Blantyre annual project technical report submitted to Technical Consultative Committee (TCC): from 1st April 2005 to 31st March 2006

/ ' r|t. RESERVED FOR PROJECT LOGO/HEADING i ! I I I I I ! i I ORIGINAL: English COUNTRYAIOTF: I'r f;. rd r-r 1 Proiect Name: SLflNTY GE Approval year Launchinq year: REPORTING PERIOD: ', MARCH, 2006 (Month/Year) ( Month/Year) Proiectvearofthisreport: (circleone) I 2 3 4 5 6 7 8 9 10 Date submitted: NGDO partner: Vz rcc95 c€tl 8in csb(n? AHE 6ro t6 .^ -o$0-. I n qltu, ?frill A!, , nfl/{te.o tl,d^€^a I i II (ANNUAL PROJECT TECHNICAL REPORT SUBMITTED TO TECHNICAL CONSULTATIVE COMMITTEE (TCC) DEADLINE FO SUBMISSION: To APOC Management by 31 Januarv for March TCC meeting To APOC Management by 31 July for September TCC meeting AFRICANPROGRAMME FOR ONCHOCERCTASTS CONTROL (APOC) I ll I I I ANNUAL PROJECT TECHNICAL REPORT TO TECHNICAL CONSULTATIVE COMMITTEE (TCC) ENDORSEMENT Please confirm you have read this report by signing in the appropriate space. OFFICERS to sign the report: Country: District Health Officer Name: A.K. MHANGO Signature d Date: .r4*tJaT District Oncho Coordinator Name B.N.Z. KANKHUNI Signature Date: ..A7.1. t-ovlo/' National Coordinator Nu-s 2 ,l,\\('&- Signature Date e I I This report has been prepared by Name : B.N.Z. KANKHUNI Designation : DOC I Signature: Date ll 25th 2007 ) { I I I I I I I I I Table of contents ACRONYMS............... ...... ERROR! BOOKMARK NOT DEFINED DEFINITIONS.... ERROR! BOOKMARK NOT DEFINED FOLLOW UP ON TCC RECOMMENDATIONS DEFINED. ERROR! BOOKMARK NOT EXECUTIVE SUMMARY .............. ... ERROR! BOOKMARK NOT DEFINED. SECTION 1: BACKGROUND INFORMATIONERROR! BOOKMARK NOT DEFINED. l.l. GsNeRalrNFoRMATroN................ ...Ennon!BooxuaRxNorDEFrNED. 1.1.1 Description of the project (briefly) ..Eruor! Bookmark not delined. 1.1.2. Partnership .Eruor! Bookmark not defined. 1.2. PopularroN Ennon! Booruanx Nor DEFTNED. SECTION 2: IMPLEMENTATION OF CDTI... ERROR! BOOKMARK NOT DEFINED. 2.1. Truelrus oF ACTrvrrrES .............. ....Ennon! BooxueRx Nor DEFTNED. 2.2. AovocRcy ..Ennon! Booxuenx Nor DEFTNED.2.3. MostLtzanoN, SENSITIZATIoN AND HEALTH EDUCATToN oF AT RISK coMMUNrrrES Ennon! BooxnreRx Nor DEFTNED. 2.4. CouuuNrry rNVoLVEMENT............ .Ennon! Booruanx Nor DEFTNED.2.5. CapRcrry BUTLDTNG ......ERRoR! Booruanx Nor DEFTNED.2.6. TRrarueNrs................ .Ennon! BooxuaRx Nor DEFTNED. 2 6.1. Treatmentfiglres........... ................Error! Bookmark not deJined.2.6.2 What are the causes of absenteeism?.................Error! Bookmark not defined.2.6.3 What are the reasons for refusals? ....................Error! Bookmark not deJined.2.6.1 Briefly describe all known andverified serious adverse events (SAEs) that Error! Bookmark not deJined. 2.6.5. Trend of treatment achievement from CDTI project inception to the curuent year ................ Error! Bookmark not defined.2.7. ORopRINc, sroRAGE AND DELTvERy oF IVERMECTIN......... Ennon! BooruaRx Nor DEFINED. 2.8. CouuuNtrY sELF-MoNIToRING aNo SrnrcpHoLDERS MEETTNG Ennon! Booxuenx NOT DEFINED. 2.9. SuppRvrsroN............... ..Ennon! BooxuaRx Nor DEFTNED. 2.9. I . Provide a flow chart of supervision hierarclry. .. Error! Bookmark not deJined.2.9.2. Ll/hat were the main issues identified during supervision? .....Eruor! Bookmark not defined. 2.9.3. Was a supervision checklist used?......... . ......Error! Bookmark not de/ined. 2 9.1. What were the outcomes at each level of CDTI implementation supervision? Error! Bookmark not deJined. 2.9.5. I4tas feedback given to the person or groups supervised? Error! Bookmork not deJined. 2.9.6. How was the feedback used to improve the overall performance of the project'? Error! Bookmark not deJined. SECTION 3: SUPPoRT To CDTI .... ERROR! BOOKMARK NoT DEFINED. 3.1, EqurevoNr .Ennon! BooxnraRxNorDEFrNED. 3.2. FINauclel coNTRIBUTToNS oF THE, pARTNERS AND coMMUNITIES.................Ennon! BooxmeRx NoT DEFINED. 3.3. OrHpn FoRMS oF coMMUNITy suppoRT.............Ennon! BooxMARK Nor DEFTNED. lv 3.4. ExpENDtruRE pER AcTrvrry ............Ennon! BoorrrrARK Nor DEFINED. SECTION 4: SUSTAINABILITY OF CDTI........ ERROR! BOOKMARK NOT DEFINED. 4.1. lNreRtnr-; INDEpENDENT pARTrctpAToRy MoNrroRINc; EvALUATIoN....,.....Ennon! BooxnreRx Nor DEFINED. 4.1.1 Was Monitoring/evaluation carried out during the reporting period? (tick any of the following which are applicable) .,.,.. Error! Bookmark not deJined.4.1.2. What were the recomntendations? ...Error! Bookmark not defined. 1.1.3. How have they been implemented? ....................8rror! Bookmark not defined.4.2. SustarNaetllTy oF IRoJECTS: ILAN AND sET TARGETS (MANDAToRv AT ...... Ennon! BooxnaaRx Nor DEFTNED. Yn 3)......... .............EnRoR! BooKMARK Nor DEFTNED. 4.2.1. Planning at all relevant levels .........Error! Bookmark not defined. 4.2.2. Funds .........Error! Bookmark not defined.1.2.3 Transport (replacement and mointenance) ........Error! Bookmark not defined. 1.2.4. Other resources... ..........Error! Bookmark not defined, 4.2.5. To what extent has the plan been implemented..Error! Bookmark not deJined.4.3. INrscRerroN ............... .Ennon! Booxuanx Nor DEFTNED. 1.3.1. Ivermectin delivery mechanisnts ......Error! Bookmark not defined.4.3.2. Training .....Eruor! Bookmark not deJined. 4.3.3. Joint supervision and monitoring with other programs... Eruor! Bookmark not defined. 4.3.1. Release offunds for project activities ...... .. ..Error! Bookmark not de/inecl.4.3.5. Is CDTI included in the PHC budget? ....... ...Error! Bookmark not defined.4.3.6. Describe other health programmes that are using the CDTI structure and how this vtas achieved. llhat have been the achievements? .....Eruor! Bookmark not dejined. 4.3.7. Describe others issues considered in the integration of CDTL................. Error! Bookmark not defined. 4.4. opgnanoNAl RESEARCH.. ,.Ennon! BooxueRx Nor DEFTNED. 1.4. 1 . Summarize in not more than one half of a page the operational research undertaken in the project area within the reporting period............. Error! Bookmark not defined. 4.1.2. How were the results applied in the project? .....Error! Bookmark not delined. SECTION 5: STRENGTHS, WEAKNESSES, CHALLENGES, ANDOPPORTTINITIES....... ..... ERROR! BOOKMARK NOT DEFINED. SECTION 6: UNIQUE FEATURES OF THE PROJECT/OTHER MATTBRS.ERROR! BOOKMARK NOT DEFINED. Acronyms APOC ATO AtrO CBO CDD CDTI CSM LGA MOH NGDO NGO NOTF PHC REMO SAE SHM TCC TOT UNICEF UTG WHO African Programme for Onchocerciasis Control Annual Treatment Objective Annual Training Objective Community-Based Organization Community-Directed Distributor Community-Directed Treatment with Ivermectin Commun ity Self-Monitoring Local Government Area Ministry of Health Non-Governmental Deve lopment Organization Non-Governmental Organ ization National Onchocerciasis Task Force Primary health care Rapid Epidemiological Mapping of Onchocerciasis Severe adverse event Stakeholders meeting Technical Consultative Committee (APOC scientific advisory group) Trainer of trainers United Nations Children's Fund Ultimate Treatment Goal World Health Organization vl Definitions (i) Total population: the total population living in meso/hyper-endemic communities within the project area (based on REMO and census taking). (ii) Eligible population: calculated as 84%o of the total population in meso/hyper- endemic communities in the project area. (iii) Annual Treatment Objective: (ATO): the estimated number of persons living in meso/hyper-endemic areas that a CDTI project intends to treat with ivermectin in a given year. (iv) Ultimate Treatment Goal (UTG): calculated as the maximum number of people to be treated annually in meso/hyper endemic areas within the project area, ultimately to be reached when the project has reached full geographic coverage (normally the project should be expected to reach the UTG at the end of the 3'd year ofthe project). (v) Therapeutic coverage: number of people treated in a given year over the total population (this should be expressed as a percentage). (vi) Geographical coverage: number of communities treated in a given year over the total number of meso/hyper-endemic communities as identified by REMO in the project area (this should be expressed as a percentage). (vii) Integration: delivering additional health interventions (i.e. vitamin A supplements, albendazole for LF, screening for cataract, etc.) through CDTI (using the same systems, training, supervision and personnel) in order to maximise cost- effectiveness and empower communities to solve more of their health problems. This does not include activities or interventions carried out by community distributors outside of CDTI. (viii) Sustainability: CDTI activities in an area are sustainable when they continue to function effectively for the foreseeable future, with high treatment coverage, integrated into the available healthcare service, with strong community ownership, using resources mobilised by the community and the government. (ix) Community self-monitoring (CSM): The process by which the community is empowered to oversee and monitor the performance of CDTI (or any community- based health intervention programme), with a view to ensuring that the programme is being executed in the way intended. It encourages the community to take full responsibility of ivermectin distribution and make appropriate modifications when necessary. vll I oo ux $E PI s! lrf \ e!:qs S-(HE !?a.. U\ H o.rc* ! ,3Zc.Yq Egr^i- iEEtsg$;qr9!*-':bo-16€ = rx EEE o€ r=?.8U:U<6e35 -voPoJ AA@^>A= .-!PH!ui BOeeE 'E \J o.r i_ o_ O .! .E qpg ; R E EE .! an'E 5- a.r *g.E.F.8 e E E - lv o L9 e 0.)F55<s-AS 9bp,rHt (ggXB a h .9_a >Hg XxelJ 0).= L, =o \ PExs oUl{ c o ^o9-u) x.9 -: 3 'Ee5<t q)-.Lc) Uv^LF*Lo.= >,o -aea €HF6 ,tre^OcYP ZE [i -UV-F o-o tr o) rc) '-6)() >L= o)OL ,A b0 lJ Lc r) E -Lg)- ssobo 1i o o. on otr o= LL LaX P; €s\\\.s Er Sdst^, s )i.srgi (\ c.| o U) U)q) a) U Q - -.:C)a t/)() (€ 0.)q) -o c) (! 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H 'E r.: o .: C).: -7EE > .\rLqEUg O O- J YE3 - 5Eoob aE(tr6E'E pc)c6tr-lg L9 = ? -0)coLF.io €fr aoXL6'- Y 9?> R=, _5 UE > 6Z.Ic q Hi'-! r.Oo-Ld LtdEH; E r99U *(d _ la9a)!uqtrFo! '= 0-)- (d L7 ,bE3 ; o)irL;<L - - ! rw 6I Lv.-L-c! 6! c) .XO.d"Ov) * cJ,.1 ? - ^ .i.goe.= -.: f-- - '1, a 'adE vi- VU0)'- ^ )^ ! d A vFESo Z 6\J .=!!Ctl =o rrt m al ?a FTt(a N ra + il ,o(c -(,o .= aNt E.gE} EF 3€ $ F-F- aa t rrr- m o!! i'=! dEE.=;; >,8 o o * IrL^' -9Qtr € €6 ra o\ €a €^ ia o\ cq :t ktr.=1i?oUgsi \o GlN aN \o6tN aN I c) ON(r.= Gg F +_ il F-6l\o r- al\o .Y() ;o- 9E Ei!6 otr >a()rrE N ia ff) lo ra ah 4)b! = oqJ Ql ol rl ol!l EI 'EgE :e6 tr.=l:?a,Uo E'=8SE 2 N o\t N o\t cqES)o9: deX d 3 ().:E *c) 9' -VU-Lr^-^ t r-r- ff) $ t-r- t?) !ic)e) .=E q)L e'=tscEc5'; 1e -< I c! A-l F oL b. (6 m I t-t 3 \l () L C) 0.) -o o q (H C)L o 0) 'a () o o a.() o (t)() (.) (F o 63 L .o L C) o C)L(.) o 0)L C)o 'a L a. (.) o q) o o- (.) E (! aL() ! o. 0.) (r) F o oo Lo E E ao (.) a o a (.) (o (.) t- 0) ! C)bo o E o o C) oo a o o al) (n ,h oq) a () oL oa L() o I I I I I I I I -ol 3o(!A ()rr -o63rel ot I el El dlPIcgl a2 :()e() 0)-o(gLE? oroHE8 0)-za-.l .e3 ): o.c)Eo> d z (H .. B o' a_ $ \$ \ -a o\ U s! t:\ \a. *P ,Y \- =L\B ulu -s ;, %O' Gx su uPi': -{s Su gS a\i o.) 1x\.SE: b:9 O ira o !t ;!\ .E\! trUAd> o. ^- aiU u.Y c) a!i3 bo\Y C\-: .-9-:s =.ds :ss Y s:U -! =6i o\v o) xp I sp o-q, I o-)s: _cE$ : xLtY:5^:o'6 :Yo d -i: 6;\ (.) il; 6 rr-S ax3 siP f SEGTION 2: lmplementation of GDTI 2.1. Timeline of activities Fill in table 3, timeline of activities for areas treated in curuent year, indicating when the key activities were implemented by the month they began and the month they ended. l5 ah c) a EE U F- 6l a0-tr+ Ftr C!: c.t 0 6I EFEE U q ox ADEE a- Fa D(, \o <x o G F U) U) q) U o! trE U o.t 3 bnrE l|Jtr c!: a- c.l J a( t-r o.6 EFEE Q c-l ,.1 hn c-.1 .= .-!E 2, o.EEE U \o al J3 a0_ titr c: N Fl q,) U' F] F Fr \o cn C) E o(J I q a U aa I L \,)\ t aa s L o (.) LL o() C) C) a () (! o .o 0) o q- o c.) (.) E F ".i1o:l -ol FI 2.2. Advocacy The District Assembly through the Health and Environmental sub committee was oriented about the extending of CDTI activities to other parts of the district. Local leaders (Traditional Authorities and Group village headmen) were also briefed so that they should pass the message village headmen and communities. Letters were distributed to various churches and as of now the district is planning to orient other stakeholders, extension workers and CBOs based in the extension area. Although, the activities above were done financial (inadequate funds) and time limit were the main constraints the district faced. The district is trying to lobby other organizations for funding and plan for advocacy properly and in good time. 2.3. Mobilization, sensitization and health education of at risk communities The communities are mobilized using the local systems like meetings where health education talks are given. The use of posters is also done and during the distribution the television was used to disseminate the information. Communities responded differently according to beliefs and the way they got the message, but the district is doing everything possible to sensitize each and every corner for the program to be successful. 17 N o -o 6) z tN O oo -c9(J(g .=u3 Ex)u-aLn6 -: (-r H .rU r) L V t- E ci! o.rb€ s, bUEEE E E Atst orE bo --; EcocA', ,\L-'-!EEE E A -! oPh-c Y - o.= bo :v (JLO-LE.EfE € E()PE= ot cd !2 =o.y,9fr t3 5; s p 9U =--(!C)oo- ! bo (n =eE= €.= ? as tr8r.E 3.= ';E!Ea .:l ',= u,-'= -ol{ "tEi S -.\FUi-^LLHV'U =o!--cgHsEA E s_e 35 E v-LLo,n,o o ! + v i!L^ii*E E -YqE a(!.-(o.0o:- LLb 9,- I +O '-'-=E (JaE=(Jc)t-t = e - ooo- r ) F+ F.Ia,, E r€i= Ho >a'- E :1 ^e 3 b I H.;r=o'EFo E(H (.) = -tl ;,\ .= :HE;UEL-L-_+SEs9;EH -., oi o=(.) >,: OO'E vF---iL LO-6r-(U -, ^ >-,.= =,P = F! cd L3(dE;6€ AEe 5 O >.9 6 u clrr E-O () ^ ()v (tr cd:J3 E E 3 Bt qI B'; Ecgrr:-^(do)EE - llJr! --LL^6 5 9';d I E 8 AE * E ^\ q ^, A, -.c-Lch,XJ-dPFTl x oA = 3t g '' BU 3 P H'E f,e e: H I ii o.r bodtr il o --q tr\<orf,oc-'i4(J Y E i', -E ll x b! G L :.gs h.E EX E E:5z i', qA =-9Ec rl9.a z= sGN \ot- ca + ta il EE c! 9l!a .a ca z ;i"1 U o( 2 G U Z = r.) FT al cl )o oe .-L Eq EE oi ze ll * cala o06 s € an ca E >.2 pt'= v^ 2 : EE iEtrEX ZeE- \ot- a ?odiEt: - = e:g EE S Fd\o > il -:\ 4qa UUq) q: \ r- o -E q a_ F IJ Q O+r{E=o.=E=o'; o'5 EH o- fl 0.)E.E J=EEEEOrit: $t I .C)lr5l . (BlNFI 2.5. Gapacity building In order to keep the project on going, health staff at all levels have to be trained so that they should have adequate knowledge. The problem arises when there are too many movements of health staff (transfers) and deaths both at district and health center levels. This leaves the gap on the work that is supposed to be done. The district is trying to provide on job training to newly deployed staff or refreshing those already there during supervision. When funds are available they are trained in CDTI implementation. l9 WHO/APOC, 24 November 2003 dll\J o.- +Lt/ f Sr o(v i ,: >! ?1L I, o c! 0 (J q) z €t\ € a rO ra o\al q) o q) o\! ra t) I s rLe o.i +L\J 9 f------- I U =v 0 () .=o !!F (r: oq) , q,) Lc!()L z 6l 6l o () o \v ?t) Err Q o 'i +F-o" s.3'U i. *u l c) cl q) q) CJ cq() o z ?a \o t6 o o \e a.) - .1 6/i+F-d ,L i! U Q a L ctt o a rl .3eI q,, E!E q) z o o \U ra -] Fl Fr t'r N LI E() o z + o.l - N o * € € o L s i. o o M o * o t o a. st: ! c o st ,* . = :\ c1 a1 qJ U q a s. AJIr t qJ U1 a* ! .9 c! o o o. E F o U(F o a C) 0) 0) ,oS (.) bo '= t- fi1 ot =lCBIFI LF cg o F Table 6: Type of training undertaken (Tick the boxes where spectfic training was carried out during the reporting period) Any other comments 2.6. Treatments 2.6.1. Treatment figures If the project is not achieving 100% geographicalcoverage and a minimum of 65% therapeutic coverage or the coverage rate is fluctuating, state the reasons and the plans being made to remedy this. Trainees Type of training CDDs Other Community members e.g Community supervisors Health Workers (frontline health facilities) MOH staff or Other Political Leaders Others(specifu) Program management How to conduct Health education * ,F *< Management of SAEs * CSM SHM Data collection i< * Data analysis * {< Repoft writing * * Others (specifo) 2t WHO/APOC, 24 November 2003 N o.l tl bag Lq) I {t a.\ bo q) bO .t rh\v\ -U5t .gBdt9q .wtEE0.)al S'v-\ab3C)Y-x .E.as;oo1 €s* >lqJ2.4.s?.SH :YF$YU\ds3 '=x: F'ra €EE' 9E€LU -ss !uSb\ 'b!: 4U9; .s 'snH.Lq .= .. 3'$ro g s\C) a. EUE F ST .= f! io'R : si :Ei5 .s Uqt F 'EeE s t* .! YrE S NS() S s's € Y \:H $ kq = \ sL) s E{ : ^\ .r!A d tuI i grUs .i rH 06 u$s €\ '= : U\ * EI$ E$\. :';s $€G tss sE = Ee\-b t SrS :UE SFI da.I sts uiSSrl\ E=' rrrt!o ult\ I\a\E\Y! O *, c) (d() L 0) o o() a(H o !o -o z () c) o F \o ol -t l0Jxl > '(fl ? sl u 9lA o.ll =ol o)ol tr()t ts an inql () bl .L *l -ot = =l czl< () cdL q) oo !e,^ 0^\ oo F I cd (J o 'd L a.() o 2 E)d -o ! o) C) an cd o C) E E oo o E() ! () IL() a. >. € o6() E L C) -o E oF o\ o x !o(t or () OId C) 5 Oq- o ! 6) -o 2) C) CdH o oo(!L C) o() do o.(c ho o(.) o 6J C)L o C) 'd L o. o o C) E o C) o E C)E (.) IL 0) o. € oo() E oo o (n a. a. (d F o\ O X () (6(.)! C) o o C)o o !o -o z (.) (dL (.) oO(E Lo oo o C) o.(n H 0) F al $Ll C)l >l 3t -tcBl .el -clol(!l bd ol()l b4 EI(!l ol EIJI(.)l ol BI .qlPJ bn .El el ol EI oiol -l €l (Rt 3l EILI ol tr- I -\ n ")U) Q a) 4 L \ -d q q) $ -va L ttl (.) =(! ; r-) J Fo L .2 .o 6 r! (t o E d(.) LF r--l o,l -ol(€t FI 1:o a4a-ae;Etxo J-6 = O >,^ o;:E!?:tr-cJ o(E oiE o 1 o o o z O rrl +< Ecn z-o voie5Eco z6 clt \o ^:! -3 t-38 EEh.qE26. E s ar =o\N o o. o ll * - ,*Ao\ , bt)od = i;i>ooE9F sN € ! a 6_ o^a =pcEUE z =\o f') H =oEU> jon FU F-! rn6lt) 9 .,pH ;!, E o 9d6-s io oF ! r-r-ta q c)bo(n cr) c) tr U ll { 6\ 9o az o s 3 5 s"H z6 o F. G.l\o =aEUZ # 9o' -tro r- cl\o \o4@d.r6 :9= b $) -::c+E - 3 a s 9 ,id; O> --6 E *o3 H v20 r-N\o O4 -5 r:,6Y n< Fl t-r F tl I2.6.2 What are the causes of absenteeism? Communities don't feel it as a problem since they don't see immediate signs and symptoms so they opt to do other things (farming, business) which they feel are important rather than going for treatment. 2.6.3 What are the reasons for refusals? -Misconception about the drug- mectizan. - The other thing could be mobilization and sensitization hasn't been done properly. 2.6.4 Briefly describe all known and verified serious adverse events (SAEs) that occurred during the reporting period and provide (in tabte 8) the required information when available. In case the project did not have any cases ofserious adverse events (SAE) during this reporting period, please tick in the box. No SAE case to report 23 WHO/APOC. 24 November 2004 <f c.l C) -o E() z s c.l o{ v c.l \ a,) rr I\ .\,q ,+ - %q AJQ t \ sL. t AJ V1 s o C) bo .E o (-) L (.) oo .T o L ooo (t a tr.l a C) C) 0)aL 0) E(n a =o L oa o 6 o U <ici r qrl =l(!lFI otr- o9:Ear o;o 4C= - boq)il- O (go6 A;J -tr9 9.1 oo o o.9 c6 9Q =t)(, o- o-!Yq!? aE ^ a.= Uo-.c tr o ot:a U tr tr=d4OOn =.L.e v4s! L-l dsc: C ii - !, oO .:: ;-::o==L6-AEZ Eo o E a :(!o=u:E o- g Qood =o .Nt9!?. o> > bo 2a o oo Io U) o oo + 1a l o -- 9p F cJX/o (-) o (! o. o E ll r ril. Irl o ^9p r- q6\ -o s F- V; € ll * - i.] d\ E] o oo o o o F s a.l ra s c- ra s\o\o sF- o\ co a- 6\6t @ ri ,o od ,o o5Ep =6 'o \o\o \o !+ t 6l \o r-if ?r) al al6l + \o c.l st co hl :o dO= / .o) !'FU o\N €tn GI $s & t--N F- .+ m ol ca qqo *3 - ^ *G!9 i o h- . ' : ?a o rr) o\F- c.l t (\ rr s NF. c)!f ?n v $ t\ t-- CJ oo d = = =E E (-) ll * Hr! L'l o ^9pv:v- - o6\ <. >v -o s ra o.lf') s E- [,^ : 10U 9akit5 (rohl s rA o\la so -o6\ ^\ H qoo=3* u =:+,otr E= U ,E<5 >Oa \o t,- "il t-- e.t\o F- c.l\o Ii =oE6> =Eo rQD FU aF- t-(\I\o F-.N\o a\N hlld =a;_rd:? ", b e)v /l: o=t o= >.'- =Ec{!t5 € = 3 q€ co oI €r- r-N\o F\ a.t F- a.l & I! t-- oo o\ ot N N (\ ca o.t $ c.l e.l c.l a- c.l € N o\ a.l a-.1 rnN 4; v ! cl (J c!q') c) ao GL 0) A I a9 \i\) L tJ6L Fs.=S.LqJA ,\9 =$c!Us.= -,tr e.:=EF E =8q)vS.ECJ$!EF.r)!l1cE Oo)!:l- Ef,= oEOOEcqlEA:.hEEE -! Yq)Ea36)v o: -o l-l Pf ) L ,v --trL! o(!: .L 0) -ICEtr El .a) trEI cq -ol ::r-l Ia(gt () .9 ol '=EXEe -ol O. !bO= - r!e9bL :-L !! (.) rt!, \JLU =(spi.j o)EE.EtrC)egtrG) L- -idGC)9qEE\OE . :',N "'l c)(.)l a =l d:l q) Fl 0r 2.7. Ordering, storage and delivery of ivermectin Mectizan@ ordered/applied for by - (please tick the appropriate answer) MOH tr WHOI UNICEFE NGDC Other (please specify) Mectizan@ delivered by - Qtlease tick the appropriate answer) MOH tr WHON UNICEFE NGDC Other (please specify) Before mectizan is ordered census update have to be done first and the number of tablets needed is based the current population. Drugs are stored in the district pharmacy before distributing them to the health centers where CDDs from various communities collects them. Table 10: Mectizan@ Inventory (Please add more rows if necessary) Remaining ivermectin tablets are documented by CDDs and retained to the health facility where a coordinator collects and store them in the district pharmacy for next use. When delivering ivermectin tablets, the total amount is documented in the health center inventory record that is placed in the drug store. The same applies to HSAs they document in their records the amount they have taken and balance from the CDDs. State/District/ LGA Number of Mectizarro tablets Requested Received Used Lost Wasted Expired Remaining TOTAL 773,476 773476 681,539 2196 89742 26 2.8. Gommunity self-monitoring and Stakeholders Meeting Has any training (of trainers) for community self-monitoring been done in the project area? If so, When? Table I l: Community self-monitoring and Stakeholders Meeting (Add rows if needed) 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. Community mobilization was done effectively and messages pertaining to oncho. were disseminated to all the community. 2.9. Superwision 2.9.1, Supervision hierarchy. District/ LGA 'l'otal # of communities/villages in the entire project area No of Communities that carried out self monitoring (CSNt) No of Communities that conducted stakeho lders meeting (SHND TOTAL 627 627 27 DHMT TOT CDDs DOC 2.9.2. Issuesidentified. -Late delivery of mectizan by some HSAs to the CDDs in some areas. -Mectizan stock records was not updated in some health facilities. Supervision at different levels was not adequatly conducted. Some CDDs were not writing transferred out for the families which got transferred out of the villages they were living. 2.9.2.Supervision checklist was used, 2.9.3. areas Feedback was given to the person or groups supervised and advise given that needs improvement and recommends on job done well. SEGTTON 3: Support to GDTI 3.'1. Equipment Table l2: Status of equipment (Please add more rows if necessary) *Condition of the equipment (F:Functional, CNFR:Currently non-functional but repairable, WO:Written off. Source Type of equipment APOC MOH DISTRICT/ LGA NGDO Others No Condrtron No Condrtion No Condrtron No Condrtron No Condrtion l. Vehicle 0 2. Motor cycle(s) 4 2F 3. Computer(s) I F 4. Printer(s) 1 F 5. Photocopier (s) 6. Fax Machine(s) 7. Others a)Video screen 1 F b) vcR I F c) power generator I F 28 29 3.2. Financial contributions of the partners and communities Table l3: Financial contributions by all partners for the last three years Contributor Year I ('provde the penod') Year 2 ('provide the period') Year 3 ('provrde the perrod') TOTAL Cash Budgeted (us$) TOTAL Cash Released (us$) TOTAL Cash Budgeted (US$) TOTAL Cash Released (US$) TOTAL Cash Budgeted (us$) TOTAL Cash Released (us$) MOH (Central + Provincial/State) MOH (District/LGA) 30.174.2 12,897 t3,667.2 Local NGDO(s) ( if any) NGDO partner(s) Others a) b) Communities Not available APOC Trust Fund Not available TOTAL 12,897 13,667.2 Contributor Year 4 ('provide the pertod') Year 5 ('provide the period') Year 6 ('prowde the pertod') TOTAL Cash Budgeted (US$) TOTAL Cash Released (us$) TOTAL Cash Budgeted (us$) TOTAL Cash Released (us$) TOTAL Cash Budgeted (US$) TOTAL Cash Released (US$) MOH (Central + Provincial/State) MOH (District/LGA) 30.174.2 12,600.2 Local NGDO(s) ( if any) NGDO partner(s) Others a) 30 1 b) Communities APOC Trust Fund 20,896.2 5,823.5 TOTAL 5 1070.4 18,423.7 These cash were meant for trainings, fuel for motorcycle. 3.3. Other forms of community support -The communities provide transport to CDDs to collect mectizanfrom health facility during distribution period. - The communities also encourage other people who refuse to take the drug to go for treatment instead of living the task to only CDDs. 3.4. Expenditure per activity Indicate in table 14, 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 I US $ = Kr07.00 31 Table l4: Indicate how much the project spent for each activity listed below during the reporting period Any comments or explanations? SEGTION 4: Sustainability of GDTI 4.1. lnterna!; independent participatory monitoring; Evaluation 4.1.1 Was Monitoring/evaluation carried out during the reporting period? (tick any of the following which are applicable) YES Year 1 Participatory Independent monrtonng YES Mid Term Sustainability Evaluation 5 year Sustainability Evaluation Internal Monitoring by NOTF YES Activity Expenditure ($ US) Source(s) of fundine Drug delivery from NOTF HQ area to central collection point of community Mobilization and health education of communities Training of CDDs Training of health staff at all levels Supervising CDDs and distribution Internal monitoring of CDTI activities Advocacy visits to health and political authorities IEC materials Summary (reporting) forms for treatment Vehicles/ Motocycles/ bicycles maintenance Offrce Equipment (e.g. computers, printers etc) Others Motorcycle, power generator, video machine 22.4 1,539 3,050.4 1438.2 11.2 140 7,3 00 3,393 828.7 DHO DHO DHO APOC APOC DHO DHO DHO APOC TOTAL 25556.6 Total number of persons treated YES 32 a ( I4.2. Sustainability of projects: plan and set targets (mandatory at Yr 3) Was the project evaluated during the reporting period?_YEs_ Was a sustainability plan written? YES When was the sustainability plan submitted? 2006 4.4. Operational research 4.1.2. 4.1.3. 4.4.1. 4.4.2. Other Evaluation by other partners What were the recommendations? How have they been implementated? Summarize in not more than one half of a page the operational research undertaken in the project area within the reporting period. How were the results applied in the project? SEGTION 5: Strengths, weaknesses, challenges, and opportunities STRENGTHS WBAKNESSES The district has managed to get a therapeutic coverage of 7loh. Lateness in submission of treatment data from community up to NOTF. The district has managed to treat all its rural villages - 100% geographically Poor community sensi tization. CDDs, HSAs have been trained. drug distribution period was long JJ 1.t At least a distribution have been done. No training aids Provision of hard covers to trained CDDs DHMT involved. OPPORTUNITIES Health and Environment sub committee briefed. Presence of health workers Plans for CDTI activities for 2004-2005 are included in the DIP. Integration of services Adequate drugs Use of ORT funds to run oncho activities Transport available CDDs, HSAs planning meetings conducted. CHALLENGES. SEGTION 6: Unique features of the proiecUother matters Availability of health workers such as health surveillance assistances, which are not available in other countries. Some villages performed below 75% as minimum target - N/ore HSAs to be trained in CDTI -Full involvement of v/headmen, CBOs and other stakeholders. [/ore untrained CDDs To train more CDDs using ORT funds as well as APOC funds. 34 I) 35 I