RESE RVED F OR PROJE C T LO GO/TTEADING (including e-mail address) ORIGINAL : Enelish COUNTRY/NOTF: TANZANIA Proiect Name: MAHENGE CDTI PROJECT Approval vear:1997 Launching vear:1997 Reporting Period: From: JANUARY 2012 To: (Month/Year) DECEMBER 2012 ( Month/Year) APOCfundinsyear: (circleone) I 2 3 4 5 6 7 8 9 10 ll 12 (13) APOCProiectimplementationyearrgport(circleone):1 2 3 4 5 6 7 8 9 10 ll 1213(14) Date submitted: fFf.n.,"u.l, ZOfS Partners: - Ministry of Health and Social Welfare(MoH&SW) - African Programme for Onchocerciasis Control (APOC) - United State Agency for International Development (USAID) - Mectizan Donation Program (MDP) - GlaxoSmithKline(gsk) - Kilombero(KDC) and Ulanga District Councils(UDC) - NGDO(s)supporting:NONE - 670 communities I i RECU LE i$ rr-lJor3 I'orActlon Tb: Tmo Forlnforlrthr To: JiR æÀ TTr tla WHO/APOC, 14 September 2009 APOC/DIR MMAHENGE CDTI ANNUAL PROJECT TECHNICAL REPORT SUBMITTED TO TECHNICAL CONSULTATIVE COMMITTEE (TCC) DEADLINE FOR SUBMISSION: To APoc Management by 31 Januarv for Marchrcc meeting To APOC Management by 31 July for September TCC meering AFRTCAI\PROGRAMME FOR ONCHOCERCTASTS CONTROL (APOC) I I i I WHO/APOC, 14 September 2009 I ANNUAL PROJECT TECHNICAL REPORT TO TECHNICAL CONSUL'TATIVE COMMITTEE (TCC) ENDORSEME,NT Please confirm you have read this report by signing in the appropriate space. OFFICERS to sign the report: Country: TANZANIA National Coordinator Name: Dr. Upendo Mwingira Signature r@4trqîf,..:.... ,.).A\.' l. ÿ;o,aDate: ...: !. Zonal Oncho Coordinator Name: Dr. Godfrey M'E NGDO Representative This report has been prepared by: Dr. George M. Kassiga and Dr' Venance David Designation : CDTI/I{TD Coordinators f'. _ ^,* ^ \ }- Signature,'*INK$ \qr" Date l5üFebruary 2013 I 111 WHO/APOC, 14 SePtember 2009 CP\ Table of contents ACRONYMS ............... ............vI DEFINITIoNS.......... ............. vII FOLLO\il UP ON TCC RECOMMENDATIONS .......1 EXBCUTIVE SUMMARY SECTION 1: BACKGROUND INFORMATION SECTION 2: IMPLEMENTATION OF CDTI 2.1. TuusrmB oF ACTrvrrrES .............. ...................... 72.2. ADVocACy ................ l02.3. MosILzetIoN, sENSITIZATIoN AND HEALTH EDUCATIoN oF AT RISK coMMtxrrms l02.4. CouptxnyrNVoLVEMENT............ ................. I I2.5. Capacny BUTLDTNG .....................122.6. TnrerupNrs............... .................. 142.6.1. Treatmentfgures........... ...... t42.6.2 lf/hat are the causes of absenteeism?........... .................. 162.6.3 What are the reasons for refusals?................. ................ l62-6.4 BrieJly describe all known and verified serious adverse ettents (SAEÿ that....... ld 2-6-5. Trend of treaTment achievement from CDTI project inception to the current year lB2.7. ORoERTNG, sroRAGE AND DELTvERy oF TvERMECTTN ......... 192.8. CouirarxtrY SELF-MoNIToRINGeNo SrarnHoLDERS Mmrmc Ennon! Booxvranx NOT DEFINED. 2.9. SupeRvrsroN................ .................202.9.1. Provide a.flow chart of supervision hierarchy. ..........202.9.2. Il'hat were the main issues identified during supervision? .............................. 202.9.3. Was a supervision checklist used? ...Error! Bookmark not de!ïned.2.9.4. l[/hat were the outcomes at each levet of CDTI implementation supervision? Error! Bookmark not deJined. 2.9.5. Was feedback given to the person or groups superttised?.Error! Bookmark not de/ïned. 2.9.6. How was the feedback used to improve the overall perJ'ormance of the project? Error! Bookmark not defined. SBCTION 3: SUPPORT TO CDTI 3.1. EqumunNr ................213.2. FniaNcter coNTRIBUTIoNS oF THE pARTNERS AND coMMtrNrrIES............... ............223.3. Orupn FoRMS oF coMMrrNrry suppoRT................ .............263.4. ExpBNonuRE pER ACTIVTTy ..........26 SECTION 4: SUSTAINABILITY OF CDTI.. .............26 4.T. INTeRNaI; INDEPENDENT PARTICIPAToRY MoNIToRING; Evar-uarloN............... .....26 4. 1 . I Has the proj ect ever been evaluated/monitored? (Tick any of the following which ) 3 iv WHO/APOC, 14 September 2009 4.1.2. What wcre the recommendations? ........ 26 4. t .3. Hott' have they been implemented? .............. ..."""""' 26 4.2. SUSTeIN4BILITY oF PROJECTS: PLAN AND SET TARGETS (MANDATORY AT......... .......26 Yn 3)......... ..........26 4.2.1. Planning at all relevant levels..... ."""""' 27 4.2.2. Funds........ ........' 27 4.2.3 Transport (replacement and maintenance) .....'.."""""" 27 4.2.4. Other resources ......-......"""' 27 4.2.5. To what extent has the plan been implemented.......... .....-........""' 27 4.3. INrscRartoN ................ ..............-.27 4.3.1. Iventtectitt delivery mechanism.s..'........'.... """""""" 27 4.3.2. Training..... """" 27 4.3.3. Joint supervision and monitoring with other programs....-.....-.-......"""""""" 27 4.3.4. Release offunds for project activities ""' 27 4.3.5. Is CDTI included in the PHC budget? .............-. ...."" 27 4.3.6. Describe other health programmes that are using the CDTI structure and how this was achieved. [lhat have been the achievements?...-..--...... ...-.........""" 28 4.3.7. Describe others issues considered in the integration oJ CDTI. ....................... 28 4.4. OpBne.rIoNAL RESEARCH ................... 33 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. """ 33 4.4.2. How were the results apptied in the project?......-....... "...""""""" 33 SECTION 5: STRENGTTIS, WBAKNESSES, CHALLENGES, AND OPPORTUNITIES..... SECTION 6: UNIQUE FEATURES OF THE PROJECT/OTHEII MATTERS ...........34 33 V/HO/APOC, l4 September 2009 Acronyms APOC African Programme for Onchocerciasis Control ATO Annual Treatment Objective ATrO Annual Training Objective CBO Community-Based Organization CDD Community-Directed Distributor CDTI Community-DirectedTreatmentwithlvermectin CSM Cornmunity Self-Monitoring LGA Local Government Area MOHSW Ministry of Health and Social Welfare NGDO Non-GovernmentalDevelopmentOrganization NGO Non-Governmental Organization NOTF National Onchocerciasis Task Force PHC Primary health care REMO Rapid Epidemiological Mapping of Onchocerciasis SAE Severe adverse event SHM Stakeholders meeting TCC Technical consultative commitree (Apoc scientific advisory group) TOT Trainer of trainers LINICEF United Nations Children's Fund UTG Ultimate Treatment Goal WHO World Health Organization vi WHO/APOC, 14 September 2009 Defïnitions (i) Total population: the total population living in meso/tryper-endemic communities within the project area (based on REMO and census taking). (ii) Eligible population: calculated as 84o of the total population in meso/tryper- 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). (") 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-endernic communities as identified by REMO in the project area (this should be expressed as a percentage). (vii) Intesration: 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 comrlunities 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 communiÿ 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 communiÿ- 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. vii WHO/APOC, 14 September 2009 FOLLOW UP ON TCC RECOMMENDATIONS Using the table below. filI in the recommendations of the last TCC on the project and describe how they have been addressed. TCC 35 session Number of Recommendation in the Report TCC RECOMMENDATIONS ACTIONS TAKEN BY THE PROTECT FORTCC/APOC MGT USE ONLY 355 Recomrnendatiorts to improve the report Complete Table l3a .for calendar year 2011 and report on APOC project/disbursed amount; Table 13a completed and also reflected in this report. Re c o mm endationsto improve Pro.j e ct Implementatio n Improve fartlter on communications tltrough SHM; Lot ofefforts done to empower cascades for SHM in their local zones to improve further its benefits Recommendationto APOC APOC - should consider making funding uvailable to support the replacement of wonr out capital eguipment. The two districts are waiting for such action to alleviate this chronic problem. WHO/APOC, 14 September 2009 Executive Summary Mahenge Focus CDTI Project is in the l4tl' year of CDTI implementation and is covering two districts namely Kilornbero and Ulanga. The two districts are decentralized with separate government funding for CDTIÀ{TD, using its own Comprehensive Council Health Plans (CCHP). This led decenftalization of our activities and working group under two Dishict Coordinators, working with the same Standard Operating Procedure of NTD. Mectizan ordering, storage, Sensitization meetings. Advocacy, Training, Monitoring and supervision. Therefore, activities of Mahenge Focus turned into a formulating of Ulanga CDTIÀ{TD and Kilombero CDTIAITD projects for easy funding through the District Councils.Despite of that, we still share all reports fr om APOC areas (Hyper and Meso endemic areas) and combine to make a Mahenge Focus Technical report to WHO/APOCruSAID of which now includes Co implementation for elimination of LF, STH and Schistosomiasis. The project operates in 670 communities using CDTI strategy in integrated form in all Hyper andMesoendemic communities. Annually and in this year being reported, the project focused on strengthening strategic training, monitoring, sensitization,mobilization, Community Self Monitoring (CSM) and Stakeholders meeting (SHM). The project re trained 1,472CDDs,270 FLHWs,449 Teachers and26CHMT members. Thereafter, did advocacy meetings for 62 PHC/Council Management Team (CMT) members,5l Ward leaders and 670 Con-rmunity leaders. The sensitization and mobilization meetings conducted in the entire project area \Mas more focused on adherence to swallowing medicines distributed for NTD as the Symptoms for infected people that were making them seek treatment are significantly less than previous years. The total population living in Oncho area, that is defined as hyper and meso- endemic is515,752 and all communities corLducted Mass Drug Administrative (MDA) from August through November 2012 whereby 410,704people were treated and this rlakes the coverage once again80.5o/o.The project has reached full geographic coverage (100%), its Ultimate Treatment Goal (UTG) was 433,23I and the Annual Treatment Objective (ATO) was 358,916. Challenges: Unavailable of reliable transport due to written off two motorbikes and worn out of Hard Top Land Cruiser. Solution:. NTDs activities are incorporated in PHC therefore CHMT are usingthe available vehicle at DMOs office. In this reporting period the project requested the vehicle from Regional NTD Office to assist for timelyimplementation of NTD activities. Lack of incentive to the CDDS from their communities Solution:. VI/e encourage CDDs to continue to volunteer and we motivate them by training them yearly.Still is our duty to encourage village communiSt leaders to lookfor any supports to their CDDs. WHO/APOC, 14 September 2009 SECTION 1: Background information 1.1. General information 1.1.1. MAHBNGE FOCUS Kilomberoand Ulangadistricts do form Mahenge Focus and they are among the six districts forming Morogoro region. I.I.2. KILOMBERO Kilombero District covers an area of 14,91SKm. bounded by Morogoro district to the east, to the west there is Mufindi district (Iringa Region), while to the south is Ulanga district and to the north the district is bounded by Kilosa district of also Morogoro Region. Most of the district lies along the Kilombero valley (part of RufiJi basin) which extend below the Udzungwa mountains. The district has 38 permanent rivers which provide high potential for hydroelectric power plant and large irrigation scheme. Udzungwa national park and Selous game reserve are attractive areas for tourists. The district divided in 5 divisions, 23 wards, 8l villages and 365 sub villages with total population of448,645 (2012). The district has two hospitals, 7 Health Centers and 49 dispensaries, 14 are private and not participating in Community Directed Treatment (ComDT) for NTD. Climatic condition of the district have increased by 2o C from its usual mild Temperature ranging between 20" C and 32" C. Rains start in early November and end in May. It ranges from 1300mm up to 1600mm. Forms of communication available include; landline and mobile telephones, fax, Internet I e-mail and post Office. However, diff,rculties in communication do arise due to frequent power cuts and during rain season due to less coverage of those n-leans of communications and impassable roads due to mud and broken bridges. The main ethnic groups in the project area are Wapogoro, Wandamba, Wangindo,Wasukuma, Wabena and Wahehe. Kiswahili is spoken by almost all community members in the district. Seasonally there is migration of cattle herders the Mang'ati and Masai from Northern and Central Tanzania. Most of the corumunities are involved in subsistence farming of rice, maize and beans but cash crops of sugar cane grown in some few areas. Big private sugar plantation do exist in Kidatu division of this district. The cattle farming have emerged recently as one of the cash earning activity in both Ulanga and Kilombero district. In Tanzania we use Sub Village communities as our working units for Community Directed Treatment for NTD implementations. Sub Villages are government created structures of which their community members do elect democratically their leaders every, after five years. The latest was just in year2Ol0. This followed the traditional chiefdoms abolishment just after independence in the year 1961. The Sub Village leaders do function as the main supervisors of MDA implementation at this lowest level. The Ward Executive Officer (WEO) is the government employee and do function as a Ward Development Secretary within the ward, which is the next largest admrnistrative unit comprising a number of villages. This level has now been fully involved as an influential level, using its Ward Development Committee to assist in health education, mobilization, rnonitoring and supervising of MDA activities. WHO/APOC, l4 September 2009 The next lower level to the Ward is a Village. Throughott Tanzania there are Village Health Workers (VHWs), trarned in a number of simple health interventions by the Ministry 6f Uealth and Social Welfare. These Community Owned Resource Persons are included in Ôommunity Directed Treatment for NTD implementation, which includedrug distrrbution activities.Mo."ou.i, each Village is subdivided into smaller units known as Sub Villages; that differ in number, from one village to another. The sub villages are referred to as communities. CDDs are chosen by the community at sub village level. The Village health workers and CDDs are together responsible for NTD control activities in their areas. 1.1.2 Ur.aNcn Ulanga District is located in southern part of Morogoro Region, 324Km from Morogoro town with a total population of234,150. It has 7 divisions, 3l wards, 92 viltages and,396 communities. Ulanga has an area of 24,560 sq. km. It has afi area of embracing many climatic zones and geographical variations from low land swamps to mountain as high as I 15 meter to 1080ms above sea level. It also comprises of 3 agro ecological zones; hot lowly flood plain, undulating Savannah miombo grassland and cool mountains with rain forests. The main ethnic groups in the proje ct area are Pogoro, Ndamba and Ngindo and the newly migratedSukuma from Lake Zone. The Pogoro tribe is still the major tribe in the district. Despite of the varied tribe languages, Kiswahili, which is a National language, it is spoken by all ethnic groups. Following establishment of the Integrated NTD control approach, Ulanga CDTI project operates in allT divisions namely Mwaya, Ruaha, vigoi, Lupiro, Mtimbira, Malinyi and Ngoheranga.Onchocerciasis is mesoendemic in 53 villages out of the 92 villages and hype endemic in the remaining 39 . The total number of communities in mesoendemic villages is lO2,while 225 conrrnunities are in the 39 hype endemic villages. All Sub village comnrunities have received Mectizan (Ivermectin) since the commencement of CDTI project in 1997 cxcept in 2009 when Epidemiological Evaluation was taking place. Table l: Number of heatth staff involved in CDTI (Please adcl more rows if necessary) District/LGA Number of health staff involved in CDTI acti\ ities. Total Number of health stafl in the entire project area B, Number of health staff involved in CDTI Bt Percentage Br:Brl Ilr *100 Kilombero 362 2t2 58.6 Ulanga 280 151 s3.9 Total 642 363 56.5 \\THOiAPOC, 14 September 2009 f .1.3 Partnership - APOC / USAID continued to fund Training activities, Advocacy, Sensitization and Resource Mobilization activities. The capital equipment for offices, report writing, communication and transport are now the duty of the Local Government or if possible the Central Government but all have proved to be possible except for Transport and Computer that can affect multiple duties such as reports, data and communication. - Other, ComDT for NTD activities were funded by the Drstrict Councils (KDC and UDC) using the funds from Comprehensive Council Health Plan. - Onchocerciasis activities are wellintegrated with other NTDs activities and we use CDTI strategy in its irnplementation. 1. DISTRICT COUNCILS 2. APOC-WHO/USAID 3. COMMUNITY. \MHO/APOC, 14 September 2009 'Please add more rows if necessa CDTI Districts/ LGAs in the entirc project area Total population in the entire project. Area Number of communities/villaees in Population of Meso-endemic zone in the project area Ar Hyper-endemic zone in the project area At Total in meso/hyper- endemic zone A3 = A7+ A2 Meso-endemic zone in the project area At Hyper- endemic zone in the project area A5 Totai in meso/hyper- endemic zone A6= A4+ Aj Ultimate treatment Goal (urG) Kilombero 277,277 124 150 274 128,485 t48,792 277,277 232,913 Ulanqa 240,248 136 260 396 i04,900 133,515 238.475 200.319 TOTAL 517,525 260 4t0 670 233,385 282,361 515,752 433.231 1.2. Population Table 2: Communities and population at risk in the entire project area whether they are treated or not during the reporting period. ATG = caLulated as the nuinLh kÿnbet ofpeople to be treated annually ii meso/htper enàe ic ards wùhin the ptoje.t a'po. uunntetr r be roched when the prject has reached rt l geographic coÿeruge (Aomalb, the prcject should be erpeded to reach the UTc at the ehd of the 34 tear of the proiect). Was a census for the project done during the reporting period? YES If No, what is the source of the data in the table above? * Source:_ CDD: YES Other source, specify: Year:2012 WHO/APOC, l4 September 2009 SECTION 2: Implementation of CDTI 2.1. Timeline of activities Fill in table 3, timeline of activities for areas treated in current year, indicating when the key activities were implemented by the month they began and the month they ended. 7 WHO/APOC, 14 September 2009 District/LGA Mobilization of communities Trainins Census/Update Drug distribution Supervision Starting month Completion month Starting month Completion month Starting month Completion month Starting month Completion month Starting month Completion month Kilombero August December October Noveryrber May October October November April December Ulanga Muy June July August July August Aug Oct Muy December TOTAL Table 3: Timeline of activities for the areas treated in the current year (Please add more rows if necessary) Comments:KilomberoDistrict conducted special Advocacy meetingsto more than 30 district leaders in December 2012 due to change of top leadership in several departments aftertransfers to other districts and new appointments.Kilombero District Council received new District Executive Director and new District Commissioner (Presidential appointees). WHO/APOC, l4 September 2009 al al
2.2. Advocacy This year advocacy r,vas done to all 30 District head of department, 51 Ward Executive Officers, 26 Ward Education Coordinator, 670 Teachers of Primary Schools and 670 Sub Village Leader at their level.This was to strengthen the capacity for all processes of ComDTimplementation for20l2 in the integrated manner. Front Line Health Workers were forefront in conducting this activity, by sensitizing all communities in their catchment area,encouragingcommunity meetings, CDTlÀtrTDsustainability, community self monitoring and projectownership. The 20 Council Health Management Team members (CHMT)were trained so as to better execute their responsibility as overseers of all health issues implementation at the all levels from the district head quarters to community level. Be better educators to government leaders, Politicians, other influential persons and local partners on the Co-implementation approach, its benefits while emphasizing cost effectiveness of the ComDTstrategy. The Frontline Health Workers remains key actors at Ward, Village, Sub Village level and community. There was no diff,rculties or constraints during advocacy, as most of leaders were with previous CDTlknowledge and experience used for many years to the work of controlling Onchocerciasis disease to a point of; now elimination. 2.3. Mobilization, sensitization and health education of at risk communities The disseminate infbrmation using our two local mass media; FM Radio stations - Pambazuko FM in Ifakara - Kilombero, Ulanga FM in Mahenge town- Ulangaremained important. Both Districts aired program and news across the Mahenge Focus communities. The other mode used in through Primary schools - School children and teachers, village public meetings, churches, mosques and through Community Own Resource Persons (CORPs). Mobilization and health education of women and minorities are done through media as above because all people are listening Radio and their participation in the meeting is very active. The Womarr had more advantage as health education is being provided during Reproductive Maternal Newborn and Child Health (RMNCH) clinics. Through these opportunities women are encouraged to educate others in their special women groups that are some social or nlcome generating ones. Response following these approaches, have tremendously produced good results as the Project is now maintaining high coverage and communities have gained the sense of ownership. Weakness/Constrain ts : Lack of funds to procure more Information Education and Communication (IEC) materials, and iLrcrease local Radio progran'rs and Radio spots for CDTI/NTD Transport problern being one of the limitation to frequent close supervision of this important activity. 10 WHO/APOC, 14 September 2009 o Conflicting of incentive issues in the project areas, as some programme pays to their volunteers during implementation of their activities while NTDs does not pay this brings conflict among community members and Programm Officers. Suggestion for ways to improve mobilization and sensitization of the target communities are:- . To strengthen HSAM using Radio programs, Radio spots, posters, leaflets and brochure o To involve more partners in the developing IEC material and formulating cultural groups, youth group and social group . To incorporate NTDs activities in the health existing system hence formal inclusionin the Comprehensive Council Health Plan (CCHP) and became a priority intervention as others. o To continue advocacy rn CDTI strategy so that the voluntary effortsshould be encouraged in these time periocl of economical hardship and conflicts among projects as many do pay the community members for their involvement. 2-4. Gommunity involvement Table 4: Communities participation in the CDTI (Please add more rows if necessary) - Attendance and participation of female members of the community at health education meetings remainiexcelient hence good progress. Women are more active in mobilizing and disseminating information to others and do participate in the implementation of ComDT for NTDs. - Some Communities provide support to CDDs by excluding them in community volunteer work during the monthof MDA. However, other does not but the CDDs have remained active. - In general there is no significant CDD attrition as more CDDs were chosen and trained to lessen the workload for CDDs. 1l District/LGA Number of communities/vrllages with conrnlunrly rnenrbers as supervisors Number of CDDs and the involved :omnrunities Number of communities /villages with female CDDs Total no. )omfirunrtres lt the entrre proJect area B, Number with cornrnunity meLrrbers as supervisors Bs Percentage Bo: 85/ 84 +100 Male CDDs Bz Female CDDs Be Total Bq- Bz+Br Number of communities with female CDDs B,o Percentage Brr= Br/84* 100 Kilombero 2'74 274 100 634 s33 |,167 274 100.0 Ulanga 396 396 100 337 327 664 327 E5.6 Total 670 670 100 971 860 1.831 601 89.7 WHO/APOC, 14 SePtember 2009 2.5. Capacity building The Health staffs in Onchoendemic areas are aware and knowledgeable on the implementation of CDTI activities. More effort was directed to the area where CDTI was not implemented tliat is Hypo endemic areas. Training was done to more than one staff from FLHF. This trainingwas found to be a positive step to sustainability as all health facilities haveat least one or more health staff trained for ComDT for NTDs.Kilombero district trained five Cascades to decentralize close monitoring and Supervision. t2 WHO/APOC, 14 September 2009 Table 5: Training at the different levels of CDTI implementation (Please add more rows if necessary) * 'New', 'Refr' Ifdetail not available, prowde tlte corresponding total onlÿ Make sure that there is no double counnng District/LGA Number of Districts/LGAs staff trained Number of Health center/post staff trained Number of other trainers of trainees ( TOTs) Number of CDDs trained ATrO Cr New C, Refr Ct Total Cq: Cr+ Cr ATrO Cs New c6 ReJ)' Cz Total Co: C6+ C, ATrO Cq C,, Refr Ctt Totâl Cr:= Cro+ C ATrO C,. Nm Cu Refr C,, Total Cre: C'o* C Kilombero 36 11 l9 36 210 l3 191 i 2t0 59 4 55 59 1,182 l8 I 1,161 1,1,79 Ulanea 2l 4 t1 2t 86 IJ l3 86 2 2 0 2 654 86 311 391 TOTAL 57 2l 36 57 296 26 270 296 6t 6 55 6t 1.836 104 i 1,412 1,576 ÿo Achievement 100 %o Achievement 100 7o Achievement r00 7o Achievement 85.9 WHO/APOC, 14 September 2009l3 3r Table 6: Type of training undertaken the boxes vhere specific training was carried out during the Trainees Type of trainine CDDs Other Community members e.g. Community supervisors Health Workers (frontline health facilities) MOH staff or Other Political Leaders Others(speciÿ) Program management How to conduct Health education Management of SAEs CSM SHM Data collection Data analysis Report writing Others (specify) 2.6, Treatments 2.6.1. Treatment ligures - If the project is not achieving 100% geographical coverage and a minimumof 65%o therapeutic coverage or the coverage rate is fluctuating, state the reasons and the plans being made to remedy this. l4 WHO/APOC, 14 September 2009 Table 7: Treatment and SAEs by dishict/LGA in all areas at risk (Please add more rows if necessary) lormula lor comoùtins theraDeulic ând peosraDhical coveraoec Thempeutic coverage mte = Numb€r of p€ople treated x 100(y") Total population living in mesoÀyper-endemic communities within the project area Geographical covenge rate = Number of comûuilities/üllases treâted x 100(%) Total numb€r ofmesoÀlper-endemic communities as identified by REMO in the project area ATO coverage râte = Number ofpeople treated x lOO(%) A ual TreatrDent Objective % UTG achieved = Number ofpeople treatod x 1OO Total oumber ofpeople !o be heated in meso/hr?er-enalemic areas vrithiD the project area (UTG) ,11O - Ih. .rtiùaû.| nMb.r ofu.od. üÿhg ln ,ûrso/hrwr-.nd.iic at$ thot. CDï prol.û lnùrdt to b.at dl, lÿ.tr.dù, ii a dw Wt UnC - th. rcdli?,6 nnb.r ofr.opL b hc tatet in r6drlpænn6b o.crt ÿi n ù. pruk r.d., tltlùaLq ta b. Mch.d wh.n rh. Wj.d hs Mch.d lul g@gqhlcol @ÿ4a5.(M ob th. pojat thouu b. .tq4bn b Nci th. UrA d û. @d oI ü. f tw oftlt Dtulæt). WHO/APOC, l4 September 2009 llr District /LGA Communities/Villaees Population Number of persons ,,vho refused the treatment Number of absentee s Number of communities r.vith < 80% therapeutic coverage Numb er of SAEs Number of serious adverse events (SAEs) referred to the health post4rosprtal Total # of comrnunitie s/ villages in the meso/hyper -endemic areas D, Annual Treatment Objective f)? Number of communities/ villages treated Dr Geographical coverage (%) Dr= D.1/ Dr*100 Total population of the meso/hyper -endemic areas D. Annual Treatment Oblective Da Number of persons treated D7 Therapeu tic coverage (%) Dr= Dl Ds*100 Kilombero 274 214 274 100 277,217 232,913 220,524 79.5 0 12,389 0 0 0 Ulanga 396 396 396 100 238,475 200,319 I 90,1 80 79.8 0 1 0,1 39 10 0 0 TOTAL 670 670 670 100 515,752 433,232 410,704 79.6 0 22,529 10 0 0 t, l5 2.6.2 What are the causes of absenteeism? . People in endemic areas are too dynamic due to various economic activities that does not necessarily be only farming, some are doing petty business ancl animal grazingthat makes them mobile all the time.Moreover, the census do fluctuate in Kidatu division as some are temporally inhabitants at Kilombero Sugar Company (ILLOVO). Most areto and from other Oncho endemic areas (Mostly Iringa and Mbeya). Then, when census are conducted on their presence; the data are included so as to receive this important service. This situation brings the increase number of absenteeism if their contract is termir-Lated or finish prior to MDA as also difficult or impossible to do follow up treatment. This is the case for both districts of Kilombero and Ulanga Districts, where by; the overgrazing following the influx of cattle headers with lot of cows led to aspecial campaign of reducing the number of cattle, hence; fluctuation of census in Mahenge Focus hencealso its population dynamics. 2.6.3 What are the reasons for refusals? o Most of the commtrnity members have taken Mectizan drug for more than l0 years whereby signs and symptoms have disappeared hence misconception that they have no infection and therefore they do not need to swallow medicine. 2,6.4 Briefly describe all known and verified serious adverse e'r'rnts (SAEs) that occurred during the reporting period and provide (intable 8) the required information when available. No Serious Adverse Events experienced since the project commencement in our focus. o Parasitologist trained? YES o Existence of nricroscope? YES . In case the pro-tect did not have any cases of serious adverse events (SAE) during this reporting period, please tick in the box. No SAE case to report t6 WHO/APOC, 14 September 2009 tr Table 8: Cases of serious adverse events (SAEs) that occurred during the reporting period (Please add more rows if necessary) SAJ* Age Sex Village of origin Date Mectizan was taken Date 1t' symptom S appeared Symptoms Health status before takrng Mectizan Date of admissron in health facilrty Date of dismissal from health facility Results of tests (thick blood smear) Outcome of prognosis Extenuating or complicating circumstances Alcohol involveme nt or not i\ o N E * Serial number of the patient WHO/APOC, l4 September 2009 lr t7 aa 1,r 2.6.5. Trend of treatment achievement from CDTI project inception to the current year Table 9' Treatments and coverage blz calendar year for the entire project area. (Please fill in the required data) Please irrdicate the UTG for the project area: 428,740 (use this figure as the denominator in all UTG coverage calculations.) torar IJIângâ dfufict did not dirtribute Mectizmin 2009 uûtil sfter the EPi Evrlurûon. Thereforê, only Kllomb€ro dish'lci dlsftibutêd Mectizrtr, This means, Kllombero dirtrid communities werr not included in theEpiEvrl rlthough lt ls wlthtn M.henge Focus ProJêci. 18 YEAR Communities/Vi11ages Population Total # of comrruuities/vrllag es ur the meso/hyper- endem.ic areas E, Anrrual Tleatment Oblectrve Er Nr"rniber of conll1lunltle s/vrllages treated Er Ceographi calcoverag e (%) Er- E3/ Er*100 ATO coverage ("',) Es: EJ Er*100 Total population of the meso/hyper- endemic areas Ft. Annual Treatment Ob..;ective Er Number of persons treated t'." Therapeutic coverage (%) I!s= E"/ E"*100 ATO coverage (%) Ero: E8i E?*100 UTG Coverage (%) 2003 527 527 527 100 100 4t7.209 350,456 283,617 67.8 81 2004 52',7 527 s27 100 100 428.325 359,793 301,079 70.3 84 92 2005 527 527 527 100 100 43s.010 365,410 312,252 71.8 85 84 2006 521 527 521 i00 100 441.013 370.501 318,s 81 72.2 85 84 2007 531 531 531 100 100 449,640 395,7 54 332.785 74.0 84 85 2008 531 531 531 100 100 453,426 401,802 318,413 83.5 94 99 2009 lt+ a1/1 214 I00 t00 256,121 205.3 82 211,543 82.4 r03 9.3 20 10 670 670 670 100 r00 498,248 418.528 lqi ?Rq 789 94 87 201 I 670 670 670 100 100 504,400 423.696 406,127 80.5 96 89 2012 670 670 670 100 100 515,7 52 433,232 4r0,704 79.6 95 80 WHO/APOC, l4 September 2009 2.7. Ordering, storage and delivery of ivermectin Mectizan@ ordered/applied for by - (trtlease tick the appropriate answer.) MoH Jll wÉo tr uiv-rcbn r O th er (fi-ease s peci fy) : Mectizan@ delivered by - (please tick the appropriate answer) MoH |_7l wHo tr uNrcEF E Other 1 please' speci ty ) : NGDOtr NGDOtr Please descrilte how Mectizan@ is ordered and how it gets to the comnt rmities o Mectizan tablets are ordered after conducting census in the affected community and getting the total population of the project. We calculate the nunrber of tablets require by multiplying the ATO times 2.2 then we get total number of required tablets. The Regional office request Mectizan and Albendazole to NTDs Secretariat. The request is sent to Mectizan@ Expert Committee for approval. Mectizan'D arrives in country through the same channel and is cleared by Medical Store Department (MSD) which handles over to the NTDs Secretariat. The NTDs Secretariat within the Ministry of Health and social Welfare are responsible for delivering of drugs through existing health system up to the District level. The District Council Authority distributes drugs to the FLHF by following request sent to them by FLHF staff. After delivery ofMectizan the FLHF staff informs the Village and Sub Village Authority on the arrival of Mectizan thereafter the CDD or any selected community member comes to the FLHF to collect Mectizan@ ready for distribution to other Cornmunity members. - Hotp are tlte renruining lvermectin tablets collected and where are the.1t kspll The remaining Ivermectin tablets are collected into bottles and taken back to the nearest health facilities and then they transported to the district pharmacy waiting for next distribution. I t I T List and brielly describe the activities under fvermectin delivery thut tre being carried out by heolth care personnel in the project area. Drug inventory and store remained drugs at central level which is the district Ordering of Mectizan@ drug, temporally storage of medicines, distribute to FLHF and then CDDs Training emd re-training of cDDs for census and distribution activities Conducting monitoring and supervision to cDDs during census update and drug distribution Data collection, aralysis and report writing Conduct fèedback meetings to affected community I r 0: Mectizan@ Inven 'Please add more rows if neces,ÿc State /District /LGA Number of Mectizant tablets In stock frorn previous year Requested Received Used Lost Wasted Expired Remaining Kilombero 0 1 ,0 1 5,000 1,015,000 943,735 0 s00 0 70,765 Ulanga l4 ,56 L 4s0,000 450,000 44t,561 0 327 0 22,673 TOTAL 14,561 r"46s.000 1,465,000 1,385,296 0 827 0 93,438 t9 WHOiAPOC, l4 September 2009 5 ' Plan for next year, financial, educational, Internal Monitoring and Evaluation 2.4. Gommunity self-monitoring and Stakeholders Meeting Table I 1: Cornmunity self-n-ronitoring and Stakeholders Meeting (Add rov',s if needed) 2.9. Supervision 2.9.1. Provide a flow chart of supervision hierarchy. NOTF CHMT/DMO I DistricV LGA Total # of communities/villages in the entire project area No of Communities that carried out self monitorins (CSM) No of Communities that conducted stakeholders meetins (SHM) Kilombero Ulansa 274 396 274 118 PT r22 TOTAL 670 452 356 COMMUNITY Level 2.9.2Nl.ain issues idcntified 2.9.3 Supervision check list used Yes/No 2.9.4 What were the outcome of CDTI implementation supervise 2.9.5 Was feedback given to the supervise d Ycs/No 2.9.6 How was feedback used in improving the overall performance of the project DISTRICT a)NTDs activities are incorporated in CCHP b)Comnrrtted DOTsAtrTDs Yes Problems and Successes Identified Yes -The project observed high Therapeutic coverage and maintai ned full geographical coverage. - The CHMT promised to fund the P/School Teachers 20 WHO/APOC, 14 September 2009 J I nnvrr nuo l--_--* /' staff training for Schisto control as only CDDs were considered for implementation of NTDs activrtics. FLHF Due to lack of transport supervision of CDDs are mainly done by FLHWs in nearby communities Yes Problems and Successes Identified Yes Mainta lr ed high therapeutic coverage - School teachers were involved in the health education to the pupils and Community COMMUNITY Communities are full involved in the implementation of NTDs activities hence there is ownership of the project and sustainability is observed. Yes Problems and Successes Identified Yes a) Sensc ofProject or,vner..-' r ip was observed hence sustainabiliÿ of the project. b) Treatment register were properly filled c) The Praziquantel distrihution to under 16 yer r.\ r " and out of school was a s.. icess to the 2nd (2010 U Langa&ZO I I Ki lomb ero ) and 3'd round in both districts clone in 2012by achievin s high coveraee. SECTION 3: Support to CDTI 3.{. Equipment Table 12: Status of equipment (Please add more rows if necessary) Source Type of Equipment l. Vehicle 2. Motor Bilie(s 3. Computer'(s) 5. Photocopier (s 6. Fax Machine(s 7. others 2t WHO/APOC, 1.1 Sr ptember 2009 APOC M )H DISTRICT/ LGA NGI )o Others No. Conditron Condrtion No. No. Conditron No. Condition 2 wo 1 CNFR 4 wo 2 lWO 1 CNFR 1 CNFR 4. Printer(s) 1 1F I F I F I CNFR a)Bicycles 44 44WO è *Condition o1-the equipment (F:Functional, CNFR:Currently non-functional but repairable, WO:Written of0. 3.2. Financial contributions of the partners and communities - There is no problem in the release of CDTI nllTD funds from the Comprehensive Council Health Ftrnds. Unlortunately Mahenge Focus has no NGDO partner to assist filling the gaps suclr as these transport and Computer problems in our two districts of our project. 22 WHO/APOC, l4 September 2009 Table 13a:Mahenge Focus: Financ contributio ns by all partners for the last three years (continued Calendar YEAR being reported 2012 GOVERNMENT contribution OTHER partners' disbursement Budqeted Amounts disbursed at the followinq levels otto disbursed NGDOs LocalNGDOs Communi ties Others APOCTrust FundBUDGET LINE Natio nal Regional District Total l. Mobilization, advocacy, sensitization et health education 1.1. Mobilization 1.2. Sensitization '1 .3. Advocacy 1.4. Healtheducation Sub-total I 1,365 993 1,233 733 4,324 1,365 993 1,233 733 4.324 1,365 993 1,233 /JJ 4,324 100% 100% 100% 100o/o N/A N/A N/A N/A ln kind ln kind ln krnd 1 ,159 1 ,016 1,478 883 4,536 !t--rrepins" - _2.'l . Training/retraining of ,CDDs 2.2. f rainingl retraining of Health workers §u-b-total ll- - lll. Supervision, monitoring, Evaluation 61203 1,746 7,949 6,203 1,716 7,s!9 6,20; 1,716 7,949 1oo% 100% l{À N/A NiA ln kind ln kind 11,838 3,811 '15,649 3.1 . -Supervision _ 3ê M-onitoring_ 3.3. Evaluation Sub-total lll 4,4.25 3,7le 0 8,174 4,425 3,7_49 0 8,17 4 4,425 3,749 0 8,174 100o/o 100Yo 0 N/A N/A ln krnd ln kind 3,910 3,616 661 8,187 lV. lvermectin distribution and management _q{g:_y919,a_d"v"91-s-9 9y9.?.ls " . . _ " " - 4. 1 . lvermectin distribution 12,666 -"0- 12,666 12,666 .9 12,666 12,666 0 12,666 100% 0 NN N/A ln kind 0 0 0 4,?.-\4qlqgenent of Severe adverse events Sub-total lV !_. ! ! !-i ! lo n a I e x p e n s e s ._§.1._s-g!q{gs _-__- _ _Q.2. Çqqippqnt Sub-total V 216,215 4,441 220.658 216,215 4,443 220.658 216,215 4,443 220.65A 100Yo 10Qo/o un N7Â N/A ln kind -soô 1,480 2,040 GRAND TOTAL 253,771 253,771 253,771 100% 0 IN KIND 30,412 WHO/APOC, l4 September 2009 3r 23 CI Table 13b :Mahenge Focus: Financial contributi: .Frna r l ons a rs for the last three rS continued Calendar YEAR being reported 2011 GOVERNMENT contribution OTHER partners' disbursement Budgeted Amounts disbursed at the followino levels o/o disbursed NGDOs LocalNGDOs Communi ties Others APOCTrust FundBUDGET LINE Natio nal Regional District Total l. Mobilization, advocacy, sensitization et health education 1.1. Mobilization 1.2. Sensitrzation 1.3. Advocacy _ 1.4. Healtheducation Sub-total I 2,365 993 233 1aa 4,324 2,365 993 aa2 /JJ 4,324 2,365 993 233 733 4,324 1 00% 100% 100% 100o/o N/A N/A N/A N/A ln kind ln kind ln kind 1 ,159 1,016 1,478 ool 4,536 l. lraining 2.1. T-raining/retraining of CDDs , 2.2. f raininglretraining of Health workers §_yp{olgttt lll. Supervision, monitoring, Evaluation 6,233 1,716 7,949 6,233 1 ,716 7,949 6,233 1 ,716 7,949 100% 100% N/A" N/A N/A ln kind ln kind 12,838 3,829 '16,667 3.1 . Supervision I2, M-o_rfrlC{ng __ 3.3. E-valuation Sub-total lll 4,425 3,749 8,174 4,425 3,749 8,174 4,425 3,749 8,174 100% 100% N/A N/A ln kind ln krnd 6,910 8,616 1,661 17,187 lV. lvermectin distribution and management of seuere aQyerge eyen_t1 4.1 . lvermectin distrib-uti_on - _ __ _ "4.,?._Mgqgg"e_pe-nt-o-[Se-vere-adversegyelt_s-- Sub-tatal lV 12,666 0 12,€,66 12,666 0 12,666 212,2"1.5 2,443 214,658 12,666 0 12,666 1000Â 0 N/A N/A ln kind 0 0 0 Y. - Ai ! ili p ttS.lexpe_ns es §.!. Sal3flqs 52. Equp_ment _ _ Sub-total V 212,215 2,443 214.658 21"2,215 2,443 214.65A 100% 1O0o/o NiÂ" N/A ..*,o ln kind . uu9 4,480 5,040 GRAND TOTAL 247,771 247,771 247,771 100o/o 0 IN KIND 43,430 24 WHO/APOC, l4 September 2009 able 13c : Financial contributions all rs for the last three years Calendar YEAR being reported 20'10 GOVERNMENT contribution OTHER partners' disbursement _a-s_qge$_{ Amo Natio nal unts disbu Regional rsed at the folk District cwing levels Total to disbursed NGDOs LocalNGDOs Communi ties Others APOGTrust FundBUDGET LINE L Mobilization, advocacy, sensitization et health education 1.1. Mobilization 1 2 Sensitization 1.3. Advocacy 1.4. H-ealtheducation Sub-total I 2,000 200 1,000 3.200 2,000 200 1,000 3.200 2,000 200 1,000 3,200 100% 1000/" 100% ln kind ln kind ln krnd 816 630 168 210 1,824 ltr.Tralqi_qg " " ?, 1 . Trai ning/retrain i ng oçP"D_g 2.2. I r arning I ret ra i n in_g -o-f H-e a I th wo rke rs S-ub--total ll lll. Supervision, monitoring, Evaluation 5,943 " 80! 6,743 5,943 890 6,743 5,94.3 800 6,743 100% 100% ln kind ln kind 2,e58 2,518 s,476 3.1-. Supervisio_n - 3.?. Monitoring 3.3. Evaluation Sub-total lll 65 1,100 1,765 65 1 ,100 1,765 65 1,100 1,76s 100% 100o/o ln krnd ln kind 924 1,389 1,570 3,883 lV. lvermectin distribution and management of severe adverse events 4. 1 . lverlnectin distribution 4.2. Management of Severe adverse events 2,891 0 2,89',l 2,891 0 2,891 2,891 0 2,891 100% U ln kind 0 il 0Sub-total lV V. Additionalexpenses ,ou,tïu 106,815 "'?1""" ,608 895 5.1. Salaries 106,815 5.2. Equipment :l3,290. 13,780 13,789 - 13,780 J q,790. 13,780Sub-total V GRAND TOTAL 120.596 120.596 120,596 IN KIND 12,078 WHO/APOC, l4 September 2009 arI' 25 _-1_. - ln kindlOOo/o 3.3. Otherr forms of community support c Describe (indicateforms of in-kind contributions of communities if any) Normally coutmunities collect drugs, store, and distribute, conducting census, data compilation, reporting ancl provision of training/meeting venues as their contribution to the implementation of NTDs activitres. This is in kind contribution. 3.4. Expenditure per activity - Indicate rn table 13, the amount expended during the reporting period for each activiÿ listed' Write the amount expended in US dollars using the current United Nations exchange rate to local curr ency. Indicateexchange rate used here US $ 1,700. - Any cornments or explanations? NONE SECTIOI\ 4: Sustainability of CDTI 4.1. Internal; independent participatory monitoring; Evaluation 4.1.1 FIas the project ever been evaluated/monitorecl? (Tick an1' of the following rvhich are applicable) V Year I Participatory Independent monitoring Mid Term Sustainability Evaluation 5 year Sustainability Evaluation Intemal Monitoring by NOTF Other Evaluation by othcr partners 4.1.2. What were the recommendations?The project is mature and largely sustainable project. with integrated approach for elimination of NTDs. 4.1.3. How have they been implemented? Sustainabiliÿ plan was developed and is being implenr ented accordingly. 4.2. Susrainability of projects: plan and set targets (mandatory atYr. 3) Was the projcct evaluated during the reporting period? N/A Was a sustainability plan written? N/A When was the sustainability plan submitted? N/A What arrangerlents have been made to sustain CDTI after APOC funding ceases in terms of: 26 WHO/APOC, 14 SePtember 2009 V 4.2.1. Planrring at all relevant levels: NTDs activities are integrated within the Council Comprehensive Health Planyearly. The planning is bottonr top therefore all levels from community to district are aware \ilith NTDs activitles. 4.2.2. Funds: Thror-Lgh CCHP and local stakeholders whom we are trying to mobilize we will be able to distribute the Mectizan, Albendazole and Praziquantel in Primary Schools. 4.2.3 Transport(replacementandmaintenance): This is the place where we do have problems as the NTD Project reqLrest APOCiUSAID management to assist us to replace the worn-out capital equipment. The District Council Authority through the Health Department Government can manage to do regular service, maintenance and repair; to the capital equipment provided. 4.2.4. Other resources: Communities are our main reliable source of success that makes us sustainable, with APOCruSAID and CCHp funds. 4.2.5. To what extent has the plan been implemented: Tl-re yearly plan completed to l00oÂ, because CCHP Plan is by 100% and APOC/USAID by1009{, funding for year 2012 4.3. lntegration 4.3.1. Ivermectin delivery mechanisms: The Mectizan delivery is within the Health systems, through the Medical Store Department (MSD) after MoHSW authorization and payments. 4.3.2. Training: Re-training was mandatory to be done at all levels of implementations as we had integrated implementation of NTDs activities. 4.3.3. Joint supervision and monitoring with other programs: The Council Health Management Team (CHMT) conducts Joint supervision with a regional checktist of supervision that includes NTD activities that are implemented tusing CDTI strategy. 4.3.4. Release of funds for project activities: The release of funds follows the Government procedures and was disbursed on the right tirne according to the plan. 4.3.5. Is CDTI included in the PHC budget? CDTI has been included in the PHC budget we expect that its allocation will increase yearlyas we are dealing with multiple diseases in ComDT for NTDs. 2l WHO/APOC, 14 September 2009 4.3.6. l)escribe other health programmes that are using the CDTI structure and how this was achieved. What have been the achievemerrts? " Fill tables 14 and 1-5 and provide describe other programmes that are using the CDTI structure and how this was achieved. What have been the achievements? * For each intervention listed in table L5, explain what were the roles played bythe CDDs (census, mobilization, distribution, data collection, storage, collection of drugs, referral of SAEs, etc ...)? , Explain what are the combinations of interventions co-rmplemented? " How were the interventions implemented? (at the same time?) 4.3.7. I)escribe other issues considered in the integratiorr of CDTI. The formation and strengthening of the Kilombero Drstlict NTD Secretariat was our top prrolity this year so as to do better integration than beforc. Our team in Kilomberois comp'sed l' il:::r );:fî:i::[î:ri:J:i'tri secre,a ry . District Pharmacist - member . District Eye care Coordinator - member :l*llîiiï**d{tïfff' This group met after ever-y four month to discuss all issues of NTD as above, integration and sustainability. We hope to do better in the coming year 2013 as we are on maturity of sustainability of this program. 28 V/HO/APOC, 14 September 2009 Table 14 : Co-im entation Type of control Type of intervention Roles played by CDDs (explain in bullet points) Number of districts Number of communities Number of CDDs involved Number of persons targeted Number of persons reached Iargeted Reached Targeted Reache d Males Femal es Total Males Females Total Males Female s Total Onchocerciasis elirniuation o lvermectin C istribution LCNCLIS Collecting mediclte Distribution Health education Mobilization Data and report 2 670 670 961 8s9 1,826 218,168 215,064 411 )1) 206,640 204.064 410,704 Lymphatic filariasis o Distribution of lvermectin and Albendazole Cencus Collecting medicine Distribution Health education Mobilization Data and report 2 2 144 744 1,061 1,018 2,085 310,848 262,692 s73,540 30 i,789 240,s67 542,356 Schistosomiasi S o Distribution of Praziquantel Health education Mobilization 2 2 259 2s9 *961 x85g *1,826 10'7,455 106,223 213,678 9l ,033 89,1 80 180,213 STH o Distribution of Albendazole and Mebendazole in Reprod uctive Health Clinic for Underfive children Cencus Collecting medicine Distribution Health education Mobilization Data and report 2 2 744 744 1,06'7 1,018 2,095 3 10,849 262,692 513,540 30 r,789 240,561 542,356 Malaria control o Distribution of LLI Ns Some involved in household ccusus according to the age, ilistribution, ITN hanging and health education (Done in Kilombero district onlv) 1 I 365 365 329 660 989 53,036 55,436 t08,472 48,3s1 51,431 )9,794 WHO/APOC, 14 September 2009 ar 29 )_ aaf Malaria control o Home management of malaria Malnutrition o Vitamin A supplementati on Trachoma a NOT APPLTCABLE Cataracts a Others (specify) a o t a a a NOTE: *CDDs were inÿolveal on health education and mobilization ro Praziquantel swallol,ÿing il Prtmaty Schools. In addition to that, the nÿûber ofPrtmary schools, have been used a.s communities for praziquantel distib 6û. 30 WHO/APOC, l4 September 2009 Involvement of communities in Onchocerciasis control r lvermectin dlstribution J ! Nor enr I Integl ll elat Cornnrunity members District and FLHF VI{Ws, Cor.nmu nity leaders and CHMT Sub village leadcrs and CDDs CDDs, Communit y leaders, FLHV/s and NTD Coordinato 1 Lymphatic filariasis District and FLHF Sub village leaders and CDDs CDDs, Communit y leaders, FLHWs and NTD Coordinato r o Distribution of lvermectin and Albendazole Community members VHWs, Commu nity leaders and CHMT FLHF and l' r'r nra ry' schools Health Teachcr S Ward ExecLrtive O lllcels and Head Teachers are the monitors and Supervisor s of this exercise FLHWs and Health Teaclicls Schistosomiasis . Distribution of praziqua ntel October I School - IHealth Nor enr Plogr.a ber I nr Employed Health -1 cachcls Health Teachers Sub village leaders and CDDs CDDs, Communit y leaders, Com munit yllead APOC ruSAI DICC VHWs, Commu nity o Distribution of Albendazole and Mebendazole Table 15: Other programmes using CDI structure (tick as appropriate) Planning -_§g\1 Inrplementation i ,r pc t.rr pelir-rri nrcrde Provision of res o 1l rc es selection ot' implementer collectiorr of commodit ies storage o1' commodit ies distri bu tion s u l)e t'v ls lon r\ir.rrrr tclring CSM Reporting tinanci al ln kind 3l WHO/APOC, l4 September 2009 iI CDDs CDDS Com munit yilead ers APOC /USAI D/CC HP Novem ber Integrat ed CDDs CDDS Com munit y/iead ers APOC ruSAI D/CC HP Done FLHW, wEo, I Ieatl Teacher S FLH Ws, llealtlr Teach ers, Leade rS APOC ruSAI D STH Novem ber Integrat ed Community members CDDs District and FLHF CDDS aat FLHWs and NTD Coordinato rMalana control Malaria control . Home management oi nralai i; o Vitamin A supplementation Others (specrfy) NB: the interventions listed in the table are justfew examples t1 32 WHO/APOC, l4 September 2009 4.4. Operational research 4.4.1. Summarize ilr not more than one half of a page the operational research undertaken in the project area within the reporting period. NO operatronal research done in2012. 4.4.2. How were thc results applied in the project? NOT APPLICABLE SECTIOI\ 5: Strengths, weaknesses, challenges, and opportunities - List the stlengths and weaknesses of CDTI implementation process. - List of strengths of CDTI implementation process: and ir-np I ementsNTDs activities. Schistosomiasis and ComDT, Mectizan, Albendazole and Praziquantel drugs and its side effects at all levels points throughout the district now extremely rare Weakness: with CDTI and work overload to the existing ones. control List of challenges and how were addressed during training and stakeholders meetings transport equipment. Sol. ÿVe tteed an NGDO partnerfor NTD to sutpport us on tlte gaps identifted in our project. Tlte CHMT rttentbers are using old butfunctional vehicles ltence timely imple nrcn tation of' actit,ities is impossible. Sol. Effirts are ongoirtg to ensure that NTD control activities are included and Schîstosontiasis elimination incorporated inComprehensive Council llealth Plans 2013. 33 WHO/APOC, 14 September 2009 t t D t Sol.: I'l/e encourage CDDs to continue volunteering ond we nrctivate them by training tltem 1t2ç1vly. Moreovcr, seelc Village and cornmuniÿ lesclers to /înd in kind supports to their CDI)s. is in at staLe of CNFR with a Functioning Printer. This delays communication and timely reporting ar-rd submission using thisas also a communication device. Sol: lÿe ttr-e u computer at the DMO's offices but sometintes its full occupied by other progr(tttt ofJicers other thart NTD. SECTIOI{ 6: Unique features of the project/other matters: NONE I a 34 V/HO/APOC, 14 September 2009 ,t' a, .? + r' .1 t