Report on the Third Round Zithromax Distribution of Konso SPW

KEMBATA TEMBARO ZONE DAMBOYA WOREDA EALTH OFFICE THE FORTH ROUND TRCHOMA PREVENTION AND CONTROL DRUG DISTRIBUTION CAMPAIGN REPORT

DEC, 2016 G.C DAMBOYA Content Page

Damboya Woreda health office the 4th round Trachoma prevention and control drug distribution campaign Page 1 1. Introduction ______4-5

2. Background Information ______6-7

3. Goal ______8

4. Objectives ______8

5. Eligible and Target ______8

6. Methods and Instruments ______8-9

7. Composition of Distribution Team______11-12

8. Role and Responsibility ______13-17

9. Achievements______18

10. Cost ______18

11. Finance ______19

12. Monitoring and Evaluation______19

13. Challenges ______20

14. Solutions Attempted ______20

15. Recommendation ______20

Damboya Woreda health office the 4th round Trachoma prevention and control drug distribution campaign Page 2 AKNOWLEDGEMENT We would like to thank ORBIS international Ethiopia for their support by technique and finance to our community get this chance to prevent trachoma disease. Besides to this, the special thanks to all ORBIS staffs for their regular follow up & monitoring to made these zithromax MDA campaign activities effective. Also our heartfelt thanks to all members participated in this campaign specially supervisors, HWs, HEWs & Kebele administrative leaders and females developmental armies leaders. At last but not least our thanks to Damboya Woreda health office & all Woreda administrative bodies for their commitment on advocacy & social mobilization in pre- campaign & intra- campaign.

Damboya Woreda health office the 4th round Trachoma prevention and control drug distribution campaign Page 3 1. Introduction Trachoma is the world’s leading cause of eye infections but preventable blindness, affecting mankind since antiquity. An estimated 8 million people are already blind or visually impaired because of the disease, and 84 million have active infection and need treatment. More than 10 percent of the world’s population is at risk of blindness due to trachoma, which has incapacitated families and communities for centuries in the poorest regions of Africa, Asia, the Middle East, and in some parts of Latin America, Australia, and Asia. Sub-Saharan Africa has the highest burden of the disease of which Ethiopian has the highest magnitude. The disease is caused by repeated infection by the bacterium Chlamydia trachoma is. Trachoma spreads through contact with infected people (discharge from the eyes ). Flies that seek out the red, sticky eyes infected by trachoma; can also transmit the disease from person to person. The disease generally occurs in poor, dry and arid rural communities where people have limited access to water, sanitation, and primary health care.

Trachoma is the second leading cause of Blindness in Ethiopia next to Cataract. According to the national blindness, low vision and trachoma survey conducted in 2006 trachoma accounts 11.5% of all blindness and 7.7 of people with low vision. It is estimated that over 138,000 people are already blinded by trachoma.

The prevalence of active trachoma (AT) in children age 1-9 is 40% for the whole country ranging from 0.5% to 62.6% in different regions of the country. It is fourfold higher in rural children than urban due to poor sanitation and water supply. Over 9 million children aged 1-9 years have active infection in Ethiopia.

Trachomatous trichiasis (TT), a chronic form of trachoma is estimated to be 3.1% for the country. This means there are estimated 1.3 million people age 15 and above who are in immediate risk of blindness unless treated immediately when a trachoma symptoms/signs seen.

According to the national survey, the prevalence of active trachoma and TT in SNNPR are 33 % and 2% respectively. However, from the district based baseline trachoma surveys conducted in other ORBIS supported rural projects in SNNPR, the prevalence of both active and blinding trachoma (active trachoma between 22- 54% and TT between 1.1 and 6.4%) are by far higher than the regional

Damboya Woreda health office the 4th round Trachoma prevention and control drug distribution campaign Page 4 findings as indicated in the national survey. The prevalence of active trachoma in Damboya woreda among children aged between 1-9 years according to the woreda based survey conducted in 2013, reported to be 41% whereas the trachomatous trichiasis rate among people aged above 15 years appears to be 1.97%.

ORBIS International Ethiopia has been implementing the WHO recommended SAFE strategy in Kembata Tembaro project to control and eliminate trachoma over the last ten years through capacity building of the local health worker through training, provision of supplies and medical equipment to eye care services. Establishment in 2011 ORBIS has done a baseline survey to determine the prevalence of active trachoma and Trachomatous trichiasis in seven woreda of the zone; Damboya woreda is one of them and came up with the results of these prevalence ranging from (active trachoma. 29-41% and TT, 3-1.97%) which needs public health intervention through mass drug administration. Therefore, trachoma is found to be public health problems in these woredas’ as the prevalence of the two indicators are high above the WHO cut off point. Hence, trachoma is till a major public health concern and need an immediate trachoma intervention program. Following these findings and as per the recommendation of WHO, Zithromax distribution program was planned in these Woreda’s.

Table -1 Summary of trachoma survey findings in Damboyaworeda of KembataTembaro Project

Prevalence of Active Prevalence of TT S.No. Woreda Trachoma in 1-9 yrs in >=15 yrs 1 Damboya 41% 1.97%

1.1.Background

Damboya Woreda is one of the seven woredas’ in Kembata Tembaro zone and a one supported by partner of ORBIS international Rural Eye Care Kembata Tembaro project. The woreda far from Addis Ababa; the capital city of the country, by a distance 364 kms and 12 kms from Durame town; which is the capital of Kembata Tembaro zone. The woreda administratively setted up with 17 rural and 3 urban kebeles and boundarying with four neighbor woredas i.e. Shashego, Kedida Gamela, Damboya Woreda health office the 4th round Trachoma prevention and control drug distribution campaign Page 5 Halaba special woreda at north , south ,East and West respectively . Eleven kebeles have got ‘’Woyna Dega’’, Four kebeles have got ‘’Kolla’’ and Five kebeles have got ‘’Dega’’ weather condition. Almost all dwellers of the woreda depend on mixed agriculture. The farmers highly cultivate Maize, Potatoes, Teff, and Enset as food crops. Coffee, avocado, Chat and eucalyptus tree are the main cash products of the woreda. Based on a survey conducted by ORBIS International Ethiopia in 2013 G.C total of 91,480 people living in the woreda in this year. Among these, 46472 females and 45008 males; nearly 14,280 are children below 5 years of age and 77,200 people are above 5 years. Kembatigna is the mother language of the residents’. As to infrastructures, the woreda has 23 public 11 private total of 34 health facilities, 34 schools (KG up to high Schools)Besides to this, there is communication medias & has bank access. Only 5 kebeles dwellers have pipeline water and hydroelectric power supply. The safe and clean water coverage is 42.2 %( 2005 E.C woreda report) while the latrine coverage is 96%. Regarding health units, there are four health centers, and 19 health posts. Human resources working at health office & facilities 16 health officers, 40 Nurses, 16 mid wives,8 public nurses,9 laboratory professionals 4,pharmacy technician,4 Environmental health professionals ,1 applied biology and 4 HIT/ICT and 40 and 3 urban health extension workers and 82 supportive staffs and totally 227 are serving the community. Based on case load pneumonia, Acute Upper Respiratory Infection, Typhoid fever, Trachoma, Helmenthiasis and Urinary Tract Infection are the most common diseases that cause morbidity in adult. Besides this; pneumonia, on bloody diarrhea, unspecified parasitic diseases and malnutrition are the leading causes of morbidity in children below five years of age. The residents exercise overcrowded living condition, poor & unadequate water supply and less practice on personal hygiene which is potential environment for trachoma transmission.

2. Goal To prevent and control trachoma and unnecessary blindness caused by it from Damboya Woreda.

2.1 Objectives - To implement “A” components of SAFE strategy to suppress the recurrences of AT by treating pool of infection.

Damboya Woreda health office the 4th round Trachoma prevention and control drug distribution campaign Page 6 - To reduce the high prevalence of AT 41% and TT1.97% to below 10% and 1% respectively after consecutive mass drug administration for the eligible population of the Woreda. - To create awareness within the community on trachoma and SAFE strategy. 3. Eligible/target

From the total of 91,527 population; 77,798, 11,899 people are eligible for Zithromax tablet which is safe and recommended by Pfizer for all individuals and 11,892 target for zithromax suspension except for children less than 6 months and pregnant mothers in first trimester which accounts 1831 in number respectively. However; the FMOH does not recommend for mothers in their first trimester or three months of pregnancy too. Therefore; Tetracycline eye ointment (TEO) replaces zithromax for those who are not eligible for zithromax, pregnant and children less than 6 moths’ age.

3.1. Target of coverage ITI recommends that MDA coverage with zithromax above 90% of the eligible population can be considered as a success in eradication of trachoma as “A” component of SAFE strategy. However, the level of our success is to work against 95% and above for effective elimination of AT.

4. Methods and instruments/logistics  A two days sensitization/advocacy training on the cause, transmission prevention modes of treatment and public health aspect of trachoma and detailed techniques of the planned mass drug distribution workshop was successfully conducted involving officials from Damboya Woreda health offices and administrative leaders.  Distribution supervisors, teams composed of health extension workers, health workers, Health development army leaders recruited from the Woreda.  Trachoma control and prevention activities were presented and discussed in detail by the health office and other participants accordingly.  Detailed technical planning was also developed in small core groups following the workshop. The planning exercise include detailed activities of Zithromax distribution ;determining the number and the duration of the distribution for each

Damboya Woreda health office the 4th round Trachoma prevention and control drug distribution campaign Page 7 Kebele per Woreda, the corresponding budgets and dates for each activities were cleanly outlined by.  All logistics necessary to conduct the campaign were prepared and distributed to all kebeles found in the woreda before the start of campaign. These included delivery of registration books, Zithromax tablets and POS, 1% Tetracycline eye ointments, tab pole/measuring sticks/, colored dosage guides and so on. Zithromax distribution manuals prepared in Amharic language, different Zithromax reporting and summary formats.In addition to this; transferring budget action plan for Zithromax distribution to Woreda finance and economic development office on time. The number of vehicles needed and the duration of campaign determined.  Posters, leaflets have been posted and distributed ahead of the distribution date. Banners were also used to inform people about the campaign  Social mobilization conducted through the woreda in pre and intra campaign on trachoma drug distribution and prevention and control strategies where many people found .

5. Composition of distribution team  Each team composed of three individuals. Totally 157 personals; 19 HWS,34 HEWs ,87 Health Development Army Leaders,12 supervisors,01 store man,01campaign coordinator,01

Damboya Woreda health office the 4th round Trachoma prevention and control drug distribution campaign Page 8 finance officer 5 woreda political leaders for advocacy and social mobilization were participated in the campaign.  One MDA coordinator with one vehicle was actively involved in the whole period of the distribution.  A manual is prepared in Amharic to help trainer (woreda coordinator) trainees in undertaking the Zithromax distribution.  Registration books of 50 pages were used during the census to enter data of the distribution.  Budget for fuel for motor cycle was allocated for the woreda.. 6. Role and Responsibilities of each individual during intra campaign

6.1 HEWs/HWs

 Calculate the required drugs per their catchment area and receive the drugs from the woreda pharmacy store  Reconstitution of Zithromax suspension  Administering Zithromax tabs and POS and providing 1 % Tetracycline eye ointment for the beneficiaries

Picture-2 shows HEWs administering ZX POS at Hego kebele

Recording a drug provided to the beneficiaries on the registration book  Daily follow up of the drug balance and reporting to the supervisors for immediate action  Compiling and reporting the data at the end of the distribution

Damboya Woreda health office the 4th round Trachoma prevention and control drug distribution campaign Page 9 6.2 Role and Responsibilities of HADs:  Health education on trachoma and Zithromax before and intra campaign

Picture-3 HAD measuring the height of children in Hego kebele

Measuring height of individuals and reporting to the HEW/HW for drug administration  Ensuring clean water is always available at the distribution site  Collection of used /empty bottles  Mobilizing the community

6.3 Role and Responsibilities of supervisors

 Supervising the overall activities of the campaign  Provision of technical support to the distribution team  Provision of drug and water in case of shortage  Follow up of the drug balance on daily bases  Compiling and reporting at the end of the distribution  Make sure the drug balance is correct at the end of the distribution  Daily monitoring and giving the feedback as to how the distribution is reaching every resident

 Monitoring and evaluating intra and post campaign activities.

6.4 Role and Responsibilities of woreda political leaders:  Community mobilizers are woreda officials including the administrators, cabinet members and other influential community figures.  Made the local leaders participate fully on the distribution with great attention.  Launching the program

Damboya Woreda health office the 4th round Trachoma prevention and control drug distribution campaign Page 10 6.5 Role and Responsibilities of temporarily recruited distribution coordinator/MDA consultants  Provide Pre-Zithromax distribution training to distribution team members.  Provide continuous supportive supervision and technical support during the period of Zithromax distribution.  Oversee the proper final accounting of the Zithromax balances against the issued and the distributed quantities.  Submit detailed Zithromax distribution report as per the standard reporting format provided by ORBIS Ethiopia, including; the Pre-Zithromax distribution training.  Submit Estimated Zithromax Distribution Cost (Specifically for Peridiem  paid to the distribution team, supervisors, etc) for the Woreda.

7. Achievements 7.1 Coverage and drug utilization The distribution was started on January 27, 2016 G.C at all sites through the woreda . The campaign took ten days excluding reporting sessions in most kebeles. Report collection was started by Feb 5, 2016 G.C as all kebeles completed the campaign and ended by Feb 6, 2016 G.C. The zone deputy administrator, zone health department head and core process coordinators, woreda Adminitrator, Woreda health office head and MDA Coordinator took Zithromax drug at the launching ceremony of the campaign. The community acceptance of drugs was impressing and distributing teams were found performing well at their duty sites from all aspects. Thus, 95% (87,370) of the eligible population 91,527; 73,361 were treated with Zithromax, 12,146 with zith pos and 1860 TEO . . The four kebeles were below 95% of the minimum planned coverage each decided to attain by the end of the campaign. This might be due to shortage of zithromax tablets, ignorance, emigration of segment of population and death and so on. As to the beneficiaries sex versus drugs type; zitromax tablet, suspension and TEO cover 84%,14% and 2% from total treated respectively. Among these, 51% of the beneficiaries were females while the rest 49% is males.1096 are children aged below six months and 764 are mothers whom pregnancy was less than three months and all treated by TEO two tubes each for 6 weeks. As a result the census population target was increased from 88077 to 91527. As to the drug consumption, 226,500 Zx tabs, 94335 ml POS and 3,720 tubes TEO was used. The distributing team was addressed to handle drugs with care and dispensed with caution and hence the wastage was tried to be minimized. Thus, wastage proportion for Zithromax tablets is .06%, for Zithromax POS.44% for TEO 0%. The campaign has also missions of health information dissemination about trachoma and SAFE strategy besides drug administration. 8000 leaflets which contains message about Trachoma & SAFE strategy were distributed to those who were able to read. Almost 97% of the distribution coverage was done by selected center sites and the rest was covered by home to home.

Damboya Woreda health office the 4th round Trachoma prevention and control drug distribution campaign Page 11 Zone: KembataTembaro, Woreda: DamboyaKebele performance by Village No of people Rx With Zx Tab No of people Rx with TEO

Pr < 6month Total eg pop.20 Fema na Femal Tota Name villages 16 G.C Male total Male le nt Male e l SedenaFarzana 290 72 220 21 25 4 1 3 94 T/Lega 337 201 341 20 27 3 2 3 223 L/Lega 318 140 324 17 30 7 4 1 161 EnjifanaBodemana 318 188 308 16 27 2 3 2 207 Amagude 364 161 291 9 26 0 2 4 172 SamunaAbalcho 495 136 326 18 14 0 2 2 156 WashanaSamuye 244 110 281 15 21 5 1 2 126 ObanaDunga 381 199 359 16 22 5 1 3 216 GarbandaShafa 431 188 375 23 25 0 2 1 213 EndasheneMureda 356 101 271 17 32 4 2 3 120 Gendel a ZatonaMangesha 367 144 264 28 19 0 0 2 172 11 3901 1640 1720 200 268 468 26 76

Hanja 307 132 315 22 25 3 2 3 156 Hobeka 488 133 282 17 28 4 1 1 151 Shenkura 354 124 278 20 40 6 3 4 147 Shamebe 358 157 320 25 37 4 2 1 184 H/got mena Gotmena 619 300 587 26 29 3 6 1 332 5 2126 846 936 110 159 269 10 44 Kalada 925 389 701 53 38 11 3 7 445 Bancha 401 215 416 51 100 7 1 5 267 M/Megere 843 334 653 50 63 9 4 3 388 Megeri e M ender 3 784 270 556 54 28 3 2 4 326 4 2953 1208 1118 208 229 437 19 59

Damboya Woreda health office the 4th round Trachoma prevention and control drug distribution campaign Page 12 Mude 561 180 378 31 39 5 1 2 212 Laloamo 348 140 296 27 41 6 0 2 167 Fofo 468 143 311 40 38 9 0 1 183 Kafo 348 136 246 21 29 7 2 3 159 Andega Hanja 430 154 277 24 28 8 1 2 179 H/laloa mo Walacho Hanja 358 138 293 23 27 4 0 0 161

6 2513 891 910 166 202 368 10 53 Alita 749 215 442 54 51 6 2 3 271 Atadamo 769 265 513 63 56 7 5 4 333 Dinkula 827 275 531 50 80 9 6 7 331 Hadara 843 290 582 39 78 3 5 3 334 Chochinga 555 191 403 23 27 5 2 2 216 Charo 542 168 346 18 30 5 3 3 189 Dato Hadashine 775 270 540 40 45 4 5 4 315

7 5060 1674 1683 287 367 654 26 93 Dagargula 1650 646 1397 88 98 17 9 14 743 Shomolo 1419 493 905 74 175 8 5 3 572 Sato 715 310 575 49 54 8 7 9 366 Ginawecho 1233 489 984 93 99 5 1 5 583 Cheramo 1524 716 1409 107 128 22 11 9 834 Bonga Gorita 1566 597 1217 167 162 9 8 9 772

6 8107 3251 3236 578 716 1294 49 159 w/urulicho 561 248 515 18 20 9 5 5 271 G/uluricho 610 213 468 24 31 4 3 5 240 T/Tekete 336 110 230 40 45 14 3 4 153 M/Bermuja 477 208 438 10 15 3 2 0 220 medeb barmuja 665 275 508 50 55 10 2 4 327 M/Gerba 597 245 541 17 22 9 5 6 267 l/tekete 183 65 150 10 15 3 3 4 78 g/garb a M/Tekete 686 280 588 119 121 2 1 2 400

8 4115 1644 1794 288 324 612 30 108 hego Maribo 650 176 380 16 12 9 1 0 193 L/Kombola 704 267 551 51 36 12 5 0 323 Wolilcha 808 331 661 75 62 6 3 3 409 M/Talota 756 345 724 105 95 10 8 3 458

Damboya Woreda health office the 4th round Trachoma prevention and control drug distribution campaign Page 13 L/Hinchine 798 254 528 52 43 13 1 0 307 T/Hinchine 705 194 465 15 22 4 1 1 210 Sigazo 877 310 745 53 46 19 0 1 363 T/Kombola 660 424 677 27 40 11 2 0 453 Laga bora 462 181 362 24 23 4 3 3 208 Shamoso 705 130 307 57 58 8 4 5 191

10 7125 2612 2788 475 437 912 16 140 Mahe 652 205 273 17 14 5 5 5 227 SikeGameto 378 235 449 14 8 3 1 2 250 SikeWolilcha 441 141 309 25 41 6 5 3 171 Duna 438 181 317 30 23 3 3 4 214 GamatoZonecho 653 258 643 49 30 2 3 10 310 GamatoGonbisa 575 134 427 21 27 6 3 0 158 Gamato Fate 784 279 771 48 74 6 10 3 337 Rike 628 220 454 35 28 4 6 4 261 Dabona 491 164 328 16 22 5 1 0 181 Gundo 482 48 102 14 5 6 4 6 66 TalotaZanocho 944 385 1056 63 49 22 6 8 454 Masana 941 229 473 36 25 3 2 2 267 yebu Habaloso 554 216 408 32 33 10 4 3 252

13 7961 2695 3315 400 379 779 50 184 Chefe 1061 425 892 55 56 9 8 10 488 Tiga 599 214 451 59 50 5 2 4 275 Kazala 922 425 785 57 55 9 6 9 488 Dambo ya-01 Damboya 1922 874 1495 154 136 8 15 15 1043

4 4504 1938 1685 325 297 622 38 100 Susuba 333 153 298 20 21 2 3 3 176 M/Gerba 2207 948 1870 164 164 16 7 10 1119 Wotamo 287 83 206 25 26 3 2 4 110 Dambo ya-02 Chefe 2881 1183 2336 255 260 22 12 15 1450

4 5708 2367 2343 464 471 935 32 99 Kazala Sumabelo 318 124 270 20 21 1 1 4 145 2nd Sumabelo 309 120 263 20 20 3 2 1 142 3rd sumabelo 419 182 356 26 28 3 2 3 210 Gembalaka 359 149 304 20 27 2 3 3 172

Damboya Woreda health office the 4th round Trachoma prevention and control drug distribution campaign Page 14 1st Holakercha 305 129 259 20 20 3 3 0 152 2nd Holakercha 368 150 302 20 29 4 2 1 172

6 2078 854 900 126 145 271 12 41 Girona 590 246 502 37 40 4 3 4 286 T/bukuko 292 126 248 18 20 2 1 3 145 M/bukuko 300 117 255 20 18 3 1 2 138 T/Gabarancho 303 121 258 20 19 2 2 2 143 HTS 268 112 228 15 20 3 2 1 129 Bara 243 97 207 15 17 2 0 2 112 L/minatofa 329 126 280 20 23 2 2 2 148 L/shincamo 274 119 233 20 16 2 1 2 140 M/Shincamo 209 82 178 17 10 3 2 1 101 Kanko 312 130 265 20 21 1 2 3 152 Kanko na m/heba 320 152 272 20 22 2 2 2 174 M/heba&Dabona 281 107 239 16 21 2 2 2 125 Dabona 260 84 174 10 17 2 2 0 96 Heba T/Minatofa 273 88 170 16 10 0 2 2 106 14 4255 1707 1802 264 274 538 28 82 Chocha 824 343 691 50 57 4 3 10 396 Garado 604 240 500 40 39 2 4 6 284 Olona 503 200 415 33 37 1 4 0 237 L/wondo 672 277 571 36 37 2 4 8 317 Wondo Aba Wondo 558 221 462 33 39 2 6 4 260 5 3162 1281 1358 192 209 401 28 60 Konshora 462 177 393 32 30 2 0 2 209 Kuarahamo 480 200 408 28 34 3 3 4 231 Mehal 762 330 648 46 53 6 6 6 382 L/Gonji 934 389 794 60 61 3 10 5 459 Gulbana 1077 412 915 64 76 3 10 9 486 Gonj Mizane 876 357 713 54 60 2 9 7 420 6 4591 1865 2006 284 314 598 33 90 L/Dekeya 590 315 535 18 12 8 3 4 336 T/dekeya 640 297 565 31 28 3 1 2 329 T/Lemecha 222 89 169 19 28 1 2 3 110 L/Homa 637 303 591 19 14 1 1 1 323 T/Homa 658 279 537 42 45 9 8 7 329 Amber ico L/Lemecha 713 368 645 23 24 3 5 3 396 6 3460 1651 1391 152 151 303 20 65

Damboya Woreda health office the 4th round Trachoma prevention and control drug distribution campaign Page 15 Senkamo 409 158 328 24 33 6 4 5 186 DumeLemecha 1165 540 1027 58 52 7 6 5 604 Kombolcha 524 178 410 46 42 6 7 3 231 Hinchine 632 214 500 55 52 6 4 5 273 Korte 759 249 637 59 41 10 1 1 309 L/Gerba 948 412 809 53 54 13 6 3 471 T/Gerba 877 379 750 44 57 7 4 5 427 Donkoricho 994 403 854 56 49 10 7 8 466 Gerem ba ZeneMetera 808 377 695 44 40 6 6 7 427 9 7116 2910 3100 439 420 859 42 158 Wera 944 357 700 60 98 4 12 8 429 Lemecha 921 405 631 129 80 3 5 12 539 H.Bonga 1817 862 1513 127 84 5 13 13 1002 Oliso 965 335 635 106 142 3 7 10 448 Haman cho Korte 1764 898 1495 98 82 4 9 14 1005 5 6411 2857 2117 520 486 1006 57 122 Kota 866 371 710 70 32 9 4 5 445 Karkeresho 1334 564 1087 86 79 12 7 9 657 K/kom bola Kombola 646 265 523 48 45 2 3 1 319 Goja 911 397 774 49 69 7 6 7 452 4 3757 1597 1497 253 225 478 22 72 Senkamo 771 300 625 14 98 3 3 8 317 DumeLemecha 309 130 254 12 28 2 4 6 146 Oliso 810 301 653 60 62 2 3 10 364 Funto- 01 LayignaLemecha 734 344 642 30 38 4 6 4 380 4 2624 1075 1099 116 226 342 28 55 Wored 76 a total 137 91527 36563 73361 5847 6299 4 520 576 42933

Report summary by kebele

Damboya Woreda health office the 4th round Trachoma prevention and control drug distribution campaign Page 16

No of people Rx With Zx Tab No of people Rx With Zx Syrup Coverage P < re 6month Total g n Total a Name of pop.201 n kebele T 6 G.C Male Female Male Female Total t o m Male Female o t h er s

3 Gendela 3901 1640 1720 3 200 268 468 0 20 26 76 3 H/gotme 2 na 2126 846 936 1 110 159 269 0 14 10 44 7

3 Megerie 2953 1208 1118 2 208 229 437 0 10 19 59 3

H/laloa 3 mo 2513 891 910 1 166 202 368 9 4 10 53 8

3 Dato 5060 1674 1683 3 287 367 654 9 28 26 93 3

6 Bonga 8107 3251 3236 6 578 716 1294 9 41 49 159 4

5 G/gerba 4115 1644 1794 3 288 324 612 4 24 30 108 4

9 Hego 7125 2612 2788 5 475 437 912 6 28 16 140 4

8 Yebu 7961 2695 3315 6 400 379 779 1 53 50 184 0

Damboy 3 a-01 4504 1938 1685 3 325 297 622 1 31 38 100 6

Damboy 4 a-02 5708 2367 2343 4 464 471 935 3 24 32 99 7 Damboya Woreda health office the 4th round Trachoma prevention and control drug distribution campaign Page 17 1 Kazala 2078 854 900 1 126 145 271 6 13 12 41 7

3 Heba 4255 1707 1802 3 264 274 538 0 24 28 82 5

1 Wondo 3162 1281 1358 2 192 209 401 1 21 28 60 6

1 Gonji 4591 1865 2006 3 284 314 598 9 38 33 90 8

Amberic 2 ho 3460 1651 1391 3 152 151 303 5 20 20 65 0

Geremb 7 a 7116 2910 3100 6 439 420 859 1 45 42 158 0

Hamanc 1 ho 6411 2857 2117 4 520 486 1006 9 46 57 122 9

K/kombo 3 la 3757 1597 1497 3 253 225 478 0 20 22 72 0

1 Funto-01 2624 1075 1099 2 116 226 342 1 16 28 55 1

7 Woreda 6 total 91527 36563 36798 7 5847 6299 12146 4 520 576 1860 3 The fouth round zithromax MDA Drug Balance of Damboya Woreda Dec,201 6G.C. Utilized Name of Target Person Drugs Balance SN (Distrib Wastage kebele Popn Treated Issued at Hand uted) Zith tab Zith sus TTC Zith tab Zith sus TTC Zith tab Zith sus pcs ml tube pcs ml tube pcs ml Gendela Coverag100 10000 3900 152 10000 3900 152 0 0 1 3901 3904 e % H/gotme 99 5500 2169 88 5500 2169 88 0 0 2 na 2126 2095 3 Megerie 2953 2822 96 7500 2820 118 7500 2820 118 0 0 H/laloam 2222 88 6500 2880 106 6500 2880 106 0 0 4 o 2514 5 Dato 5060 4104 81 11000 5482 190 10993 5474 186 0 0 6 Bonga 8107 7940 98 20700 8940 320 20606 8940 318 94 0 7 G/gerba 4114 4158 101 9759 3366 216 9748 3342 216 0 0 8 Hego 7125 6452 91 17000 6780 280 16988 6330 280 0 450 9 Yebu 7961 6973 88 20231 7500 368 19943 6870 368 281 510 Damboy 4345 96 12000 5386 200 11996 4952 200 0 420 10 a-01 4504 Damboya Woreda health office the 4th round Trachoma prevention and control drug distribution campaign Page 18 Damboy 5744 101 12500 7883 198 12496 7861 198 0 0 11 a-02 5708 12 Kazala 2078 2066 99 5500 2214 82 5500 2178 82 0 0 13 Heba 4255 4129 97 10500 4018 164 10500 3896 164 0 60 14 Wondo 3162 3100 98 7500 2959 120 7500 2918 120 0 0 15 Gonji 4591 4559 99 11500 4545 184 11500 4500 180 0 0 Hamanc 6102 95 15000 6060 244 15000 6060 244 0 0 16 ho 6411 K/komb 3647 97 9000 3888 150 8992 3876 144 0 0 17 ola 3757 Amberic 3410 99 8500 2880 134 8500 2880 130 0 0 18 ho 3460 19 Geremba 7116 7027 99 19000 7110 320 19000 7110 316 0 0 20 Funto-01 2624 2571 98 7310 2820 110 7310 2820 110 0 0 Wored 91527 87370 95 226500 93600 226072 91776 3720 375 1440 24 a total 3744

Zith tablet by pos by pcs ml TEO by tubes Drugs unissued from a store 0 0 Received from other woerda 14000 5760 0 Balance at store 0 0

Post Distribution Zithromax and Tetracyline eye Ointment Inventory Status Report. Organiztion: Damboya health office,Project Name ORBIS international Distribution Round: 4th ,Distribution period:Dec,20/2016 G.C Report / Cover letter REF.NO.______Zone:- Kembata Tembaro_District:_Damboya Date:______Amount category of the Exipry dates and qtys Distributed Ending Beginning Amount (utilized + loss/adju Balanc S.No. Product Name Balance Received wastage) stment e Exipry date 1 226125 1 Zithromax tablet in tablets 226500 0 375 Feb,20/2018 3072 3120 2 Zithromax POS in (Bottle) 0 48 Dec,12/2018 G.C 3 Tetracyline eye ointment(tube) 4000 3720 0 280 May,2018 G.C

Woreda Coordinator during MDA responsible Woreda store man/keeper Approved by Head of woreda health office Temesgen Abye Aba Name(Full) :Bilcha Ketsele Delalo Name(Full) :_Wondimu Deniel Hechure Signature:______Signature:______Signature:______

Damboya Woreda health office the 4th round Trachoma prevention and control drug distribution campaign Page 19 ______Date in E.C:______Date in _ Date in E.C:______E.C:______

Damboya Woreda health office the 4th round Trachoma prevention and control drug distribution campaign Page 20 6.1 campaign Cost The budget transferred in two phases to the woreda as a program running cost to conduct a campaign is 283,620 ETB. The cost of donated Zx drug is estimated at ETB 17.41 per tablet; 3,943,365 ETB, and ETB 3.28/ml ;302,875.2 ETB for POS while that of TEO is 2.57 ETB per tube;10,280 ETB. The unit cost per person treated was 56.09 ETB (USD 3.11). Thus, the total budget expenditure at the woreda is 4,540140.2 ETB (203411.3 USD/. From this we can conclude that how much it costs.

Finance The budget transferred to the woreda to conduct the pre distribution training and the actual distribution was ETB 283,620 ETB. The overhead budget utilization status is as indicated by table below. Table- 3 Shows budget utilization by items. S. Description of Budget Budget Varianc Remar N activities planne Utilize e k o d d 1 Peridium for 255,12 255,12 0 training and 0 0 distribution 2 Stationary 5,000 5,000 0 3 Fuel purchase 8,500 8,500 0 4 Refreshment 15,000 15,000 0 Total Budget 283,62 283,62 0 0 0

6.3 Monitoring and Evaluation The progress of the distribution was monitored daily at each kebele and Village level and challenges, best practices and other experiences were communicated with respective supervisors and Woreda administrator and MDA coordinator. There was also meeting every day at woreda level for afrequent week with site supervisors to discuss on issues related to campaign and to evaluate daily performance. Daily communication about the progress of the distribution among supervisors, distribution teams was held regularly during the whole period of the campaign. The supervisors, MDA coordinator and WrHO head were interviewed the residents on the way of site supervision to assure the community accessed by drugs. In the same time identification of 2560 individuals not present during a campaign time integrated with it. In addition to this, post zithromax MDA campaign survey conducted in 4 selected kebeles; which have high performance, in randomly selected 40 households which have averagely 6.7 households each with

Damboya Woreda health office the 4th round Trachoma prevention and control drug distribution campaign Page 21 total of 268 members and from them 11 individuals aren’t present during the campaign due to seasonal migration of labor. Among 40 households interviewed above 95% knows about trachoma disease, zithromax campaign and the ways (personal hygiene and environmental health) of prevention. 7. Challenges  Some supervisors delayed to submit a report.

 Some teams are incapable to make drug balance accurate.

 Mobility of the productive age group residents to other areas for labor work affects the coverage of some kebeles.

 In some extent ,a few people refuse to take a drug

 Shortge of time for distribution of drugs

 Shortage of drugs

8. Solutions attempted  Daily evaluation and intimate communication with supervisors

 Intra campaign orientation and site performance monitoring season in every morning on report compilation and drug balance.

 The WoHO made persistent follow up on MDA coordination till a campaign completed

 Convincing the people who refused to take a drug an awaring them on SAFE strategies

9. Recommendation 1. Drugs should be availed as requested to cover all residents of the woreda 2. There must be post MDA distribution evaluation at all level to address gaps found and strengths for coming distribution. 3. It’s better to develop the data base for this for program to get quality data and to easily manage the daily performance. 4. Trachoma prevalence survey should be conducted per year

Damboya Woreda health office the 4th round Trachoma prevention and control drug distribution campaign Page 22 Damboya Woreda health office the 4th round Trachoma prevention and control drug distribution campaign Page 23