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GOMBE STATE C.D.T.I.PROJECT. I ORIGINAL: English COUNTRY/NOTF: NIGERIA Proiect Name: NOTF/APOC- WHO CDTI PROJECT GOMBE STATE. Aporoval vear: December 1999 Launchins vear: March 2000 Reportinq period (Month/Year): l't January 2006 - 31't December 2006 Proiectvearofthisreoort: (circleone)l 2 3 4 5(6)78 9 10 Date submitted: January 2007 NGDO nartner: UNICEF. vlz Fc: Acx -,:r To: { Sitt rsb l b? I AHE t BFo I t Fo I ' For hfcrmgilon ; g ro,5i R. i l I 0 8 JU|N 2007 I ffifu, I )/- d.gaKbna- I #rE# t ANNUAL PROJECT TECHNICAL REPORT SUBMITTED TO TECHNICAL CONSULTATTVE COMMITTEE (TCC) I g.i $u{ v t ry AFRICANPROGRAMME FOR ONCHOCERCIASIS CONTROL (APOC) 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: Country: _NIGERIA National Coordinator Name: P. O PEARCE (MRS) s-t ) vtL- Signahre: .. W.t.\ z'- L5 -)/--\- L.' Date: ..?.iI I Zonal Oncho Coordinator Name: P. O PEARCE (MRS). Signature: . W*:!{- Date: ...L i. l,; I z vuV This report has been prepared by Name : HARUNA ALI D Designation Signature Date Table of contents ACRoNYMS.......... ..... vt DEFTNITIONS""""' "'vlr FOLLOW UP ON TCC RECOMMENDATIONS.. .........1 EXECUTTVE SUMMARY........... ....................2 SECTION 1: BACKGROUND INFOR]VIATION....... ..........."'."""'3 1.1. GnNpneI- INFORMATION....... .... J 1.1.1 Description of the prolect (briefly) 3 1.1.2. Partnership... 5 1.2. PopuLerroN 6 SECTION 2: IMPLEMENTATION OF CDTI....... ...""'8 2.1. Turmt,rxrB oF ACTIVITIES...... - --.. .....8 2.2 Arvocacv ......11 23 2.4. COVN,TTXNYINVOLVEMENT . ..13 2.5. CepaCTrY BUILDING . .....14 2.6. TRrnm,mwrs........... 2.6.1. Treatmentfigtres............ 2.6.2 What are the causes of absenteeism? 19 2.6.3 What are the reasonsfor refusals?.... t9 2.6.1 BrieJly describe all htown ondvenfied serious qdverse events (SAE{ that.... 2.6.5. Trend of treatment achievement from CDTI project inception to the current year 20 2 7 OROBRN.IC, STORAGE AND DELIVERY OF IVERMECTIN 2,8, COTWTMUTY SELF-MOMTORINGENN STETPHOLDERS MEETTNG.,. 2.9. SuppRvtsIoN 2.9. t. Provide aflow chart of xtpervision hierarchy -.......- 2.9.2. Wat were the main issues identified during supervision?..... not deftned 2.9.3. Was a supervision checklist used? ....Enor! Bookmark not delined 2.9.4. Whatwere the outcomes at each level of CDTI implementation rupervision? Enor! Bookmark not defined 2.9.5. Wasfeedback given to the person or groups xrpervised? Enor! Bookmark not deftned 2.9.6. How was the feedback used to improve the overall performance of the proiect? 26 SECTION 3: SUPPORT TO CDTI....... -........27 3.1. Equml,mur -.....27 3.2. FrXaNcnrCONTRIBUTIoNSoFTHEPARTNERSANDCoMMLINITIES..........................28 3.3 OrrmnFoRMSoFCoMMLINITYStlPPoRT........... ... ...........28 3.4. ErcsNDrnrRE PER ACTIVITY............. ...--......28 SECTION 4: SUSTAINABILITY OF CDTI....... ...........29 4.1. IwnNar; INDEPENDENT PARTICIPAToRY MoNIToRING, EveLuattoN ... .......,-.-...29 1. t. t Was Monitoring/evaluation cqrried out during the reporting period? (tick any of the fotlowing which are applicable) ........., ...Error! Bookmarh not deJined 1.1.2. lV'hqt were the recommendations? ....Enor! Bookmark not delined 1.1.3. Hov,have they been implemented? ....................Etor! Bookmark not deJined 4.2. Susra.rt.{aerr-lTy oF rRoJECTS: eLAN AND sET TARGETs (vaNoaroRY AT................30 YR 3) 1.2.1. Planning at all relevant levels. 1,,-, Funds....... 1.2.3 Transport (replacement and maintenance)-.-.... 1.2.1. Otherresources.. 1.2.5. Towhat extent has the plan been implemented-.--. 4.3. IwcRanoN.... 4.3. l. Ivermectin delivery mechanisms....'.......'.. 1.3.2. Training..... 1.3.3. Joint supervision and monitoring with other programs 1.3.1. Release offundsfor proiect activities-'. 4.3.5. Is CDTI included in the PHC budget?................... 1.3.6. Describe other health progfammes that are usittg the CDTI structure and how this was achieved. What have been the achievemerrts?-........ 32 1.3.7. Describe others issues considered in the ifiegration of CDTI. JZ 4.4. OpPNETIONAL RESEARCH. 32 1.1.1. Summarize in not more than one half of a psge the operational research undertaken in the project area v'ithin the reporting period. Enor! Bookmark not deftned 1.1.2. How were the results applied in the project? .....Enor! Bookmark not defined SECTION 5: STRENGTHS, WEAKNESSES' CHALLENGES' ANI) OPPORTUNITM,S .......32 SECTION 6: UNIQUE FEATURES OF THE PROJECT/OTHER MATTERS............32 Acronyms APOC African Programme for Onchocerciasis Control ATO Annual Treatment Objective ATrO Annual Training Objective CBD Community Based Distributor CBO Community-Based Organization CDD Community-Directed Distributor CBIT Community - based Ivermectin Treatment CDTI Community-DirectedTreatmentwithlvermectin CSM Community Self-Monitoring GMC Gombe Media Corporation. GSWC Gombe State Water Corporation LGA Local Government Area LOCT Local Onchocerciasis Control Team MLGCA Ministry for local government and Chieftaincy Affairs. MOA&NR Ministry of Agriculture & Natural Resources. MOH Ministry of Health NAFDAC National Agency for Food and Drug Administration and Control. NGDO Non-GovernmentalDevelopment Organization NGO Non-Governmental Organization NOTF National Onchocerciasis Task Force PHC Primary health care PHCC Primary health care Coordinator REMO Rapid Epidemiological Mapping of Onchocerciasis SAE Severe adverse event SHM Stakeholders meeting SOCT State Onchocerciasis Control Team TCC Technical Consultative Committee (APOC scientific advisory group) TOT Trainer of trainers LTNICEF United Nations Children's Fund UBRBDA Upper Benue River Basin Development Authority. UTG Ultimate Treatment Goal WHO World Health Organization ZOTF Zonal Onchocerciasis Task Force. Definitions (i) Total pooulation: the total population living in meso/hyper-endemic commumfles within the project area (based on REMO and census taking). (ii) Eligible population: calculated as 84Yo of the total populafion in meso/h1per- endemic communitres in the project area. (iii) Annual Treatment Objective: (ATO): the estimated number of persons livtng in meso/hyper-endemic areas that a CDTI project intends to treat wifrr ivermectin in a given year. (i") Illtimate 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 firll geographic coveragq (normally the project should be expected to reach the UTG at the end of the 3'o year ofthe project). (v) Theraoeutic coverage: number of people treated in a given year over the total population (this should be expressed as a percentage). (-) Geographical coverage: number of communities treated in a given year over the total number of meso/tryper-endemic communities as identified by REMO in the project area (this should be expressed as a percentage). (vii) lntegration: delivering additional health interventions (i.e. vitamin A supplements, albendazole for LF, screening for cataract, etc.) through CDTI (using the same systems, training, supervision and personnel) in order to maximise cost- effectiveness and empower communities to solve more of their health problems. This does not include activities or interventions carried out by community distributors outside of CDTL (viii) Sustainability: CDTI activities in an area are sustainable when they continue to function effectively for the foreseeable future, wrth high treatment coverage, integrated into the available healthcare sen,ice, with strong community ownership, using resources mobilised by the community and the govemment. (i*) Communitv self-monitoring (CSM): The process by which the community is empowered to oversee and monitor the performance of CDTI (or any community- based health intervention programme), *ith a view to ensuring that the programme is being executed in the way intended. It encourages the commrurity to take full responsibility of ivermectin distribution and make appropriate modifications when necessary. FOLLOW UP OlI TGG REGOTTE]TDATIOI{S Using the table below, fill in the recommendations of the last TCC on the project and describe how they have been addressed. TCC session Number of TCC ACTIONS TAKEN FOR TCC/AMC MGT Recommenddion RECOMMENDAITONS BY THE PROJECT USE ONLY in the Report (Please add more rows if necessary) I WHO/APOC, 24 November 2004 Executive Summaty Gombe State was carved out of the former Bauchi State on lst October 1996. It is made up of 11 L.G.As 10 of which are onchocerciasis endemic. Mectizan treatment started in the State since l99l as part of the former Baichi State. CDTI implementation started in year 2000 and all the 10 endemic L.G.As are incorporated. The State has a total population of about 2,353,879 while the population of endemic communities in the l0 CDTI L.G.As is 1,384,864. In the period under review a total of 1,085,776 persons were treated in 966 communities in the 10 CDTI L.G.As while 603 persons were treated in Gombe L.G.A. (clinic-based treatment) The UTG as well as the ATO for the year is 1,163,258 The performance this year (under review) is 100% geographical coverage, TsYoTherapeutic coverage and93%o of the UTG. Majority of the population of the endemic communities are peasant farmers who are always at home during the rainy season in order to cultivate their farmlands. In the dry season most of the youths in the rural areas move to various urban centers in the State and outside in such of white