NGKG4 APOC annual project technical report to Technical Consultative Committee (TCC): January to December 2003

___l I l I I I I I ll I I I I I I I I KOGI STATE SIXTH YEAR ANNUAL TECHN|CAL T\EPORT oN COMMU,IITYDTRECTED TREATMEI.J- yiiTH iV[ <ivii:.]Titl I I .1, I NlGEllir\ EqUNTRY[l-Orp: - -l e'nbJrdr r,lnrvrr:- I NGKG4 I I LAUrLaHrruo YeA*: ! i tt APPROVAL YEAR:- 1 997 Reportirrg Period (t\4onthiyear) _{q [!a ry to _D_e_cember, 2003 ;133 I l l,/ -_l,lub rtt ' \f,s-il i I pate submitted:__il5eo 2oo4 APOC ANNUAL PI-IOJECT TECHNICAL REPORT TO TECHNICAL CONSULTATIVE COMMITTEE (TCC) n 4 JAl,l. 2005 H*9-U., lAIffi AFRIC/,N PROGRAMME FOR ONCHOCERCIASIS CONTROL (APOC) lI I i l lANNUAL PROJECT'iE( ;Hl.llCAL t".'EPORT TO TECHNICAL CONSULTATIVE COMMITMENT ENDORSEMENT Pleasc confirn you irave i"e;rd this report by Signing in ttre appropriate s.pace OFFICERS to sign the report: Country: NIGERIA/LIBERIA National Cc rrdinator: Signature.. Zonal Onch o Coordinator &oe has been prepared by Narne: l. This report Dcsignatio Sigrrature: Date: State Cg"ordinator}'i$r(* ft,\ 3\ :'=7 1Signature..... -. -iJ-oate....\5... 1. C=*l* Table of contcrrts i-i ACRONYMII DEFTNItoNS ......... FOLLOW UP ON TCC RECOMMENDATIONS. EXECUTIVE SUMI\,4ARY.... SECTION1 BACKGROUNDINFORMATION ..1.2 1. 1. GtiNL l(rrl I ,i'CiiMATlON.. .... 1 _ 2 1 1 1. Desc tptioti of tite ptnjt.it ij,iief!.v) ... 1 _ 2 112 Parln=rship .2_3 1.2. POPULATION AND HEALTH SYSTEM. .. 4 - 5 SECTION 2 IMPLiMENTATION OF CDTI 6 2.1. pERtOD OF ACT|V|T|ES. . .. ..... 6 22 ORDERING STORAGE AND DELIVERY OF IVERMECTIN.. .... 7 - 9 2 3 ADVOCAC,\. AND SENSITIZATION .......... 3 2 4, MOBILIZAT CN AND HEALTH EDUCAI-ION OF AT RISK COMMUNITIES..... 9 2 5 COMMUNII IES INVOLVEMENT IN DECISION-MAKING. ..10-13 26 CAPACITY rUlLDlNG... .. . .... 14 2 6 1 Train n9.... 14_19 ? (; :t EcluiS'rnent and huntan resou/ces 1g_ZO COT{DITION OF T'{E EQUIPMENT - PLEASE STATE. 27. IIiEATMEI'fS 2.1 1 Trea,.rrenl figure 21_22 ? i 2 Tren I of treatment achievement front cDTl project inception to tltt' current year... .... 2g 2.8. SU.P-ERVIS CN. . 3J-31 SECTION :} SUPI'ORT TO CDTI 3.1. I.INANCIAL CONTRIBUTIONS OF THE PARTNERS AND COMMUNITIES. .,. 32 3.2 OTI]ER FORMS OF COMMUNITY SUPPORT .... 33 3 3 I XI'I NDITURE PER ACTIViTY . ....... 33 iii IV 1 t I ; I I I SECTION ,] SUSI \INABiLII'Y'OF CiJ]I IN II ttNAL, IN ]EPENDENT PARTICIPATORY |/ONITORING, EVALUATION 4.2. COI\4MUNITY JELF-MONITORING AND STAKEHOLDERS MEETING 4 3 :;t,JS TAINARII TY OF PROJECTS PLAN AND SET TARGETS (MANDATORY AT YR 3) 44 lNrI r,iitrilL, 4 5 ( )l'l lin tlON/. . RL:SEAIi() 1 SECTION iI STRI.NGTHS, WEAKNESSES AND CHALLENGES 3J 1A 35-36 ..37 .3E ii I Acronyrrrs APOC A IL' ATrO CBO CDD CDTI CSM LGA MOH NGDO NGO NOTF PHC REMO SAE SHM :CC TOT UNICEI" UTG WHO SSI MCH VIT A lAfrican Programme for Onchocerciasrs CorrtroiAt't r-r[ta Treatment Oblectrve Ar',rru. f '., : ':3 Obiectrve Conttt-r rrrity-[3aseo L,i!i.1i ,.,.,, ^ . r Comnr.r n ity-Directed Distributor iomm rnity-Directed Treatment with lvermectin Comrn rnity Self-Monitoring Local Government Area Ministry of Health Non-Governmental Development Organization Non-C cverhmental Organization Natior al Onchocerciasis Task Force Prima y Health Care Rapid Epidemiological Mapping of Onchocercrdsis Sever,: adverse event Stakeirolders meeting Technical Consultative Committee (APOC scientific advisory) Trainer of trainers Unitec Nations Children's Fund Ultima te Treatment Goal Worlo Health Organization Srght Savers lnternational Mater ral and child health Vitan: n A ilt 1 q w ttqtttq %tttq s tt rytq Definitions (i) IlItl!]IppL ation: the total popuiation lrving rn mesri/hyper-endemrc comr runrtres witlrrn the rroject area (based on REMO and census taking). (ii) l-lrULblq -p1'pulation: calculated as 84% of the total populatiorr in nreso/hyper- enclerlic c tmmunities in the project area. (iii) Annual Tr-'atment Obiective: (ATO): the estimated number of perscns living in niilsolnyp,rr-endemic areas that a CDTI project intends to treat with ive-rnectirr in a gtven yeai (iv) Uitrrrate Treatment Goal (UJG): calculated as the maximum number of people to be treate i annually in meso/hyper endemic areas within the project area, ultimatell to be reached when the project has reached full geographic coverage (norntally he project should be expecied to reach the UTG at ihe erC of ihe 3'd ye:rr of th project). (v) Ilrefjepgu ic coverage; number of people treated in a given year o\ er the total lrrilrLrlatior (this slrould be expressed as a percentage). (vi) Geoqraphical cdveraqe: number of cominunities treated in a given year over the total rlum rer of meso/hyper-endemrc communities as identified by REMO in the prolect ar:.a (this should be expressed as a percentage). iv il q Wt fr fr fr m H I f, ry H n h fi nIft H q FOLLOW.UP OI- TCC RECOMMENDA Using tlte table celow, fill in the recorrmei'dations of the last TCC cn the proje;ct arld descrrbe how th, y have been adciressed. TCC 16 Report 56:1 Numbcr of Recomnrcndation !l tle Report 56 (i) TCC Recommendation fCC accepteO report and commended the state for the achievement made so far and bncouraged the state to keep the spirit of sustainability as an example for other state. ror rtctepoc ttncr use only the - -ffi!-nlo *rr 1o*"r*o "the State Governor via the Honourable Commissioner of Health to intimate him on the su'ccess of CDTI and the need to release counterpart funds to help sustain the prcr{ect. As there wbs no response a remrnder memo was forwarded. No positive report was given. Letters were written to the 21 Chairnren on the need to release funds to sustain the projects in their various LGA. None of the LGAs gave a positive response. Some difficult LGAs like Olamaboro LGA were visited to solicits for fund release for CDTI activities EXECUTIVE SUMI\iARY Kogi State ts made up of twenty one (21) LGAs with 2,403 communities all of r,ihich are endettrtc.wrth Orrcl :cerciasis. The projected population for the state is 3.2 millron based on the 1991 census. The project was one of tfrl first four (4) projects approved rn Nigeria in 1977 During the period of report persons 1,150,595 were treated in 2,394 communities. We hope to validate th -. census update within the first quarter of year 2004 to ascertain our UTG for tlre year The Annual Treatment Objective for the year was 1.2 million representing 90% t rerapeutic and 99.6% geographic coverage respectively. Population migraticns occurs mainly during Christmas festival and more comnronly in 5 LGAs of the State where they cerebrate their traditional festivals thrice in a year. There are also lrttle ntigr;,tion of the nomadic fulanis in some LGAs viz; lbaji, Bassa, Kogi and Lokoja. This accor-nts for flunctuation in the census update of the areas. 7 SOCTs, -1,'Nutrilion officer and l MCH Coordinator were trained as TOTs on V,t. A supplementation r,nnile 234 LOCTs and 2B Nutrition/MCH health officers were';'ainel as super./rsors of CDJs on vitamrn A supplementation in 14 selected LGAs. The trarning was facilitated by Sight Savers lnternational (SSl) and Helen Kellers lnternational (HKl). 1,806 CDDs were irained from 1,275 communrties in the 14 selected LGAs. . Tlre greatest challenge and embarrassment the project faced in the reporting year was to nreet r.rp tlre dead iine date for report subrnission, this was due to lack of funds fron'r the"" State Governmen Tlie srtuatron was con"rpc-rnded by ; cor contiiritmer i of C JDs as a result of non incer tives by the comnrunities. At the LGAs it was worse Cue to unsiable leadership and la;k of funding and this contributed to late collation of our treatment figures. lnfact, lack of funds and non Gompensation of CCDs pose a major ccnstraint to the smooth conduct of CDTI at the 3 levels. However, the commitment of the 7 SOCT 362 LOCTs was a major strength which helped us to overcorrre trrtal failr.tre as personal funds were utilized for travels to advocate for CDDs incentive in the communities. SECTION 1 : Bacr<qroi.rnd lnformation 1.1. General ln 'ormation Kogi State is located in the Middle Belt of Niger-ia and shares bounrjaries with Niger, Nas:,arawa State and the Federal Capital Territbry to the north, to the east, tlre State has boundary with Benue State, to the South with Edo, Enugu, Anambra and Ondo States, while to the West it has a boundary with Kwara State. The two largest rivei's in Nigeria, rivers Niger and Benue form a Confluence at Lokoja, the ,l State Capitai. There are also several other fast flowing rivers nan-ely rJfu, Atratttbra, UL'ele, lnachalo, Okura arrd Oyi, which trarrsverse the several endemic cortrttrunities in the State. .Tlre nlarn occupatrorr of the people ts farmrng, lurlbertng, fr:hing and trading. The vegetatron rs made up of rarn forest in the Western par: of the State, wooded savanna and grassland in the east, forest savanna nto'aic to the sor-rth and guinea savanna in the north. onclrocerciasis was ". frrst reportecl rn Nigeria in Kogi State in 11J07 at Lokcla. Kogr State r: a multilingr-ral State of about eight (B) ethnic tribes but three major langr-rages v z lgala, Yoruba and Ebira are predominant. The topograpl"ry of the State is highry undulating, while some parts are mountainous, some riverine and as sucl-t, 50% of the communities are hard.-to-reach areas especially in' rainy season, whrle the rer,raining 50% have manageable"network of roads. However, all the 21 LGA headqu arters are well connected with all season roads except one (lbaji). Tlre adminisrrative structure is a politically elected Executive Governor at the State level and politically elected chairmen in the 21 LGAs of the State. Se,",eral hierarchies cf traditional institutions aie in place to oversee tl^,e dis i'icts and corlnrunitiel . More comrn.rnities have primary health areas. 1,1.2. PARTNERSHIP centres ancl,,health posts, srtuate j in CDTI The parlners involved in tlre project irtrplernentation in the State are IV1OH, SSl, APOC, 21 LGAs and 2,403 corrrlunities and tlre Federal Ministry of Health through the NOCP rZonal level) supports tlre ordering of Mectizan from Mectizan donation cornrrrrttee lr paris. The partni rship between the Governrnent the NGDO, and the benefiting communitie,; has been very rewarding. The MOH provides office accon modaiion, pay salarie.; and emoluments of SOCTs. The State Government conlributed in terrns of counterpart fr-rnding during the 3'd, 4th and sth year of the project irlplernenta iion but unfilrtunately, this seized in tlre 6tr' year and this i,ad a high frLrstrating r.ffect on CDTI activitres rtt tlre State. Tlre LGAs non financial input irr the programme coupled with non-payment of salarres to heir staff frustrated or-rr CDTI activities and as suclr, non-supervision of the CDDs, ronitoring of distribution exercise was witnessed This also affected the Lrrrtrrrrely c ,llation of treatnrent figures resLllting io late sr-rbrnission oi treaiment reports by CDDs. Also the conrrnuniiles' non-cornpliance to pirynrerr: of 'lDDs incentives contributed to high rate of CDDs lack of commttments in most 5 q F t ry h ffi h ,h B lh H ffi qt il; H &I q 11 E cottrttttttrities a td as such, late cornprlatron of treatnrent frgures was tnevrtat le. -io sonte cotlrnur ities tlrey willrngly accept therr responstbrlrtres to assist the CDDs. Nine conrmunr tes rn Ekirirr-Ade drstncts in llumu LGA drd not distribute lveimecirn durrttg thrs rep;rttttg period. 'l-iris was ouL'to re{r-rsal .of CijDs to cirstitbul.e as i;re conrtttunitles c:uld irot resolve on the conrpensation of therr CDDs despite seve;al sensrtrsation v ;its to resolve the conflict. The State prol':ct NGDO (SSl) made sorre visit to the State and some comnrunities to solicit for rr:lease of funds and payment of CDDs incentives Also supply of tnecttz-an and otlrer nraterials and sorle other logistrcs/techrrical supports by tne NGDC helpec to encourage the SOCTs from the frustration faced durrng the course of CDI i activities in the reporting year. To prevent fut rre occurance of these brttei experience wrtnessed in CDTI activitres in thrs reporting period, plarts are on tlre gr-ound to carryout a hrgh pcwer advocacy meeting with rhe political leaders in the two tiers of Government in the.c'tate for release'bf fur C. Also, there is a plan to remobilize the communities leaCers on CDDs incentt res. There is also a plan to start inrplementing colrmur-ity s.:lf- monrtorrng anl stakeholders rreeting in sorne selected communrtres to empov/er the conrmunit,es to monitor their CDTI activities themselves. As this works. we hope to expand the scope to cover the whole communities. 3 Population and Health SYstem l_aflql Communittes and population (Piease add more rows tf necessary) at rrsk in the entire project area urhere they are treated or not during the reporting period CDTI Districts/LGAs in the entire project area Total population in the entire project area Number of communities/villages in Population of Meso- endemic zone in the project area Hyper-endemic zone in the project area |\ Total in meso/hyper endemic zone Meso-endemic zone in the project area Hyper-endemic zone in the project area Total in meso/hyper- endemic zone 1_r Ultimate treatment Goal Adavr 63,845 57 1 58 62,806 1,039 63,845 53,630 Ajaokuta 46,145 50 50 46,145 46,145 38,762 Ankpa 95,880 129 UJ 214 66,1 30 29,750 95,880 80,539 Bassa 90,543 100 56 156 63.622 26.921 90 543 76,056 Dekina 106,293 162 80 242 83,493 ?2,800 106,293 89,286 lbajr 70,817 127 Atr.qJ 172 52,997 17,820 70,817 59,486 ldah 53,317 39 L 39 78 29,202 24,115 53,317 44,786 lgalamelaiO 78,326 115 i55 170 52,201 26,125 78,326 65,794 ljumu 60,994 25 oo 111 11,360 49,634 60,994 51,235 Kabba Bunu Xogi 64,603 42,933 39 30 tt 117 ,89 156 119 17,820 il ig+ 46,783 64,603 54.267 31,s3s +2,v':t i0,003 Lokola 39,1F6 84 tt 91 1,549 37,607 39,1 56 32,891 Mopamuro 23,775 -4 ',15 19 1,289 22,486 23.775 19,971 Ofu 100,895 113 98 211 86,s83 14,312 100,895 84,752 Okene 65,018 50 i 10 60 50,124 14,894 65,018 s4,615 Okehi 49,942 64 i15 j 79 38,331 11 ,611 49,942 41,951 1.2 I rbgi _ I lorojI."r"::h r r r.rr't r ll.f#l-+ r f f f f, rr rr Ogorimagonqo 30.260 28 .l 11 3e 22,839 'tq,tsi 7,421 30,260 25,418 29,534 43,691 36,700Omala 43.691 59 61 120 '1fi;'oo;c 91 118 62 126 188 23 310 67 838 91 . 148 76 564 vagG--Elst 41.203 21 31 52 14,231 26,972 41.203 34.614 Yagba West 25.585 11 ,7 18 3,701 21,884 25,585 21,491 Total 1,284,369 1,369 1,034 2,403 753,284 531,085 1,284,369 (a Source: National census CDD Other, specify: Year: 1991 UTG = catculated as the maxrmum numb,r of people to be treated anni]ally rn meso/hyper endemic areas within the proJect area ultimately to be reached when the project has reached full geographical coverage (normal the project sh;uld. be expected to reach the UTG and the end of the 3'd year of the project). colllMuNlTy: A community in the context of this project is defined as a group of people that settled in a location sharing common interest NO.TE: Thecensusup-dateinmostcommunitres\,/erenotvalidatedasaresultoflackolfundsandassuch,theaccuracyrsnotguaranteed.-lhis has led to up-shoot in the therapeutic coverage percentage in most commun[ies. We pray to correct the coverage rate in the coming year when census revielv and validation must have been done. r-Er:f SECTION 2: IMPLEMENTATION OF CDTI slllo -- Ac tivities P,Jn. "g of audg;: "gB :rg Time frame _ Month of imp_Lementa_{on __ SOCTs Februar"y'january 2 Otrrce supplies anc equipment maintenance January State Coordrnator No fund release Production of MIS Form January State Coordinator No fund release 4 Valrdation of census figure up-date in the January - February communtieis SOCTs/LOCTs and CDDs i No fund release Ordering of mectrzan tablet February State Coordinator February High power aCvocacy meeting with the new polrcy makers state/Local Government on CDTI sustainability i May ZonallSSl/SOCTS Orientation training of APOC responsible on reference tc CSMI/SHM. LOCT to their post ; May iCDTI sustainabilities l I l SOCTs No funds o(J. Targeted monitoring/supervision of LGA health staff i June - November l SOCTs Scantly done through personal financial efforts r Collectionicollation of treatment reports I i I I June - Dqcember commitment 10. i locrslsocrs Lately collated due to scanty I CDDs/1-OCTs/SOCIS Done with partistial reports from the field at long intervals Irrr Report collation and planning for year 2004 December fffffsf o 7. 2 2. o-&A iBlNG, STORAGE AND DE Mr.:r;t,',ttt1l()orclered/applred for Lry - (plcasc,trck tlre approprrate arrswer) lvlol il Iwt1o [ ]UN|CEI- [ ] NCDO i l Otlrc s (lrlcase specify)____ Mc:r:t zan (ll) delivered by (please trck the appropriate answer) Mol,l I wHo [ ] uNlcEF [ ]NGDO t l Plt'ltr c tlescttbe how Mectrzan (R) rs ordered and how rt gets to the communities. llt:Pcrts of Mecttzan treatnrent are conrplied by LGA coordrnators and submitted to tlrc s t;rtc (ioorclittator' The quarrtrty of Mectizan required by each cornmunity for lltr: 1' t.'ccctlrtrg year ts based orr populatron treated X 3 in each community. This is colla:cl at state level and sent the State NGDO, Sight Savers lnternational.(SSl) who ,laces order through NOCP io Mectizan Donatron Comilittee rn pt;is. Tlre,'learance of the drugs flom tlre Lagos airport and its storage befbre coilection ts tlt r responsibility of UNICEF. The state received her consignments from the -NGD3s, arrd inform the LGAs for collection of their consignrnents. Thc itrst ltne health facilitres receives and stores the consignment for communities It.t tlr,:tr lr.rttsdtction Each comrnunities are rnformed to send their CDDs for the collr':{rorr ilf tlreir drugs. {-- NoCt--ll- -- _-l\ .\ SSI t FLHF _1 t- I l I __+I locr Ii_-l I I Y I I 7 t-coMMUr'ilTYL ___ r r ttt T r : tr n fr #l# F IIt ItttttttttI I I t I I I I !r Table 3: Mc'ctrzllrr i R) lnventory (please add rrore rows rf necessary) Statc/Drsinct L GA Adervi Ajaokuta Arrkpa Bassa Dekirra lbajr ioar, igJiamef al( )cloltr tlumu Kabba/Brrnrr Xogi Lokoja Mopamuro OfLr Otrene Okehr bgorimaggllgo Omala Olamaborcr Yigba Ea:;t Vigba West 190,450 88,450 238,000 240,000 295,000 195,000 172,000 230,000 180,000 150,000 120,000 120,000 BO,OOO 270,000 200,000 162,000 190,450 88,450 238,000 240,000 295,000 185,500 155,000 210,000 162,000 j 150,000 120,000 120,000 80,000 26s,000 180,000 162.000 90,000 130,000 270,000 1 10,000 85,000 3,526,400 1 87,516 88,41 5 232,832 239,790 292,566 18s,393 150,144, 207 ,113 160,325 143,885 116,279 115,287 78,241 260 363 177 ,147 139,172 87,829 125,230 248,809 99,472 21 6 136 (+ 241 B 93 '1 16 162 89 104 -1ir- 212 197 69 172 269 121 2,152 0 0 0 0 s 0 0 0 0 0 0 0 0 O 0 0 0 0 Ilo 0 0 0 0 b 0 0 0 0 0 O 0 0 90,000 130,000 270,000 1 15,000 85,000 3,620,900 0 0 0 o 0 o 0 0 0 0 0 o 83,600 3,382,869 The wastecl clrrrgs were r:rther crr.rshed whrle nrost of thenr were missing as sorne CDDS"' were not cerreftrl er ough rn the handlrng of the rlrirg. Slale aclrvtltr:s trtr sj'lverntectin clelivery lhal are being handled by healtlt care pers)<tnnel in lhe ptolr:r;l-irrr: - 8 Number of Mectizan (R) tabletRcceivedluseolr-ostiwasteoRequested by LGAs Expired 7ttttttItt r1 rg I I1 t Ig I I I I . Collcctrorr of [v]c ctrzan for storagc . Alloc:tllott ol Mt ,:ttz;trr to CCDs frorn cor"rrrlurrrtres rn thcir jrrrrsdtctron. . Retrarrn{l of rrt .v CDDs. . Attertrl to rnrnor ireatntent reactrons . Monrtor/srrpervr';e distribr.rtron . Supcrvt:;t()n of treatment collatiorr. . Facrlrtlrtc (,liM/ iI-lM Any otlrer cr)rrrn)cr rls Norte 2.3 Advocacy altd Serrsitization Advocacy vtstt vere tnade to 14 LGAs by some SOCTs for the release of furrds for sustetra+xlc of CDTI in the state. Tlrrs did not grve the desired result ,.Jue io instabrlrty oI th,'Local Courrcil coupled wrtlr epileptic fund allocation. Approval of courltc-'tp.ttl fun:ls by the State Governrnent was grven rn the year's budget several tnentos fot tlte ielease of funds was fonruarded but yrelded no result. The clrffrc.ttlttesiconstraints faced'were frequent changes in the Local Government Couttcrl, ncw b eeds of polrtical leaders and policy nrakers at the State tevel. Trr ovt:rconro hese challenges, there rs the need to organise with our NGDO partnt:r zonrrl oordinator and conduct a ir glr poruereJ advocacy rreoting u,'i1i1 llre polrtrr;;rl k-.acle:r',/policy makers both at the State and LGA levels. - | o :;cns trze them on tlte need to sLrpport CDTI activities. - (lrintrrtu-lsstakeholdersrneetrng. Howcvr:r, wL. pray for an rmproved situatron as soon as Local Government Council is stetl-rrlrzccl Mobilization and Health Education at risk communities SSI sponsored the production of locally produced IEC materials. Radio annoLrrcenren.s and jingles in tlre local dialet as a mearrs to health educate treatnrent clef rr,rlters in sorne comnrunrtres rn Olan-raboro LGAs This yrelded posrtrve rcsulr as there was remarkable rncrease rn thp population treated as conrparcc.l to yJars back. CDDs rnccntn es has continued to pose problern in most communities as they still behevc tlrat Ciovernment could do sornething about .tlreir renruneration as in the "u5s rrI NlDs rocal guide. To thrs effect attainment of ATO could not be reached in sonr() r:orrrnrrrnities in ljurnrr LGAs and some few communittes. Tlre nralor we lkrresses and constraint is the failure of conrnrunities to compensate their ODDs, lz ck of fund release by the LGAs to LOCTs for mobilization in drfficult 2.4 I r; colt'tntunllto:i FailLrre ntovcrnt'rrI of SO()Ts CVll ll t, ttrr rrr To ()vr't((\jp(, tltt ,l of the State Govr-.rnment to to the LGAs to conduct release counterpart funcjs for spots-check sLrpervrsron and r;lr;rllenges, establrslrrlcrrt of furr::tional cofirlLrnrty sclf motrttotlllg commiti':e witlr prec-lorrrinant leaders in the communities as members woLrld ['re rrrstitutionalised. - AclcqtrSte prlvision and utilization.of IEC materials in at rrsk comnrurrrtres. .- ltlcttttfrcattor and training of local NGos to participate in cDTl activities. - I rarrrrrlg of some pupil teacher to participate.in CDTI activities. 2'5' Fenrarle atterrd'ance at community health education meetrng is competitive to that of , men bLrt lherr participation on decisiorr makrng is shallow. There are c uite a number of fernale CDDs in some communities but the exact frgure per LG,A is not readrly available as at the time of rqoort. Efforts would be rlacle to asc6rtain the figure next tlme , 1 Lf ! t 10 'al I Lt i 2.5. c o m m u n i ti e s i n vo r ;:[;T' Ll"J,fJ:l ;ff"TL?p,t ion i n th e c Dr ( p re a s e add more rows if necessary) involved in CDTI I Number of c -es/villages with Number of CDDs and the communrties I communrty tnenrbgl5 as Supervlsors invclved - Totat - Irtale CDDs i Female CDDs l Total communitie"/villages with female CDDs Number of health staff health staff involved in of I comrnunity communities i members as in the entire I srpervisorsproject IcoTr Number of I Percentage communities I with female cDDs iin the DistncL'LGA entrre I I prolect atea Adavi Ajaokuia 4.)t.J 12 '58 60 Ankpa Bassa 21 ' -i8 - 214 t30 104 56 a')')ZJ-) 162 Dekina 32 242 290 lbr;, - 16 172 189 I 169 , ldah 14 78 r lgalamela/O 19 170 i 166 ' llumu 18 111 202 Kabba/Bun" Kogt t ^t.^ ^LUF.! =\ I .'! ^ - ^ ^-l. it;'7- a tt 156 IJ ,L Z ltY 115 1)) 120 /w lIY 12021130Ofu Okene 18 60 *{1 Tf f f f f r f f r r r r r r r r r r r r activrties IUDt79 I 14otieni n -^- -^^^---v-lJ aJ- -- 12 1-Qr(J 39 i20Cr.;'',a'a Olamabcro 22 too 21?, Yagba East to 8252 - Yagba \,^/est 62 3,207 NOTE: The data on health staff in the entire proiect .atea uras not available as at the time consrdered in the next report. The data on rnember of community members as supervisoi's anQ No of commltnities with female CDDS could not time of compilation of this report This was because these information came up as a new rnquiry. Efforts would data rn the next report. of frlrng this report Thrs would be be ascerlained as at the be made to include this 12 rrrr?fffffffffffrrrrr 12 18 tl l; ; : , ::]:l: "r:::ll;.r,reir ;i.rr retrarrre,cr i,rs facrrrrarors o,, Vrt A suprprcnrenratrorr t 2 I lr:irltlr stafi of MOH - 2 were. trainecJ as facrlrtators on Vrt A supplernentatron. 3 t o(l Ili ' 3 i2 frorrr 21 LGAS were trained and retrarnecl | 4 CDuS - 32J7 were earlrer trarned from Z4O|conrmunities etc. 2.6.2. l o(l l/Nutr lron/MCH Officers were trarned in the 14 selected LGAs for vitarnin A t sripplernen ation. - CDDs from the 14-selected LGAs were trained ofr vitamin A I supplementation The attrition rate of CDDs in sorne comrnunities is t ::*::;'ff::,:1"ff"1":;::,:11Tfi:ffi::.""":?$iI ;TT:[::,;:]:[ffi::i:TT:,ffi::ffffiTJT; I Yagba West and Kabba Bunu LGAs t I I I I I I t I l l TJ 13 Timelrne of activrties for the areas treated in the current year r rooiiiziiion oi communities rnonth month month iPlease add more rows if necessary) Tlainrng censuslupdate Drug drstrillurion Cn v,i3rnrn A s'.polerilen13: r^ SiJ.-"s-=-c".pI"trc. ---SGrt;!t -o"tn --cottprtt'o" Si:., ^S-rr,ontr, Co.pret.. - .. Si;rt,"g rnontn Co-pret,on rnonth month Supervision - -- Si5n,"g -ont^ Cotnp,eiron month Adavt N/A N/A June J une Noi done Not done Ajaokuia June June July August Ankpa J une August Bassa April June June Dec Del.rna ^ Jr-rne J une May Sepi -ioal - June J une Not done Not done ldah June J une June June lgalarrela/O June Sept June June Not done Not doneljumu Kabba Bunu June J une Not done , Not done l Not done Not doneKogt lok,lri -- Not done I Not done June J une March March June JulyMopamuro Ofu June iM'v JuneJune Aprrl Okene re June - Not done i'Not done I i l Okehi June June Not done I Not done l 14Itr r f f f f ff f ffffffffr I r 1 Nov. Og;i,rnagongo -' "- -,:' lurne I .tune March Aprrl l\.'lay Sept Omala June JUne luarcrl tvtdy 'vrdy oi?.rar:.: r.ii:ll-e -[jt ocnJ J,-;re June Nci:cne Nct cione ?agbt v /esl June July 'Aug Nov NOTE: . Communrty mobilization and health education was not donq as all the. communitles are fully alvare of CDTI achvitles rather ernphasis on CDDs ncenhves,,'/as relayed to few communities visited . Training of SOCTS/LOCTS/CDDs on vttamin supplementing using CDTI structures was conducted rn the 14 selected LGAS . Census update dtd not take place tn most communrties as most CDDS complained of double work Lvrth lrtrle or no incentives Ho,,./ever. up-date of treatment registers were carried out side by srde with distribution of lvermectin in most ccmmunities. - I I I I I I I I I I- T I I I I - I' -.' $-. -,,@-*n*q,.&4r*re&ejr:s*,.4&E#8ffilti&Edflffied. Ta b I e .5 : _- __lte r n lf' g_e!_t ft_e -dlfg tei tlg-ve I of C DT I i m p I e m e n. i ttumULio1 OEtrictslLGAs staff , Nunrber of health centreipost staff trained lTOTclar l-Fel.l--Totaiirll Number of other trainers of trainees Number of CDDs trained DistricU LGA ATrO New , Ref. .t Total , ATrO New i Ref. Total I .: ._t iI-t' Ada"r *- 13 r--.i __j-,i 1104 i Ajaokuta 12 Ankpa 21 Bassa Sel<rna 18 i 18 15 32 28 14'16 '32 16 ' i162 a A-7JLJ / 290lbalt ician-- -- 101414 189 lgplamela'O llrrn, --- " 13Llo19 tb1818 169 169 Kabba/Bunu 1417 ,17 202 14 ', 14 : 10t.,, ; | 115Kogi Loko1a 15 i 15 ' 11 122 lvlopamuro ,o 12 12 120 o?i, -- ?736 30 td l4 ,.) to 'i20Okene Cken a\^-.J-e' = - - Omala 18 _ 1______ 't4 tt i8 0 108 -/ 120IU IC C IJ 16 l- - 12 0 - - Olamaboro 'I i '' i248 i - - -------t ' i l'82 lr Yagba V/est Total .--- - 12 12 ',62 ; 353 363 1?78 j t 32O7 I Yagba East 16 Achievement 100 ' Nerv Refr' lf detall not avarlable. provide the correspondrng total only. Make sure that there is no double counting. There r4as no fresh tra nrng on CDTI duflng lhe reportrng peflod but trarnrnq on vitamin A supplementatron was conducted at the LGA and communrty levels Puprls teachers have never been rnvolved in CDTI achvities and as sucfr. we hope to train some teachers in some commLrnrtres who would compImenl the responsibrlrtres ol the health staff rn the project areas 17 I I E E - a- - - - - Tablc 6 Ty1 e of trarning Lrndertaken (l-r,.k tltc-'boxes where spiecrftc trarnr-rg wAS catrrrecl outdr-rrirrg the reportrng perrod) Trarnces Typc a of trairrrrr<y Prograrrr ntanagentcnt How to t:orrrltrct lrealtlr cclucTtron Managenterrt of SAEs CSIN SHM bata collcctrorr Data arralysrs Reportwrrtrng Others (specify) Other community nrembers c.g Community .s_upervisors Health i workers I (f rontine Ihealth I MOH stafffacilities)- | or others I Political leaders Others GP9.1{y-}_=__,CDDs XX t I i i d e. f. g h - Any othe, comments. Apart frortt the training conducted for new CDDs in some,communities there was no other fornr of orgallised training as a result of lack of funds. We hope to carryout sonle trainirrg on a, c, d, e, f, !r, and lr above to further consolidate our plans for sustainability. 18 T h h +r h h FI h h h lr II h h h ht h F b U. 2 6.2. Ecluiprne nt and humarr resources Table z: lit;rttr: of equrprne.t (please acici nrore rows rf ,e:cessary) Source I APOC I MOH Type of Equipment 1 Vehrclo. (2) 2 Motor t;yclc (1 J) 3 Conrltrrtcrs (2, 4. Prrnters (2) 5 Fax Machrrres (1) 6. Generator (1 ) 7 Nr cortrlrtloner (1) B. Photor:ollrcr ( ) Condition of the equipment * Functional but one needs replacentent of tyres FLrnctiorral Functional Functronal rLrnciional f unctionat Faulty but reparrable Currently non- fLrnctional bLrt repairable Firnctional runitionar Funitionat =l-t i I DrsTRtcT/ i r,rcooLGA . I l please state Othcrs Fr,rnctional 9. 10 11 TVruori (1) Gerrerertor (1) Refrlrlr:rator r1)- * Cotlcltttotr of t re equrpment (Functronal, Currenily non-functronal but reparrable, wrrtten off) I lle 6 Hrr16' Heros motorcycles clonated by APOC are written off for lar:ft s1 sparel. parts llrc prol ;ct intends to intensrfy advocacy at all levels of Government to adequately pronrpt tlre rele rse of counterpart funds wrth tlre counterpart funds and the assistance we hope to receive from the NGD9 partner lltc' nta ntenance and replacement of equrpment would be easily addressed. , 19 I it I t I T il I h Nl I fl tttt lf, tf {f tr tr Descrrbe llrt' ,rrk:t1t:acy of availablc kttowlt:clgealllet ntappotvL.t at alllcyels Tlrt:rr.) rs :clequate ancj knowledgeable nranpo,//cr at all levels o, ctlTl tt't'tplt:tttcttta lon At the cotntttunrty level nrajorrty of the CDDs are sclrool leavers and as sttc;h, MIS Forms are fatrly completed. The only hrndrance to their oerf or lna nci,, is non-contpensatiorr The Prolcct selddrnly experience transfer of staff. Advisory visits to avert problems werc rnade to few LGAs where such problem came up. However, staff changes wett'Cffcct'rcj ttt few places where CDI-l actrvrtres were becornrng unstable as a rcsult of lacx of cornmitrlents on their part ? 20 2.7. Treatments 2.7 .1 - Treatment f igur". LGA TOTAL POPULATION ELIG. POPULATION PERSONS TREATED 63,845 60,867 60,1 93 46,145 DRUGS USED Adavi Total Alaokuta Total 151,409 44,871 88,415 Ankpa Total 95,880 83,016 l 77,001 232.832 Bassa Total 90,543 81 615 80,797 239,790 Dekrna Total to*1-- 106.293 96 952 92,932 292 556 70,817 64,046 64,039 185,393 ldah fo--- 53,317 50,014 50,002 150.144 ig ila m e la, Od " t, f1.'ta f / o,JZO 70 673 -- ,0595 ___'_ 207,113 iu'lru Totai -- 60,994 56.295 56,002 160,325 KabbaiBunu Total 64,603 57,985 57,597 143.885 Kogi Total 42.933 41.374 40,046 116,279 Lokoja Total 39,1 56 36,1 70 35,589 115,287 Mopamuro Total 23,776 22.266 22,136 78,241 Ofu Total 100.895 88 309 85,671 260 363 Ooori Maoonoo Total 30 260 27 801 25 705 87 829 C.e"r tctaf 49 942 46 786 46 629 139 172 21 t''' .ll--!Il-rn*rl-tl .r n_Grrr$]dr##{? 44,732 65,018 l I 91,148 i 60,68s l I 60,884 177,147 , 248 809 'Olamabcro Total Omala Total 83,087 l 81 608 r 3e,333 j 38,932 i 125,230 i Yagba East Total 36,216, 35,647 99,472 Yagba West Total 25,585 I 24,382 , 23,843 , 83.1 68 Grand-Total 1,284,419 1,173,239 1 ,1 50,599 3,392,969 22 -.-ilfiC-., -I- J{ rltl ""r .L. CI Okene Total Table 8i Treatment and SAEs by districUlGA in alhareas at risk (please add more rows if necessary) DrstnctJLGA - Communitiesfr'rttage J __--, Popuf ?tion --ToGt#of--A.r'urt,-\@;"..rt ffi Number of Number of a bsentees SAEs' Number of Number of i communiti j Treatment , communitie I al/coverage , es/villages Objective ; s/villages I l%l Annual , Nunrber of I Geographic treated I I I I population of the rnes uiirypEr -endemic areas : Treatment Objective Number of persons treated Therapeutrc Persons coverage who(%) refused the treatnrent 310 202 serious aCverse events (SAEs) referred to the health posuhospital rn theI meso/hype r-endemic Adavr 58 58 50 i 100 I 63,845 I 50 100 46,14s , 44,971 i 60.1e3 I Ajaokuta 50 50 "44.732I Ankpa 214 214 214 100 I gs,88o 83,016 | 77 001 80 2 7q6 3,460 Bassa 156 156 Dekrna 242 242 Z+Z 100 90 543 81 615 t,80 797 89 2,) , ,978 100 106,293 96 952 92 932 87 514 3 100 lbali lo-ar., 172 172 100 70,817 64,046 64 039172 90 78 ';a 78 100 53.317 50,014 I 50 002 94 12 l*ra;;Eb - io - --1io -- 1to 100 78,326 70.673 70 595 90 5129 ljumu tll 111 102 92 r 60,994 56,002 I 56,002 I I 092 149 Kabba/Bunu 1 56 156 156 I 64,603 57,985 | 57.597 92100 89 ,197 Kogi '1 19 119 119 100 i 42 933 41 374 I 40.064 I 93 i0 I Lokola 91 19 91 9191 100 i sqo Mopamuro 19 100 23.77 5 22 268 22.136 93 105 27 Ofu Ol.ene \il = 211 a0 a? 100 100 1a: 19 ' --ri 5ij ;C 100 89 Lir u rci Lg 9i2 5 88 309 c0 o85 ,:;ai *_ tv.J 85 671 6C 88i ";^';;; 85 Y4 -93 ott 2A .,-; 1a_, 958 ;[lu a 23 r r I rI tr r r ! f f r r- - IrrF--{ -{ 39, I 56 36,170 i 35 589 2',: i et -4, a^ 2, ;35 35 i =?:: ^ - ^^^ -A:)JJZ- oy 323:r 333 3C 2aa 43 4r112A J9 12b rJ'-r i tJ'j/)nr:i: 120 Olamabcro 188 188 Yaoba L:ast 52 52 Yagb; .'icst 1B 188 100 91 , 148 83 087 81 608 90 I.ZV' "24 414 2052 100 41 203 36 218 36.218 87 1B18 100 25 58s 24,382 24 382 93 505 2403 2403 2394 99 6% 1284375 1172594 1151708 90 3% 9.275 10567 F_c_rr ir r-r I a for com putinq'thera peutrc and qeoq ra p h ical coveraqes Therapeutic coverage rate ()'tr) Geographical coverage raie ('ir) ATO co,",eraqe rate'* ( ,'c) \ % UTG achieved"" 1 151708 1,284369 2394 2403 1 151198 1172554 1151708 1 172554 x896%= 895% x 100 = 99 6% x 100 = 98 20h x 100 = 98% 24 +I I I I I II*+I. ] f F - !t'- n- --T--* i ATO = the esaimated number of persons living in meso/hyper-endemic areas that a CDTI project intends to treat with lvermectin in a given year. UTG = The maximum number of people to be treated in meso/hyper-endemic areas within the project area, ultimately to be reached when the projeca has reached full geographical coverage (normally the project should be expected to reach the UTG at the end of the g'd year of the project). '- The AiO and UTG for the year rs 989'c of the total populatron in the meso/hyper-endemrc communities. 25 ? 7.? I lr,, lrrlltr /il1(l iltc the lrkcly C.lUs;es c.rf Ollsentr:ersrrr ' nl l)orsorls whether restdettt or not rn the some communities were r(rrJlstered Arrd dirrrng drstrrbutton these people are counted as berpg it[-isetrt. This is the situatron in those LGAs with higlr rrurrrber of absentees. - [.)t ;trtllttttot-t often dorre at pcak of farn.rrrrg season when rnost people stay i6r tlr rr l;r:rrrs ' t I"v) ltirttotl to other towtrs partrcularly for trading and casl'r crop farrling. ^ Il e CDDs distribute at their own leisure espeoally as most of them are not - cc npensated 2'7'3' Brrcfly clescribed all known and verifred serious adverse events (SAEs) and provrde rrr l;rlrlr: 0 thr-' required rnformatron when avairable 2.7.4. llr r;;rsr-. t,tc plcasc trc k prolect has ,no case -"j3'"g:q[] adverse event (SAE) during thrs repor.trng period, **** lr=-1 r___l 26 Table 9: ;Cases of serious adverse events (SAEs) that occurred during the reporting period (Please add more rows if necessary) S/N. , Age l I Sex I Village of origin Symptoms I Health , statusi before I tarins , Date o admrssion in health facility appeared rut tdt iluntDer of the patient T^=': ,,'.'es ^c se .,c-s adverse aaaai ':corler iu-rng the repc l,- j ::- : l 27 was I tests (thickI bloodjs-e3.; Outcome of prognosis gor complicati ng circumstan involveme nt or not health facility il.S. Trend of treatment achievement fromCDTt project inception to the current year Tabf e 10: Treatments and.coverage bv calendar year for the entire project area. (Please fill in the required data) Communities/Villages TotalYEAR Total # of communli' es/villages in the meso/hyp e(- endemic areas Annual Treatment Objective Number of communiti es/villages treated Geographi cal covera9e (%) ::- Annual Treatment Objective Population Number of persons treated Therapeut ic coverage (%) -_= ATO coverage (%) - UTG coverage (%)poPulatronof the meso/hYp er- endemic areas ^.''^I JvO 926 826 \ 926 100% 100 fasizz-zoo poo -- 2n,ssl ; 85v" 85% 97% lset 1926 i926 1926 ,,1000k ltto 2;76 2176-- 1noy" 100 Tao,eol 064,000 ,622,671 ' 820/o I 66-/o 86oio 884/o 84% 86%2000 2001, 2403 2La3 2387 --1 2403 100% 1.00 1 ,22,110 . 1 ,0C0 000 , 1 ,051 .125 j 88 2% 88.2% 2002 l2oo3 - 2403 %C, 2403 2403 2394 i 100% I 100 7,263.200. 1.ooo.ooo I 1,iol,187 i 88 2% ), 88.2% 98o/o1 J8a375 172,554 I 1 151708 2004 --;'; -- I I I i 87o/o : 98% I i8e6% I I CDTI look of rn onlY 5 LGAs rn 1998. in 1999 rt was extended to '13 LGAs ln 20oc the whole 21 LGAs came on board trll present date 29 ) I I 1 :irrrrr 2.8. Strpcrr,ision 2.8.1 l')rrpurVrrton hterarclry flow chart I t___ NOCP ZONAL -\ I ,l I L -;)?- SSI ) .,/' __*z tsocrs I I _L TRADITIONAL RULERS 2.8.2. Tlre rna n issues identified during supervision were:- Poor record keeping (only eligible pbrsons registered in some places) Lerck of counterpart fund at all levels V(-)ry potr CDD incentives. Few Re3ister not kept with the comnrunity head but with cDDs. Corrlpla nt of mild reactions such as swelling of lirnbs, rtching and skin rashes which rrake S(rrle unwilling to take ilre drug. lnacleqL:ate supervision and rnonitoring by Locrs due to lack of logistics. [Jnclcrtrt,:atment due to poor censLls update. I lrqlr rat: of absenteeism and refusals rn sorne communities. lJrr>ken down motorcycles in sonre LGAs. Delay in collation of treatinent figures dure to non-compensation of cDDs. LocTs J I l-.----- COMMUNITIES 30' -, 283 284 a Was srrp-' -.rvisron checklrst used? Ycs The otrtcrrr,es at each rever of cDTr irnprementatron supervised. ldertrfrcd cornmunities with poor records were corrected and cDDs update srrch records. Advocacl carried out to solicit support for the cDDs in terms of community conlrrltrrlr rrr lowatrds provrdrng rncentrves for the CDDs. Loc Is cl rected to carry out mop up treatment in areas of low/under treatment of the populrtion and cDDs were also directed to re-visit all house-holds that were not met at home dttttttq lhi lr first visit to erlsure that the rate of absentees was reduced drastically. Most cot}rnunities would need revalidation of census as some figure are incorrect ancl resullrrrg to high treatment percentage. 2 B 5 wir:; ftrcc -back given to:"the supervrsed, and lrow was the feedback ursed in rrltr;rovrrrg the overall perforrlsnce of the project. Feed'back wils Erven to the supervtsed and this has herped in the coverage as reflected rntlre total lropttlal otr treated wlren co*rpared to the treatnrent coverage of the previousyear' cottt:r;tron of identified poor records and advocacy to the LGA authorities soliciting for funds sttpllorl for easy movement of Locrs to the communities, Early distribution of Mectrzarr llr:forc lhe rainy season comntence nrarrdated to 31 SECTION 3: Suppor r to CDTI 3.1. Financial colrrributions of the partners and communities Table 11: l:ttrattctitl contributions by all partners for tlre last three years _C_o_ntributor Ministry of Healtlr ---- - Local NGDO(s) (if trtGOO Partner(s, oiiiricvIcn bttrers ;i- b) _.-._.- c) communitres nnOC n-rust nuncf TOTAL Year 3 (Jan Total Budgeted (us$) 10,000.00 22,592 67 21 ,000 00 (MOl-t) arry) ,- Dec. zoOol ITotal I ,lreleased 1us$) 5,000 00 22,592 67 18,000 00 Budgeted I released(us$) | russl I 30,000 00 | ro,ooo oo I I 48,s56 30 | +e,sso so 21 000 00" I r r.ooo oo sa,zs-o-!0 58,730.00 lo1tei,et--I L L I I I I 11232r-.67 lf there are prolrlcttts ,vith release of counterpart funds, how are they addressed? The governlltt:ttt tt:k:;rsed cbunterpart funds irr year 2000,2001 and 2oo2along side with salaries and enrolLrrne nts of CDTI staff. Also, there was al spr l-over of ApOC was as a result of late release of funds funds to tlre preceeding year (ZOOZ - 2003). This from APOC management. I I 32 3.2. Othcr forrli ; of community support The r;orr rn'rL,,lty In-kind support inclride:_ ' Prayots fot all the participants'who have nrade it possible for comnrunity to benefit from the laulable program. Provrs;rotr of snackslfood in sotre cases during community mobilization 3.3. Expcnc.liture per activity - lndic;rtr:'tlrc expenditure on activities below in US dollars using the current United Nations exclrange rate to local currenoy. Table 12: lrrclic rte how much the project spent for each activity listed below during the rc.porting period. Activity Dru[ oerivery fror, NorF He area to central collection of contmuntty Mooitrziiiorr :rrrct trr:alil.r eouCaiion or iomrnuniiiei fralning ol CDs _--.-..-lrarn,ng ol lrc;rlllr :.taff at all levesl Supervising CDDs and distribution lnternal rr.ronrtorrng of CDTI activities AcJvocacy vrsrts to tealth anO potilical authorities iEC materrats NOTE: Expenditure (y_s_g)_ point The attttltlrrt spent on vistts to some LGAs by some members of SOCTs cannot be quatlttItc'cl ar, tlrese was done through personal efforts through personal funds. However, tl e State Government approved the sum of 5 milliorr as counterpart fr-rncl;Jor C )Tl actrvities in 2004. lt is hoped that this approval will have cash backrnr; for r rlooth running of CDTI activities. 33 il * *'\ t I I I I I I I I I I I I I I I I J II I Sunrnrary (rcllorlr tr;) forrns for trea[ment Vch icles/Motor t :yr. lc.s/Bicycles tna i ntena nce Office Eqtrrprrrcrrt e g computers, printers etc) Others rbiAa lotal numtrer o The state has tlacle budgetary provision for cDTl in the next financial year apart from the salaries errolrrrrre ,ts of cDTl personnel and office maintenance. APoc has gtvetr approval of their assistance on some targeted activities for the next 3 years. SECTION 4: Sus ainability of CDTI 4.1. lntcrnar; ir,dependent participatory monitoring; Evaruation 4 1'1 Was Motttt,rtttg/evaltration carried out durrng the reportrng period? (tick where applrcablc.; yr:.rr 1 partrcipator/ lndependent nronitorirrg. Mrtl Term Sustainability Evalua\ion. 1r year Sustainability Evaluation. Irrt,:r'rral Monitorrng by NOTF otl'c'r Evaluation by ottrer partners (s|GHT SAVERS INTERNATIONAL) No No No Ncr No 4 1.2 a Sorlc of tlr,: recommendations Aclvor;acy 'or the sustenance of the cDTl at State, LGA and community levels woLtlcl l)c tt'-'cessary to solicit for political will and release of counterpart funds. The cDDs shor-rld be re-trained on tlre inrportance of accurate community census. A,rl llrcrr slr.rlls rerating to the condr-rct arrd updating of community census 34 Irersons treated I' Ilr'rl l() )ls shotrlcJ pay regular sLrpervisory vrsrts to CDDs especrally during cr.lrrrltrr:r of corlrnunity census ancj drug clrstrrbutron ' ' Yotttlr ttt -ltlcltocerctasis endemrc comnrunities shoulcl be involved rn cDTl activtties atrd r:hitt 1ed with responsibilitres of disseminating simple information about CDTI to thcrr 1tr:e s and families. o'[r;rrr]rrr(l rf pupil teachers on CDTI to help in the supervision of CDDs ' '-l-tilllllllq lf sonre community rnentbers in selected project areas on community self nrorrrtorrrg CSM/SHM. ' Advocac'/ visits to some Chatrmen of LGAs by DPHC/Coordinator to solicit and srrpport f rr the payment of counterpart fund by the state government. NOTE: Supervtsoly vls ts were made to communities by the LocTs. However, these were still inadequate bec,ruse of lack of enough logistic support from the LGAs 2. cornnrurrityself-monitoringandstakeholdersMeeting Table 1 3 t Drslrrr l/l ( ,A roral Total # of iomnruprlres/ vrllages rn the errtrre ptolecl area (,trtrttttttttity self-rnonitorirrg and Stakeholders Meeting (p/ease add more rtt vs if rrecessary) No ol conrntuntttes thal carrred out self ntonrlorrng (csM) I lte two communities that we tried to implement CSM, could not effect the programrne due to some internal communal clashes. We intend to intensify effortp to get sore conrmunities into csM/sHM.implementation in year 2004. No of Lommunriies rnat conducted stakeholders nreetirrg (SHM)_ 35 4.3. Srrstairrability of projects: plan and set targets wlr.rI Lri'rangenreats have been rnade to sLrsta, (marrdatory at Yr 3) CDTI after APOC funding ceases I I rn tctrl; of? 4.3.1. [)lirrrrlr g at all relevant levels 4.3.2. I trrrrls [-'tlsttrtt g that government makes budgetary provrsion for CDTi at all levels and also release such approved funds. 4 3.3. lrirrrsl; t11 (replacerxent and maintenance). Govert rnent plans to rnairrtain sonre project equipment througlr counterpart fundsiif releasi d. 4.3.4. C)llrer r esources. 4 3 5 [)lease provide a written plan with set targets and achievements for so far. 4.3.6 To wlta-t extent has the plan been implemented. 36 4.4. lntcgration Otttline tltt't'xte'lcl of rrrtegratiorr of CDTI rnto tlre PHC structurre and the plans for Complete rrrtcc;ral ron 4.4.1. lverrrrectrr delivery mechanisms. The t OC i-s/DHS are PHC staff in their various LGAs. They are the people resllottstble for collectirrg Mectizan from the State. However during collection of vaccllres from the State Cold chain store NPI Managers have also assisted the LOCTs rrr lhe collection of Mectizan tn some LGAs. 4.4.2. Trarrrrrrg Pritlrary Healtlr Care facility workers wdre trained as part of integration strategy. 4.4.3. Jor,t sr-rpervision and monitoring with other programs A lorrrt rn;nitoring team with other PHC progranrs has been deliberated. The prollosecl team when inaugurated would be empowered to monitor all aspects of health car: delivery system. 4.4.4. Relca:;o ol funds Ptopo:;;tls'tl'tettto for tttonitoring are ntade but approval of funds are not effected, 4.4.5. ls (lt) I I rn;luded in the pHC budget? Yt::, 4 4 6. otlrt:r lroa tlr prograrnrnes ilrat are using ilre CDTI structure are ' V-iLurtrrr A supplementation program in 14 of the 21 CDTI LGAs in the State. A tratlrlttc;-of-tratners workshop on Vitamrn A supplernentation was organized for the SOC'Is Subsequently, the SOCTs trarned the LOCTs who trained ilre CDDs to distrrbrrte lhe supplements. 4.4.7 Otlrcrs rssues considered in the integration of CDTI include pooling of resources viz malr'r, tttarerial and money together to get things done especially in face oJ diff rcLrlties 37 4.5. Opcrati:natresearclr 4'5 1' stttllart;e in not niore tltan otte half of a page the operatronal research undertaken in ilre pr:r,;ect area within the reporting period. There we.i r)o ()pcratrorar research co.ducted during the reporting perrod. 4.5.2. l-low wc o the results applied in the pro.lect? SECTION 5: Strengths, weaknesses and challenges STRENGTHS - well ,robrrr; ed and highry interested communities. - MqsLCDDs clespite their demands for incentives still distribute Mectizan(R). - Adequartr:ly staffed health facilities in the communities. - Avarlal-,rlrty ,1f prolect vehicres (rnotor verrrcre arrd nrotor cycres). - Avarlerbrtrry rrl skrlled cDTl manpower (Socrs & Locrs). WEAKNESS - lnadeclttatc '."upport for project plans by government at State and LGA level. - Lack oI llro isron of incentives for CDDs - lnadeclttrrto i6g15{ic support for LoCTs which affect supervision and monitoring. CHALLENGES - To erlstrt('r ottttrtunity comntitment to providing incentives to cDDs, visit to some co.mmunrttes was inevitable. - To get glovernment involved in the release of approved fund through visiis to the commrttee c,n budgetary allocation was made. - To erlstlrc: 1 rovtsion of incerrtivgs for cDDs, few visits were rnade to advocate with the Commtlrrrty ,-:ads - Persottal ftirds was comnritted to sponsor some LOCTs for collection of treatment reports ;r:; ,rost cDDs lack nrotrvatron for ilre work. - cost o{ r;.rrrrrLrrication to parlners were made with personar funds. 38