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Osun $Trto GDTI Prolect I I I I I I a Osun $trto GDTI Prolect I I ONGINAL: English COUNTRY / NOTF: NIGERIA Project Name: Osun State CDTI Approval Year : 1998 Launching Year : 1998 Reporting Period (Month Near): October 2003 - September 2004 Date Submitted : MAY, 2005 NGDO Partner : UNICEF YEAR 6 ANNUAL PROJECT TECHNICAL REPORT TO TECHI{ICAL CONSULTATIVE COMMITTTE (TCC) AFRICAN PROGRAMME FOR ONCHOCERCTASTS CONTROL (APOC) _ [E&__ -', rD+\L tioR asl. co} \ 8s Ntl for lniormotion ro, $f1\ 1 7 A0UT ?005 *\0 AYHf I ANNUAL PROJECT TECHNICAL REPORT tr I TO TECHNICAL CONSULTATIVE COMMITTEE (TCC) ENDORSEMENT OFFICERS to sign the report: Cou ntry N!GERIA National Goordinator: Name: Dr. J. Y. Jiya Signature: Date , oflofru' DEffi3 Zonal Oncho Coord i nator: Name: O. Jaiyeoba Signature EDS Date ft$r^eh This report has been prepared by Name; Mr. Matthew Lelaboye Designation: Sfafe Coordinator Signature <-. 4 J Date: 4Alr II WHO/APOC, 24 November 2004 I Table of contents J ACRONYMS V DEFINAT!ONS VI FOLLOW UP ON TCC RECOMMENTIONS 1-2 EXECUTIVE SUMMARY 3 SECTION 1: BACKGROUND INFORMATION 4-7 1.1 General lnformation 1.1.1 Description of the project (briefly) 1.1.2 Partnership 1.2 Population and Health System SECTION 2: IMPLEMENTATION OF CDT|.. 8-23 2.1 Period of Activities 2.2 Ordering, Storage and Delivery of lvermectin 2.3 Mectizan lnventory 2.4 Advocacy and Sensitization 2.5 Mobilization and Health Education of Risk Communities 2.6 Communities lnvolvement in Decision Making 2.7 Capacity Building 2.7.1 Training 2.7.2 Status of Equipment and human resources 2.7.3 Treatment figures 2.7.4 Trend of treatment 2.8 Supervision 2.8.1 Flow chart of Supervision I 2.8.2 lssues of note ilI WHO/APOC, 24 November 2004 2.8.3 The use of Checklist 2.8.4 Outcome of Supervision 2.8.5 Aftermath effect of Feedback SECTION 3: SUPPORT TO CDT!.......... 24 -25 3.1 FinancialContribution 3.2 Expenditure per Activity SECTION 4: SUSTAINABILITY OF CDTI 26 -31 4.1.0 Sustainability at the State Level 4.2.1 Sustainability at LGA Level 4.3.1 Sustainability At First Line Health Facility Level 4.4.1 Sustainability at Community Level SECTION 5: STRENGHTS AND WEAKNESSES 32 IV WHO/APOC, 24 November 2004 I r Acronyms I APOC African Programme for Onchocerciasis Control -.- ATO Annual Treatment Objective AtrO Annual Training Objective CBO Community Based Organisation CDD Community Directed Distributor CDTI Community Directed Treatment with lvermectin CSM Community Self Monitoring FLHF First Line Health Facility FMOH Federal Ministry of Health GCCC Government Cash Counterpart Contribution IFESH lnternational Foundation for Education and Self Help LGA Local Government Area LOCT Local Government Onchocerciasis Control Team MOH Ministry of Health NGDO Non-Governmental Development Organ isation NGO Non-Governmental Organ isation NID National lmmunization Day NOCP National Onchocerciasis Control Programme NOTF National Onchocerciasis Task Force NPl National Programme on lmmunization PHC Primary Health Care REMO Rapid Epidemiological Mapping of Onchocerciasis SAE Severe Adverse Event SHM Stakeholders Meeting SMOH State Ministry of Health SOCT State Onchocerciasis Control Team TCC Technical Consultative Committee (APOC scientific advisory group) TOT Trainer of Trainers UN ICEF United Nations Children's Fund UTG Ultimate Treatment Goal WHO World Health Organization V WHO/APOC, 24 November 2004 Definitions: (i) Total Population: The total population living in meso/hyper-endemic communities within the project area (based on REITIO and census taking). (ii) Eligible Population: calculated as 84o/o of the total population in meso/hyper-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 lvermectin 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 of the project). (v) 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-endemic communities as identified by REMO in the project area (this should be expressed as a percentage). VI WHO/APOC, 24 November 2004 t E)" N o 8q () z t HE cl Q Cr Eq.gpEe-r"€q EEE: o F 0sEEgeEEE., o ; o o E b E ,A EEls8- 9{:' -)lU ='= = o tr E;i€tEaia€E:E* o- UJ eEnrB;A;EBEEE[E F -;esEE*EeErsg; m z lrJ eEe#EBi#:-gEE: Y F EE=EE:fg;EE;E; o E g Iz E E f ; E ; E $ ? ;3 T F tL q p, c o [ = e fr X. e 3 E E; rEcHE 2.;E;€#EEEE E.EE$.EEEE;E 6pBB r(U(JfO-u,+=GONO.=OGoj?cooX€c=E=a-o U' z o I C F o o E (J- .= a E F=$Jfi o E (, Po oo J .c o= C) E o o E o IIJ o o o t L a () .9 -. -,(E0 l- ECL 2EX_co tr-c SE to t 6l q) ! q) z t N (, E;f Eg;E# a EEnoEE = f;g;qE =ErHE6-.e sl;E *E gfi= =;E_5SE iE E '=E E ;;g*gI ;tH.g o- 6-= yX qo) 5E E o o.X =o- o).= o gt BgiB$;Od]'E iE i€EHIEEE;E .€o-tEO--O-!.t F =Z = :EE*IEEE;Eg gt# -3; E 5; : o tcq :fr3g =.e €: PEsE .9(uaoPEE.=AEHtssgsES'HE i8;E eri=PEHLiEAq inE;E; F FEI:E,, E EEE ;gE: , €Eg gbo.i E E5 qEgE€ g-E;R N o) .C o- oP o -ctr o o Y 9PEa E 6 oa EEE il.d E_6(9-lLI r_= ,=E o q o-(u8s zoa=;5E3 N (f) Executive Summary Osun State is one of the States in the South Western part of Nigeria and is located in the B Health Zone. The State has a population of about 2.2 million (1991 census). lt is estimated that 824125 people are at risk of Oncho. lnfection in all the 30 LGAs in the State. The latter is a predominantly Yoruba state. Other ethnic groups like Hausa, lbo, Fulanis and Agatus also reside in all parts of the State. Osun State project is in the sixth year of its implementation. Emphases were majorly placed on grassroot involvement and participation for CDTI sustainability. lntegration planning meetings were held as an important strategy to enlist the active involvement of other PHC Programme Officers in the State. lnauguration of CSM & SHM in 207 and 117 communities were maintained. Consequently, 85% of the 997 endemic communities in the project site supported CDDs in either cash or kind. Expectedly, all the 997 endemic communities were targeted and mobilized appropriately. However, it is pertinent to note that the 997 communities were treated giving 100% geographical coverage. The total population is 814030. The Annual Treatment Objective (ATO) is 701000. The Ultimate Treatment Goal (UTG) is 691926. ln summary, a total of 669018 people were treated during the period with 1617631 tablets. However, 149,714 people were treated with 431 ,006 tablets in the sixteen (16) at risk Local Governments. Targeted trainings were conducted for all categories of Oncho. extension workers. ln summary,200 CDDs were trained /retrained, while a total of 150 Health workers were trained during the period, sponsored by UNrcEF. Besides, uNlcEF also sponsored 2nd and 3'd quarterly state oncho. review meetings and advocacy to 14 endemic LGAs, which were used as opportunity for information dissemination, cross fertilization of ideas and support for programme implementation. The only major challenge confronting the project was the issue of provision of Government Cash Counterpart Contribution (GCCC) for CDTI activities at both the State and few LGAs. 3 SEGTION 1: BACKGROUND INFORMATION 1.1. General lnformation 1 .1.1 Description of the Project (briefly) Geographical location, topography, climate Osun State is one of the States in the South Western part of Nigeria and is located in B Health Zone. lt is bounded by Kwara State to the North, Ekiti and Ondo States to the East, Ogun State to the South and Oyo State to the West. The State has a land mass of about 8,572 square kilometers. The State hastwo distinct seasons, dry season and rainy season. The rainy season begins in March and is heaviest from June through September/ October. Farming generally begins in April, most farm work is completed by October, after which the harvesting is carried out. The dry season begins in November and ends in mid- March. Po p u latio n : Activities, c u ltu re, lang u age Osun State has a population of about 2.2million (1991 census). Yorubas constitute the major ethnic group, although some minorities such as the lgbos, Hausas, Fulanis and Agatus exist and cohabit peacefully with the indigenes. The State is essentially an agrarian State with aboutT0% of its population engaged in one form of agriculture or the other. ln addition, it is a State that is internationally recognized for its rich cultural and tourism potentials. Comm unication Sysfem (road...) The major roads in the State are tarred but access roads to most of the endemic communities are in poor condition. Some are only passable during the dry season. Despite this transportation by road remain the major means of + communication among the communities.
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