Year 3 CDTI activities report: Yobe State Nigeria : December 2001

AFRICAI\ PROGRAMME FOR ONCHOCERCIASIS CONTROL (APoC) Year 3 CDTI Activities RePort YunusariYusufari Nguru Bade Bursari Geidam Tarmuwa Jakusko maturuFune Gujba Gulani CW CAP g lrf, SI-n A-o rA For Action To: TCLALI E{i* )" 1,c,( For lnformolion To, ]lr( " lr,r zvtt\oz- Yobe State Nigeria December 2001 EXECUTIVE SUMMARY. yobe State was created out of the former Borno State in August l99l.It is situated in the North Irastern part of the country in Sahel Savannah and desert features in the northern part of the State characterize its topography while the southern part has rocky hills and mountainous terrain with rivers giving it the identity of the Sudan Savannah. The river Yobe is of particular mention as it cuts across Six (6) LGAs and it serve as breeding sites of the black flies. The State covers an estimated landmass of 47,153 sq. kilometers, with a population of 1.4 million people. Yobe State has a total of Seventeen (17) Local Government Councils. Twelve (12) of which are Meso-endemic with few southern areas having hyper-endemic communities, especially in those belts that mn across the Biu LGA of Borno State. The people of the state are mostly involved in farming, cattle rearing, fishing etc. Treatment started in the state in the year 1995, after CBM signed a Memorandum of Understanding to assist in the control effort. Over two hundred thousand persons have been treated since then. The State wrote a proposal to APOC for possible assistance in the year 1997 to implement CDTI, and this was approved for funding in September 1998. The State APOC proposal for assistance was approved in 1998, and so CDTI is in its third year of implementation. There has been tremendous achievement in the area of community awareness and ownership of the prograrnme. 2The State government is well mobilized and is always ready to take up full responsibility of its partnership contributions towards the programme' Since CDTI implementation started in the state, the goverrlment has constantly released counterpart funds to the project In the year 2ool a total of 3 I 1,535 people were treated with 799,074 tablets of Mectizan in 245 communities given 85'% coverage SECTION I: BACK UND RMA There are 245 communities undergoing treatment currently in 12 LGA's of the state' The coverage population of the communities is between 1000 to 3500. These communities are defined in terms of 8 to l5 people living in each household or even more' giving a total of 356,729 people. C omm unities I mP le menti ng C D TI1.2 A total of 245 communities are currently implementing GDTI in the state' The implementation of CDTI has brought about a lot of financial and logistic support to the progralnme. This is responsible for the treatment of these communities as Jagainst a total of 98 communities that were receiving treatment in twelve LGAs before implementation of CDTL 1.3 E SAi LGA TREATMENT ROUND ITIKA 7 2 NANGERE 7 J POTISKUM 7 4 GULANI 7 5 GUJBA 7 6 JAKUSKO 7 7 NGURU 7 8 KARASUWA 7 9 TARMUWA 7 l0 FLTNE 7 ll BURSARI 7 t2 BADE 7 TOTAL 7 Note: Although most of the communities are in the seventh round of treatment, some are in various rounds of treatment. 4SECTION II. THE IMPLEM ATION OF CDTI Table I S/N Di No. Comm / Villages No. of Comm/ villages That selected CDDs No. Commi villages that collected Drugs No. Comm /villages that decided on the month(s) of Distribution No. Comm /villages that' decided on the month(s) of Treahent No. of Comm /villages with trained CDDs No. Comm / villages Palng r CDDs in castl or kind. I I FIKA 30 30 30 30 30 30 30 2 NANGERE 7 7 7 7 7 7 4 J POTISKUM l0 l0 l0 l0 l0 l0 6 4 GULANI JJ 53 33 JJ 33 JJ 26 5 GUJBA 21 2t 21 2t 2t 2t l9 6 JAKUSKO 14 t4 l4 14 l4 t4 l0 7 NGLIRU 9 9 9 9 9 9 7 8 KARASUWA 5 5 5 5 5 5 3 I TARMUWA II lt ll ll ll ll 8 l0 FUNE 42 42 42 42 42 42 38 lt BURSARI 45 45 45 45 45 45 32 t2 BADE r8 r8 l8 l8 1.8 l8 l2 TOTAL 245 245 245 245 245 245 195 N.B It's a difficult judgement determining the accuracy of these indicators, as compliance has not been one hundred percent from the very beginning of the project year, but with persistent mobilization and education, most cornrnunities complied. APOC management can do something about updating these indicators, so that project can be comfortable in providing more accurate and realistic data. 5TRAINING OF DIFFERENT LE OF STAFF INVOLVED IN CDTI TABLE 2 Note: Although health post stafftrained are also TOT, but we did not include them in the number of the TOT trained in column 4 above because of the fear of duplication. 2.1 Trainins obiectives / achievements s/N District/LGA No of training undertaken No of TOT trained No. of Dictrict or LGA stafr traincd in CDTI Nu of ccntcrs / post stefi trained on CDTI No Of CDIh traincd. I FIKA 3(LOCT,PHC &CDDs) 7(SOCT& LOCr) s(Locr) ll 3l 2. NANGERE J 7 5 ll 42 J POTISKUM 3 1 5 il 46 4 GULANI J 7 5 ll 4t 5 GUJBA 3 7 5 l1 39 6 JAKUSKO 3 7 5 il 27 7 NGURU ) 7 4 ll 28 8 KARASUWA J 7 J ll l3 9 TARMUWA J 7 5 1l t4 l0 FLINE J 7 5 ll 9 ll BURSARI 3 7 5 ll l8 t2 BADE J 7 5 ll 22 TOTAL 36 84 57 234 330 CATEGORY OF WORI(ERS NUMBER TO TRAIN IYT.IMBER TRAIITED PERCENTAGE OF COVERAGE LOCT 57 57 r00% PHC Worker 235 234 97% CDDs 337 330 98% SOCT 7 7 100% TOTAL 636 62E 99o/o 6)) 2.3 Developed Troininq moterials used various training Materials were used by the project. These materials includes, flip charts, CDD brochures, registers, measuring sticks etc. Improving the oualitv ottroining In preparation for the CDD training, the Socr and Locr have perfected their strategies in ensuring that the training is carried out in such a nuumer that comprehension and participation by the participants wilr be achieved. Above all, the socr team is taking a back seat approach during trainings now to give the Locr more opportunities to ass,me their ful responsibilities as trainers of CDDs. MOBILIZATION AND EDU TION OF TARGET CO S/N DistricULGA No. of Comm. and villagcs Mobilized. No. of Comm/ villages that received Health Education I xo. or I Adrocecy visits to State or Regionel Directors of l Hcelth. I No of MOH Strfr involvcd in Mobllization. No of NGID Statr involvcd in Mobllizetion I FIKA 30 30 2 14 I 2. 7 7 2 t4 I 3 POTISKUM l0 l0 2 t4 I 4 GULANI JJ 33 2 t4 I 5 GUJBA 21 2t 2 t4 I 6 JAKUSKO l4 t4 2 t4 I 7 NGURU 9 9 2 l4 I 8 KARASUWA 5 5 2 14 I 9 TARMUWA H ll 2 t4 I l0 FLINE 42 42 , t4 I II BURSARI 45 45 ., t4 I t2 BADE I8 l8 2 14 I TOTAL 245 245 2 t4 I NANGERE 7N.B 'l'he executives of the ministry of health participated actively in advocacy to LGAs and in the mobilization of communities. This we found so encouraging to the programme. 2.2.0 Mobilization strategv Mobilization strategies involve the use of policy makers both at State and Local Government levels, which proved quite effective. As a result of mobilization ellbrt, communities were able to select their CDDs even though all communities showed willingness to support CDDs, not all communities were able to give incentives to CDDs. 2.2.1 Response of communities Most communities are pleased with the partnership strategy of the programme and are happy to be involved in the planning stages. Their response is quite encouraging. The only envisaged problem is that of total commitment and sponsorship of the CDDs fbr training and collection of the drugs during distribution. 2.2.2 Suggestion to Improve Mobilization Communities should be encouraged to support CDDs by way of community effort instead of looking upon the government with the hope that they will alleviate that 8responsibirity from them in the near future. Those communities that are doing well hre commended. while the rest will be urged to do better. s/N. TREA M NT TOTAL 2 * NB Mop-up activity is stiil going on in some communities. No, of Comm villeges Totel Pop. Of Trcrtcd Comm. No, of Eligibtc pcoplc treetcd No. of Eligibtc Pcople 'frcrted No. of Comm / vllhges in which CDDs rrc hcrlth workcrc Distributions Superviscd by heeltt workcrs No. of No. of trcrtGd Comm/ vilhges with Summery forms.FIKA 30 51,259 45,469 40,594 None 30NANGERE 7 20,209 t7,34t t7.200 -) 7POt- ISKUM IO 20,st4 17,573 12,946I l0GUt,ANI JJ 53,565 49,984 49,533 I -5* JJGUJBA 2t 28,035 25,945 )< 1'71 I 2tt4 20,566 r8,883 t8,686 I 6 7 t4 JAKUSKO NGUI{U 9 r6,080 t 5,46t t4,966 I8 9KARA SUWA 5 8,584 7 q)q 7,3 t9 5il 13.771 t2,945 t2.662 I () i0 * ll 'fARMTIWA FUNE 42 48,425 45,045 40,225 Ill* 42B URSARI 45 42,412 39,962 36,961 I2I 45I]ADE I8 22,338 r8,993 15,296 Itl l8CLIN IC BASE 19,970 19,970 19,970 I 245 365,729 334,403 311,535 None I 245 I I l0 STREN GHT/WEAKNESSES&SU GESTIONS STRENGHTS: a Yobe State governmont is very much committed to the programme. This level of commitment is highly commendable as project can continue on its own when outside support eventually stops. The project has dedicated SOCT implementing the prograrnme. This team has been with the programme right from the onset and is determined to carry out their roles and responsibilities together with their LGA counterparts. The project has enjoyed tremendous support of the assisting NGDO and NOCP. Their back seat support system to the state is highly appreciated as it makes the project to take full ownership of the programme right from the onset. Acceptance ol'programme by communities is a success indicator. They ask for their drugs even when it is not yet distribution period. CDDs turned up for training yearly despite relative complaints of lack of support. The project has identified few CBOs (Community Based Organizations) that will be useful in the implementation process. This is a boost to the community mobilization efforts and the participation of women in CDTI implementation. a a a a WEAK l'he Low literacy level of the people has made selection of cDDs very difficult in some communities. M.sL ol'the community members claim they are too poor to support cDDs. [,ack of adequate supporl on the part of the LGAs. SUGGESTI ONS: ' There should be increased community mobilization. Emphasis should be on women participation to discourage treatment by proxy or the men getting to relay second hand information. which may not be correct to the women. ' Advocacy visits to LGAs should be intensified. The present trend of lack of commitment is disturbing. The project intends to involve the State commissioner for health, the permanent Secretary and the Director to go *rund the LGAs befbre the next distribution round of treatment begins. o I)HC worker should participate more in supervision of CDDs in their local areas ol'assignment witrrout necessarily expecting rewards. o Involvement / training of cBo's to improve cDD perfornance. These cBos will be carried along in the implementation of the programme. They will be encouraged to attend the Zonar oncho Taskforce meetings. a 5 :l 9l,'U't'tl Iili t, N l. Communityself_monitoring. 2. State / LGA review meeting / project evaluation. 3. Advocacy visits to LGA,s. 4. Community mobilization and Health Education. 5. Re-training 6. Community registration. 7. Mectizandistribution. 8. Review meeting. TRY OF TH NTRIB UTION.MINIS 'l'he 1'ear 2001 is a rewarding one for the project as the state government was abre to 'Ipprove and released the sum of Two Million Naira (2 million) to the project as counterpart funds r1