Taraba state: year 4 CDTI activities

i I I a AFRTCANI PROGRAMME FOR ONCHOCE,RCTASIS CONTROL (APoC) Y E,AR 4 CDTI ACTIVITIES REPORT 2OO1 ar(r L 4,1.t-ozl For lnformotion To, .D t P- U,-^l tJ,r zgllor- Zing rbi Wukari Kurmi akum Sardauna Gassol Bali GashakaDonga S Karim Lamido Lau Yo rro Jalingo Ardo I(oln For Acticn To: TCLA14 'l-e4 c5_\ C!P blri D I.J ffiOCTOBER,2OOl ,l.q-*;:,- IiX ECIJ'I'I VE SU M MAIIY lrrrabl Statc is locztccl in thc nortlrcastern part ol'Nigcria. It lies roughly between latitude 6" -10' and 9".36' north irnd [ongitudc 9".10' 11".50' east, with a land mass ol- approximately 55,000 square kilornetres. Thc statc is very tnuch endemic for onchocerciasis as the topography made up of undulating hills and mountains, interwoven rr,irh rnarshy and swampy land bcing tlrained by many tributaries of the Benue River and its tu,o nrain tributaries ('l'araba and Donga), provides conducive breedhg environment llrr thc blacklly (sinruliunr spp.). Mass Mcctizan(D distribution started l0 years ago with the CB'l'l approach. At that time rhe srare was in partnership with the NGDO Africare. With the exit of Africare in 1996, tryo NGI)O's have been involved in the state's Mectizan@ distribution programme. Christofell Blindem Mission (CllM), a foreign NGDO and Mission To Save The Hetpless (MITOSATH), an indigenous NGDO. With the arrival of APOC on the scene in 1997. the orientation changcd to thc CDTI approach, and treatment figures increasing steadily. 'lhe state progranrr-nc has just concluded the distribution for the fourth year ct)-f I. APOC contribution to the project has been tremendous. Additional capital equipment has becn received from APOC (one 4-wheel drive vehicle and l0 motorcycles)- Also MI1'OSATH has donated l0 bicycles to ten communities for use by CDD's during the distribution season. In addition the NGDO's support the project with vehicles, and technical support in the form of training and many more- 'l lre statc qoyeltrltcrlt has becn supportivc o1' thc progralllrl)c. -l'his year a pledge to r-cleasc thc sr.rnt o1'N.l.2 ntillion naira as counterpart lunds has becn partially fullilled u'ith rltc rclcase gl-t[e sult el N2.0 nrillion naira. 'fhis is asidc the pa1'ment of staff salaries lrnrl r11sLilrc provision olrtlllce strpplics ancl tnaitttcnancc of tl-re statc project vehicles- llrc cqrrrrrrrrrriries tlp tlre gtlrer hirnrl havc slto',vtt cortsidcrablc intercst ill thc pr().lcct 2 r.lrc' c.rrrrit*rtc by supporting trrcir crroscn distributors. ilowcvcr *la,y conrnrunities will still rvisli tllat thc qo\/crllmcnt wotrlcl takc on this responsibility as well' ()ur ultinrate trcatl'llcnt goal is to trcat 850,000 pcrsons- Al[ prcvious trcattrlcnt gtlals (1997-2000) have been surpasscd. .l.lris year,s treatment objectivc to treat 820,000 to pcrsons has bccn greatly surpasscd with 881,871 persons having bccn trcated so far' This Iras cve n cxcceded the ultimate treatnlellt target' This is so partly because of the fact that r.r,ltcn thc ultinratc goal was cotttputctl irl 1997, Ibi L'(in rvas thcn Irol utrdcr trcattnctrt' Sittcc thcn that targct has not wuetl rt-viewcd' I i -) I I I I , S |roN I I}ACK RO D FO TI 1.2 A total ot'1.597 ctltntnunitics in thc l2 l'CAs wcre targeted lbr mass Mcctiz-an@distributionthisscason.Atypicalcomrrtunil'ywilllravcbctwecn 500- I ,000 houscholds on thc averagc and is headed by a community leadcr (.litttro. Miti-irngwa :ts tltcy arc callccl)' llouscholcls on tllc othcr hand will Iutvc tltl tltc itvcritgc bctrvccn 5-8 pcrsons' lltlwcvcr' it is not unusual to have lr<ltrscltolcls with ovcr 20 pcrsotts' l.l '['hc treattncnt rounds tbr the LGA's are as follows rbi TREATMExr nouNoLGAS/N t0 Cashaka 9 Bali2 8KurmiJ 7 Donga4 6Karim-Lamido5 6Yorro 5 Ardtt-Kola 6 1 5 5 Sardauna 'l'akurn 5 Ussa tt 9 l0 Zing 5 3 t2 RM N:o ll SECTION 2: .rHE, IM*LEMENTATION oF CDTI( october 2000 to September 2001 l'ablc I -l.hcrehasbccrlanincrcascinthcnurnbcrolcotnlrrtrnitiesintlrelburthycaraSaresult tll.ttlorei:omnruniticsaddcdirr'I-akum,Ibi,GashakaarrdDongaI,GA.s..I-ltenuntber tlt-Ot-lttltttuniticsconrperrsatingCDl).shasincrcascrrlrcnconrparcdwiththethirdyear tlistrittu(ritu.'['lris poirrts ttl the irtcrcllsc itt a\\',arcncss ol-thc proqrallllnc conccpt by the cortt trl tttritie s' 6 Na of comm. paylng CDD's in cash or kind No of comm. with trained CDD's No- of comm. that decided on mode of treatment No. of comm. that decided on month of distr. No. of comm. that collected drugs No. of comm. that selected CDD's No. of comm. LGAS/No 82989tt98989li9lt t8s22922922922922<)229 A r<lt> *,rO llrrl i2 72139r39r39r39r39r40DortgaJ 50636l63636l63Cashaka4 ll0143143143143143144rbi5 r30r56r56r56l5(r156156Karinr- Larnido 6. 62130130130130ll0130Kurrtri1 t28172172172172t72172Sardauna8 102t67161167t67t6l167'l'lltrrtt9 621515/)15t00Ussal0 7l838l8lIt3ttlttlYorrt'lll l0lll0il0il0ll0110ll57,ingt2 I,1551,5651,565l,5651,5651,5651,597't'oTAl- !!.r^!lt!-f{(j L)r DlrrIrF'l{liN'I' t'EVBL-s I MI'I,IiMIiNTA'IION. ()t. tj'l'AI''F INYOI'v-pl)- IN cD'1'l IV (l il,-V N,l 1,, l:)2-r 'l () l,,ClNt ll(lllltltBtrtttltetll]lltlllt'.,1..(rrIlrrlrrlll..r,..l..rr:t....t,ttrlttr.lr.rl|)fi()rl()llrc:rcltritl rlir,trtlrttlirttl"'ttri"llr''1rrt'ir"tlrrrrl(lrcrtlrir't'liv('s(ll'lr:linillP-fllotalol'12 s()(''l'. s'1 . I .OCl-. ?711 I lc:rltlr workcrs an(l 2' 186 CDDs' Out of this number' a rrrr:rl <rl- l4 SOC'|-. 53. l'(X"f' 224 llcalth workers and 2'034 CDDs werc lrained. which reprcscllts 92uh itchtevellrcllt' 2.2 DEV l) ED 'l(AlN lN(;M l'lr tAl- USIi l). A', rrrtttt[, trrrirrirrll trr:rlcti:tl'r lll:tl rr'<'r<'rrscrl incltrrlc thc Training Manual' CDI) (irri,rr..r,,r.lrrrrr. r-li, (-lr:rrts:rrrrr rlrt'Virlc.'l-ape 0n ('D'l'l' T'he state and 1.,..:tllrtrvt.t-lllll('llll(.:llll\lrlrvccllcctivclYrrsctltltescltraterialsdurtttgtrallllllB. 'l'lrt'v wcrc ot-lrctncntl()tls lrelp in increasitlg tlnderstalldlllS as wcll as cncotlragcd ParliciPat ioll' )t t( N( ()t,( l)l ).1 lVl,'rr' ('l)l)"r rv.t. l:ttgt'lt'rl firr lr:rirrirrp' rlris YC{lr so as lo rcdtlce the workload ,rl'.:onrt' CI)D's rvlto lravc a hig area lo covcr"l'he itrcrease in CDD's is alst-l partlyaSaresulto|.thecolnmunitiesthatarestart.illgtrcatlrrelrtlortllcllt5t time. They perlbrmed credibly well ln thelr varlous oolrlrtrurlltics"l hi:' accountstbrtlrclriglrcr.tlulllbcl.olllculllcttcutotltlrisyorrr..l.lroylrrrvckcpl tltclt.rcctlt.tlsol(lctttlttctt(str:,rvc.llll:1.1(lllllllrllic::ttttrlltrtvt.tlt.ttrtrtrstratcdgood lrtdlldBclllcttt t'l tlrc ivct tttct'litl rlr rrg': itr tlrcir posscssiolr INII'TU-)YINC I'II Ii QI.IAI'I'I'Y OII'TITAININC' lllcprtlicctllcitllltrrtctlltltcllttrttcctslt.tvcIlcctt.tlllcl(}L1.\l)())c<tllt,.ttcgr,tir.l, ol trilill(jrs ttlvtllvctl lll tllc tl'lllllllg [)l('Lc5)l ltc (rrrlrrlrrg \\'Ll( ("trrltt' (r"l I'r t.(X I '\ (tlltl lll )(rlll! llt'rllrlr( L'! (r'r-rr 't"l l'1 111' "( ){ I I fl\ B.t OF STAFF INVOLVED IN CDTI'ilrAI NIN(; OF DIFFIi,R I,INT LEV E,LS IMI'I tn tll.E 2 EIVIIiN'tA,I' ION t.(;A No. of training undertakcn No. of 1'O'l trainc<l/rc' traincd 'l'aryeted No- of health staff No. of health staff trained on CDTI Targeted Na of CDDs Na of CDD'S trained Ardo-Kola 2 4 rlt 7 t06 98 tlali 2 5 22 t9 2s8 230 I )()llr1.l 2 4 28 26 2t2 207 Glrslrrrka It) i 2 4 26 t7 89 89 2 5 22 l5 241 219 Kartttt- l,.utt ttlrt Kumtt ) 4 5 32. l8 73 284 281 t8 r50 138 ') S ardau na 2 _5 26 29 290 234 Tiilltrrtt 2 4 24 2l t7l t7l t Issu Yorrtt 2 5 4 I6 l6 lr0 105 2 26 ZI ll5 I t3 4 5l 20 21ll t2 160 154 224 2,186 2,034 Tins 2 II ),I'A I , E,T U I ;\ corilbine tcarn of'Moll antj NGDO ofl'icials paid advocacy visits to chiel' [.,xcctrtivcs ol.l-GA,s and thcir Courtcilors. paramount Chicf-s, Rcligious leaders and prontinentctlmtnunitymernbcrstosolicitlbrtheirSupportfortlrcprogramme. (btttttttttltty rnobilisation was citrt ictl tlut irl I'5ti0 corllnlunitics ol'thc l'597 targetcd l7 ctlttllnunities coultl not bc rrlobiliscd as a result of communal conllict, which has prcvcrttctlilccesstothecotnntuniticstlrltastlispcrscdtltosccomtnunities. Mobilization was done almost ontire ly on pcrson-to-pcrson basis using thc paramount chicls.cornmunityleaders'eldersandinflucntialmcmbcrsofthccommunities.In stltttc instances, town criers lvcrc uscd to disseminate information. Posters were placcdinstratcgiclocationsittthccommunitics.l,oCT's,SoCT,sandPHCworkers wereinvolvedinthemobilisationexercise.Theuseofelectronicmediafor informationdisseminationisnotquiteeffective,aStheirscopeofcoverageisvery lirn itcd. O I l,l 'I'l A EI) C o F 2.2.1 THE USEOF MED Since media houses have gone commercial' the project has not utilized them rnuch but has instead been using other methods of getting the people e nlighten ))) RESU LTO FMOBILIZATTON EFFoRT. ,l.llcconttrtuniticsol..I.arabastatehaveappreciatcdthisprogrammealot, cspeciallvasitlrastodowitlrannualtrcatmcntfbrtlrccontroltlf-thediseasc 'l'trc1' have also apprcciated thc CD'l'l programlllc and ctlncept' t{l.lsl'o NSE oF'-I'll E, COMIU NI'l'lES. ( ioo<l tcstirltotlics llavc bee n qivcn' by tllc ctlttrnrttnity rtlctrlbe rs <lf this 2.2.3 uottr.le rtitl tlrtrg callcd lvlcctizan' tlrc 1ll:rttrlirtg lrtttl irttplcttlcntatiott lhcr ltave trccortlc pltrt ol'tltc llroqratlltl)c lll 'l'hcy havc supportcd thcir CI)t)s relativcly 9 irrtltc;lasl'an<larchopclirlol.ctlnl.inuingwiththcclongatcdtreatmentcoursc tll.thcdrug.l-heywalrttocotrtirttrcsupportinStheCDTlprogrammetosustain it. htrt ollcn cornplain ol-povcrty and with somc people qucstioning the rutiorralc bcllirrcl thc qovcrtltncttt not bcing ablc ttl out rightly pay CDDs by *at ot'gctting thcm crnploycd in tlte proccss' 2.2.,1 WII,I,IN (;NSS ()F'l'llli coMM U NI'tI ES TOP ARTICIPA'tE INCDT I. lhc cottrrlrtrnitics havc all cttlbraccd thc programmc atttl participatcd in varf ing dcgrces' Whilc thc philosophy ol-community ownorship is understood illtcrlrlsol.sclccti<lttol.(]t)t)s'dctcrmininghowthcdrugwillbedistributed, ruronitoring and cvaluation' etc' paymcnt for CDDs is still expected to be shoulderedbyGovernment.Alotofthecommunitiesfailtounderstandwhy GoverntnentwillpayoncCategoryofl.Iealthworkersandnotpaytheother. ThisisespeciallyinrelationtovolunteersfortheNationaltmmunisationDays for Polio eradication' where a substantial amount of money is being paid to its irnplementers in the field for three years now' Asrvccontinuetopurslleourcolnmunitymobilisationeffort'itisourbelief that thc communities will better understand the concept of CDTI' l0 M()I}IL IZATION AND |it) TION O TARGE,T 't'Alll,li 3 S/rtrr r,(; A No. of ta rgtltd c(rmm. No. of ctlln m nrobiliscd No. of tB rgct c(rnlm. that rcccivcd hcalth cducrtion No. of advocacY vlsits t0 slatc or rcgional dircctors of hcalth No. of MOll slaff involvcd in mobilisation No. of NGDO staff involvcd in mobilbation r\rtli,-K olit 9lt 9lt () ll I 6 2 ) llali 729 )29 229 2 6 [ )o nga t4() li9 139 5 I 4 (iaslr aka (rl 62 67 6 5 lbr 144 l]6 rl6 I 5 6 Karirn-l,trrtridtl t56 156 156 5 I 1 K rrrrtr i I:10 130 l]0 5 2 S lr rti a ttna t72 t72 t'12 I 6 I I itktrrtt t61 t67 t67 5 2 I Jssa Yot rtl 100 93 9l 5 8l 8l 83 6 2 il5 il5 I,580 il5 5 2 2 I,597 l,580 ll l2 AfcwtnoreCommunitieshavcbeencnrolledintotheCDTIprogrammeinthe crldemicLGA'sofGashaka,Donga'lbiandTakum'Alsosomecommunities [)rc\,ious[ydisplacedaSarcsultofcivilunrestinTakumandUSsaLGA,shave rctrlntcd an(l thcir trcatlllcrlts bcg'un I I I I ti () I -) AC Ill E,VE, MENTS 3.1 .T E Distri[ltrtionofMectizan@startedinrnrcdiatelyafterthemobilisationandtraining. r.rrc tlirtribtrrio. was s.pcrviscir by thc t,oc'r', scoT and in some instances PHC rvorkcts at N4cctizan@ collcction cctttrcs' ln somc cotnmuttitics' community lcadcrs ltlstrttrttkllltrtitttltcsupcrvisiorr.[{csultsol.trcatmcntareshowninthctablebclow. l(cstrltslitirtt(lctltntnuttiticsol.lbil,GArnaynotbcobtaincdastheareaswerc al]cctcdbyarrncdcomnrunalconllict.iustbclbrcthccndofthcdistribution.Allthc irllcctcd cortinrutritics have bcen btrrnt and the people displaced' 881,871 persons were treated representlng GE CO 3.2 82u/o geogr aP hica I c ov e ra gc T ENCU PO lruLATION. A totalof l'076'191 persons were resistered in Taraba state l.-l BLE POP ON A total of 960,589 persons were eligible H,LlGl lbr treatment in thc state 3.-l AI}S NTE ANt) RE LS. t)uringthcperiodundcrrcview'theprojectwitnessedallotofcommunalclashes rvlrichncccssitatcdnlovetncntfromoneplacctotheotherbycommunitymembers. .].trescarcbcyondourcontrol,buttheprojectwillmonitortheirresettlementbefore lltc ttcxt tlistril'rtrtitlrt cxercisc' l IZ SE,CTI0N 3. ATE ( 2000 to Serltem ber 'r'RFIA1'MEN'I' RESU L'I'S FOIT TARA BA ST 200 u t,(;\ Arclo-Kola 59.5 79 lla li Dortga Cashaka It)i K aritrt - l.rtrtritlo I 79.360 , Ktttttti 5 (r.03 tt lsltt'tlltttttlt I 5 5.0(r7 l'aktrrtt 13.97 5 LJ ssa 5 5.208 Yorrt-l 7 | ,202 / irrq 8 r .662 'l o(:rl ltoltulalirltt rlf t rc:t tctl ('orulrtttlritics* I.o76J9l 1 l)trlrtrllt(itttt llgtrrcs rcsLr h tll' ctlttl'lict. No. ol ta rgctctl comln. No. rlf cligitrlc pcoltle No. ol cligiblc pcoPlc treated with Mcctiza n(D No. of comm. ln which CDD's arc Itcaltlt workers 98 5 s,965 5t.231 83 l15 1,597 960,589 lrrt cxcl tr.sivc ol- the 6 ctlrtlll.ttttr ities irr Ibi Nil i-n aisptaced as a 156 177 167 'l'O1'r\t. I No. of trcatcd comm. with summary forms No. of Dist. Supervised by lrcalth workers 984 229598,821107,201229 140475.247115,349140 r r 7.084 94.408 63438,57943, I 536311.341 130569,53 876,64014485.261 4| 50,77 5160,094 r30547,21550,276 156 r30 5t32.133139.390112 452.86463.238167 93546,04149,201r00 83455,67860,936 il5463,7 49(r9,I 40 1,57 6538tt 1,871 l3 a s'l'll t,)N(;'l'll & WIiA K NIISS ES/SUGG EST IONS vc IIrcnt rtici ation a [,tr o ltrcnsth: Alrnost all l-GAs havc shown aclcquatc political comnrittnent to thc progranlme. 'fhey havc bcen wilting to co-operate with the state team' \\/citkrrcss: Vcry lbu' t'(lAs hitvc rclcascd tirnds lbr thc prograrnrnc' strtggslio-n: C'ontinuos aclvocacl' to l'GA chicl'cxecutivcs' cspecially lrigh lcvel rutlvocitcy by natiortal artd z<lnal ollicials' 'l'raining Strcrrgtlr:Moretrainingcentreshavcbeenestablishedtherebybringingtraintng ccntrcs ltrrther closer to solne communities' Sral'lins Strclglh- Statling at both thc statc and LGA level is quitc sufficicnt Most of the o a a statl'are quite dedicated to their dutics ll calth ctlucationa ndm obil ti n a !1ry-qr:!h: Already there is a high degree of awareness of the programme among tlrcpctlplcinmostcomtttunities'espcciallyinthosecommunitiesthathavebeen llcrlclitingforqtritcsomctimcnorv..I.hcrcisclamourlbrthedrugeveninareas not covcrcd bY CDTI t,ogistics hicvc lcs problctll Aclditional 4 u'hccl clrivc car and l0 motorcycles from APOC and l0 do.arcd try, I\41.1.( )sn.l't t has grcatly irnprovcil thc transportation B/c{krusS:Mtlt<lrcl,clcs.erpecteclttlbentadcavailablebyl-GAsareeithernot proviclc<J ()r not acletlLratcly' Itraintaincd' Strg11c1$rq: ('tlntinttos ittlvocacy to l'(iA ohicI cxecutives' cspccially ltigh lcvcl Strcng![ a ?a a t4 advocacy by national and zonal oflicials' rll nlc lan in nd al ti a Stryntth:[)lattningisdtlttc,,t,cllinadvanccol.thcdistributiorrpcriod.Rcleaseof lirndsbyAl,ochasnowitttprovcdconsidcrably.Statcctltlntcrpartlundshave hccn rcceived this Year \ Lrqgcstttltt lrurl)' rclcasc tll-litrrcls u'ill g'rcatl)' cnhance pro'lrarrrnlc planing and its cvcntttlt I ilnPlctncntattort CDI) 's pc rfo rmance of sk lnvo lvettreq tof thc NOCII focused fhc S ta tc Min ist rY 0f Ilcalth a GenerallyCDD,sarervillingtoperformtheirtask.Iloweverlotsofthcmcomplainof irradequateorlackofsupportliomtheircommunities.CDDturnoverisveryhighand ever)/yearasignificantnumberoftheCDD.sarenew.Thisisexpectedtobethc trendasmostoftheCDD'sareyoungschoolleaverswhowilllaterobtainjobsorgo lor lirrther studies and move away from their communities' NOCP has been supportive in terms of 'l'echnical advisc and supervision" They have rurqattizecl workshops' review meeting and consultative forums to keep projects I I.lrestatcMinistryot.Ilealtlrrunsthcprogral]lnlCtlrrouglrthcctlntrolprogramme. .I-hcMirristryisquitccomrnittedtoaSuccesstulinrplerllentatitlltolCD.flinall cnclcmiccomnlunities..fhoughcounterpartFtrndsforthcproject.islicquentlynot rclcasedbytlrcCovcrtltncntcarlycnoughtbractivities,thcproiectappreciatesthc ler c I tl l' tlteit' ctlrltttl itrtlctlt l5 ! I tr' I t I I I