Westem Equatoria CDTI annual project technical report submitted to Technical Consultative Committee (TCC): January 2011 to December 2011

I $ .t + i"-"-'-----"-'- "- -'-!i wBSTERN EeUATSRIA 61alEa) CDTI PRSJECT ilt Ii whoweqproiect(@gmail.com i tlttI - --..-..-.,-..-..-..-.-..-.JL-,-..-..-.--.--.-..G ANNUAL PROJECT TECHNICAL REPORT SUBMITTED TO TECHNICAL CONSULTATTYE COMMITTEE (TCC) DEADLINE FOR SUBMISSION: To APOC Management by 31 Januarv for March TCC meeting To APOC Management by 31 Julv for September TCC meeting AFRICAII PROGRAMME FOR -*€q-:-*Por Ai#on rorftx, -.'f*iaolan 'o \inCEV, I [-Seb^\4 i i I I I @,v oNcHocERcrASrs coNTRoL (APOC) ORIGINAL: Enelish COITNTRY/NOTF: Republic of South Sudan Proiect Name: Westem Equatoria CDTI PROJECT Approval vear:2003 Launching vear: Dec 2004 : January 2010...To: ...December 2010.. Month/Year) G4qq!UfED-- APoCfundinevear: (circleone) I 2l + S (6) 7 8 9 l0 ll 12 13 APocProiectimplementationyearreport:(circleone) t Z f + S(6) Z S q tO tt tZ tg Date submitted: 29' July 20l l @erg: - Ministry of Health - African Programme for Onchocerciasis Control (APOC) - Mectizan Donation Program (MDP) - Christoffel Blinden Mission - 904 communities I RECU LE 2 I lUlL. zott Ip-oc / DIR I ANNU A L I'RO.I ECT TE,CHNICAL RE I'ORT 1'() I'l:C I,l NlCAl, CON SI.J l-'l'n'll VL, COMM I'l'l'lil ) (.I'CC) ENDORSEME,]\T Please confirm you have read this report by signing in the appropriate space. ()I.'FICERS to sign the rePort: ('ounl.rr . Sor"rthcrn Sudan National Coolclitrator: I)r l,urcia Willianr KLrr //) SignatLrrc: l$/k: l)ate: 2,\...iJulf i2ol I Zonal Oncho Coorttinator: I)avid Jacob []ido I)atc:, .#.).rr,r' t20 | t NGDO l{r:prosentativc: Fasil Chanc I'lris rcport \\ias prcparcd b;': I)avicl Jacob Ilitltr Dcs i gnatiot.t : I)ro.i cct C oord i n ati ng O1'li ccr wEq. I ( a I)al.c: . r-tr-Tt,\rl,r ,'lo I I Table of contents ACROI\IYMS DEFINITIONS.......... FOLLOW UP ON TCC RECOMMENDATIONS EXECUTIYE SUMMARY SECTION 1 : BACKGROIIND IIYFORMATION....... -...... l.l. GpNpnel INFoRMAnoN ......."""""" 4 1.1.1 Destiption of the project (brie/ly).. """"""" 4 1.2. PopuLATIoN .....""""""7 SECTION 2: IMPLEMENTATION OF CDTI 2.1. TINaei.rNs oF ACTIvITIES .............. .'............"""" 9 2.2. Aovocecv ..'....""""' 10 2.3. MoslllzerloN, SENSITIZATTON AND ITEALTH EDUCATION OF AT RISK COMMLINITIES 11 2.4. Covrutnurv INvoLvEMENT................ ....""""" 12 2.5. Capectrv BUILDING ...."'.....'..""" 13 2.6. TRsammxrs................. ....'..""""' 15 2.6.1. Treatmentfigures............. """""""""""' 15 2.6.2 What are the ciuses of absenteeism? '.......... """"""""" /8 2.6.3 What are the reasonsfor refusals?...'...'...'.-... """""""" /8 2.6.4 Briefly describe all lonwn ond verified serious adverse events (SAEI that -..'... 18 2.6.5. Trend of treatment achievementfrom CDTI project inception to the current year 20 2.7. ORoeRrNG, sroRAGE AND DELIvERY oF IVERMECTIN """"'21 2.8- CovuUNtrY SELF-MONIToRINc AND SterpsOLpERS MEETING ............... ...............22 2.9. SuppRvlstoN................ .............""23 2.g.1. Provide aflow chart of supervisionhierarclry. """"" 23 2.g.2. What were the main issues identified during supervision? """""' 2j 2.g.3. Was a supervision checklist used? """"" 24 2.g.4. What were the outcomes at each level of CDTI implementation supervision? 24 2.g.5. Wasfeedback given to the person or groups supervised? """"""' 24 2.9.6. How was the feedback used to improve the overall performance of the project? 24 SECTION 3: SUPPORT TO CDTI EqurtvmNr ............."'24 FTNANCIAL CONTRIBUTIONS OF THE PARTNERS AND COMMUNITIES............... ............25 OrHgn FoRMS oF coMMUNITY suPPoRT................ .-...........29 ExppNpnuRr PER ACTIvITY ................ ............29 SECTION 4: SUSTAINABILITY OF CDTI 4.1. INreRNel; INDEPENDENT PARTICIPATORY MONITORING; Eval-UerION .............'. .....29 4.1.1 Has the project ever been evaluated/monitored? Qick any of the following which are applicable) ............ 4.1.2. What were the recommendations? """"" 29 4.1.3. How have they been implemented? ........--.... .'."""""' 29 YI 3 4 3.1. 3.2. J.J. 3.4. 24 29 llt 4.2. SUSTATNABILITY oF PRoJECTS: PLAN A].ID SET TARGETS (MANDATORY AT...... ..........29 Yn3)......... """"""'29 4.2.1. Planning at all relevant levels...-. """""" 30 4.2.2. Funds.......' """"" 30 4.2.3 Translnrt (replacement and maintenance) """"""""""' i0 4.2.4. Otier resources.. """""""""' 30 4.2.5. To what extent has the plan been implemented""""" """""""""" 30 4.3. INTEGRATIoN............... """""""""' 30 4.3.1. Ivermectin delivery mechanisms """"""' j0 4.i.2. Training.... 4.3.3. Joint supervision and monitoringwith other programs..... 4.3.4. Release offundsfor project activities 4.3.5. Is CDTI included in the PHC budget? """""""' 4.3.6. Describe other health programmes that ore using the CDTI structure and how this was achieved. What have bien ihe achievements? """"""" """""""""' 30 4.3.7. Describe others issues considered in the integration of CDTI- 4.4. OprnarIoNAL RESEARCH """""""""" 34 4.4.1 . Summarize in not more than one half of a page the operational research undertaken in the project area within the reporting period' """' i4 4.4.2. How wire ihe results applied in the proiect? """"""' """""""""" 34 SECTION 5: STRENGTHS, WEAKNESSES, CHALLENGES, AND oPPORTUNrrIES.... """""""""34 SECTION 6: UNIQUE FEATURES OF THE PROJECT/OTIIER MATTERS """""' 34 iv .v I Acronyms APOCAfricanProgrammeforonchocerciasisControl ATO Annual Treatment Objective ATrO Annual Training Objective ; CBO Community-Based Organization CDD Community-Directed Distributorj CDTI community-Directed Treatment with Ivermectin ' CSM CommunitY Self-Monitoring LGA Local Govemment Area MOH Ministry of Health NGDO Non-GovernmentalDevelopmentOrganization NGO Non-Governmental Organization NOTF National Onchocerciasis Task Force PHC Primary health care REM0RapidEpidemiologicalMappingofonchocerciasis SAE Severe adverse event SHM Stakeholders meeting TCC Technical Consultative Committee (APOC scientific advisory group) TOT Trainer of trainers UNICEF United Nations Children's Fund UTG Ultimate Treatment Goal WHO World Health Organization Definitions (i)TotalpoBulation:thetotalpopulationlivinginmeso/hyper.endemic .o*-iltiililthin the project area 1Uas"a on REMO and census taking)' (iD Eligible population: calculated as 84%o of the total population in meso/hyper- endimic communities in the project area' (iiDAnnualTreatmentobjective:(ATo):theestimatednumberofpersonslivingin ."rofrffiild.*[ *ur tfrut a cpu project intends to treat with ivermectin in a given Year. (iv) Ultimate Treatment Goal (UTG\; calculated as the maximum number of people to u"ffiper endemic areas within the project area, urti*atuf, io Ue .*"h"J when'the project has reached full geographic .or"rug. (normally the project should be eipected to reach the UTG at the end of the 3'd Year of the Project)' (v) Therapeutic coverage:.number of people treated in a given year over the total poprtilOt lthitthit thould be expressed as a percentage)' (vi) Geographical coverage: number of communities treated in a given year over thetotalnumberof-",o/hyper.endemiccommunitiesasidentifiedbyREMo in the project area (this shoufd be expressed as a percentage). (vii)Integration:deliveringadditionathealthinterventions(i.e.vitaminA ,upfr--*ts, albendaz-ole for LF, screening for cataract, etc') through CDTI (usingthesamesystems,training,supervisionandpersonnel)inorderto maximise cost-effectiveness and empower communities to solve more of their rr"urin f-uronr. This does not inciude activities or interventions carried out by community distributors outside of CDTI' (viii) Sustainabilitv: CDTI activities in an area are sustainable when they continue to frn"tionffitively for the foreseeable future, with high treatment coverage' integrated into the avSilable healthcare service, with strong community own-ership, using resources mobilised by the community and the government' (ix) The process by which the community is "-p"*.*d t" o,",,*-nd-n1onitor the performance of CDTI (or any "o--unity-based health intervention programme), with.a view to ensuring that il;a;#;j;i;s ;xecuted in tile way'intended. rt encourages the "o--ui'ity to take full" responsibility of ivermectin distribution and make appropriate modifications when necessary' vi FOLLOW UP ON TGG REGOMMENDATIONS Using the table below, fill in the recommendations of the last TCC on the project and describe how they have been addressed. TCC session 32 Number of Recommen dation in the Report TCC RECOMMENDATIONS ACTIONS TAKEN BY TIIE PROJECT FOR TCC/APOC MGT USE ONLY Report related (i) The section on suPervision (2.9) is copied and Pasted from the East Bahr El Ghazal report or vice versa- This is not acceptable Noted and advice taken positively. (ii) Financial data for 2008 and 2007 of exactly the same which is unlikelY. Please confirm if this is the case and ifnot, provide accurate data Correction made to this information. (iii) Report on independent participatory monitoring under section 4.1 and not under section 6 Noted and followed uP as advised. (iv) The report must be endorsed before submission to APOC This has been done. Proiect related o Implement TCC29 recommendation to conduct census This has not yet been implemented, but currentlY work is going on with the NGDO partner to en-'sure that the census is conducted in the near future. (ii) SSOTF to approach and interest other NGDOs to join in and support onchocerciasis activities SomeNGOs have been approached that are interested in doing advocacY and communication work for NTDs in general. This is still work in progress and details will be shared at a later ooportuniW. (iii) Increase the number of health staffinvolved in CDTI and follow uP on the plan to involve school teachers, youth grouPs, women groups The number of health staff involved in CDTI work was increased from 178 in 2009 to 203 in 2010. The Plan to involve school teachers, Youth srouDs. women groups in CDTI activities is also work in This has been done with the Director General for Health for Western Equatoria state, and preliminary information received is that the Project coordinating officer will be employed. Most (6 out of 10) of the OV CountY SuPervisors are now employed bY the Follow up the decision to absorb the project coordinator and other CDTI staff into govt emPloYment A total of 2,296 CDDs were available for CDTI work in 2010 as compared to 1,363 CDDs in 2009; bringing down the CDD/population ratio to 1:305 in 2010 as comPared to 1:506 in 2009. CDD/Population ratio is still high. Train more CDDs and seek creative ways to address the problem of CDD attrition Investigate and address the issue of high refusals Whereas the willingness to implement the recommendations is unquestionable, the rePort of the independent ParticiPatory monitoring has never been received. Report on the recommendations of the independent particiPatory monitoring and report on progress on imPlementing the recommendations (vii) This was done in MaY/June 20tlSustainability Evaluation (viii) { I , Executive Summary This is report covers the activities implemented by Western Equatoria CDTI project from January 2010 to December 2010. The population at risk in 2010 in Western Equatoria CDTI project was 699'760 across l0 "o*ti"r. The project had an ATO of 516,80i people and a UTG of 587,798 in this reporting p;ti"d A totai of3f O out of 904 villages teated; ieaching out to a population of 512,941 ihereby achieving geographic and theiapeutic coverage of 92%o and73%o resPectively' Population displacement was relatively lesser as compared to what it was in 2009; since the LRA rebel activities have been contained by the South Sudan security apParatus- With the relatively improved security situation, more people received treatment; 512,941 in 2010 as "orp*.a to +67,264 in 2009; a9.7 o/oincrease inthe number of people treated' In 2010, a total of 995 new cDDs were freshly trained as comPared to 784 new CDDs in 2009; and were newly trained and 432 received refresher training. A total of 20! staffs from the FLHF staffs were trained in data collection, drug distribution, health education and management of severe and minor side effects of mectizan' During this reporting period, a total of 2,296 CDDs were available for CDTI work as "o-pi"d to t,fOg 6OOr in 2009; bringing down the CDD/population ratio to 1:305 as compared to l:506 in 2009. The cDD/population ratio still falls short of the recommended; however the project will continue working closely with the partners to continuously work to increase the numbers of CDDs for the subsequent mass treatment cycles' The project continued to face a number of challenges, the major ones included: o Lack of counterpart funding to augment what is provided for by APOC and the NGDO partner. In some instances some project activities could not take place due to inadequate funds. o Insecurity still existed though it was not as bad as it was in the previous years' The general security situation has impr&ed and there is a sense of normalcy returning to the community. o CDDs still request for incentives despite having been-told at the time of selection that they are expected to work as volunteerr. Th.t. is a general ne_gative perception that is attached to volunteer work and this leads to high attrit'ion rate of CDDs in the project. SECTION {: Background information t1.1. General information 1.1.1 Description of the project (briefly) Geographical location, topography, climate WesLrnEquatoria CDTI p'roj-ectis [ocated between latitude 4.0'N - 6.5"N and longitude Z6oE - 3loE in the south *"i.* region of South Sudan. The project office is,located in yambio town in Western Equatoria state. The state borders to the North with Lakes, Warrap and Unity states, to the East with Central and Eastern Equatoria states. The southern and western iarts ofthe project area share international boundaries with Cenffal African Republic (CAR) und D".o"ratic Republic of Congo @RC) respectively' River Nile traverses the Equatoria region dividing it into Eastern and Western Equatoria' The topography of the state is plut"uu, and the projectarea transects two hydro-topographical zones of the Nile and Conlo watershed that ii characterized by fast-flowing rivers of Yei, yale, Bahr-N aam,Era,Miridi, Lesi, Sue, Yubu/Ringasi/ Ibba, Biki, Mbungu and Duma' All the rivers drain northeast to the Jur and east to Bahr el Jebel, which form a confluence at the White Nile. It is because of climatic and topographic conditions that the disease prevalence rates are high, as the black fly thrives in suitr an environment. The vegetation of the project area is mainty savannah with woodlands and then rain forests to the southem parts' Population: activities, cultures, language The majority of the inhabitants of Western Equatoria were settled agriculturalists and they practicJ subiistence farming; current settlement patterns have been impacted by prolonged conflict. In this community]tn" poputation gets dispersed into seasonal farmsteads whereby temporary settl"m"nts ".op'up in u..ur that -are intensely cultivated. There are vast expanses of grusslund that are occasionalfy competed for with pastoralists from neighbouring communities/states leading to popuiation displacement. The languages spokel by the people of Western Equatoria u.e EaUnOu,Zande,Moru, Baka, and Morukodo. The Zande is the most populous ethnic grouP. Communication systems (roads...) The roads are still not good and the project area can be accessed through North-western Ulanda and Central E{uatoria state. There are also scheduled UNWFP flights between Yambio, the state capital and Juba, capital of the Republic of South Sudan. A network of roads to all counties exists, though their maintenance is irregular and may be difficult to use during the wet times of the Year. Mobile phone communication exists in the area with the presence of Gemtel, Sudani and Zain companies. Intemet communication can also be accessed through the WHO office in Yambio town. Administrative structure The Administrative structure of the Westem Equatoria project is according to the govemment of South Sudan structures. The state forms the highest level of administration followed by the counties, payams and bomas. The states are administered through Governors, counties by County Commissioners, and payams by Payam Administrators, and Bomas by Boma councils' In 2010, the project ur"u *ur-"d.inistired over the l0 counties of Ezo, Tambura, Yambio, Ibba, Mvolo, M*idi, Mundri West, Mundri East, Nagero and Nzara' Health systems and health care delivery rt " gorr*ent primary health care systim is the main health care service delivery and there are ciallenges of staffrn! and medical supplies an9.qIlpt nt. There are a total of 156 pHCUs,36 pHCCs andi rural hospitals namely Yambio, Lui, Tambura, Nzara and Maridi hospitals. Number of health staff in project area and number of health staff involved in CDTI activities. There were a total of 868 health staffs across all health facilities in the project area in 2010' zol lzl.+ur) were involved in GDTI activities. This is an improvement from the 2009 figure that was 20.5% involvement of health staff. Table 1: Number of health staffinvolved in CDTI LGA - County -Number of health staffinvolved in CDTI activities. Total Number of health staff in the entire project area Br Number of health staff involved in CDTI B, Percentage Br:Bzl Br *100 Ezo 66 18 27.3Yo Maridi 118 l0 85% Ibba 57 15 26.3% Mundri West 101 16 ts.8% Mundri East 94 45 47.9o/o Mvolo 52 t3 25.0% Tambura 65 3l 47.7% Nagero 63 t6 25.4Yo Yambio 129 2l 16.3% Nzara 123 l8 14.6% Total 868 203 23.4Yo 1.1.2. PartnershiP Indicate the partners involved in project implementation at all levels In Western Eiuatoria CDTI project, the partneis involved are the health services providers at the state ministry of health, .ourty health department and primary health care centres and units;904 communities; CBM - NGDO and WHO/APOC' Describe overall working relationship among partners, clearly indicating specific areas of project activities The working relationship among partners is good. Befole the training were conducted, joint planning *u, don" with the partnlrs i.e. NGDO, SSOTF and APOC and the outcomes later were trinslated to other leveis and the communities where mobilization and distribution of mectizan were carried out by communities through their CDDs. The project in conjunction with NGDO/SSOTF carried out advocacy with a view to atfract government and community ,uppo.t. The project has maintained a strong partnership with the affected communities' State plans, if any, to mobilize the state/region/district/LcA decision-makers, NGDOs' NGOs, CBOs, to assist in CDTI implementation' Duringthe reporting period, the project mobilized the state and county officials to bring CDTI to the attention of all'partners involved in CDTI. The communities leaders are were charged with the responsibility of overseeing social mobilization at Boma, village level' - ApOC/SSOTF/CBM;rovided refrJsher training of project coordinating officerthat was then cascaded to the ,ounty and payam supervisors and finally to the CDDs. The staffs at the frontline health faciliiies ensuied thaimobilization of community members took place' 6 1.2. Population ;ry: Communities and population rt risk in the entire project area whether they are treated or not during the reporting period ruchedJult geograpn" *r"-g" (*ii$-* i6""f i*ta u upected to reih rhe UN i'rhe ewt of the ld yr oJttu pryect). Was a census for the projettdone during the rcporting period? No- If No, what is the source of the data in the table above? * Source: Annual projection ofpopulation growth subjected to the 2004 REMO population figures. CDD register books- other source, speciry: - Yea:2004 - CIrTI Districtd LGAr in thc cntirc Toasl populrtio! i! thc utirc Numbq of coomuniticCvilhga ir PopulatioB of MBHdCMiC anc itr ahc projcct rrcr A, EypGrerdmic arc ir ahe projctt trca A, Told iD 66oy'hypcr- cndemic anc A, - A,+ A, M6EtrdeDic zonc in thc projcl rrct HypF cndoic zonc i! thc projcct arca Totd in medhype cndemic zonc tratmctrl Goal /Irrct Ezo 42,3s5 95 95 42,155 42,355 35.578 Maridi 65.933 63 63 65.933 65.933 55,384 Ibba 34.83 I 45 45 34.83 I 34,83 I 29.258 Mun&i West 92,708 95 95 92,708 92.708 77.t75 Mundri East 97.987 90 90 97.987 97.987 82,309 Mvolo 179,139 220 220 179.t39 t79,lt9 150.477 Tambura 6t,s36 45 45 68.s36 68,536 57 -570 Nagero 16,375 29 29 t6-375 16,375 3-755 Yambio 81.480 132 132 8l,4E0 81.4E0 6t,441 Nzara 20,4t6 90 90 20.416 20,416 t7.149 TOTAL 699,160 293 611 904 291,459 408301 699:760 5E7.79t i"ct orea, allimleb, to be reachedwhen the Prujec, If you rre using the term community or village, define whit constitutes the community or village'. A village in the southern suaan conte*t is defin"ei as a given geographic area that is.under the jurisdiction of a.given. local executive chief rhe boundaries of every such *rlr-*ity are defned by the chief;Je; of local authorities. In thii such community' it is common to find that the people speak a common language, have similar culturav.oli"t t uaiii#r like marriage, funeral rituals and usually make communal decisions about the general welfare of their corn unity. The number of communities cited in this reports are as per these society norms. Is there any other information of interest about the population in the project area? If so, include it here' None' SEGTION 2: tmPlementation of GDTI 2.1. Timeline of activlties Teble 3: Timeline of activities for the areas treated in the current year Comment None LGA - County Mobilization of communities Training CensuVUpdate Drue distribution Supervision Strrting month Complction month Sterting month Completion mnnlh Starting month Completion month Strrting month Completion month Strrting month Conplction month Ezo March May June August July August September December March December Maridi March May June August July August September December March December Ibba March May June August July August September December March December Mundri West March May June August July August September December March December Mundri East March May June August July August September December March December Mvolo March May June August July August September December March December Tambura March May June August July August September December March December Nagero March May June August July August September December March December Yambio March May June August July August September December March December Nzara March May June August July August September December March December 2.2. Advocacy Number of Poticy/decision makers mobilized ir,"-proj."t cooriinatin! officer mobilized four (4) senior health officials at state level; these were the State Minister if Health, State Director deneral for Health, the Director for Primary Health care and the Director General for Administration. At the county level, seven (7) Courty Medical Officers, four (4) County Administrators and 674 Community Leaders were sensitized in the Project area. The reason to undertake advocacY The reasons for undertaking the advocacy included to: o Get the State authorities to be involved in the CDTI activities . Trying to get support for the CDTI activities just like any other community based program would do. . f.y a bring discussion of the integration of CDTI activities onto the agenda of the State MinistrY of Health SYstem' Outcome of the advocacY The state council ofMinisters expressed willingness to support the OV program and ensure the implementation of absorption of the CDTI project staffs into the government primary health care system The constraint exPerienced . Although the state officials expressed willingness to support the CDTI activities, they could not nr-fy mention a timeframe in which specific actions that required input would occur. E.g. the inclusion of staffto payrolls' Suggestion on how to improve advocacy Soiri of the suggestions to include advocacy include: . Having a team of project beneficiaries/or persons with a life experience with OV being part olthe uJro"u.y i.urr, ,o that a strong.t -ettuge be sent out to the decision makers. o Involving people that are already champions of the project work so that they can convey in" -"ssuge that we have for the decision makers. . Making use of already existing community based organizations in the project area to particif,ate in the communiry mobilization and sensitization' . inrnolving influential persons like school teachers, church leaders and other community leaders in the advocacy campaigns' . Increase the relaying of information about OV on the FM radio stations' o Have a systemati" plun in collaboration with the MoH to adopt co-implementation of activities to motivate cDDs through funds other programs like polio campaigns and bed net distributions. o production of IEC materials and composition of songs about OV in local languages' 10 Mobilization, sensitization and health education of at risk communitles The use of media and/or other local systems to disseminate information There is one FM radio station that was used to disseminate information to the community within its area of coverage. Mobile phones were also used where available. There was also use of the traditional word oimouth; whereby information was passed on from one person to another through the system of community leaders and local chiefs. Mobilization and health education of communities in including women and minorities Mobilization and health education of the community was done at the community meetings. The health education sessions at the health facilities tended to target the women since they are usually the majority of care takers at these facilities' Response of target communities/villages Theie were geneially positive resPonses from the community: . Community members that had physical signs of the OV disease were very willing to volunteer to distribute mectizan. . Communities positively acknowledged the additional health effects like expulsion of intestinal worTns and this increased the willingness to take the drug. o Communities understood their roles and responsibilities in CDTI Accomplishment Some accomplishments were realized that could be attributed to this sensitization: o Improved therapeutic coverage. . . Generally the cDTI strategy is accepted in the community. o Communities have spoke out on the changes that they are beginning to see in regards to the physical OV manifestations that they had 1l 2.4. Gommunityr involvement E!g-4,: Communities participation in the CDTI Comment on: Attendance of female members of the community at health education meetings The attendance of female members in health education meetings is still low but is gradually growing in good number. During the scheduling of health education in communities, at the Fnccru and at community gatherings female cDDs actively participate. In general, how do you rate the participation of female members of the community meetings when CDTI issues are being discusses The attJndance and participation of female members in CDTI issues is still low. However the few that attend usually take lead in decision making at the CDTI meetings. Incentives provided by communities for the CDDs No provision of incentives by the community to CDDs. Attrition of CDDs. Is attrition a problem for the project? If yes, how is it addressed? Yes attrition is big problem for the project. The project tries as-much as possibfu to convey the message on the CDTI philosophy to the .orn.uiity members so that the CDDs begin their work knowing that it is purely on voluntary basis. Other issues There is health education on OV that goes on both the primary and secondary schools in the project area. LGA - Countv Number of communities/villages with community members as suPervisors Number of CDDs and the communities involved Number of communities y'villages with female CDDs Total no. communities in the entire project area B. Number with communitSr members as supervisors B< Percentage Br BJ B, *1OO Male CDDs B, Female CDDs B" Total B.= B,+B* Number of communities with female CDDs Bro Percentage Blr= B'JB,*100 Ezo 95 52 s4.7% r88 15 203 l5 ts.8% Maridi 63 44 69.8% 343 22 365 22 34.9o/o Ibba 45 29 64.4Yo 92 l0 102 10 22.2% Mundri West 95 7l 74.7% 154 l9 t't3 19 20.0% Mundri East 90 62 68.9% 195 ll 206 11 12.2% Mvolo 220 98 44.5% 447 5 452 5 23% Tambura 45 26 57.8% t07 l8 125 l8 40.0% Nagero 29 l3 44.8% 98 6 104 6 20.7% Yambio 132 85 64.4% 318 30 348 30 22.7% Nzara 90 62 68.9% 202 l6 218 l6 17.8Yo Total 904 542 60.0o/" 2144 152 2,296 152 16.8"h l2 2.5. GaPacitYl building Describe the adequacy of available knowledgeablemanpower at all levels' There is generally * iirpror"ment in the adequacy of knowledgeable manPoyerjt the county and state level of the prij""t. The challenge is mtre at the community levels' The project is also involving schoof teichers, youth grouPs, women Br]{Rs and religious leaders in the CDTI trainings. Moie support frlm epbC'and the SSOTF to improve the capacity of the project staffis alwaYs welcome. Where frequent transfers of trained staff occur, state what the project is doing, or intends to do, to remedy the situation' The project did not "*p"ii"n"" frequent transfers of trained staffduring the course of this reporting period. l3 I&5: Training at the different levels of CDTI implementation Number of Districts/LGAs staff treined Number of Health center/oost stalf trained Number of other treiners of trainees ( TOTs) Number of CDDs trained ATil) a. ,Ref i Tohl icr ATrO Reh c, Tot l Ca c.+ G ATrO C. R"Ir i Totrli c,rCr 1 6"+ Crrc,. ATTO 4.. Nu i R"l, CrF c.+ c* Ezo J 0 2 2 27 l5 3 l8 0 0 0 0 5',10 68 33 l0l Maridi 3 0 3 3 46 7 3 l0 0 0 0 0 378 169 72 241 Ibba 3 2 0 2 9 9 6 l5 0 0 0 0 43s 62 25 87 Mundri West 3 ) I J 40 l0 6 l6 0 0 0 0 570 72 30 t02 Mundri East 3 a I 3 ll 40 5 45 0 0 0 0 351 150 50 200 Mvolo 3 0 3 J 7 6 0 0 0 0 -320 143 40 183 Tambura J 0 t 3 23 26 5 3l 0 0 0 0 22 75 45 120 Nagero 3 2 0 7 t2 l2 4 l6 0 0 0 0 385 53 3l 84 Yambio J 0 t 3 44 l5 6 2l 0 0 0 0 792 150 75 ,r< Nzara 3 2 0 2 9 ll 7 l8 0 0i0 0 477 53 3l E4 TOTAL 30 10 l5 26 252 1s2 i 51 203 0 0 0 0 5.503 995 432 lrL 9/o Achievement | 86.6Y. 7o Achievement 805% 7o Achievement i OOyo oz Achievement i 25,9Yo 7684-ude the corretpondtng totol onl!' Make sut' thot there B t4 Corrntv/LGA 1t l3 Table 5: Type of training undertaken Trainees Type of training CDDs Other Community members e.g Community suoervisors Ilealth Workers (frontline health facilities) MOH staff or Other Political Leaders Others (specify) Progtam manaqement How to conduct Health education Management ofSAEs CSM SHM Data collection Data analysis Report writine Others (soecifu) Any other comments - None 2.6. Treatments 2.6.1. Treatment figures If the project is not achieving 100o/o geographical coverage and a minimum of 650/o therapeutic coverage or the coverage rate is fluctuating, state the reasons and the plans being made to remedy this. The project has reached 92o/o geographical coverage andT3Yo therapeutic coverage. Some of the reasons for not achieving 100% geographic coverage include: . Inadequate inputs (funds) for the expected outputs. The project primarily relies only on APOC funding. . Insecurity in some parts of the project area . High CDD attrition . Inadequate community mobilisation in some communities- Plans to remedy this are: . Considering lobbying for funding from other sources like NGOs, o Continued sensitization of the community members about the CDTI philosophy. . Ensuring that adequate community mobilisation for involvement in CDTI activities. l5 2.6.2 What are the causes of absenteeism The causes of absenteeism included: r Treatment commenced in the rainy season and most people had their priority put on preparing their fields for cultivation' .Somehadtravelledoutoftheirhomesandhopedlknewthattheycouldstillgettheir medication on refurn' 2.6.3 What are the reasons for refusals? There were no clear reasons given ror r"ru*t, r"* mentioned that they had no symptoms of disease and saw no reason for taking the med'ication and some others mentioned that they were worried of the side effects that could arise from taking the medication' 2.6 Briefly describe all known and verified serious adverse events (sAEs) that occurred o"iirg tn" reportint period and provide (in table 8) the required information when available' There were no cases of serious adverse events reported to the CDTI staff during this reported during the Period Parasitologist trained? None has been trained Existence of microscope? None is available Has the project reported all sAEs to Mectizan Donation Program (MDPX Please tick ;;;. N"i.ppticaUte since SAEs have not been reported' XNo In case the project did not have any cases of serious adverse events (sAE) during this i"po.ting pe.ioO, please tick in the-box' None was reported No SAE case to rePort l8 tr Elc_!: cases of serious adverse events (sAEs) that occurred during the reporting period - Not applicable since there were no SAEs reported' sNr Age Sq Village of dtSrn Datc Mctia w taken lrde I Symptoms Hcdth statN beforc taking Mcctra Datr of DatG of dismisal from hedth faailie R6ults of lcsts Outcmc of Progn6B Ext@ubng q @mphBttnS circlrctanc6 involrcrcni symptoro appeared hcalth frcrltty or not 0 NA NA NA NA NA NA NA NA NA NA NA NA NA l9 2.6.5. Trend of treatment achievement from CDTI project inception to the current ycar Bu!g2: Treatments and coverage bY calendar vear for the entire project arer Please indicate the UTG for thc project area: 587,798 (for 2010) YEAR Communitieflillages Population Toul # of comunrtres/villag * rn the rcscy'hyper- cndemrc uec a. Amual Trcat nent ObJcctrve B Nmbsof communttie s/ullagc treatcd F. G@glaphr cal coverage ('/"t EF E./E.rtm ATO cowmSc vt EF Total populatron of the mesdhyper- endemic uo E, Amul Treatrnent Objectrve E- Nubsof pcmns treated n- Thqapeuhc coveEge ('/'') EF ATO cove6ge vn ErF U1G Coverage vt 2005 410 185 t92 46.8o/o 103.8% 425.751 205,542 22J.t63 52.4% 108.6% !8.5o/o 2006 410 245 290 ?0.70/o 18.4% 434,691 205.s42 247.6s3 57.0% 120.5o/o 42.8% 2007 410 310 325 79.2o/o 105.8% 425.752 276,gst 280.725 65.9% l0l.lo/o 65.9% 2008 683 600 540 79.1% 90.0o/o 506,847 361.889 303,E29 59.9o/o E4.0% 59.9% 2009 903 841 880 9?.5% lO4.60/o 689.419 491,833 467.264 67.8% 95.0o/o 67.8o/o 20r0 904 904 836 92.4% 92.4o/o 699,760 s16.803 s12,941 7l.3Yo 99.2% 87.3Yo 20 2.7. Ordering, storage and delivery of ivermectin Mectizan@ ordered/aPPlied for bY ,n,, E *rn F **"" D Mectizan@ delivered by - Qtlease tick the appropriate answer) NGDO D wHo speciff): tr & tr please describe how Mectizan@ is ordered and how it gets to the communities After the annual treatment cycle, the Project Coordinating Officer receives information from the community about mectizan usage, wastage and remaining stock. This information is then sent over to the SSOTF. The SSOTF compiles this information and uses it to prepare an order for submission to MDP. MDp reviews application, approves and forwards the recommendation to MERCK. MERCK then ships the mectizan to South Sudan and it is received by WHO country office. In conformity with the data that had earlier been received from the Project Coordinating Offircr, corresponding amounts of mectizan is supplied from the SSOTF to the project. At projeci level, each county supervisor collects the mectizan from the project office and tfrll notifies all Payam Supirvisors of the mectizan availability for collection. The payam Supervisors on collection notiff and invite Boma Supervisors to collect supplies for their corresponding communities. ft " go-u Supervisors, some of who are CDDS share this information with other CDDs and the communities. The community members then decide on the time for the mectizan distribution to the rest of the community members. "*--trOther (please a a a a Tabte 10: Mectizan@ Inventoty I,f,r-U". of Mectizane tablets Countv /LGA In stock from nrevious Year Requested Received Used Lost Wasted Expired Remai ninp Ezo 0 93,689 93,689 93.591 98 0 0 0 Maridi 0 142.890 142.890 142,766 124 0 0 0 Ibba 0 80,000 80,000 79.916 84 0 0 0 Mundri West 0 222.500 222,500 222.500 0 0 0 0 Mundri East 0 199.318 199,318 199,154 164 0 0 0 Mvolo 2,538 396,256 396,256 389,468 0 0 0 9,326 Tambura 0 147.323 147,323 147,256 67 0 0 0 Nagero 0 40,500 40,500 40,500 0 0 0 0 2l How are the remaining ivermectin tablets collected and where are they kept? Whenever there are balances of ivermectin tablets, the CDDs are charged with the responsibility of submitting them to the health facility staff so that they are stored in preparation ior the next treatment cycle. The amounts of stock of medicines that remain are communicated to the Project Coordinating Officer that in turn communicates this to the SSOTF secretariat. List and briefly describe the activities under ivermectin delivery that are being carried out by health care personnel in the project area. The activities that aie carried out by the health care personnel include: o Training for both new and old CDDs within the communities before the mectizan distribution. . Issuing the CDDs with mectizan tablets and collecting the remaining balance from them for inventory and storage at the health centre at the end of distribution cycle. . Conducting community mobilization and health education on OV program' . Facilitating the process of selection of CDDs by the community. o Management of any person with minor or severe adverse side effects reactions and keep records. Any other comments None 2-8,- GommuniBr self-montlqring aIC Stakeholders Meeting Has any training (of trainers) for community self-monitoring been done in the project area? . No If so, When? N/A Table 11: community self-monitoring and stakeholders Meeting County - LGA Total # of communities/villages in the entire Project area No of Communities that carried out self monitorins (CSfr{) No of Communities that conducted stakeholders meetins (SHM) Ezo 95 0 0 Maridi 63 0 0 Ibba 45 0 0 Mundri West 95 0 0 Mundri East 90 0 0 Mvolo 220 0 0 22 0 I 176.394 176.289 105 0 0 0 0 49.000 49.000 48,925 75 0 0 0 I z,s!q 1.547.870 1,547,870 1.540.365 717 0 0 9326 o Describe how the results of the community self- monitoring and stakeholders meetings have affected project implementation or how they would be utilized during the next treatment cycle. N/A 2.9. Supervision 2,g.1. Provide a flow chart of supervision hierarchy' SSOTF Secretariat staff Reporting Project Coordinating Officer at State level County OV SuPervisors Payam SuPervisors CDDs Communities Su 2.g.2. what were the main issues identified during supervision? The main issues found during supervision were that: o supervision checklists were not being used universally. . Record keeping; CDDs filling in the treatment registers and summary forms is still Problematic. 23 Tambura 45 0 0 Nagero 29 0 0 Yambio r32 0 0 Nzara 90 0 0 Total 904 0 0 I t i il 2.9.3. Was a supervision checklist used? Yes, Supervision check-list was used. 2.g.4. Whatwere the outcomes at each level of CDTI implementation suPen'ision? On-job coaching and mentoring was given to the County OV Supervisors.that were found to have not been doing supervision of their counties. They were also shown how the data collection sheets should have been filled and it was emphasized that this needs ' to be cascaded to the Payam or Boma Supervisors' 2.g.5. was feedback given to the person or groups supervised? ' Yes feedback was given 2.9.6. How was the feedback used to improve the overall performance of the project? o On the job training was given to the staff supervised on how to update the household information, fill the summary forms and tally sheets. o practical sessions were given to poorly performing individuals and those performing relatively better were also encouraged to coach their colleagues. SEGTION 3: SuPPort to GDTI 3.{. Equipment Table 12: Status of equiPment Source Type of equipment APOC MOH DISTRICT/LG A NGDO Others No Condition No. Condition No. Condition No. Condition No. Condition 1. Vehicle I F 0 NA 0 NA 0 NA 0 NA 2. Motor cycle(s) 5 F 0 NA 0 NA 0 NA 0 NA 3. Computer(s) 2 F 0 NA 0 NA 0 NA 0 NA 4. Printer(s) I F 0 NA 0 NA 0 NA 0 NA 5. Photocopier (s) 1 F 0 NA 0 NA 0 NA 0 NA 6. Fax Machine(s) 0 NA 0 NA 0 NA 0 NA 0 NA 7. Others a) Laptop I F 0 NA 0 NA 0 NA 0 NA b) c) ; le, WO:Written off)' How does the project intend to maintain and replace existing equipment and other materials? If integration of the CDTI activities into the government PHC was to take place as desired, the state MoH would ideally maintain and replace the existing equipment through the counterpart contribution to the Project' 24 ll L ll !- L 3.2. Financial contributions of the partners and communities If there are problems with release of counterpart funds, how were they addressed? The project is noireceiving any government counterpart funding for direct implementation of CDTI activities. Additional comments - None 25 Table l3a: Financial contributions by all partners for the last three years Table l3b: Financial contributions by all partners for the last three years (continued) Table 13c: Financial contributions by all partners for the last three years (continued) Two (2) vear orevious to Calendar YI G6VERNMENT ontrlbutlon I IAR belng reported 200t OT}IER Panners' dlsbuBcmont Budgeted Amounb dbbutled at tho follolvlng lovtls % dlsbuEsd NGDOs LocalNGDos Communl tloa OtherE APOCTrus-t Fund BUDGET LINE onal Reolonal Dlstrlct Total . Mobittzatlon, adyocacy, sensi hellon et 14,e=b-4t9492-- -o.oo 0.00 0.00 0.00 N/A 1,250.00 0.00 0.00 0.00 5,250.0C l.l. MoDnEarpn o"oo obn 0.00 0.00 0.00 -I.UA 0.00 0.uu 0.00 0.00 0.00 b.tio -b.o'o 0.00 odd i,.dd 0.00 - oo0 oJo N/A 0.00 0.00 0.00 0.00 4. Health education 0.00 0.00 --*-b5o N/A 0.00 0.00 0.fl) 0.00 0.00 Sub-tota,, 0.00 0.00 0.00 N/A 1,250.00 0.00 0.00 0.(x, 5,250.00 tl. Tnlntno b.oo o.do ' d.od -'o.b-it 0.00 2.1. TraininE/retmining of CDDS 0.00 0.00 N/A 5,375.00 0.00 0.00 r r,025.00 2-2. Tminino/retrainino of Health workors Sub-total ll 0.00 o.d-o 0.00 0.00 0.00 N/' 0.00 0.00 0.0c 0.00 0.00 0.00 0.00 - oloo N/A 5,375.00 0.00 0.00 0.00 11,025.00 lll. Su!,e,vision, monitorlng, EvatuatlgL o.00 o.(ru 0.00 0.00 0.00 N/A 0.00 0.00 0.00 0.00 0.00 5.r. uupgMsroq 0.00 - -.- - -o.do --'o.do o.m - d."ii 0.00 o.00 0.00 N/A 0.00 0.00 0.00 0.00 0.00 3.3. Evaluation 0.00 0.00 0.00 N/A 0.00 0.00 0.00 0.00 0.00 Sub-tohl Itl 6:60 0.00 0.00 0.00 N'I 0.00 0.00 0.00 0.00 Mnffi;AEtrlbuaon and managemilt ^, ceverh dvetse avanls ii i,o -' o:"do - -' '-' o-.bit 000 o.ttii ' "o.oit 4. 1. lvemectin distribution 0.00 0.00 0.00 N/A 3,375.00 0.00 0.00 4.2. Manaqement of S€vere adverso svelts 0.00 0.00 999 N/A 0.00 0.00 0.00 Sub-totat N 0.00 0.00 0.00 N'A 3,375.00 0.00 0.00 0.00 13.080.00 v. Additionat expenses 5,008.80 0.m 0.m 5,m8.80 5.008.E0 100% 0.@ 0.00 0.00 0.00 22,8(x).00 32"0m.6 52. EquiprEnt 0.00 0.00 0.00 0.00 0.00 N/l 0.m 0.00 0.00 0.00 5,008.80 0.00 0.00 5,008.80 s.008.80 100./. 0.00 0.00 0.00 0.00 54,E00.00 GRAND TOTAL 5,008.E0 0.00 0.00 5,008.80 s.008.80 100y1 10,000.00 0.00 0.00 0.00 84,155.00 0-0( 0.00 o.ot 0.00 0.00 5 t Sderl6 ttLtotel V 28 3.3. Other forms of communityr support Describe (indicate forms of in-kind contributions of communities if any) . Communities provide food items to CDDS during distribution period. o Communities assist by picking Mectizan from Boma to CDDs in the village' . They offer cooks, *"i", carieis during trainings and also offered venues for ffaining' 3.4. Expenditure Per activitYl - Indicate in table 13, the amount expended during the reporting period for each activity listed. Write the amount expended in US dollars using the current United Nations exchange rate to local currency. Indicate exchange rate used here-2.8 SDPs- - Any comments or explanations? None SEGTTON 4: SustainabilitY of GDTI 4.1. lnternal; independent participatory monitoringl Evaluation Has the project ever been evaluated/ monitored? (Tick any of the following which are apPlicable) Year I Participatory Independent monitoring Mid Term Sustainability Evaluation 5 year SustainabilitY Evaluation Internal Monitoring bY NOTF Other Evaluation by other partners 4.1.2. What were the recommendations? Not applicable 4.1.3. How have they been implemented? Not applicable 4,2. Sustainability of proiects: plan and set targets (mandatory at Yr 3) Was the project evaluated during the reporting period? -No Was a sustainability plan written?-No When was the sustainability plan submitted?-No What arrangements have been made to sustain CDTI after APOC funding ceases in terms of: 29 4.2.1. Planning at all relevant levels - No plans made yet 4.2.2. Funds - No Plans made Yet 4.2.3 Transport (replacement and maintenance) - No plans made yet 4.2.4. Other resources - No plans made yet 4.2.5. To what extent has the plan been implemented -Not yet applicable 4.3, lntegration Outline the extent of integration of CDTI into the PHC structure and the plans for complete integration: 4,9.1. Ivermectin delivery mechanisms The Ivermectin delivery mechanism used now is that: . wHo delivers the mectizan to the state ministry of health o The state ministry of health is then responsible for releasing the mectizan to the County Health Department stores in the Counties . It from the County Health Departments that they will later be dispatched to frontline health facilities in the PaYams. . Most payams in the project area have health facilities, so there were no instances of having the mectizan kept outside the health facility' 4.3.2. Training: In regards to tiain"ing there is willingness of other programs to cooperate- These include EPI (Expanded progrurn"on Immunization) and GW (Guinea Worm Eradication program)' The finai implemeniation needs to be finally planned and executed. 4.3.3.Jointsupervisionandmonitoringwithotherprograms Not much progress has been noticed here' 4.3.4. Release of funds for project activities There were no funds released from the PHC system' 4.3.5. Is CDTI included in the PHC budget? Not yet. 4.3.6. Describe other health programmes that are using the GDTI structure and how thiswasachieved.Whathavebeentheachievements? There is no Health programme using CDTI structure' . Fill tables 14 and 15 and provide describe other programmes that are using the GDTI structure and how this was achieved. what have been the achievements? o For each intervention listed in table 15, explain what were the roles played by the CDDs (census, mobilization, distribution, data collection, storage, collection of drugs, referal of SAEs, etc "')? 30 Explain what are the combinations of interventions co-implemented? There is no clear set out arrangement for co-implementation yet' How were the inter.ventions implemented? (at the same time?) The interventions are not implemented at the same time. The different programs utilise the same Persons in the community to implement the Programs. 4.3.7. Describe others issues considered in the integration of GDTI. This is not yet applicable in this project' 3l 4.4. Operational research 4.4.1. Summarize in not more than one half of a page the operational research undertaken in the project area within the ieporting period. None has been done' 4.4.2. How were the results applied in the project? Not applicable' SEGTION 5: Strengths, weaknesses, challengesr and opportunities Strengths: o Has a committed CDTI staff. . The State government acknowledges and appreciates the work being done in the OV program uid hu. promised to support CDTI activities at all levels. . The project is well facilitated in terms of transport with a functional car and motorcycles for the implementation of CDTI activities' . The communities are generally supportive of GDTI work. Weaknesses: . Minimal/no financial contribution from CDTI partners' . CDTI is not integrated into the existing government PHC services' o Inadequate supervisory - probably due to lack of the required skills' . Timeline of activities does not foster a situation of maximum output of results e'g' distribution of mectizan usually coincides with the peak of the rainy season and this leads to poor coverage. Challenges: . The available population figures cannot be continued to be used since they are based on projections and not actual recent figures; a complete community census is required' . Despite there being a generally imfroved security situation, lingering fears still exist of sporadic s,.rrprise u:ttuJtr of thl rebel forces now operational in the neighboring countries' o Counterpart'funding from the government is not yet forth coming; this raises questions of sustainability. AdvJcacy work-with the state ministry of health will be continued to ensure that this haPPens in future. . Community ownership/participation is yet to reach a fairly desirable level. More advocacies to be done at community level so that the CDTI philosophy is embraced fully' Opportunities: ^ -. The goodwill gesture shown by the state authorities should be built on to pursue the integration agenda further. o EpI and guinea worrn eradication programs are being implemented in the project area and there is an opportunity of collaboration in management of these projects' SEGTION 6: Unique features of the proiect/other matters None. 34 Page I of2 Kabore, Mme Rose Ouedraogo - aPoc De: Envoy6: A: Cc: Objet: Jai Tewani fftewani@satguruun.com] lundi 15 ao0t 2011 11:37 sawadogo, Mr S6bastien - apoc; rajeshrajeshkumar@hotmail.com; 'RAJESH CHOUDHARY' Aholou , Mr. Yaovi - apoc; Kabore, Mme Rose Ouedraogo - apoc; Toure, Mr lbrahim - apoc; llboudo, Mr Sambo Etienne - apoc RE: R6servations de vol pour les r6unions de septembre2011 Bonjour -- RLR --- xp / ouezezl 0D/ouA2 6210D l.HOMEIDA/MAMOI,N PR 2 ET 4'7L Y OTSEP 3 KRTADD HK1 3 ET 927 Y OTSEP 3 ADDOUA HKI 4 ET 926 Y 17SEP 6 OUAADD HKl 5 ET 470 Y ].7SEP 6 ADDKRT HK1 6 AP OUA 226-5O30L652 - SATGURU SERVICE-OUAGA - A 7 TK OK15AUG/OUA25210D B RM *AIvIA27LO7LO - 752 4OO fcfa JM/su LSATJaLL/LL34z 8r,5TG4 o43o 0625 *1A/E* 2 loLo 1325 *lelE* l-135 2o4o *1A/E* L 2345 o14o+L *LA/E* TRAVEI,S AND TOURS -- RLR --- RP / OTJA262LOD / OUA262LOD l.HOMEIDA/MAMOUN PR 4 ET 47L K OSSEP 4 KRTADD HKl 5 ET 909 K OSSEP 4 ADDLFW HK]- 6 ET O3O K OSSEP 4 LFWOUA HK1 7 ET 926 I 17SEP 6 OUAADD HK1 8 ET 470 Y 17SEP 6 ADDKRT HKl 9 AP OUA 225-5030L652 - SATGURU SERVICE-OUAGA - A 1o rK orrseue/ouA262LoD 777 600fcfa JM/SU L'IIVGLL/1-1362 8L5TG4 o43o 0625 *l-A/E* 2 o95o 1235 *1A/E* l-4oo 1530 *1A/E* 1L35 2o4o *IA/E* L 2345 0L40+l- *'LA/E* TRAVELS AND TOT'RS From: Sawadogo, Mr S6bastien - apoc [mailto:iawuaogotOon.f,o.afro.who.int] Sent: Monday, August 15, 2011 8:43 AM To: rajeshrajeshkumar@hotmail.com; RATESH CHOUDHARY; Jai Tewani Cc: Aholou f t',tr. Yaovi I upo.; Kabore, Mme Rose Ouedraogo - apoc; Toure, Mr Ibrahim - apoc; Ilboudo, Mr Sambo Etienne - apoc subject: TR: R6servations de vol pour les r6unions de septembre 2011 Bonjour, Rappel Nous attendons ces reservations pour l'6tablissement des TRs. Je vous remercie pour votre prompte r6action. Sawadogo oms apoc De : Sawadogq Mr S6bastien - aPoc Envoy6 : mercredi 10 ao0t 2011 09:11 A : rajeshrajeshkumar@ hotmail.com;'RAIESH CHOU DHARY' l5/08/201l- Page 2 ot'z cc:KaborerMmeRoseouedraogo-apoc;Aholou,Mr.Yaovi-apoc;Toure,MrIbrahim-apoc;Ilboudo'Mr Sambo Etienne - aPocdi;fiil neseruauons de vol pour les r6unions de septembre 2011 Bonjour Monsieur Rajesh, Merci de bien vouroir faire des r6servations de vors pour res participants de ra r6union du groupe consultif du CSA et du TCC33. Ci-joint les 2 listes' Bonne journ6e et merci surtout pour votre bonne collaboration' Sawadogo oms aPoc ? t 15/08/2011