Kebbi CDTI annual project technical report submitted to Technical Consultative Committee (TTC) : December 2002 to November 2003

II KEB'#{ STATE CqMMU\,{ITY DIRECTED TREATMENT WITH IVERME CTILY ORIGINAL: English riod (uqntnrYear) : December 2002 to November 2003 :d: January 2004 "i"*il'+ffi+i'l+.rf';:"li+'-r*'+, -"ffi !i"''iii-'-- - - - - - tor I Tot ,"..,t;'pir+yrilili.llj . -.: :l-11,i,:'--rr;- -i!--14, l'.'.1- i.: r,'- , /. - FOURTH YEAR ANNUAL PROJECT TECHNICAL REPORT TO TECHNICAL CONSULTATIVE COMMITTEE (TCC) AFRICAN PROGRAMME FOR oNcr{ocERCIASIS CONTROL (APOC) I I 1 r I : I I :.-# .'rc ?"tr. 6 n{drmotlo \\tr ,AO , nI tnt3. O\- t' i I i I l I Proiect Name: Kebbi CDTICOUNTRY/NOTF: Nigeria vear: December 2000LaApproval Year: SePtember 2000 NGDO Partuer: Sight ln Savers Jigaw, bmftrt Nigcr Trrrbe Ogun I t_.-_-,_ ri {.. L[ I 7 il0v. 200{ + i! r-) r- I D I R ,: WHO/APOC, 26 SePtember 2003 I I i I I I I I I I I I I I I I -) Nassrreve Orrdo t, t. I E I t 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: t I I I I I I I I I I I I I i This report has been prepared by Name , kl.t Country : Nigeria National Coordinator Name : . Signature : .. Date Zonal Oncho. Coordinator Name Sr*,r Signature Date , l-?r* r AgozeI Designati on {/.RD?3Li...Qffi CtrL 1l WHO/APOC. 26 September 2003 Signature Date t,WtEt^l-I, Table of contents ACRONYMS Iv DEFINITIONS FOLLOW UP ON TCC RECOMMENDATIONS EXECUTIVE SUM},IARY v 6 8 9 9 9 9 1 N I: BACKGROUND IN 1.1. GENpRel rr.-FoRMATIoN.... l .I .I . Description qf the prqiect (brie.fbl) l.I .2. Partnershin 1.2. Popt.iLnt't<lr.- AND HuaL.l*u sysTEM SECTION 2: IMPI,E NTATION OF CDTI...... PeRroo oF ACTIvrrrES ORpeRnc. sroRAcE AND DELIVERY OF I\ ER}IECTIN Aovocacy nNo SENs rrrzA'rroN MostLlzr\ttoN AND HEr\LTH ED ATIO\ OF AT RISK (JOI\4MI NITIES Cor,trl.tr NIr Itls INvor.\/E F]NI- IN DECISIO\-VIAKtNG Ceprct IY Btru-Dr\G 2.6.1 . Troining... 2.6.2. Equutment ttnd humun resources CoxolrtoN oF TIr! Eol- IPI\,IEN'I' * PLusp s'f.{l't 2_ l- ).7 t TRearivirNrs 2.1. 2.2. 2.3. 2.4, 2.s. 2.b. 2.8 St'prnv'rsrol SECTION 3: SUPPORT TO CDTI 3.1. 3.2. FtNercral coNTRI OrsER FoRMS oF A\D COI\,IMUNITIES iVIUNITY SUPPORT -1.-1 ExpuNon'rjRu PER AC'nvtr Y SECTION 4: SUS'I'AI NABII,IT'Y OF CDTI..... 1.1. 4.2. IN't'lnNnt-; r\ r)lrptr\DEN I p.{R I'tctpAl oR\' \.loNrroRrNG; Et'aLrra ltoll Cov H,t t,N trv sELF-MoN troRt N nn o SrereHoLDERS MnrrrNc; .J4 Qt tcrr IxrA Drr rr!'n r) D /-:E'I-e NTaNII\-1l'r)Dv l r vp 1\L- P D ECTS: PLAN AND SETTA 4.4. INt'ecnalroN 4.5 Oppnarro \AL RIISIIAR('H WHOiAPOC. 26 September 2003 ............ r7 ............17 13 16 .......... l8 .......... 19 ......19 .........21 ..........21 ..........22 .........22Treutntent figures) 7 3. Trend o/'tt'calntent oc.ltict't,tttt:nl {rotn C:I)TI proiett inc'cption tct the. ('urrent vcur 27 29 29 30 . ........ 31 ..........31 ..........31 ..........32 ..,.,.....32 SECTION 5: STRENGTHS. WEAKNESSES AND CHALLENGES ............33 Acronyms APOC ATO ATrO CBO CDD CDTI CSM LGA MOH NGDO NGO NOTF PHC REMO SAE SHM TCC TOT TINICEII T/TG wHo African Programme for Onchocerciasis Contol Annual Treatment Objective Annual Training Objective Community-B ased Organization Community-Directed Distributor Community-Directed Treatment wrth Ivermectin Community Se I f-Monitor i n g Local Govemment Area Ministry of Health Non-Governmental Development Organization Non-Governmentai Organization 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 trarners United Nations Children's Fund I-lltimate' l'reatment Goal World Ilealth Organrzation lv WHO/APOC. 26 September 2003 Definitions (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/o of the total population in meso/h1per- 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 Treatrnent 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) Geoeraphical 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). WHO/APOC. 26 September 2003 FOLLOW UP ON TGG REGOIUIMENDATIONS Using the table below, frll in the recommendations of the last TCC on the project and describe how they have been addressed. TCC Session - 17 ACTIONS TAKEN BY THE PROJECT At the time the report was sent there were reports from a communities which were outstanding. The final heatment figures therapeutic coverage for the project at the end of the third 1(December 2001 - November 2002) is shownbelow : In the first three years of the project, the State released US$29,60( counterpart funds, while the six APOC LGAs conhibuted US19,56t the fust year, but due the reduction of funds allocated to LGAs, LGAs have nninly paid salaries of staff and in some instances sr amounts of funds were released for direct CDTI activities. Some fu were also spent as part of integrated efforts (general pHC activitit monitoring and supervision) and it was difficult to separate the ac funtls used for direct CDTI acfivities. Only 80.5% (i.e. 153 CDDs) were identified as needing training and was the number that was retrained. Monetary il activrtres has alra been a problem. thus the project encourage communities to compen: them or motivate them by assisting them rn their farm work. Most communities have trained CDDs and because of the low liter Ievel rn some cofilmunitres, these communitres arrange for CDDs fi other communitres to come and treat them. The people of these areas predominantly Moslems and it is difficult to get female CDDs and e access to women during mobilization for treatment has been diffic The supporting NGDO (Sight Savers International), the State and L control teams have arranged special mobilisation sessions for women addition Islamic scholars and teachers were fiained on CDTI so that t can assist in mobilization and health education of women. See response to comment 249 (ii) below The rssue of geographical coverage is noted and will be included in subsequent reports. The geographical coverage in the third year 100% The project rs making efforts to ensure that the project is sustarnable. ' State government has provided funds for direct CDTI activities. Tt has been a dearth of funds at all the local govemment areas. He, activitres are being carried out rn an integrated manner, particulr monitorrng and supervision of CDTI, thus it is difficult to separate exact amounts expended by the local govemments for direct CI activitres. Efforts'are however being made through the local governr semce commrssion to the local areas to 6 Number of Recommendatio n in the Report TCC RECOMMENDATIONS Comment 244 The project did not achieve the desired therapeutic coverage and geographical coverage was not given. Comment 245 The State released about US$2,813 while the six LGAs did not release any funds for CDTI activities. Comment 246 The project had a ratio of 5 CDDsicommumty, but only 80.5% (153 out of 190) communities had trained CDDs. 63.7% (121 out of 190) commuruties gave monetary incentrves to the CDDs. Comment 247 Lack of trained CDDs in some communitres and./or monetary incentives may be responsible for the low coverage. Involvement of women was seen by the project as an rmportant issue. Comment 248 TCC 15 No report provrded on sustarnability as recommended Comment 249 TCC recommended that(r) Geographrcal coverage should be included in the reporl(ii) The pro.;ect should reporl on sustainablhty as requested by TCC WHO/APOC, 26 September 2003 di NOTF should find out why a good project is declining in performance and report to APOC management of the actions taken in order to rectrfy the situation. (iii) it Treatnent coverage for Kebbi State CDTI for year III Geographic coverage of the pro.;ect was 100%o. All endemrc communities were treated Summary of CDTI Treatrnent figur-es from Year 1 to 3 for Kebbi State CDTI Project funding for CDTI activities Contrary to TCC's cornrnents the project has been doing well si inception. Please find attached a srururuuy of the therapeutic coveragr the project by local government since inception of the project. project has maintained a coverage of 82o/o since its hrst year and the S government has continued to contribute funds for direct CDTI activi aside salaries paid to personnel. 7 Local Govt. Area Population No. Treated Coverage I Bazudo 27,517 22,023 80% 2. Ngaski 22,086 18,540 84% 3 Sakaba 34,804 28,663 82% 4. Danko Wasagu 48,083 40,048 83% 5 Zwu 5,668 3,560 63% 6. Fakai 8,1 93 7,015 86% Total 146,411 119,849 82% Year I - 2000 Year 2 - 2001 Year 3 - 2002 Pop Treat Cov Pop Treat Cov Pop Treat Cov I Bagudo 30,180 24,403 8t% 26,965 20.271 1s% 21,577 22,023 80% 2 D/Wasagu 31,996 27,628 86% 32,858 28,202 86% 48,083 40,048 83% 3 Fakai 7.941 6,694 84% 8,392 6,934 83% 8,193 7,015 86% 4 Ngaski 36,141 28,892 80% 35,436 29,028 82% 22,086 18,540 84% 5 Sakaba 3l,068 25,564 82% 31,791 27,674 87% 34,804 28,663 82% 6 Zrnt 3,398 2,311 68% 3.710 2.510 61% 5,668 3,560 63% Total 140,714 rt5,492 82% 139,212 114,625 82% 146,411 119,849 82% WHOiAPOC, 26 September 2003 Executive Summary Prepare an Executive summary of the report in not more than one page. l. Background on treatment and population data - Total corffnuntttes, communities' heated, total population, UTG, ATO and persons heated. 2. Background on population movements. 3, Training data - CDDS, health workers, Total population (community) per CDD trained. 4. Challenges and how they were overcome. The Kebbi State is located in northwestern Nigeria. The State commenied the tnrplementation of Community Directed Treatment with invermectin (CDTI) under the African Programme for Onchocerciasis control, (APOC) in 6 LGAs (Bagudo, Ngaski, Sakaba, Zuru and Fakai) of the State in September 1999. lt was an expansion of an already existing Community Base lverr.nectin Treatment (CBIT) Over the year advocacy visits were taken annually by the Director PHC l\4inistry of Health and the State Oncho Team members to solicit for support of Local Government Areas and ihe Traditional rulers to solicit for support and smooth implementation of the programme. ln the fourth year the prolect, the State Commrssroner of Health briefed tha press to .cnrmemorate the l"lational onchocerciasis Control Day in February. 2003 ,^-eDbt State rs f,rriciorninantly moslems and many nomands who move durrng the dry seasons and return at the commencement of rains. The project treated 119,849 person (82% iiierapentic coverag-) ri, rts third year (2002) and targeted to treat 130,000 persons in 2003iii the end of the fourth year.148,492 persons (83ouo therapeutic coverage) were treated in i!i9 enderlic conri,ri.ti,rtres witit a population rsl 1TT .331 ivlectizan@ was recerveo early through Sight Savers and drstributed to the six endemic Local Government Areas artC comntunities collected them at agreed collection points. The non r-elease of funds lrorn APOC affected programme rmplementation. No trainings of State or icrcal government control teams were carried out during the year. The Local Government areas trained/retrained Community Directed Distributors where necessary, A total of CDDs were trained Sight Savers provided nrotor cycle and bicycle spares for monitoring and supervision and funds for the training of the lslamic scholars, Traditional Birth Attendanti arrd lmams. The State provided US$7,407 as counterpart funds, The funds were used for nronitoring and supervrsron and repairs of the state project vehicle. 'r'2003, we invoivec w.iys uf reaching wornen in pi;rtlah. by having separate nrobrlrsation ::ssloos i'iri v'voirrrri; allC the trarriing of lslamic Scholarslteachers, Traditional Birth Attendants and lmams on CDTI. Despite all these the lack of female CDDs and incentives for CDDs has continued to be a problem for the project. 8 WHO/APOC, 26 September 2003 SECTION {: Beckground inf,ormation 1.1. General information 1.1.1. Description of the project (briefly) - Geographical location, topography, climate - Population: activitres, cultures, language - Communication system (road...) - Administrationstructure - Health system & health care delivery (provide the number of health posts/centers in the project area if the informatron is available). 1.1.2. Partnership - Indicate the partners involved in project implementation at all levels (MOH, NGDOs -national, international) - Describe overall working relationship among parhlers, clearly indicating specific areas of project activities (planning, supewision, advocacy, planning, mobilization, etc) where all partners are involved. - State plans if any to mobilize the state/region/district/LGA decision-makers, NGDOs, NGOs, CBOs, to assist rn CDTI implementation. Kebbi State is located in the North Western part of Nigeria, the State was created out offotnter Sokoto State in the year 1991, the State compris; of 21 Local Government Areas of the State with a pcpuiatron of over 2.06 mrllion people iteobr has a boundary with Niger and Bentn Republic on its North West boundary, to the North and the East is Zamfara State. The major rivers are. River Niger and River Rrma. The vegetation mainly comprises of Sudan and the Savannah grass tanO witfr mountainous hills in rnost of the project areas. The climate consists of the dry season (November to April) and tire wet season (hlay to Cctoberi. il,a niatn ocl:up-:trul ;, lt-rrr lieollltt tS iai-nllr.rg. iisi:ing, rearing And tfadlng f-irC per,plC are rrlostly indigenes li\',i'r-J rn pernranent settlement, with the exception 6f Fula,-,, nomads. Commurrity leaders in consultation with their elders and communrty members make decision. Kebbt state is linked to other parts of Nigeria through the national telecommunication system with eratic services to most of the LGA headquarteis particularly in the endemic areas. N/ost raods leading to the LGA headquarters are motorable, but the roads to the communities are mainly laterite roads which become very inaccessible in the rainy season because rnot of the communities are end of the road communrties access to these communrties is ursually by l-irc,trsl6 motorcycles. 4-wlteel cir^ive opr through foot paths during the rarny season. The state has a democrattcally elrcted governor as it's head of government with elected chairmen and concilliors manning the affairs of government at the LGA. The lMinistry ofhealth like other Minrstries is headed by a commiisioner of Health who oversees all health and health related lssues in the state. The department of primary health care is one of thedepartments in the ministry and the oncho programme is under tlris department There is a drrector of PHC who oversees PHC acttvities ancl drsease control at the state and LGA level. There are programl',18] offtcers for Oncho anci olher heaitli programmes at the state and LGA ,,vho ,:versees the rmy;le,-rrentation of programn-le actrvrties. lslam ls the religious practised by the majority of the people, and the marn tribes are: Hausa, Fulani, Kabawa, Dakkarl<ari and Kambari. l\4ectrizan (R) distributed started in Kebbi State in 1995 in 7 LGAs (Bunza, Bagudo, Ngaski, Sakakab and Zuru). Latertwo LGAs were created namely Fakai in Zuru LGA and Shanga in yauri LGA 9 WHOiAPOC, 26 September 2003 Before the implementation of Community Directed Treatment with ivermectin (CDTI) Community based treatment with lvermectin was used as a strategy for distribution of lvlectizan. ln1995,16,254peopleweretreated,50,2g2,in1996, lo,710in199z,andg4,1g7 tn 1998. With the support of the African programme for Onchocercisasis control (APOC) 96,316, 115,492and 121,818 persons were treated in 1999,2000 and 2001 i-espectively. ln 2A02186,896 person riryere treated giving a coverage of . ... . for 1ggg, 2000, 2001 and 2002 respectively. Sights savers international has since 1995 supported the distribution of mectizan to control riverblindness in the state, using the community based distribution with the introduction of CDTI in 2000 APOC because a partner and had since then supported the programme with vehicles, oflice equipment, generator and logistic inadquate to direct funding of programme activities. The partners, SSl, NOCP(zone C) and the state (including) LGAs and communities have worked harmonously in implementation of project activities, from planning to advocacy, mobilisation and monitoring and supervision of CDT|., SSI support distribution in Suru, Bunza and Shanga which are not supported by APOC. The state plan to hold a sustainability workshop for policy makers and decision makers at the state and LGAs level to advocate and develop strategies to surtain the programme. A community is defined as a group of people livrng in one place, with same/srmilar culture atrd occupation with a shared rnterested livrng together (Even though there may be religion dtfferences). ln some cases smali clustered hamlets are gro0ped together as a community, while in other cases blg communrties are sub dtvided into smailer unrts for easy implementation of CDTI by communrties. The cornmunities themselves norrnally take deciston aboul tlresu Crvrsrons 10 WHO/APOC, 26 September 2003 co c.l ko o 0)a \o N o o +r uq) o'L q) SGi *() -!U(d *sto'o al 9 UHB6)ps 3ts aOi=^ qSos- b.ES -H T\ E .\ iB i,i :qY\L5.:. I sSd9r 3 'a- u -+LA,O)\-p E$h -.s ? HL '=L L< -sh Qr "iilu boi-s d sr\ !s- YFL'ir .:$ ^. trbE EssEA9iSBO>$o ;Lq,eo.qshe sd a -uP SF ?su^lqr 5F.aJt q $:ti R} .H -Hq)9D 'a '\ 'o GioP()tr! ! bDEq\(dE ':qJ=ki$t '5 F^9>ko .\=' o x o'i 6o -R s Bz =sc(jS; EEtoo dtrs S o;-S S EESaLiaE3 gEs.e 9Hs's E E aJ \ bn|<T P E€ .^MqdFio\y" 9E8- dti\l:i Io:5 gz-Et s{ rr (l f\ L Ft= hJ -S Lq) '-l 2d -23 5 6t, cllzl I I I ; 5CB ^O6> CJq q) (.) q) o\ \);_ o \ B q) U) U o-v <, o Ho bo L op.() H C) bo r € o H () d 0)r (.)rd >. C) H() 0) ctq) L cl q,) rr EeOEfl :.'o; o; S)4s.2 -!G!o: .F6 I E*EAts& )! oE a-6floG.E E)dCEOEEd -l..-lN*l .ElFFI o o 6l a o ni (J Fp oi :6- =cd = 8e $\otr)\o N Ot co co c.) s .{- a.l ao \o o\N$ coO .f co:t o\ al o\$ 6t a I <oo .= aN s €'E ool.iF 3,8 F- $ c.) co t--t @ ca @o t--Otf .t r) co @ @$ s$o ro(.) r-t- o :''l r.Ef 5&E.=6; >.!o)0,)"E F E'E N= o O O O O o E:q, c)i ! ?.; E #si r- <- cA coF-s@ @O c- $ O $ co oo @$ O <-$O c.) ra F-tr 0 6)6!6 o(D E, E6q) o €J .o tr z /, l" I IL q,) o. -, oN q).= trE do oF O co v:f Oca $r- O o\o\ .eE ts9o! .E P- EcJ:\9E ii€.gotr >:(D >r(C N O O O 'EgE q)t: ?er6 oF! z O ca :f <- O cO $ t-- O o\o\ dd0) .=ic{ €.r- cliJ:i --r E X'd = o.:ts *qr 9' v9-L LA-A r- s c.) cor-$ @ co @ F- s O co co @ <- o$$o (o t) t-t- o) >trF -o:Y .iq)d o'Q =tror-r .i '= -42ri< a AU(JFI bodEA J4 bo z cd .od& cd Cn oo cd d It E N d -vd H tl i< F A community is defined as a group of people living in one place, with same/similar culture and occupation with a shared interested living together (Even though there may be religion differences). ln some cases small clustered hamlets are grouped together as a community, while in other cases big communities are sub divided into smaller units for easy implementation of CDTI by communities. The communities themselves normally take decision about these divisions. t2 WHO/APOC, 26 SePtembet 2003 ti SEGTION 2r lmplementation of GDTI 2.1. Period of activities KEBBI CDTI TIME PLAN OF ACTION FOR YEAR 5 S/n Activities I't Quarter 2'" Quarter ardJ Quarter 4th Ouarter Expected Outcome 1 Advocacy to state and LGAs NGDO, NOTF, ZOTF Political and financial support from state and LGAs 2 Procurement of Mectizan NOTF Early availability of Mectizan for distribution to collection points. J Procurement and Supplies Project Effective administration running of the office. 4 Training of SOCT/LOCTs Facilitators Retain staff on CDTI activities & implementation. 5 Contact visits to district and community leaders LOCTs LOCTs Disseminate information to CDTI and Mectizan dishibution. SOCT/LOCTs Create awareness on Oncho CDTI to the general public and policy makers through the media. SOCT/LOCT & TBA SOCT/LO CT& TBA SOCT/ LOCT SOCT/ LOCT Assess control activities and decide on way of over coming. State/Lor--al Oncho Meetrng Slakeholders meetlng Oncho Week6 1 8 SOCT/LO CT& Comm. Strengthen partnership, create awareness on roles and responsibilities, solicit support and sustainability of CDTI. 9 SOCT SOCT SOCT SOCT To report and share experience with other projects withrn the zone. l0 Attending ZOTF meeting Advocacy visit to policy makers MOH officials/SOCT and LOCT Sensitize policy makers implementation of CDTI and solicit for political commitment and financial support. 1l Mobilisahon and health education of LGAs and communities SOCT/LOCTi NGDO SOCT/ LOCT/ NGDO Ensure active community participation in CDTI implementation. 12 Selection of CDDs (where necessary Community Comm. Ensure that the CDDs; Pop reaches 2:250 is aftained. 13 Training of CDDs TBAs & Islamrc Teachers SOCT/LOCT SOCT/ LOCT Sensitize CDDs. TBAs, Islamic teachers and community representative on the need to ensure good treafment and therapeutic coverage in communities. t4 Up date of house holds regisfration CDDS/LOCT to supervise) CDDs (LOCT to supervise) Ensure that all members of communities are registered and improve and attam exact coverage. 15 Distrrbutron of Mectrzan CDDS CDDs CDDs Control and prevent blindness due to Oncho 13 WHO/APOC, 26 September 2003 i i lr t6 Self monitoring and supervision by LOCTs Comm. LOCTs Comm. LOCTs Comm. LOCTs Create awareness in community on the need to ensure adequate therapeutic and geographical coverage. t1 Monitoring SOCTNG DOA{OT F SOCTA\G DOA{OT F Ensure proper registratiorl adequate therapeutic, geographical coverage. l8 Collation and submission of reports to SOCT Corrn/ LOC-T Comm/ LOCT Report on treatment in the communities t9 Submission of reports for analysis to SOCT and NGDO SOCT SOCT Analyse treatment geographical coverage for the year. 20 Follow up Eeatment (for absentees where needed) CDDs CDDs Ensure that all those not treated are treated before the end of freafment round and irnprove treatment coverage. 21 Submission of follow up reports to LOCTs, SOCT andNGDO CDDs/LO CTs CDDs/LO CTs 22 Preparation for next treatment round LOCT/SO CTA{GD o Look at the propi:r performance in the treatment round and plan for next treatment. Improve therapeutic coverage. t4 WHO/APOC, 26 September 2003 c.lOON k() .o 0) e.()a \o c.t O H o A B ra) () G)H o 0)E .o o (! 0)H 0) H() -o 0) (! o () () ..i o a o F-l O o Ar \o() oEaro>\ .1 -^:5ti(! ilEUgod i bo@ Sd"t '! q4 u ()(t\6-r .'dH * E.HEF! S aE . EG, \ a!$ i9T HEbn-rtri- 'i E-s E9YH/ts Fa --o; rts -:v;g rts .HU!\o \,jG o''i o o r Y'ti S H-s -o9dH E cs1 fa\s =E\u(vs'70) s,+d3 s9u:9S- +jA s 71 .! .A(la$ .(.os F9SH\orS'q S s4ii .i E.sE ()qd^It tr!?a H*;'o(,; UE:+trO r\ va $ o !,) oL \J U s: N q)q q) o_v t<(d o olr C) 0) o cd oH (/)(! ol<(n 0) H a o o cB(H o o 0) F c.ir o,I -liitFI ,.I U) o 6)€ gE Q N a.l c) >r = C ^l c..t a.{ f a0EE al ai - - /a- .>- /i - ^l E O OT a oJ! +6 EE Q c! c. 1)a al o- ,J) aa ^l a-rJ e O N a) ,J> C-i a ca al a-o 'J) hnEE ?E d= dt <)k CI /. .l .J a\ ,) aa OL C a.l EJ !6 z 6) d o q q o Q] o HE U C on g U CJ CC ^.1 -q? a (, ^l :) a Ocl ') .)- ') a-lO N -q 'J! 5 2, a0CE ?tr d= .l C c\ .J Li al U a) .l .c L c.l .co Lr- -l -c CJ * * OT 6l H o EE U l( a0e,E ?tr G= + o.: iJEs: -otroo z o! EE oI cn , z. a.l =:) aX ,1. (, ^l i al: f al -= ,.) c., an 6DdE 6t= C a-l -a , c.t ,, a\ 'c a): 6l -.c:r c., ^l -c .J a\ -o F] (J o o .o ho .d FA .V d bo z .odIZ(o a oo d (o a ttr N (€ f(d trr rl F E< 2.2. Ordering, storage and deliye4y of ivermectin Mectizan@ ordered/applied for by - Qilease tick the oppropriate answer)MOrr a wHo E uNrcEF E NGDO Other (please specify) Mectizan@ delivered by - Qtlease tick the appropriate answer)MOH ! wHO E uNrcEF fl NGDO trOther (please specify) : Please describe how Mectizan@ is ordered and how it gets to the communities At the end of every treatment round an inventory of drugs used for the treatment in the preceding year is carried out and sent to the NGDO. The NGDO will then report on reatrnent and apply to Merck for the drugs for the next Eeatment round. UNICEF collects the drug and clears in country while the NGDO will collect the drug from the TINICEF and deliver them to the State or inform the State to come and collect its allocation. From inception of the programme the drugs were usually issued to the Local Government Areas after trainings and they inturn deliver them to the agreed collection points where Community Directed Distributors are trained issued drugs for their, communities. In 2003, the drugs were delivered to the Local Government Areas, who in turn ensured that they reach the collection points from where the communities collected their drugs for distribution. Table 3: Mectizan@ Inventory (Please add more rows if necessary) State activities under ivermectin delivery that are being carried out by health care personnel in the project area. llr-,rlth ('ar e proqlell)nr(' arc responsrhlc lirr collectron ,r1'dluqs llorr: Ihe State \4OI I arrcl errcul'inu thlrt thc tlrlLqs are deporrlcrl itt Jollculion c('lrlra\ lili lhc cornnrunrlle:, lo cornc and cc,ilcet tlrcir rlrrLgs. I)riol trr rlnr!. Ir all)lttgol'('l)l)'t]rcrr'trlit'cl ihcrltltugstbr-distubutiournIhcrrcomrriunitres. i'hchealthpL'rsonnel \.lsrt atlcasttrtice1oeusut'ccorrectcensr.lsupdriteantldistribulronof rnecttzan. 'Ihe1 alsotreatca:eso1'srde lieatior.r"s rr.here rcl'c rrc<l or i tleurr fletl Any other cornments State/District/LG A Number of Mectizan@ tablets Requested Received Used Lost Waste Expired Bagudo 75000 60000 59896 8 0 0 Ngaski 80000 70000 64381 l3 0 0 Sakaba 120000 100000 99564 )t 0 0 D/lVasagu 130000 105000 104755 43 0 0 Zw 20000 I 5000 14961 0 0 0 Fakai 30000 25000 24946 t6 0 0 TOTAL 455000 37s000 368509 t17 t6 WHO/APOC, 26 September 2003 tr { I 2.3. Advocacy and Sensitization State the number of policy/decision makers mobilized at each relevant level during the current year; the reasons for the sensitization and outcome. Describe difficulties/constraints being faced and suggestions on how to improve advocacy. .'\ch'ocac1'uas puitl to r-illagc leadcrs sclicit sLrpport 1<'r select CDDS ancl Supen'isc rhc ntectizan distribution rlithin their cornrnunities. On sensiti,,alion. ef'forts are being ruadc to rcaclt u'ontcrt itt purclah q'e have concluctecl a r.l,orkshop lor Islarnic school tcachers, I'BAs inciLrding tuarkel \\'onlcrl to disserninate iulonnation to all conccrrecl LGAs and comurunitics trt larger. CONSTRAINS/DIFFICULITIE S Lack of incentiyes to the CDDS Lack of Female CDDs Lack of enough transport, accidented .r'ehicle has just been repaired 2.4. Mobilization and health education of at risk communities Provide information on : The use of medra and./or other local systems to disseminate information Mobilization and health education of women and minorities - method and response Response of target communities/villages Accomplishments Weaknesses/Constraints Suggest ways to improve mobilization of the target communities. r)rl nrobrlizalton llti' il'f t)rinati()il ,ri'1hc bl;rck l']r irherc 1t)utr(l dalr.gcr> tl\!()clit1r,(l \i ltll li.r... ptoplc .,r hr, itai,c itlst'lri Iltt'hr.'t'rltr,,''tl, \ r rir\r Irtr)\ r:!r,rir.-1r,1;1,1 \tr,il1]l.r Iriip ihalts unrl t,rslcrs \\r,i1..u\(,(1 [r] ticttlottsitatc t() tlle toitlt;lrtIl!liu\ illa Ilaz.tt'tls r,l'tlte c.itt) rrrlt i() []tc ctrlttuttrntlr arrrl ti ltas ]tccrt lcsLli{((l 1() lhc Jrccftance anrl dciarrirct \ rit fzrkille tlic mcctriau terh[crs r car ]r . Ihe Iirllowinc chuncis ol crinrr.rrrrrczrtiorr rrcr.c uscrl to rcach pcoplc arrti rntirrnr (hcrn ahout (-[) I I rnd thcrr rcspou si [rr lrtics. Kt'hhl Srarc \lrnrstr-r ,tl-[nlirnlatiol (to dtsscrrlui.l(e lnfi)rntatirln tlrtough rrrctJra ulirrr-r:r) I o,'al (r()r'crtlrit':llr {tt'l lir'(-otllnlts\toltcf ( to rlrq,.'rIt0;tt(,tnlilrntalt0tt to lril ;ortce r nr'ii I ( i-^i: rrr thc :l,rlu (,orrimuurL,r' throush tlicir L'zidels Radio -fcler rsion t.-\utJro uncl !'isrLal arls tbr cas\ commuuicatiorr; ltclrsrous lcaders ( rht'oucil \\ orkshop on ('D'i'I ) 'l ou n (')'ic'rs rn lhe cotnnrunrIre s_ llcalthl-.dtrcatioruasprrrridedrhrr)ushtalksat corlnlrnllr\ Ierrlsr.rrth - ('trrnlluultl,! ltiLrlcrr cltlcr s - ( orntltulllt\ \lr,rithe|s - t'onlltluutt\ rlrre r-1r.,l dr.U tttutor.s - Iic'lrgrttur lct,lcr -, - \\ ol lreri () r otqts - \\'onren rn purdah 2rf lhc !'olllrnunrty, lcurlcrs'housc. The ways to improve mobihsation of the target communitres llighcr-pou'crcti iuir.'ocac\'\'isils to the conurunirv lcatlers bv Statc I-C.,\s C'hairrncn Director Hcaltlr and ('orrncilors Hcaltl:. lnlllr()r'crl piil-tt!'tn.)tlr)n 0f'r"'(]lilmrr|rr[,, lcar]cr: lrt (.(]jlrrlllilllCnl t7 WHO/APOC, 26 September 2003 ca)OO e.l k()p () a.o cn N (-) tri o r-l oo \ = o=o- o!a9 'O :1 .; o4r E-.C= d =.-O ==!Ur € ;-=o.'.u J.-O SL t<-d=p. i.a . ::OU-!2 E\(! := U-I q)-= Ct ==NF a atao-cl a,Lo=- - '!'-o -E=o j;: E 2-)b0 :-: (l) =- -o E= a.El dU aY=Q)>'3^-qz!q;. -t --1 F J: nf: f ) u t'J./ C) Lv *-t,' hD-=tr ?UE !..2 o=t _n a-1 =:9pE i -HE 6 H ='i.9 u '4;Ho .=7. =eL= 9a')"(r-J. <)!t13J = () cr,! o.= .!'. iu *():-:Ldii!Gttr t -9 o ".r H_^ >.-o a =!H ! 'E! ="1iU)-?c, ir= od3: oo< '!- P.O - E q (6--OO.JO?9 =-x€;:#o'J= gil aitr = c-x 0() I {= qo-ci .0()'==H > l) ,-H5 ..EF(,) ^ () u;3E A=>dxq-- EBo.-2": <E60= = o () o() ?.4 .Eo 2,9H6 FE =oI .3stron zE ,t,. oo(l ru o\ O o\ E-g tb.E EX € E€E = =tuz3> $ .+ (u tiE -oEi69qZ R3v5 !E(')E .OE troi5a z + it oF @ o$ 6 €€ \o \o 9-EA qii[rr v O c.t 6t za) @ @ @ @ @ \o Ee,>o 6'5sa9A >OBr EO EEE! O otrqrqG o=EEEE ,oze --l -o bD Er.r r i EE fEEHE 2aEa 6l o9 o F-_ O $sf o'\ r- o\ \o \o F- 6 @ @ c.l @ € -.9 39f.rLtr.EE E (g =2I=Ei: E.= tr ()3 E - ''F 9* O *+ sfc- o\ tr o o -=o -q -EoeA c(F Lo z ,, ;-. *:a', 0a d o lro \o <f c.l o\ € bEeEEE d c! >A tr Y o orr =n >Yz.E \c r- t- \o $ + \D + alr 9r qlo=-= 9JEbHE; EEE:E =:!€ ozi.=A F-\o @ al \D€ c.l v6l € (\ c.l IJ L A o 'o ho(t m d oo z cdp J4 cd(n oo(d r a tr N (g .V .d tu o d v) CE oF : t3 V) qi uq) osE: a-!ITOPES?\ f\ -tod6iE!tso5Ei Ftra .-(J (l)Etrtr (l) ao 9E api aLr .9 3. )'= H= ^tr\JO TI 'r; EIc.I FI I I 1i ,t I tt ) 2.t6. Gapacitybuilding 2.6.1. Training \o tl'illllills\ \\'crt !'()tt(lrrr1.'ri Irr 2ii(i.i '[irc (r-arnrnu: thui rr.,r't plunncrl liri lltc r..at \\cru r() be lirndcJ hr \lr( X . htrt .luc tr) r'torr tclcasc lrrn(i), ir'.lllutg ttl-Statc antl Lot'itj ( ioi'ci-ruircrr{ ()nch,r pt.ls1r1]1]gJ ciit.[ trot takc ltiacr' lhc\rll)l)()rlttts \(iD() Sig.lrt Sarcrs fiinclc,-l the narrliu{.1 ot j4 Islanric -leachers- 24 Cterics irnd 2l 'traditional l]rrth \ttcn(lants rtn C'D-l'1. \\'llh thc atnr ol'r'cachrllg \\'omen rn1'rurclah by- ht-alth etlucatrng irncl rnobrlisrng thc-tn. 49 WHO/APOC, 26 Septemb er 2003 Trainees Type of trarnrng CDDs Other Community members e.g Community supervisors Health Workers (frontline health facilities) MOH staff or Other Political Leaders Others(specifu) Program management How to conduct Health education Islamic Teachers, Clerics TBAs and Management ofSAEs CSM SHM Data collection Data analysis Report writrng Others (specrfy) Table 6: Type of training undertaken (Tick the boxes where spectfic training was carried out during the reporting period) - Any other comments: 2-6.2. Equipment and Human Resources Table 7: Status of equipment (Please add more rows if necessary) of the equipment (Functional, currently non-functional but repairable, written off). How does the project intend to marntain and replace existing equlpment and other materials? APOC MOH DISTRICTiLG A NGDO Others Tlpe of equrpment Source Condition of the equipment * Please state 1. Vehicle I Repairable I attached to the pro ject 2. Motor cycle 6 Repairable 3.Computers I Repairable 7 motorcycles 4. Printers I Repairable 5. Fax Machrnes - Non 6. Others a) Bicycles 35 Repairable Repairable 21 bicycles b) Photocopier I Functional c) Project I Functional 20 WHO/APOC, 26 September 2003 coOoN k C) -o 0.) 9.() CA \o N U oA o F sN ii) o e -a o o \ -\. 5E o o bO o a_ S o o a o\ qt o ts I z; l. $ U(0 o:- \)L o \ B q) q$q) S o d o Eo o. E F t-.i(, C) (.) () H .q) (,) d bo CdFF -i1 orl -oldt FI o) 6lL 0 e U q) ! z ! cv .Lb e o) OJ q) q) \vo F o O o .1 aci f-rLi L t-r(l): o€) ,., q) L. 6l(l)L z 6lv v :-l6rl =-l .L q t----- C) o) () t) o\LF o) dL d)e !s c)0 €3tr :-l 2El ol c)l I I E,;:;,F.-j 9t'a< 3 * q) q) q) e,) \o F cll O q) Fl 9q) t'e o q) z 6rr v F .,i = q) q) 0) LF c (J tr q e El tr F - Describe the adequacy of available knowledgeable manpower at ail levers. - Where frequent Eansfers of trained staff occur, state what project is doing or intends to do to remedy the situation (The most important issue is what measures were taken to ensure adequate CDTI implementation where not enough knowledgeable manpower was available or staff often transferued tluring t-he course of the campaign). 'l () lrarn ull health st:tl'f'trt all endemic LCiAs to avorcl fi'e<1rent trai11 ou nerv6.posted staff to endcrnic commuuilic's. 2,7. Treatments 2.7.1. Treatmentfigures t. 2. -1. 1. 5. 6. Baguclo Ngaski Sakaba DiWasagu Zttrg Irakai -i otal 26.264 33.340 32-544 42.966 4,035 t1.{)-13 li!.192 'l lrt (rtattttcnl c()\clitlic thrs r-ear 2t)t)-l as rl \\'as in 20()2 rras ian iltrc to rnass rnigratr6n ol's6nre cgu1nlulitres rul) \\ asagu [-(i{. thcr-nrrgratcr] f1r \rgcl state li)l tarming rearin!1. 22 WHO/APOC, 26 September 2003 c.)oo e.l k 0.) -o o p. o C') \o N O o Pr{ oH caN r >'1 F d 0.)k(! ooa{ o.d 9s':F} .= oo -C \r >.. A'x(gu oq)t<s .) P E+0).EEt ()S bt aS UUo:0).:tr S'\U.\ dFOO!Lj ou .oE o.\ o)3 o. IOEP.s s9- 9\ 0)a) !LEB-3)idrtr\ ^E no S? \ s E a) q) t\ ltI\ olol oJ HI>xl EEIE lqlQEIEsloottrotE()l(Bol EtsI 'plEqldEl x 'ol()l 9ld(.) L (H l<() -o zt cd() H Po c) 'a ti cg g.9qds €Potro'ao HHp.z() IJ] €&E .ts' €-d8,fl o'50)d .56 H -tnHd traH()Uo-= oEE "r Eg =l EI il 3tvt ..L 0)l v() =l '=g UI FLtq -d sl 'o3 gde 0-)dILtr -il ():it t-LE ->l >\ .! al sqp .91 dHPIbi EI Htll (H5 iil o = ol !^. * 3l#I ot trI EI Eel-?E El sqx 5l bi zt? (.) (!}r() bo !u^ (J^\ oO -t- (.) $r obo cd t<() oo 3.: .=v (t trbo o() o cdo li C) o o C) o,(H r-. l C)t -oldt HI!l ZI () cd l-r o bo(d t< C) o(),^ 0) o.d!() F 6t ol s EI <t !tdlol '=l ol .ulkt b0 otolfl trt 3l olpl di!lol a dl 3l -l €l slJI EIqJ ot rr. I a X IJ C) E 0) o (-) oF o\ . G o --: El t S:.ifrtee* .o Y 9vE? oE b* s g q€2-.6&*E69 0- €32E bs -otrco =!zd cai\o \o\o(\ c..tF-N co 00 F- € \o F- \o t)\o o@ =E .E 5"eE EE[}EE oO r-\o @ cO N o\ @ \o\o ctt-- €r-(\ (a Fr \o o!o500o d^O- !. ro(! Sre\ oo FoF 3 =oq6.9tsr3 =xEz* :o d o-a =CoEE9TJ 9-o' -FO tr oa do!uE o PE6-s io o-: o ts = - 3* -o -bF- n{ o\@ o\ \oo\ F-@ o\o o\ o\ t-- o\ s h o\ \o o\ o\(+) o\ v @O o$ ca aa .a .f$ \o \o\o o\ o\s cO\o$ t'-O o\ \o!+ € =\o a- I co car-st @ co @ t--O .i- $ co@@ .d- s-ti- O ?a rnr-F. r- w ca a- <1- oo ca @O t--O$ o $ cO@@$ o .+ *o c.)(+) r-t- \Oa! q€ b 3 -!F6=+ F E S'" - 3 a.q.o^-g E 8"b E- : E d 3g vaO E .9oE br) ^ G^ i] 9e\bo<- uori q-6oo- o E dog -==odE tr= E) ;E'- -o o -Ee(! o.=;EP cd:J !D-o'FU o 0) tr Htr (-) o\oo o\OO o\OO sO \o OO \oo\O soo O c..l O Od c.t OOO ce OO cAs Oo <- O O. @ oo o ?a) r- w cO t-- .f @ @ F- v $ cO@@$ O$ afO (f) COtrt.- O co .i. .d- OcO va- O o\ o\ OJ E r') o .o bo ca f4 (d bo z .od .v(d a (d d L.] t li N cd .v c! tri F.l t< F ;\ Li q) U a) L q) o B q) V1 \) s J4 k (, cdokd cd 4 r r') F.l o k € .o rl.] (n (! 0) (d 0)rF ciir -l .ol 6JtFI ) cooO(..l k() .o () & c)(A \o N (J o Ar o ll{ F $ o.l n tl it:t TIf the project rs not achieving I 00% geographical coverage and minimum of 65%. therapeutrcal coverage rate or coverage rate is fluctuating, state reasons and plans being made to remedy this. The projcct is achicving 1009,0 geographic covcragc and over (r5% ther.apcutic co\ erage. -l-hc prt-r-iect still necds good sLrpcn'ision atld tnouitoring to cllsurc that ttlis is tnaintained. 2.7.2 What are the causes of absenteeism? 2.7.3 2.7,4 o \irlrt'lllcilt ()l'lattlicrq to nctghlroiurng Stutc: rrf \tqcr and Zatrrlara (luring trt:atntinto Molcurc-ut rrf'Fulaur nou-ratls q'tro can be aual, lbr up to a year. Briefly describe all known and verified serious adverse events (SAEs) and provide in table 9 the required information when available. r No citcc ol'rcuert irdr erse reactlon or evL.nts u.ere rcported In case the project has no case ofserious adverse event (SAE) durrng this reporting perrod, please tick in the box. No case to report 25 WHO/APOC, 10 April2003 caoON kp. O o Oi{ +r \o c\ AJ \l\ q) o' L\) .a q) v) * -\ (J V1 V)q) Q -S I -o \)L o a) %\J q.) S 'o o r 0) o. bo li op. 6)H o oo k ! E OF oo o d trl a a () (J o H() (,) o 0) qr () dr) o.f ,t ,ol cdl FI -troo()tr -dlpo; oiE; ! ;goBtr.F tr '.=EA(,oia EEEHFgEIUS o bo ok o. (H o otr oo o Oa cOi'i o .9!a ET Eo-.d trdcd dqo Oa-al EEF3q ,-1 E qi .q (i: . o-cg'-9- ^ 9,- A -@dsor'F o =id-]l* o a\ Y (.d (g € - I ooN =iatr;frsEEs og tr c/) *rY H oL4d)HF-PA #E h'r: d N 'Eqa H 3 EgaEcS qr 0,) oQc6.4 =boao X() cn oO{ o.> 4Ax coOO o.l Ho -o () a. 0) U) \o6t O o trr oH ts r-N q) .a 6q) >) C)L rr () -6LOOL5(r P.!oo c., q) .. LEo.(n -, f ) ! o6 .LO .ttrEI9!lFEI >dl ool E>le -olIto ! bJ) oh BoL'o Qd tro9E $)ri1 ,-- F- NUI ()l =ldlLI il) bJ)Osn^F 6>RFr ><- -o O o\r- \o o\ o\ \o o\ o\ F-co o\ co o\ \o o.\ 6\$ @ \o t-- o\ \o o\ o\ o\ o\ o\ o\ tr- @ o\ @ o\ \o o\ o\ .f @ 6\ F- o\ \o o\ o\ \o o\ o\ o\t--@ o\ oo 6\ o\ o\$ @ O r-OF- t- o\ t @ \o c.t\o o\ N o\$ t--\os o\$ oo o\ N o\$ oot O OOr- OOOo € ooO o\ OOo OO\o \o ooOd ca aao *3 = o H-cdiiEoa'o. F=-ob =@u = qr o o e s:;tl oo\<B- o o 'Eo =boO cd^gEE oo FOF 'o .o od .o6b *o iozfr o -Es,do= =EE -cu:< 9*',F9 o\ s N N o\ dv co ca t--r- \o € o\ o\ oo o\ o\ m o\ o\OO o\OO o\OO 6\OO 6\oO 6\oO \oo\oO \o ^\ o\O aa co c.)\o @ @@ N o\ o\ @ @ @@ O a] O N =o =oo EU 9C -95(J b/l 6J =@hi ", b sj +!oE>-'- -oE5;38F tr - gl-dF Etrtro q o H oO o ^ bfl(J 6^ -'o-\ <,>! -o 0 -Es,d o.azE5 Ccd: < 94'FU qio O ! YJO E E= 3;tr:.:z6 a,o ce ca\o @ co@ N o\ o\ t! t-- o\ o\ @ o\ o\ o\ o\ OON OON N o c\ N $ O c\l oO c{ O c\ r- ON @ OC{ o\O c.l O ON 2.8. Supervision 2.8.1 State to supervise the LGA while the LGA will supervise the CDDS diskibution the mectizan. Provide a flow chart ofsupervision hierarchy. State - Local govemment to Supervise the - Communities The State Onch. Team members will visits the local govemment will supervise the CDDs at the community level to detect any problem and solve it if necessary, if not referral should be done from low level to intermediate up to the high level. 2.8.2 What were the main issues identified during supervision. The main issued identify during supervision was:l). Census not up dated 2). Not dosing 5 yrs old child when he was 4 yrs of age last year.3). Poor keeping the records. All the above observations were amended one after the other with the presence of concern LGA director health and disease control. 2.8.3 Was supervision checklist used ? The check list was used. 2.8.4. what were the outcomes at each level of GDTI implementation supervised The out comes of each level of CDTI irrplementation supervised was:- srATE: the record of drugs inventory and issues of spare parts were property kept. LOCAL GOVT: All observed errors were corrected and no any other such observations. 2.8.5. was feed-back given to the supervised, and how was the feedback used improving the overall performance of the project The feed back we have reflected to the report submission observation. The communities now they are willing to each year. theres no much their treatment earlier 28 WHO/APOC, l0 April2003 Ii SEGTION 3: $upport_to GDTI 3'{. Financiat contributions of the partnerc and communities Table I l: Financial contributions by all partners for the last three years If there are problems with release of counterpart funds, how were they addressed? ()')'a 611oc211,,, to I-(i.{ tclttlcrerl thenr rnahrlit; to pay thcir contrilrrrtions on yearl1,basrs. ljris *rll al]'ecr :ustiitnal]tltt\ ettld ttnlcss thtngs arc chunurng that countct'part {lre e rpecterl to lrc rclcase . - Comments 3.2. Other forms of community support - Descnbe (indicate forms of in-kind contributions of communities if any) LJv ttYcn c()t'll. lnulz(' nnd rrcc Contributor Yerr2 (Dec. 2000-Nov.200l) Year 3 (Dec. 200 I -Nov. 2002) Year 4 (Dec2002-Nov.2003) TOTAL Budgeted (us$) TOTAL Budgeted (us$) TOTAL Released (us$) TOTAL Released (us$) Ministry of Health (MOH) I 1800 12600 r 2600 r r800 I2.600 Local NGDO(s) ( if any) NGDO partner(s) 13027 13027 I 3455 13455 6,t45 6 APOC LGAs 25s68 32800 25,000 Others a) b) c) Comrnuntties t2t6 l2t6 ts02 1s02 1,650 APOC'l-rust F-und including capital 34695 33284 34280 34113 TOTAL 86306 59327 94637 6t670 29 WHO/APOC, 26 September 2003 3.3. Expenditure per activiQr - Indicate the expenditure on activities below in US dollars using the curent United Nations exchange rate to local currency Table 12: Indicate how much the project spent for each activity listed below during the reporting period Comments Funds spenl tc pro.jcct b), NGDO tc'r carryout distribLrtion this year (detail to lre prot'ided hl'SSI) as no lunds rvere receivecl fi-onr APOC. , Activity Erpenditure ($ US) Source(s) of funding Drug_{g-!!.very fr_94}O_l! HQ.ale-a !q c trEll 9_o_&9qogp9_llr!_9tqgg{p}.ryty_-_ Mobilization and health education of communities ,{qrlq' lq-ing !f Ltealth staff at all levels and distribution It!gryl_g,oq!!e11r-,g of CDTI activities Advocacy visits to health and political authorities(cost included in support distribu_!9_q) IEC materials Summary (reporting) forms for treatrnent Jehicles/ bicycles maintenance and spares Office_ Equip_mg nt ( e. g c.o mputers, prinlers etc) Others(communication, tnsurance and others) 242 468 445 JJJ 885 37723 SSI SSI SSI SSI SSI SSI TOTAL t<a*{ u+{ Total number of persons treated 30 WHO/APOC, 26 September 2003 rSEGTION 4: Sustainability of GDTI 4.1. lnternal; independent participatory monitoring; Evaluation 4-l.l Was Monitoring/evaluation carried out during the reporting period? (tick where applicable) Year I Participatory Independent monitoring _ Mrd Term Sustainability Evaluation 5 year Sustainability Evaluation Internal Monrtoring by NOTF 4.1.2 4.1.3 Other Evaluation by other partners r \ o itrilrtittltrrt!. or cr alttatiott * as carned out clurinu thr: reportiu-u pcriod What were the recommendations? r \-\ How have they been implemented? " \\ 4-2. Gommunitr self-monitoring and stakehotderc Meeting Table l3:Conrmunity self-monitorrng and Stakeholders Meeting (Please atlel more rows tf necessary) 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. -l hc ltairttnq alld llllplelilclltatton of cortururnrlr'scllmonitorrng ln<1 stakeholders nrecting rvas htrclgct.'d ro bc cartlctl oul, tn thc liturlh vci:r. and rras to lrg Ji1njg61 b1 ApO( .'ilus corrld not be car.ricd irut rlre to lack ol-Iuutl:. 4.3. Sustainability of proiects: plan and set targets (mandatory at yr 3) What arrangements have been made to sustain CDTI after APOC funding ceases in terms of4.3.1 Planning at all relevant levels. 4.3.2 Funds 4.3.3 transport (replacement and maintenance) 4.3.4 other resources 4.3-5 Please provide a written plan with set targets and achievements for so far4.3.6 To what extent has the plan been implemented Dishict/ LGA Total # of communities/vrllages in the entire project area No of Communities that carried out self monitoring (CSn$ No of Communities that conducted stakeholders nleeting (SHM) TOTAL 31 WHOiAPOC, 26 September 2003 a I I I t I 4.4. lntegration Outline the extent of integration of CDTI into the PHC structure and the plans for complete integration 4.4.1 . Ivermectin delivery mechanisms 4.4.2. Training 4 .4.3 . Joint supervision and monitoring with other programs 4.4.4. Release of funds 4.4.5. Is CDTI included in the PHC budget? Yes each an every year 4.4.6. Describe other health prograrnmes that are using the CDTI structtue and how this was achieved. What have been the achievements? 4.4.7. Describe others issues considered in the integration of CDTI. 4.5 Operational research 4.5.1 Summarize in not more than one half of a page the operational research undertaken in the project area within the reporting period. . \o opc-ratiollu l r esca r-ch \\ a s uudcr-ta ken tn th(' prolcct clunng the peuod untte r- r.er.rc rr .\ gr-Oup o I' Scrcrttist lrarl hoqcvcr stttrnrtttcd a proposal 1o .\P()('lirr an operatioual rcscarclr to lo,rk ur tl)c p;ohlcnr ol '.\ r'rttrcn nl i',ut.t-iir anrl Icrnulc ('l)t)', J hiq ri:rs sulrnrrttcd irr . ,. 4.5.2. How were the results applied rn the project? r ".\ a I I j a t 32 WHO/APOC, 26 September 2003 t f I a t I SEGTION 5: strengths, weaknesses and challenges List the strengths and weaknesses of CDTI implementation process List the challenges and indicate how they were addressed. Strength and Weakness [.ach o1' rcleitse o[ funds bv fi1;y"t.r-,,nent an(| ..\trOC' Challenges Sustainabilitl, ol-thc progmntnte post ApOC) I I t JJ WHO/APOC, 26 September 2003