed as a percentage). (vii) lrtlcBrrtliotl: dclivcrirrg aclditional hcaltlr irrtcrvurtions (i.c. vitarrrin ,A sr,rpplcrrre rrts, albend'-'zole tbr LF, screening fbr cataracr., ctc.) rhrough CDll (using Ilre :rrr1t, systcnls, training, supervision and pcrsonncl) in olclcr'to,,,,,r,u,,r. cost- eflbctiveness and empolvel' corlntunities to solve rlot'e o1'tltcir. lrealth pr.6trlcprs. -fhis does rrot include activit.ies or irttcrventions carriecl or-rt by colllnLuir[] distri butors outside ol CD'il. (viii) Surstainability: CD'fl activities itr an area arc sustaiuable wlrcrr tScy cor"rrlLrc r() titttction ef)-ectively for the lbreseeable tr-rturc, with ltiglr tr.crLrncpt er)vq-irt.'.integlated into the availabre healthcar.c scrvice, *iLt.l \rrong ..,,,,,,,,,,u,, orvnership, t-tsitlg resources tttobiliscd by the corrlnr-rnity lncl thc gr*,.,r,.,.,.,.,t, (i.r) CornmLrnity self'-rnorritorins (CSM): The process by which the corpsrupit.5 is etlrpclrvered to oversee and monitot'thc pellblntarrce ol'CD-l'l 1or .rrr_y u1rrrrrrrrrrrrtr-based health inlervention prograrnrle), willr a view ro ensLllpg Il,.il tlre programme is being executed in the way intencled. It encourages tlre igrr lrLrrrir-1to take full responsibility ol ivernrectin distribution arrci nral<e apl)r-ofr;1re nrod ifl cations rvhen necessary, 6 WllO/A POC, 24 Novcnrbsr 2004 FOLLOW UP ON TGG REGOMMENDATIONS Using the table below, t'ill in the recomrnendations ol' thc last 'l'CC ott thc projcct iurd describc how they have been addressed. TCC scssion FOI( TCC/.4PO( lllG'l'L'Sl:, Ot\l) (Plart:;a ttdd tttctrc rows if'nec'cssury) .l -l 7 Number of llccontne ncktt ion in tha llcporl TCC RECOMMENDATIONS ACTIONS TAKEN BY THE PROJECT Wl l()in l'(X ,2l Norerrrlrer'lt){).1 * Executive Summary Prepore an Executive summury of the report in not more lhutt one poge. Ogun State is one of the 36 States in the Federal republic of Nigeria. Located in the South Western part of Nigeria, it is made up of 20 local government areas with a pro.iected population of 3'3 miliion.,The greater proportion of thc State lies irr the tropical rairr f'orcsr zone with a sizeable featur'e of Guinea Savannah in the northenr parr. 1-he people in the State are predominantly Yorubas of which there are ljebus, Yewas, Egbas, Aworis, Eguns, arr<J Remos. The prevalence survey of 1994 and the subsequent REMO refine of 1997 ancj 2000 revealed that the State is endenric for Onchocerciasis. Mectizan distributiorr in the Stiltc staned in year200l with support from IFESH and APOC. CDl-l is being inrplerrenrecl in 952 comtnunities in 8 LGAs. The total population ol'the cnclcmic arcas is llZ,qO6. l)opulutitltt lllovclllcllts occttr witlt tlrc ntigratiorr ol'yourrg orrcs li'91t tlre rulrl lrcas Itr rrr,Irirrr centers in search of greener pastures. There are also rnovcnrents wlren l'arrrers andparticularly tishermen move temporarily to new areas during particulal. scasons. Irsstivc seasons (religious or .traditional) provide opportunity fbr rnovenrent ol' per.sons fl.onr comtnunity to coll"lll'ltlllity and lrom urban arcas to thc cor.r'rnrunitrcs. ancl vicc vcr.sa. During t.hc pcriod being reportcdg3T conrmuuitics wcrc covcrccl and 25ti,359 pcrsops trcarcdthus achieving 98% geographical coverage and 83% therapeutic coveragc. the treatrrrerrts rncant a coverage rate of 99Yo ol' thc Ultinratc'frcatnrcnt Coal ol'2b2,421,rrcl l0l,), ul'tlrr;Annual Treatmenr Objective of 255,233. 768 health workers (280 new arrd 488 reliesher) and 2,000 CDDs ( 192 rrcw ap4 I ,tigti refresher) were trained during the reporting period thus achieving l007oo1'ATros tbr.healrh workers and CDDs respectively. 153 State and LGA policy makers were nrobilizecl as,i,cjll as 285 village heads, 148 wonren leaders and 133 religioLrs leaders to sLrpper.r CD'l'1. The strengths of the implementation process irrclucle thc involvcrncrrt ol'rclrgigus organizations and churches in the CDTI process, high cornrnunity awarcrrcsJr.,l'the burrcllrs of Mcctizan treatlnent, willingrress of comntunity rncnrbcrs to cornply wil.lr annual ttc11ll.; 11, availability of trained health stafTat all levels, willingness of,rnost CDDs rt-r conrinLrc wirS Mectizan distribtrtion dcspitc lack of or inaclcquatc iriccntivcs, prcsc.cc ol'a c.r,rrrirtcil supporting NcDo, and release of firnds by the State goverlrrert annu.lly sirce pr.ilr.urrr.r.rc inception. Weaknesses experienced are non-release of counterpart lirncling by LCAs cspce ialll tlLr.r.g this campaign period preparatory to the general elections, non-institr-rrior.r ol-conrrnunrrl se Il- monitoring and inadequate involvement of the FLHF staff in the cDTl process. Challenges facing the project include instability o1-political appointees/curr'rrl(cr.irranriri.rr committees at the Local Government level, unsatisfactory qual'ity in recorcl liccpirrg, arrcl inadequate nurrrber of CDDs in some comntunities. 8 E E ll to I li, lr & WIIO/Al)()C, 24 Ntlvcntbcr. 2004 SEGTTON {: Background information \ 1.1. General information l.l.l Description of the project (brielly) - Geographicallpcation,topography,clim:rte Ogun State, otherwise known as the Gateway State, was carved out of the delunct Western Statc on 3'd February, 1976by the Federal Military Government of Late Ceneral Murtala [tam at Mohammed. lt lies within the tropics. It is bound in the West by the Benin Republic; in the south by Lagos State and the Atlantic Ocean; in the East by Ondo State; and in the North by Oyo and Osun States. Ogun State occupies a total areas of 16, 409, 26 scluare kilonrercrs.'l-lre clirnate tbllows tlre tropical pattern with the rainy scason starting about Murclr trncl cnclirrg rrr Novernber, followed by dry scason. - Po;rulation: activities, cultures, lirnguirge. The orojected population forthe State is 3.3 million. 1'he rlajorethnic groups are the Egbas, Yewas, Aworis, Eguns, Ijebus and Remos. These all belong to the main Yoruba ethrric grou1, Nigerians trom other parts of the country as well as expatriates also live in the State.'l-hc languages spoken are mainly Yoruba (language of the majority) and English (thc otficial language). There are several dialects of the indigenous langLrage, includirrg l.lebLr, Rerro. Egba, Yewa, Awori, Egun, Ikale and Ilaje.'fhe rnajoroccupatiorr ol'thc population is farming. Fishing, weaving of traditional cloth (Aso-Oke), and prodr.rction of traclitiopal dresses, 'tie and dye' (kampula and adire) are practiced. Settlement p;rttern is largely dispersed. - Communication systems(roads...) Roads bctwccn ntajor cities are in good conclitiorr, but acccss roacls Io nrr.rsl ol'thc crrrlcrpie communities are ill poor shape. Some are not passable during the rainy sclrson. Despitc thrs. transport by road remains a major means of comnrunication among the contntupities.'l'tre electronic and print media are also veritable channels of cornmunication. - Administrationstructure. The State consists of 20 Local Covernment Areas that are headed by Chairmen - politicians elected by the people. There is a legislative arm nrade up elected Councilors fi'onr var.ioLrs wards. At the State level, the Executive Goverrtor is tho l-lcacl o1-adnrinistratiorr.'l'hcr.c lr.c tlre Legislative and JudicialArms. There is alsothe traditionaladnrinistrative sysrcnr which lias the district and community leaders in charge. They support the rnoclern adnrirristrativc st:t ul), The capital of the State is located in Abeokuta. - Health system & Health Care Delivery (provide the number of health posts/centers in the project area if the inlbrnration is available). There is an official PHC policy and structure in the Project area. It is a system of health care services where community participation fbrms the mainstay with support fiom the State, Local Coverntnent a.nd NGOs. Level of functionality however varies across the Starc. l-hc health facilities in the State are spread and located in various LCAs, arrd they range l;orn Health Posts to Hospitals. There are 426 Health Clinic/centers/ Posts arrcl 8 l:lospiials irr tlrc Project Area. 9 WllO/APOC, 2.1 Nor cnrbcr' l()()l Table l: Nurnber of health staff involved in CDTI (Plea.se add more rows i/'necessary) 1.1.2. Partnership The partner involved in.project implementation in ogun State are IFESFI/UNlvA; FCN{NoCP-National &zonal otfices}, State Governnrent, various Local covernrnerr.s er,cl thcEndenric communities. Sonre religious organizations ore assisting in the distribLrtion.l'lvermectin. These include such bodies as CAN. Bible Society of' Nigcria, NASI,A l.DAwAFI' NAwA-ltU-DEEN arrd Clrristian Corpers' Fcllowship. ionr" Muilier Assgciurigps and commercial motorcycles riders' associations are also invotvid in tlre CD'fl process. IFESH/UNIVA is mainly. involved in planning, occasional aclvocacy and also assisr.s irrproviding teclrnical aid in Training,.o,,'r,r-,r.,nity mobilization, co-ilnarrcirrg l,rogrlrprrre activities, monitoring, encouraging in Mectizan treatrnent. The NoCI, zonal olilee pr.ovielesthe enabling and favourable envirotrtnent lbr project irnplementatior.l, arrd gives sugrpor.tivc supervision of CDTI in ogun State. The State, LCa arrci enclemic cornrnL,nitl carry ouI rhcrr various resporrsibilities under CDTI.'I'he religious groups assist in.o,r,-,-,,,,.,ity mobilization and creation of awareness. Partners are working together in harmony to achieve a successlirI irnplc-nrentation ol'thePrograrnrne. There are plans to serrsitize and rnobilize 2 localNCOs per LCA as well as rhe new political cffice holders that will come in after the country's geneial eleoions April - May 2007. District/l,GA Numbcr of health staff involved in CDTI activities. Total Nurnbcr ol' hcalth stafl'in thc cntire projoct area llr Numbcl of hellth stalT involvcd in cDl'r Pclccntlge llr ll.r=l}r7 ,r, * t,,,, Abeokuta Norlh r85 96 520 Abeokuta Sou0r 20s 96 47Y" Ewekonr 185 96 52o/u lrb t2'7 96 7601, lirn il6 96 ll3tl, Oblli:nri-Orvrxle 190 96 5 lnl' 68%Odeda l4t 96 l'cwa-Norllr B2 ')() 'l'otal 128 I 768 6lltllt ++. iL {l L, f,I tF l0 Wl-lO/A l,OC, 24 Novenrbcr. 2004 'lo -l F o{ F) Iz o3 oa(D a- F) od F) a 3 Io o o-(T 3 oxo I &7 a rr:1 oxoI 6o ox F)(n o 6o o7f te z o :r I r.U =.C)"llf, H.3 f sD:53 v (! =='("(Dx +tn \ (, hJ 5 o\ 55 o{ \UJo\ tJJ i, (Jr h.JU) 5 t+){ UJ io l.J rgtJ t'J)o{ UJ oo UJ)o o\5{ IJ \.1 A 'o ='o -l3 6€ s;'e tr !l x=.p =a;oai=at -. \o Ur}J UIUJ a5 \to\ NJ O oo @ \o 7Ele' 3='3I;B Bd=. I \o UI hJ (,J OA I !o\ I \o l.J o I co oo o \o ok iJo :=d);.i@5 io ci I B6' -l 6D d'g NQ. i!d o lr z (D o t!(, D' Uqo lr1 t, N) -a o o\ 5Fa -l UJ ! UJ o\ "N' UJO A .y" UJ{ (}J "ro t.)(/J NJ)o !(JJ oo jo o\A{ l-,) \) A Err a@,,L "1+ a I I :NE.33:cL o o Ot<( e a'E:^D -!.-f =a ':.: 6 (, }J Ae o\ I A5 oa{ I t, IJJ{(}J o\ (Jt tJ l+J s UJ \t t+J ".o N) UJ tJ\o{t! oo o\A{ UJ N){ 5 q il \ *D s =.>BNE ='o6- lDr h,J o\ hJ 5N) h.) I\o o\ o\ N) Po(]J UJ6 A o\ UJ\o UJ (-) o\ 5 tJ oo '5 \o o\ t.JF\o ooo (JJ J})(}Jo5 tJ{ 5 -lo a[5EEH -9 B o - N I ! o! tr !t ,+ o J lla{ la,(\IU a 16- o lt"JR;tb'r3 AJ\-a5 ?fD S h' s-ar -tO 3rr3rQ=- .+ :i>s\ -=.1,3\ oSoeq tc\.rii ara:s :i .d! iS XG,:(\s\\-\ :-*(!:-\l .ci oIr \-GRb ==\Pa{ PS $T<: N_* * (, o t .J 3 z ,E) o p) o o o Fr)a = ,.,o o A) ' if- ro o <, p) o A) 7i CD t! -l(D tDli D) (D o o - o -o rD to .D o- aj - a o a =:. UA o - .D 'o o]. oc .o (D :. oF (\ o(\ ? A\ V1 a(\ 4 (\\ (! o (\ OA =.(\ (t\ Oo N I z I \ V) f\ aG (\ (\ $ f\ a. (\o U 1_ :i +-xt: c-S x$ LE' dR ND\=^{-s(: :d 6:. -\ :G \,S Rns -sF q.s Gt'. o s. t D a) a\ R\ s.(\\: a. a\ 'i .D - U) CaoI 'o o 9. I I I , = .E t IJI/ a Co rj .t- l+ lJL tr' ll r IL r,il I \.\ s.xBi airrl\si Oa s. G N h d * OA G .G G F t\ s G o c) ^. l. tr OO F s a. =+Gt- s E \ t. a\: R. ,S =.a F ;. ='>g $ fi9er : 3.=)J-S € ii.; s il€3 F aa ;.rlJq :. €*B S E? * i d& * = -+N - ii. 61,: s' Fqos2 5q.Er =aiZ5R'n ='\-ctk!\o ar{,Y +ru +&6'E.S{;- ^\O ;E 3U* (DS- =s' i==t.F='E ^\A)tv \ a E 6\6il\r) .arD|\ :-'ts,, E TDf,a= -5 Ig :rF.dX'pu ar\! b =.65/-- ='=.:(DA=Z S qB -r:soq,i. 's tFlJaf(\ifgN &g's 'E J o- A] a F)3 o. I o V, F)5o rp c)o 3 JJ,o = IJ .> a L o !J L t* i tt' 'Iltf E $ ) * SEGTION 2: lmplementation of GDTI ( 2.'1. Timeline of activities Fill in table 3, limeline of activitie.rfor areas treated in current ycar,indicating when the liey activities were implernented by the month they began and the rnonth they ended., :d a- r3 Wl-lO/APO(, 2.1 Nor crrrbcr lt)tt.l Fl H r't l) I 'z ,l Go A) Co o' 3 o &(D o7i ?), a ct' m ox) o-oog D U) o 6 r D z (r) .) 11 a D IJ 01 A)f IJ o\ FD TJ o\ A) tsJ o\ D'5 p o\ 0)a l'.J o\ F) t9a o\ ID tsJ o\ ==oq 7 oo E!9 =+ lr^ o l9 o. 5 o IJ o\ E a l9 o. o IJ o. o IJ o\ ao IJ o\ o IJ o' o IJ O o\ o 3EO+ o IJ o\ IJ O o\ l9 o\ l! l\) o\ l! o\ l.J NJ o\ _a oe Fl ra(la NJ o\ c trq IJo C(ra I.J , tIq t.J o\ C(ra l'.J I (ra NJ o\ C 0a IJ O o. rra IJOoo\ oo OH = 4 z. ! v z z '4 _(, ia 0q ort a e (D Z = z z = = z = o d3 ?J o ; o\ 'no IJ -') .D p o. Yl .D ,o- IJ o, ,n rD i. Oo, oo IJ Oo\ ,r, .D NJ o\ '!(DI NJ o' _a =50q 0a (, z .s l\.) o\ zos l..J o, zo s N) o o\ z o s IJ o\ zo TJ o\ z sp o\ zo s NJ o o\ z IJ o\ o Ii 9E o T' C 19 .n rDC' N o\ noC N) o\ ,f1 oo N) o\ TI o NJ O o\ +1 og N) Y](Dg t.Jo o\ 'rl(Djt t.Ja o\ -qt =E'oe a (D o zos tJ86. -z s h..) Oa z a.Joo o\ z NJ o6\ zos 1...)8 o\ zos tJ o\ z l'.J o o\ zos NJa o\ oo33o; o t-l la)lcr lo IUJ ; 3 o o A)o 6'0 at (D A) -(T DD -o FD o o- =' o r) = - - .D .D DJ -t - R.. c\(\ l a4 .q. G o Q 4q U -Jt =o 5=oqd A)-(h o oI o- .) o o. d I A' o- (a o A](! o 7n au(D o P o- a +- + o a IJ 5 z a =Jta t: ! -i ! *t it I s * t 2.2. Advocacy ADVOCACY AT STATB AND LGA LEVBLS Chairman Local Covernment Service Comnrissiorr. Chairnrcn ol' LCr\ Directors; Ceneral Services arrd Administration. Treasurers SLrpervisory Counci lors tbr l{ealth. NO 2t) 20 b 20 2o 2o e. _i z+ S/N LGA VILLAGE HEADS WOMBN LEADEII RELIGIOUS LBADBIT I Abcokuta Nolth 50 t8 t2 2 Abeokuta Sor.rth 74 23 30 3 Ewekoro 23 l9 20 4 Ifo 22 t7 l0 5 lmeko/Afon 30 l5 t'l 6 Obaferni/Owode 3r t4 l4 l8 t2 7 Odeda 29 l8 8 Yewa North 26 24 TOTAL 285 148 133 n/s STATB NO LGA I ['lonourable Commissioner for Healtlr I 2 Chairman, Ilouse Cornmittee on Flealth I Permanent Secretaries 5 a. Health. Hospital Management Board 4 Directors: 9 LG Onclro Otllcers a. PHC & DC. Department b Training c. Hospital Services Dept. Nursing Services Department.d Planning, Research & Statistics Depan. Pharmacy Depaftment. (, h Finance and Administration 5 Principals t2 a. School of Nursirrg. 3 b School of Midwit-ery 2 c Sclrool of l{ealtlr Teclrnology I d Reproductive l-lealth Centre. l06 Programme Otflcers: a. NPI unit I b Roll Back Malaria unit I c TB/L unit. I d HIV/AIDS unit. I e Health Education unit I 1 f. School Health Service unit. I (, Reproductive Health unit. h Monitoring & Evaluation unit I I Women - In - Health unit. l0rTotal 52 l5 Wl-loiAPOC. 2-{ Novcmbcr' 200,i t I *+ Reasons for the sensitization: o To firrther sensitize policy makers on their responsibilities for CDTI execution and. sustainability, especially in the area of financial support. o To encourage their participation in Conrmunity se lf Monitoring. o T share ideas and encourage particlpation of the decision makers in the CD'f I proce ss o To encourage giving of appropriate incentives to CDDs. Outcome: - The State has continued to release counterpart funds . Some of the LGAs have also continued giving counterpart firnds - CDDs in a number of communities are being motivated. Constraints: - Changes of policy makers at the LCA level - lnadequate logistics - Lack of tunds to ensure proper fbllow up To improve advocacy: o Sensitization in media houses should increase. o Personalities with high-level contact to Sl.ats arrd LCA clricl'erue rrtir.cs rrced Io bu identified and mobilized. . High level advocacy visit to the Executive Covernor will strengthcn governrrcnt contnritnretlt to the CDTI process, particularly i1'thcre is a clrangc ol'guald alisl the 2007 general elections. r6 WllO/n l)O('.24 Novcnrhel Jrxll 2.3. Mobilization, sSnsitization and health education of at risk communities Mobilization meetings were also held with Religious Leaders fbr support in the aspect ol- giving incentives and ensuring a paradigm shift in the lackadaisical attitude of CDDs towards Mectizan distribution. Mobilization of Cornmunity Development Associations and Landlords Associations were carried out with Local Government Coordinators to achieve better covcrilgc and boost cortrrrrutrity participatiorr. Regular meetings with Christian Association of Nigeria (CAN) resulted in rlore Chlrrches being involved in selection and support of CDDs. This is particularly the case in Abeokr,rta North and Abeokuta South l-GAs. Such churches have declared l-lealth Weel<s duling which communities are mobilized, registered and treated. Some religious associations (both Christians & Moslertts) like the Chrisl.iarr Corpers Fellowship (a Christian organization for national youth service corp mernbers), NASFA f, DAWAH, NAWA-RU-DEEN, including some evangelists and missioners are involved irr dissemination of information on Onchocerciasis control Usc of Mcdia Houses: The State Mirristry of l-lealth has inaugurated. and tirganizcd a rcgular' Programme tagged OGRUMED for various health activities (irrcluding Onchocerciasis) tliat are implenrented in the rural conrrnunity. Airing o{'this in OC'I'V, OCIJC, N'l'A ancl lrVl News was regularly done. l-he Onchocerciasis Programme was also aired in the lbllowing Media: / 'Eto Ilera ni lpinle Ogun' in Paramount FM 94.5. ./ OCIJC -'l-lealthy, Living Scgrncnr'./ Mid-day News on Health and Environnrent [Onclro Day] ./ OGTVNTA News in Yoruba, English ar.rd E,gun. LE.C tnaterials e.g. posters, handbills, calendars and photograph were distribLrtccl Lo clrurelrcs and sonre cornmunities. in some cases this was combined with lectures on discasc epidem iology and treatment Response of target communities/villagc: Cornmunities have been demanding fortheir Mectizan drugs, and thcre alc occasiorrs whcrc the drurg is dernanded for a second tinte in a particular year. Accomplishments: Increase in therapeutic coverage and geographical coverage. lrtcreased involvement of opinion leaders in the CDTI process Ways to improve mobilization and sensitization of the target communitics:/ Creater interaction with the community members by health workers to increase lhcir' awareness of their roles and responsibilities/ ldentification and mobilization of more local NCOs and CBOs '/ lncreased media campaign for continued individual corrpliance to Mectizan treatrrent r' Involvement of elected politicians at the local level in the mobilizatiorr of their pcople t7 Wl-lO/APOC, 24 Novcmbcr 2004 2.4. Gommunity involvement Table 4: Communities participation in the CDTt (Pleose adtl more rov'.s iJ'nacc.;.tun') Comment on: - Attendunce of female members of thc communily ut lrcullh educuliott nrcctittgs' 'l'lris is lirilly satislactory - In generul, how do you rule llte purticipution ol'Jenrule nrcmbers oJ tha utmmunity meelings when CDTI issues are being discusses: Some fernales are recognized cotnmunity title holders e.g. Iyaloja/lyalaje, ancl are opportune to raise issues at cotnrnunity rneetings. Their opinions are nolmally soLrght on sor)le issr.rus and can be irrlluenti:tl. In sorne cases female participation at conrrnunity nrectirrgs dcpcnrls on decisions of tlre elderly male menrbers. - Atlritiotr of CDDs. Is attrilion u prohlemJitr the pntjcct? I.f'yes, ltrtn'it'it ttltlrcs'tttl? 'l'his is rtot a rnajor problcnr irr tlrc projcct. Other issues Nil. District/LGA Nunrbcr of conrruuniticVvillugcs with comnrunily mcmbcrs as supurisors N urrrbcr ol' cornurunitics /villagcs rvith lenralc ('l)l)s Nunrbor ol' c0nrnrunitics with lcnr:rlc CDDs l] ',, Brr= l]ilrllJ{ " I lx} Total no. comnrunities in thc cnlire projcct area B{ Numbcr with cqmnrunity membcrs ls supurisors Br Pcrccntagc Bo= B/ l]4 *100 Malc CDDs l]7 I.'cnralc CDDs llr Abeokuta Nortlt ll9 238 95 333 28 24y, 4lYo 38Y" 2'3')/u j [iol, I I .39,o 11()./:1 /U Abeokuta South ll0 210 r05 315 45 JJEwekoro 88 r46 87 233 2t3rrb ll0 r38 75 25 lmeko-Afon 92 t46 88 234 35 20 25 Obafemi- Owode 176 159 64 223 180Odeda 104 t23 57 Yewa North r53 173 96 i 261) 2ti ItJ.j",, Totll 952 I 333 667 2000 239 25.1'9'<, l8 Wl-lO/A POC. 24 Novcmbcr' 2004 Nunrbcr ol'CDDs und thc conrnrunitics involvcd 'l'otal --i'ar'.*,, rrg" 1r 2.5. Gapacity building - Describe thc udequucy of uvailoble knowledgeuble nruitpower ut ull levels. Adequate trained staff is available but most of these need to be trained. llherc frequent lrausfers of lruined sluff occur, slute whul lhe projccl is tloing, or intends lo tlo, to remedy the silualion. (The mosl irrtporlanl i.ysue lo describe is yvhut mcusurcs were taken to ensure adequate CDTI implentcnlation whare nol enouglt knuv,lu"lgettbla nturtltovl'cr was cpuilable or if stu/fs areJrequently trem.sJbrrecl during llta coursc oJ'lha cutttltcrigtr). 1'he project organizes in-house training fbr all health staff newly posted.'l'lre trained health staff are encouraged to do a brief training for successor while handing-over, iu carse ol'.rc- deployments. t9 WllO/n l'OC. 24 Novsnrbcr' 2004 i.b \c (! 1| o o s -lo -l f' 6 D ,z o f o a- a 0, (J o. 0) ni' T' Io6- .D rj oxo aJ a rn o z! a oo ,f D(, o + Coo F s zo -o 56c \o hJ NI €o €o 5 cao o\ o\ o\a O a o\o o\O o\O -t a o z (D o t!a) - 0 if l.J5 o\ o\O l-.J5 o\ o\ NJs o\ o\O NJ5 o\ o\o N5 o\ o\ N)5 o\ o\ l..JA o\ o\O NJA o\ o\o St' ^bl) c. O^rAtii .o o\ 6 o a .\ hJO6 € € hJ hJ 6 € o\ tJ o\ o\ l! o\ o\ = TJ "r]o.i o\ t.) o\ o\ l-J o\ U o\ tJ o\ o\ -la ?I b\ i.r ^ -J+r.'9 oilg o o a) la l..D *= <5 5craO -ir) =ro tJ o\ tJ o. s e' 6 e s o Fr I H ; -t 6 .E b$ o +:'o : o 3 zE -.!!., 'l 6Oq6 ,6 Ej !eq=' tD \co\ .} o G oo s b,Jooo l.J NJ NJ NJ5 NJ N) o\ h.J o }J NJ tJ5 N NJ o\ N NJ NJ5 l..J l..J o\ hJ o N) NJ o tJ+ N) NJ o' t9 -a ?r, E Ei'$ Qrr g z .D o(, U A' (Da \oh) 6oo tJP o NJ5 tJ|.J o\ t'.J NJA l.J NJ o, l..J l.J5 NJ 19 o\ l..J o tJ5 NJ N)Ol NJ O t-J ID'l6 l(Dlu ;I P. oq p) o + -)ta'ao (D od o 'no U -J 3 ,o (D ts o FO o e(\ q G :-\ \G\ =%\ o G U, u1 \) : b \ s \4 o F d o \ o a- 0a o ?i- o i 5 a oa a : IJ ! z l: o- a IJ ]J l+ 3i i= rt tr t& 'FiIl8 Table 6: Type of training undertaken (Tick the boxes where specific taining was carried out during lhe reporting period) Any other comments 2.6. Treatments 2,6,1. Treatment ligurcs If the project is not achieving 100% geographical coverage and a rrirrinrurl ot'05.20 therapeutic coverage orthe coverage rate is f)uctuating, sratc thc reasons ancl thc plans being rnade to rernedy this. 'f rainees Type of training CDDs Other Community members e.g. 'Cornmunity supervisors Flcalth Workers (fiontline health facilities) MOI-I staff or Other Political Leaders IFESI-lfleld Otficer Others(spec i l'v ) Program managernent How to corrduct ilcnltlr cducation Mitnitgcnrcrrl of SAUs CSM SHM Data collection Data analysis Rc'porl writirrg Others (specify) 2t WLIO/Al']Oc, 24 Novcmbcr' 2003 'J .l t- z<o.D 5A) I o o- o a- DJ oo :o) o- .D'(D5 >5 o'rD5F o a rnd 7C o o a> l-rD+o -T A) z>oct +8 'x D) \(, ^!4>6' \otJt tsJ +r { o. \o N) oUJ oo@ \o 5 r;.x$ftFerJY-OJD '' ,/ -. = + H E 1F:SH,6q \o ?j l9 OJ. {o\ \oI'J o @oo \o -rH .Ed * o5= ;'o tr oJ- \o(, -I 5 o\ \oNJ 66 \o Ezc i.= Eo == J Ffi 5 E' \o @ \! oOo OOo o \o A o' Oo o .\o o' o -o ot Oo\oo\ o\ "83i5 oo566' D oo 3 3 5 5' = Ei UA(!(, UJ h-) A o\ J\ .l- { {(/J i')L^JO 5 "rr, \.1 (JJ 'to t.J(JJ NJ)o{ UJ oo )o o\A{ L! !u{ 5 JG ;, o* itroi,t^- = e :i!6.r+t HH ^ FH? e t.)?)\ ?Jt t9(,(, ".o (}J l.J{ a 5 l\.)t,) 5(/J (JJ NJ{{ (,t t'J "}l..J\o o\ UJ J'r UJ\o NJ t.JI{o\o ^-lTrt P@:ioa= 7gelo) h.JUr co ttJ\\o UJ9 co t.J _6{\o ! s .} co5 UJ(Jl{ ooa NJ{ t/J\o N) Lrr o. (,J(Jr NJ{ tJ .:-,' o\ oo UJ z +rJ caei Nd=ir9o *- o @ UJ s oo UJ\oo\ \)\o \oo\ oo -o o\ oo UJ\oo\ @ \oo\ oo5 1O o\ oo\o\oo\ { co\oo\ -to:tOo s6€ -N OII()trG=. o o15 c A) z 4 z z 2 z = = z = B*-Ei (, (rJ 7 \o tJ = v 2 o\ 9r- z^X- cu E g, 1 OG z Z z z z z z z 9z6e>a rnX 7, z rI II 9, ! APo =6$sIE* € +a 3Bs $in = z z z z z zz = i fD A' o J o. tt =.o o A' =A)tft A' v, D] lrlir T1 o =3 a 6i r) o = = =. le .D - ,J ru 3. o- ,e .D o - o 6' ; o a - 'QrD -t rD ID Ti .D v.) .) o a - .J(ta o I A) oo O fto DD :-o er o o rD 'Dr,a rD :'! A) lztcl= l+lol-lo l''-r IHloti ll ls_lol(r l"l=l- -J o o -o : =. = = =lt.. a -o rD -Io =o- rD 6' r) o =C i. fe 5 rD :o t e. .D a) - .D O) op) (l) o- -to o) c =q A) - C = ee o 1= 3 =o- o = o ? = = = 3. (1) IDrt o- rD =a aJ CL o- F m7 C =.D E .2. o : .D z = rD o o ol -: L ='a' D' (\) ) -) IJ L a =j a IJ l- 1*. & :- iE iI 4 r E F fr -t U o o ,a< :<rD:-il 0a o p) (D >lz :f ltr =lrillril; .D l'nN+o =1tuJlo .I,to ilo ^t-\J t-sls fltgl'lzoI lo IO Re L \oEA ts I ntfi ll ;N! ! : G G ^-Sx -a iis i Ess A. ati E *r3 F !-,s .i. =\:b x\s€F* S IIa; \i$ -=R+ s' 's.A = )lZ;] 3 ql1il i* =lErD q 3lol$ * El;, *l\i d ^ lriciC : +E rd.lElo :l o aliFS s AEEt s Xl[:E ; il^ > q (v l- .it H a18 ,-t, i Yx: \ idi<\., :i X' =':\a:s.o i' 3Ni' i o -\Q i 3 *i q' ix:!>v .-i. s 'EfrD ==lIr.'o- :s;dIDo rX:N { (Ptr=.p) t:i\i=. iooSs:.Gl.5:iF'E e-ti-o\'-q. t/.!o -.'o tra)hr *rDni A)F^ Gisat- Oa a Oa t> F. I IJ t- Z. f, l: IJ ! :lr EL . i& ,L u T l) 2,6.2 What are the causes of absenteeism? Absentees recorded went to the neighbouring conrrnunities to atlend to cmcrgcncy calls e.g traditional meeting at the next village, relatives on sick beds or wives/fernale relations that put to bed. Some workers were transferred. 2.6.3 What are the reasons lbr refusals? The project did not receive any information indicating relusals. There coulcl have beerr initial refusals, but thesc werc followed up and trcatcd latcr.. 2.6.4 Briefly describc all known and verified scrious adverse cvcnts (SAEs) that occurred during the reporting period and provirle (in table 8) the rcquircd information when available. Nil case. ln case the project did not have any cases olserioLrs aciverse events (SAE) cluring t6is reporting period, please ticli in the box. No case to report 24 Wl-lO/Al')OC. 24 Novcmbcr 2004 r-rl l-l lF0Idt: lrDl* ; PD (D U) o o =.o e_ FJo rD I rD o o = (n rrla TD ao o =a - .D o- o tr:. (,a rD a rD of f rrq 'o rD a o o- \ a * \a\ sq \ a a G3 .\ Cr) G\ (\,\ G ru IJ ri J IJ ! L c = q o IJ l- I* 15 ql it ffI s - I I i i I i z z ! o cLY dTo^ _._ o = =' aO@a .) JU oG4+, a 3E o 3 o -o 3 D o fD al) 2 + 0q .]) U) rDI -o 3 GE oI oo 39 7,', rJ =. UA o oa ao rt o D3. (ra O<. (rq = ='DJ (,Q rD o J 5-ia6=@ -cqFo6-o6 3 5'>o:a- x5e;3- (D i'7tsr trF,6P =J -O r'!3 oYOJ Up o U 0) o =Ea /,o= i r'ot, Ca to6; d'7 p )qF te = IJo IJ \o @ IJ I J -J IJ o\ f,J t.Joo5 tJoO N) o tQ N) tJ \o\o\o G\o oo \o\o -l rn 7 € IJ \o N l.J \o t-) \o tJ oo +.5 8of:, I C Efr s 3 d -{ O -.5 Rtrl ='> r =.=- il( cr6 + HE d Ss. h: ,fi \o NJ \o NJ \o NJ \o NJ -lO o\\o{ F: ^-l -q.t P o=tso== =60o= \o \] oo = .o TJ \o I-J !O o\\o --l cr5 ,32 a1== 3.,H = C q .Q !E\o co(/.) \o F,oO FI"G 6 n,;d+ tt 9'J 3i =ooEo"a \o @ o\ \oo\ \o UJ \o \o o\ Oo o\ oo o\ .o o\ O\o o.oo\ \o (l =5 =a =(D D llcl(l I I F,1 F lr': "il o- ^.,\od J :-ci - o (.) - l- o\ Oo\ i..r co OO i ,.r -]{- tJ{ UJoo tJ\l +: l.J N) -ls o- qu :{o-=-Fr= >!-o c <!* =o9a,'b+, IJ i..r NJ IJ t.J i..r }J -to t,J5iO N) lv PtJ -ls Fr oJ_g.i: o:C 7?!r o"- IJ @ L, \o NJ .l- UJ t{ IJ FA \o tJ TJ @(rl tJ O{ -l oo @ r', o}Z U,+ qn rd5DO o @ UJ .o o\ @O !O o {U) .o -.tO .o o\ o\{ .\o o\ \o o\ oo o\ i.J -o o\ @ trf o\ 6 o\ o\ o\ -t\c -lOJOd .o^ U 0cc oo- ^<D\oo J9aJ aloq-o FI F :', .: ll o E t', rll = o Co o \o\o -o o\ \o \o @ .o o\ @ \o @O ._o o\ o\o .o c\ oo- Se -iv^lA UA(! l-lItrlcr l.Dl.o |,, o\ =l i.r,.ti$ r-l atD(Til5o =+o- 'l rb!!rU+q6pr50c+(D lcr akitloo l=- tD l=3loro l-; pa YO rD- t.0 .r J.rD6 lDO .:t!+ro D) e:!s;Fa =n \ ,a \(\ s :r (D (r) (D r)!) .D (! eFl o tD tD{a l?p t9 \ r\J\) (u tD a .D DTt, tt tD IJ -lll ao rD ?1 A' a D' a / = .l- 7_ o t- IJ I rf x* : *di, 1i 4 TF ++ & $ IJ 2.7. Ordering, storage and delivery of ivermectin Mectizan@ ordered/applied tirr lty - Qtlea:;c tick tha upprultriulc un.;wcr) MoH E WIIOf] UNICII,}..f] II'DSH/UNIVA Other (please speci fy): Mectizan(D delivered by - Qtlcu,,se ticfuhc tppropriale answer)MOHN .WHOU UNICEFE I IF'ESIL/UNIVA Other (please spec ify): Plc:rsc tlcscribc how Mcctizau@ is ortlcrcd and how it gcts to tlrc couurrrrnitics lF'ESl-l / UNIVA tbrwards cor:rplcted Mectizart Applicatiou lbrnr tt-r Mcctiz.un Donation Program through the NOTF. The conrpleted fbrrn is based on drug requirenrents calculatccj based on total populatiorrs received tiorn the cornmunity level tlrrough tlre Fl.llFs and LCAs to the State. On approval, consignrnent is received through UNICEF and sr"rpply is made ro the State Ministry of llealth by the assisting NCDO. l{ow it gcts to tlrc cotrrlnulritics. State Coordinator collects Mectizart liorn lF'USFI Field Ol'lrcer to replcnish s[ars sl.orc. LC Coorclinator applies for total recluirecl by thc Frontlirre llctltlr Facility Stal'l, arrcl rrulics [5csc availabletothem. CDDsfinallycollecttheneeclcclnunrberoftablctslbrthcconrrrr,litics. Table l0: Mectizan Inventory .., 4 i J ) State/District/ LGA N urn ber ol' Mcctiz:rrr''' t:rblcts Requestetl Receivctl lJ sctl Lost \\'rrstc l,. r p ilcrl Abeokuta North 200,000 85,000 80,049 J I .4beokuta South 210,000 100,000 88,0 t8 I Ewekoro 105,000 70.000 62,650 lfo lrneko-Atbn Obafenri- Owode Odeda 100,000 r20,000 150,000 100,000 90,000 r00,000 130,500 90,000 82, t uti 89,,t65 trz,tr: riu.i9 r Yewa Nortlt I 10,000 100,000 91,463 TOTAL 1,095,000 765,000 686,337 l4 7 2 27 WllO/n P(X'. 24 Novr;rtrbur. 2t)0.1 / How are the remaining iverrrectin tablets collected and where are thcy liept? [-G Coordinator retrieve left over tablets and distribute to other cornmunitics, but state distrihute to static centcrs for clinic based treatrllcnts. r' [.ist and trriefly dcscribe the activitics undcr ivcrrrcctin clclivcry that arc lrcing carliccl otrt by health care personnel irr the project area. - Requisition, Collection and supply to endenric comrnunitics. - Keeping of Mectizan lnventory. - Updating Registers and supply of Mectizan. - Notification to the comrnunity of availability o1-drurg. - Monitoring and supervision of Mectizarr distribution. r' Arry other comments 2.8. Gommunity self-monitoring and Stakeholders Meeting Hus uny lraining (of truiners) Jbr comntunity salf-ntoniloring hee n dona in thc pro.jctt uret? IJ'so,ll/hen? Tablq I l: Cornrnunity selt--rnonitoring and Stakeholders Meeting (Acltl rtnrt if nccclcdl Descrihe lnw lhe resulls of the utnmrunily sclt- moniloring unrl slukaltoltlct.s tneetittl;s have affected project implentenlutittn or how they would hc utitizctt tlurittg tltc ttc-tl lrealnrcnl cycle. CSM & SFIM were not done due to unavailability ol'lirrrcls lbr this purp()\c District/ LGA Total # of coutrlunilies/viIlagcs in the entirc project alea No ol'Cornrnunrtie s that carriecl <lut se Il' rnorritoling (CSM) No oI' Contr'nrrrtrtrcs tlrat corrrlLtctcci stal.e lrolrle ls niccling (Silllvl) TOTAL WllO/r\l'0(, 26 Scptcntbcr 2ttt).1 ;2.9. Supervision 2.9.1. Provide a llow cltart of supcrvision lticritrclty. Scc tltc I'lr.rlr ch:rrl uu pg 25 LC COORDINATOR & LOCI' ITRON'I'LINI] I IEAI.TI-I ITAC]ILI'I'Y S'I'AIrI. COMMUN ITY DI RECTED DISl'I{I t] U'I'OI( 2.9.2. What were thc main issucs idcntitictl durirrg sultcrvision?/ Inadequate nuntber of CDDs in some areas/ lnterntittent posting of stafi'at healtlr facility levcl rcsulted in lacl< ol'continLrity. '/ Low level of integration ol'CDTI activities into I'}l-lC irr sormc l-ocal Covcnunurt Arc1s. r' lnadecluittc cotntnitment ol-sorrre FLI-lF stall'to Mcotizatr clisrlibution. '/ Late subnrission of summary fbrms to LG coordinators by r--Lr-rF stal'r./ lnadequate involvenrent ol'sonre cornnrunitics cluc to lacli ol'unclcl'stlnrlirrg ol'the ip rolcs 2.9.3. Was a supervision checklist used? YES c"l t)t f9-l( l( li STATE COORDINATO R & qOCT 29 WllO/n l'()('. 2.1 Novcnrhcr 2oo4 2.9.4. What were the outcomes at cach level of CDTI implenrcntation supcrvision? LGA Lcvel:- r' FLHI'- Staff encouraged to see CD'fl as part of their routine activitics, arrcl some havc adopted this. r' Ncwly posted stall'have bcen given oriurtation and latcr tririucd on CD'l I r' l.OCTs lrave heett retraincd on record keepirrg ancl reportirrg in orclcl to assist tlrc l:l.lll stal'l'in early data collation and reporting. Community Level:/ Communities are being re-rnobilized on their roles and responsibilities. Therc is cvidencc of high commitnrent towards Mectizan distribution by sotne opinion lcader-s./ Cornrnunities have been sensitized to select more CDDs. 2.9.5. Was fcedback given to the perso, or groups su;rcrviscrl,l YES. llorv was thc ll'cdback uscd to iutllrovc thc ovcrall pcrlbrrnlncc gl'thc project? Some commtlnities selected rnoreCDDs, and there was increased comnritnrcrrt by hcalth stai'f' to ensure that all those needing treatments got ther.n. This resulted to rncrelrc in total rrrrrrr1.rcr. of people treated and coverage of more conrnrunities as opposecl to tlre 2()05 tr.catnrcrrL cye le . 2.9.5 lD L b E IF & 30 WFIO/AP()C. 24 Novcnrber l(X)4 SEGTION 3: Support to GDTI 3.{. Equipment 'f'able l2: Status ol'ecpriprrrent (lrlausc utlcl ttnrc ntw.t if rrccas:;ury) Status of equipment (Please udd nutre row.s iJ'nccessury) *Condition of the equiprrent (F:1.- WO:Written off). unctional, CN l'-R:current ly non -lirrrcti ona I bu t repai lable, Source 'l'ype ol' Equiprnent APOC MOH DISTI{IC'f/L GA IFESI-I/ UNIVA Othe rS Contlition of the equipment * Pleasc statc L Vehicle Stolen I ord 2 Nil Iruncl.ional 2 2. Molor cycle Functional 8 Nil I'-unctional tr l"u rrct ional J 3. Computers Functional I Functional I Nit 4. Printers Written I Functional I Nit Nil5. Fax Machines Functional I Nil I 6. Air Conditional Functional 2 Functional ) Nil Nita) Lap Top Functiorra I I Nit b) Generator Functional I Functional I Nir c) Bicycles Functional Nit FLrnctional Nit d) Public Address l Systern I Functional 4 Nit Nir e) Television 20" i) Money Sal'c Functional l Nit t.,- il Functional I Irunctional ') Nit Nit Nir -i.r i r g) Reliigerator Furrctional I Nit Nith) UPS Functional 2 i) Stabilizer Nit 2 FunctionaIj) Photocopier Functional I Nil Nit Nit Nrl Nit Nit Nit k) Slide Projector l) Storage Boxes Functional I lNir Functional Nil Nit Functional 4 I rn)_ V('ll rr) Ovcr llcatl | )rtr Ior Irttrrct ionrr I liurrcriirrrll o) Writing Board Functional I Nir p) Information Board Nil Functional 2 F-urrctional I 3t WllO/A l,OC', 24 Novcrtrbci. 100.1 IIow iloas tha pnlecl intend lo nminluitr unrl rcpluce c:istitrg cquipttrcttt uttrl otltcr ntutcriuls? The project intends to maintain existing equiprnent frorn the counterpart contributions at tlre State and L,GA levels. This calls tbr-increased and continuous advocacy to policy malicrs. Replacetnetlt. it is lroped, will be etl'ected in the inrerim tiom the Apoa"frusl. I,uncl. Equipment needing replacement have been inclucled in the revised work plans and br,rdgers subnritted to APOC Managemerrt. The pro.iect also hopes that IFESFI/UNlvA will support in this case. 3.2. Financia! contributions of the partners and communities l'able l3: Financialcontributions by all partners fbr the last three years '/ I.l'lhcre ura prohle GCCC is ofien approv, Arltl it itt tt u I c0 n, ilre tt].s 'ttts willt rclct.;e oJ'cottttlarlxrrt Jitrttls., ltrnv h,art IItay tttlilre.s',t'cl? ed and released - APOC should not hesitate to release lurrcl promptly 3.3. Other forms of community support / Dcscribc (itrtlicutcJbrnts o/'itt-kind cottrihutiotrs' oJ'cutttrtttutities' i/'utt.y) ' Purchase of more register notes fbr registration of the population. - Venue allocated for training i.e. palace, Town Hall. Contributor \"car J ToTAL ICash i Buclgelccl ,(us$) I TOTAL Cash [{cle lsccl (us$) -L..u .l1'Ol'At_ Caslr Lluclgcte rl (us$) 1'O1'Ar, Cash I(e lcirse rl(us$) Ycar'5 't'o1-At. Cash l) rrrlgr:te tl ( tJS$ ) 't'o'r'AI_ C'aslr l(elr'.r:rrl rt l\hrMOi-l (Central * l)rovincial/State) s2,860 | sazso 60,340 i t5.680I 9,319 9i7r) 20,560 10,200 2,200 2,20() 0Nit 98 0 25.415 t3,250 t6.020 16,020 Nrl Nit Nrl Nrl --- Nrl NrlN I I N Nir Nrl Nrl Nrl Nrl Nrl Nrl Nrl Not quantilrc d Not 1 guilrrtilie cl _i0.000 I l0 -l () 0 82,030 0 -51.41-i J5 t67,785 39,228' IJO,OJJ 61.261 t-cA 25,000 ' 5,600 [,ocal NGDO(s) ( Church Society) Nit il0 IFESH/UNIVA 35,000 15,650 0thcrs a) Nil lNi Nil Nrl b) c) Nrl Nit N N rl Not visible 45Communities APOC Trust Fund 51.4t5 25,000 'to'tAL 15,17110 I I J,949 32 Wl-lO/APOC, 24 Novcnrbcr 2(X).1 I 3.4. Expenditure per activity / lndicate in table 14, the anlount cxpcnded during thc rcporting pcriocl lirr cach uctivity listed. Write the amount expended in US dollars using thc currerrt Urrirud Nations exchange rate to local currency. lndicate exchange rarte used here $ l=N 126 Table l4: lndicate how much the project sperrt lor each activity listed bclow durirrg the reporting period Mobilization and health education of conrmunities I,C.\iN I'OC' M(]lt,ilrESlt/ N4(_)il,L.CA/n I)()(' L.(iz\. MOI-l MOr r.t cn,lF trst t/uNt v/\ 13.305 \,1( )l | 1 1>1 ;1 ' l-l'.1 :'l l, t ll_\l!j\ TOTAL 52,991 Activity Expcnditure (li US) Sogryc(s) ol'lirudirrg Drug delivery liorn NOTF HQ area to central _cp].!gg!tq-pqrt qf com nr u n i ty 280 7832 il,t.sil/UNtvn ilrlist t/tJN t vn.Nl( )t t/' r\ l'( )( Traini of CDDs 4859 Training of health staff at all levels APOC/MOI I APOC/MOFI Supervising CDDs and distriburion lnternal rnonitor of CDTI activities t842 4235 3938 Ad visits to health and litical authorities 4812 IEC materials Surnm fornrs for treatment t 163 0 Vehicles/ Motorc les maintenanceles/ bi I 0,41 8 Maintenance of Office Equiprnent (e.g. conrputers, llrintcrs, l)hot()copicr ctc) Total number of rsons treaterl '/ comnrents 258,359 WII()i,\l'( lr I l Norrrrrlir,r ..(ro I33 ilE r' SEGTION 4: Sustainability of GDTI 4.1. lnternal; independent participatory monitoring; Evaluation 4.1.1 Was Monitoritrg/cvalttittiott carrictl out tluriug tlrc rc;tr-rrling llcriurt'l (ticli any of the folkrwilrg which arc applicablc) Year I Participatory lrrdependenr nronitoring Mid Terrn SustainabiIity Evaluatiorr 5 ycar Sustainability Evaluatiorr lnterrral Monitoring by NO'l'l' Other Evaluation by other paflnels None was carried out during the reporting period 4.\.2. What were thc recommendations? 1.1.J. IIow have they beerr int;llelnclrtcrl? 4.2. sustainability of projects: plan and set targets (mandatory at Yr 3) Was thc proiect evaluated duling the reporting period'i --No Was a sustainability plan written'/ Yes Wherr rvas the sustainability plan subrn itte d? ___ _-_.lu ly, 2006 What arrllngemeltts have bcen maclc to sustiriu CDTI ll'te r.{l'OC I'rrrrrlirrg eerrscs irr terms oP 4.2.1. Planning ut ull re le vunt levcls. Afterthe evalttation stakeholders were invited to a plannrng ancJ clcblrulr)g n)cerrrg rvltere tentative 3-yearwork plans were dcveloped lbr both Statc & l--(;,\ lcvcls. Ilrc annual work plans are refined foreach year.'l'lre trost important thing is that a cirltur.c ttl planning is being cultivated irr health worliers. 4.2.2. Funtls release The State government has a history of releasing coLtnterpart contriburions. This is expected to continue. Sotne LCAs have bcen rcleasing luucis but othcls havc rrr-lt. Eftbrts are being made to use the Local Covernnlcnl. Departrnent ancl lolunr ol LLr\ Chairmen to lobby those that are not releasing funds. in addition, thc ol'llcc ol't6c 34 Wl-lO/n l'OL'. 24 Novernbcr.2U04 r} i! f)eputy Governor is to be approached to be of assistance irr this respect its it lras oversight f,or tlre LCAs. 4.2.3 Transporl (replucentent und muintenunce) Using the counterpart funds released by government transport will bc rnerintained. Tltcrc are instances where old vehicles in the department are released fbrCD'fl activities. IFESFI/UNIVA is supporting with 2 velriclr:s. [ror rcplacerrrcrtt tltc projcet cxpccLs APOC to come to the rescue. 4.2.4. Other resources The project hopes to mobilize t'unds tiorrr government at all levels lbr tlrc procLrrcnlcnr. of needed resources. The project irrtends to approach sorne local NCOs to assist in getting some of the materials needcd, particularly at tlre [,CA rrncl ctlrrn]ulrity lcvcls. 4,2.5, To what exlenl lrus the plun been implcnrcnted Over 80% of planned activities for the year havc bccn irnplcrncntcd 4.3. lntegration Outline the extent ol'integration of'CD'fl into the PLIC struoturrc and tlrc plarrs l'or conrplctc integration: 4.3.1. Ivermcctin dclivery mcch:rnisnrs There is a sharing of transport and stolage facilitics lbr lvelmcctin.'l'his is more pronounced at the LCA and health facility levels. 1.3.2. Training Progranrme staff benetlt fiorn joint trairrirrg such as ItlJM, Nl'}l, lllV/r\lDS, I'B/LEPROSY arrd Health Education Programrncs. 4.3.3. Joint supervision and rnonitoring with othcr progr:luls Usage of Prograrnnte logistics fbr othcr hcalth activitics arrd usuge ol'NI)l nrotole-1'e lcs forCDTI supervision are the vogue within the project area. This is rrore pronourrcecl rLr the LGA and FL,llF levcls. .1.3.-t. Rclease of funds lbr project lctivitics Funds release lollows the nonnal channels rvithin the Ministn 4.3.5. Is CDTI included in the PHC budgct? CDTI activities are reflected in the health plans for the State and LCr\s 4.3.6. Describe other herrlth programnrcs tltat arc usirrg thc ('l)'l'l stnrctrrrt.irrrrl how this was achieved. What have been thc achievcrrrcnts? Some Community Based Organizations are using the CDI-I str-ucturcs to assist tn rlre Roll Back Malaria[RBM), TB/L and NPI. 1,3.7. Dcscribe othcrs issucs consitlercd in thc intcgr:rtiorr ot'('l)'l'l ; .I .,C Iv n (r r( .t. ta )r )t t1'l I nt t' 35 Wll0/n l'(X . 24 Novcnrbcr'2(X)J 4.4. Operational research. 4.4.1. Summarize in not more than one half of a pagc thc ollcrational rcscarclr undertaken in the project area within the reporting period. None was carried out during the period of reporting 4.4.2. How were the results applicrl in thc projcct? SEGTION 5: Strengths Ittvtllvctttcttt ol'rcligiorts orgituiz.atiorrs arrd churclrcs irr thc ('D'l'l l)r'()ce s\. High cornntunity awareness olthe benefits of Mectizan treeltrnent. ancl rvillingscss tc) conrply with anrrual treatntcnt. Availability of trained health sratTar all levels, Willingness of most CDDs to continue with Mectizarr distribution despitc lacl< ol'or inadequate incentives. Presence of a committed supporting NCDO Release of furrds by the State governtncnt arrnually sincc ;rrogranrrne ine e ptisrr Weaknesses / Sorne LGAs are yet to release their counterpart tunding. ,/ Non-institution ol'conrmunity self'-monitoring ,/ Inadequate involvement of the FLHF stall'irr the CDI'l pr.ocess Ghallenges - lnstability of oLlr political appointees/caretaker/transition committees at [hc [-ocal Covernment L,evels. - Non -release of tirnd atter scveral approvals by tlic LC policy nral\crs. - Quality of rccord keeping srill needs ro be intprovecl. - Number of CDDs is reducing in sonre comrtrunities. Opportunities '/ RegLrlar advocacy and sensitivity, to the clccision mirl\cr.s ./ Targeted training of personnel. (New Stal)). ,/ Intensify rnobilization in the community. * SEGTION 6: Unique features of the proiect/other matters I 36 Wl lO/n l'()('. 24 Novcrrrbe r' l00J