AFRICAI\ PROGRAMME FOR ONCHOCERCIASIS CONTROL (APoC)

Year 3 CDTI Activities RePort

Yusufari Nguru

Bursari Bade

Jakusko

Fune maturu

Gujba

Gulani

For Action To: TCLALI rA CW CAP g lrf, SI-n A-o December 2001 E{i* )" 1,c,( For lnformolion To, ]lr( " lr,r zvtt\oz- EXECUTIVE SUMMARY. yobe State was created out of the former Borno State in August l99l.It is situated in the

North Irastern part of the country in Sahel Savannah and desert features in the northern part of the State characterize its topography while the southern part has rocky hills and mountainous terrain with rivers giving it the identity of the Sudan Savannah. The river

Yobe is of particular mention as it cuts across Six (6) LGAs and it serve as breeding sites of the black flies. The State covers an estimated landmass of 47,153 sq. kilometers, with a population of 1.4 million people.

Yobe State has a total of Seventeen (17) Local Government Councils. Twelve (12) of which are Meso-endemic with few southern areas having hyper-endemic communities, especially in those belts that mn across the Biu LGA of Borno State. The people of the state are mostly involved in farming, cattle rearing, fishing etc.

Treatment started in the state in the year 1995, after CBM signed a Memorandum of

Understanding to assist in the control effort. Over two hundred thousand persons have been treated since then. The State wrote a proposal to APOC for possible assistance in the

year 1997 to implement CDTI, and this was approved for funding in September 1998.

The State APOC proposal for assistance was approved in 1998, and so CDTI is in its third year of implementation. There has been tremendous achievement in the area of community awareness and ownership of the prograrnme. 2

full responsibility The State government is well mobilized and is always ready to take up of its partnership contributions towards the programme' Since CDTI implementation to the started in the state, the goverrlment has constantly released counterpart funds

project

tablets of Mectizan In the year 2ool a total of 3 I 1,535 people were treated with 799,074

in 245 communities given 85'% coverage

SECTION I:

BACK UND RMA

of the state' The There are 245 communities undergoing treatment currently in 12 LGA's

communities are coverage population of the communities is between 1000 to 3500. These

giving a total of defined in terms of 8 to l5 people living in each household or even more'

356,729 people.

1.2 C omm unities I mP le menti ng C D TI

the state' The A total of 245 communities are currently implementing GDTI in

and logistic support implementation of CDTI has brought about a lot of financial

communities as to the progralnme. This is responsible for the treatment of these J

against a total of 98 communities that were receiving treatment in twelve LGAs

before implementation of CDTL

1.3 E

SAi LGA TREATMENT ROUND ITIKA 7 2 7 J 7 4 7 5 7 6 7 7 NGURU 7 8 7 9 TARMUWA 7

l0 FLTNE 7 ll 7 t2 BADE 7 TOTAL 7

Note: Although most of the communities are in the seventh round of

treatment, some are in various rounds of treatment. 4

SECTION II.

THE IMPLEM ATION OF CDTI

Table I

S/N Di No. No. of No. No. Comm No. No. of No. Comm / Comm/ Commi /villages Comm Comm Comm / Villages villages villages that decided /villages /villages villages That that on the that' with Palng r selected collected month(s) decided trained CDDs CDDs Drugs of on the CDDs in castl

Distribution month(s) or kind. I of Treahent I FIKA 30 30 30 30 30 30 30

2 NANGERE 7 7 7 7 7 7 4

J POTISKUM l0 l0 l0 l0 l0 l0 6

4 GULANI JJ 53 33 JJ 33 JJ 26 5 GUJBA 21 2t 21 2t 2t 2t l9 6 JAKUSKO 14 t4 l4 14 l4 t4 l0

7 NGLIRU 9 9 9 9 9 9 7

8 KARASUWA 5 5 5 5 5 5 3

I TARMUWA II lt ll ll ll ll 8 l0 42 42 42 42 42 42 38

lt BURSARI 45 45 45 45 45 45 32

t2 BADE r8 r8 l8 l8 1.8 l8 l2 TOTAL 245 245 245 245 245 245 195

N.B It's a difficult judgement determining the accuracy of these indicators, as

compliance has not been one hundred percent from the very beginning of the

project year, but with persistent mobilization and education, most cornrnunities

complied. APOC management can do something about updating these indicators,

so that project can be comfortable in providing more accurate and realistic data. 5

TRAINING OF DIFFERENT LE OF STAFF INVOLVED IN CDTI

TABLE 2 s/N District/LGA No of No of No. of Nu of No Of training TOT Dictrict or ccntcrs / CDIh undertaken trained LGA stafr post stefi traincd. traincd in trained on CDTI CDTI I FIKA 3(LOCT,PHC 7(SOCT& s(Locr) ll 3l &CDDs) LOCr)

2. NANGERE J 7 5 ll 42

J POTISKUM 3 1 5 il 46

4 GULANI J 7 5 ll 4t

5 GUJBA 3 7 5 l1 39

6 JAKUSKO 3 7 5 il 27 7 NGURU ) 7 4 ll 28

8 KARASUWA J 7 J ll l3

9 TARMUWA J 7 5 1l t4

l0 FLINE J 7 5 ll 9

ll BURSARI 3 7 5 ll l8

t2 BADE J 7 5 ll 22 TOTAL 36 84 57 234 330

Note: Although health post stafftrained are also TOT, but we did not include them in the

number of the TOT trained in column 4 above because of the fear of duplication.

2.1 Trainins obiectives / achievements

CATEGORY OF NUMBER TO IYT.IMBER PERCENTAGE OF WORI(ERS TRAIN TRAIITED COVERAGE LOCT 57 57 r00% PHC Worker 235 234 97%

CDDs 337 330 98%

SOCT 7 7 100%

TOTAL 636 62E 99o/o 6 )) Developed Troininq moterials used

various training Materials were used by the project. These materials includes, flip charts, CDD brochures, registers, measuring sticks etc.

2.3 Improving the oualitv ottroining

In preparation for the CDD training, the Socr and Locr have perfected

their strategies in ensuring that the training is carried out in such a nuumer that comprehension and participation by the participants wilr be achieved.

Above all, the socr team is taking a back seat approach during trainings now give to the Locr more opportunities to ass,me their ful

responsibilities as trainers of CDDs.

MOBILIZA TION AND EDU TION OF TARGET CO

S/N DistricULGA No. of No. of Comm/ I xo. or No of No of Comm. villages that I Adrocecy MOH Strfr NGID Statr and received visits to State involvcd in involvcd villagcs in Health or Regionel Mobllization. Mobllizetion Mobilized. Education Directors of l

Hcelth. I I FIKA 30 30 2 14 I 2. NANGERE 7 7 2 t4 I 3 POTISKUM l0 l0 2 t4 I 4 GULANI JJ 33 2 t4 I 5 GUJBA 21 2t 2 t4 I 6 JAKUSKO l4 t4 2 t4 I 7 NGURU 9 9 2 l4 I 8 KARASUWA 5 5 2 14 I 9 TARMUWA H ll 2 t4 I l0 FLINE 42 42 , t4 I II BURSARI 45 45 ., t4 I t2 BADE I8 l8 2 14 I TOTAL 245 245 2 t4 I 7

'l'he N.B executives of the ministry of health participated actively in advocacy to LGAs

and in the mobilization of communities. This we found so encouraging to the programme.

2.2.0 Mobilization strategv

Mobilization strategies involve the use of policy makers both at State and Local

Government levels, which proved quite effective. As a result of mobilization

ellbrt, communities were able to select their CDDs even though all communities

showed willingness to support CDDs, not all communities were able to give

incentives to CDDs.

2.2.1 Response of communities

Most communities are pleased with the partnership strategy of the programme and

are happy to be involved in the planning stages. Their response is quite

encouraging. The only envisaged problem is that of total commitment and

sponsorship of the CDDs fbr training and collection of the drugs during

distribution.

2.2.2 Suggestion to Improve Mobilization

Communities should be encouraged to support CDDs by way of community effort

instead of looking upon the government with the hope that they will alleviate that 8

responsibirity from them in the near future. Those communities that are doing well hre commended. while the rest will be urged to do better.

TREA M NT

s/N. No, of Totel Pop. No, of No. of No. of Comm No. of No. Of Eligibtc of Eligibtc Comm / Distributions trcrtGd Trcrtcd pcoplc Pcople vllhges in villeges Superviscd by Comm/ Comm. treetcd 'frcrted which heeltt vilhges CDDs rrc workcrs with hcrlth Summery workcrc FIKA forms. 30 51,259 45,469 40,594 None 2 30 NANGERE 7 20,209 t7,34t t7.200 -) POt- ISKUM 7 IO 20,st4 17,573 12,946 I GUt,ANI I l0 JJ 53,565 49,984 49,533 -5* GUJBA I JJ 2t 28,035 25,945 )< 1'71 I 6 JAKUSKO t4 2t 20,566 r8,883 t8,686 7 NGUI{U I t4 9 r6,080 t 5,46t t4,966 8 KARA I 9 SUWA 5 8,584 q)q 7 7,3 t9 () 'f I ARMTIWA il 5 13.771 t2,945 t2.662 i0 * FUNE I ll 42 48,425 45,045 40,225 ll* I 42 B URSARI 45 42,412 39,962 36,961 I I 2 I]ADE I8 45 22,338 r8,993 15,296 tl CLIN IC BASE I l8 19,970 19,970 19,970 TOTAL I 245 365,729 334,403 311,535 None I 245

* NB Mop-up activity is stiil going on in some communities. l0

STREN GHT/WEAKNESSES&SU GESTIONS

STRENGHTS:

a Yobe State governmont is very much committed to the programme. This level

of commitment is highly commendable as project can continue on its own

when outside support eventually stops. a The project has dedicated SOCT implementing the prograrnme. This team has

been with the programme right from the onset and is determined to carry out

their roles and responsibilities together with their LGA counterparts. a The project has enjoyed tremendous support of the assisting NGDO and

NOCP. Their back seat support system to the state is highly appreciated as it

makes the project to take full ownership of the programme right from the

onset. a Acceptance ol'programme by communities is a success indicator. They ask

for their drugs even when it is not yet distribution period. CDDs turned up for

training yearly despite relative complaints of lack of support. a The project has identified few CBOs (Community Based Organizations) that

will be useful in the implementation process. This is a boost to the

community mobilization efforts and the participation of women in CDTI

implementation. WEAK

5 l'he Low literacy level of the people has made selection of cDDs very

difficult in some communities.

:l M.sL ol'the community members claim they are too poor to support cDDs.

a [,ack of adequate supporl on the part of the LGAs.

SUGGESTI ONS:

There should be increased ' community mobilization. Emphasis should be on women participation to discourage treatment by proxy or the men getting to

relay second hand information. which may not be correct to the women.

Advocacy visits ' to LGAs should be intensified. The present trend of lack of commitment disturbing. is The project intends to involve the State commissioner for health, permanent the Secretary and the Director to go *rund the LGAs befbre the next distribution round of treatment begins. o I)HC worker should participate more in supervision of CDDs in their local

areas ol'assignment witrrout necessarily expecting rewards. o Involvement / training of cBo's to improve cDD perfornance. These cBos will be carried along in the implementation of the programme. They will be

encouraged to attend the Zonar oncho Taskforce meetings. 9

l,'U't'tl Iili t, N

l. Communityself_monitoring.

2. State / LGA review meeting / project evaluation.

3. Advocacy visits to LGA,s.

4. Community mobilization and Health Education. 5. Re-training

6. Community registration.

7. Mectizandistribution.

8. Review meeting.

MINIS OF TRY TH NTRIB UTION.

'l'he 1'ear 2001 is a rewarding one for the project as the state government was abre to and released 'Ipprove the sum of Two Million Naira (2 million) to the project as counterpart funds

r1