U*-*" Cn TO, \Ir I WHO/APOC, 24 November 2004 Ao Afi H
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I I I I I I RESERVED FOR PROJECT LOGO/HEADING I I I 1 I I v L.. ORIGINAL : English COUNTRYAIOTF: Tanzania Proiect Name: CDTI Tunduru focus Approval vearz 2004 Launchins vear: 2005 Reportins Period: From: l't Januaryr2007 To: 31't December 2007 (Month/Year) ( Month/Year) Proiectyearofthis report: (circleone) I 2 13] 4 5 6 7 8 9 10 Date submitted: January,2008 NGDO partner: Sightsavers International ANNUAL PROJECT TECHNICAL REPORT SUBMITTED TO TECHNICAL CONSULTATIVE COMMITTEE (TCC) DEADLINE FOR SUBMISSION: To APOC Management by 3l Januarv for March TCC meeting To APOC Management by 31 Julv for September TCC meeting AFRTCAN PROGRAMME FOR ONCHOCERCIASTS CONTROL (APOC) HL .L u- r tcce6 rsb' (0P' AfiC: t 1 rF\r lrt0ir Afi) Fo Gluu*-*" cn TO, \iR I WHO/APOC, 24 November 2004 Ao Afi H. ANNUAL PROJECT TECHNICAL REPORT TO TECHNTCAL CONSULTATTVE COrVrVtrrEE (TCC) ENDORSEMENT Please confirm you have read this report by signing in the appropriate space. OFFICERS to sign the report: Country: Tanzania National Coordinator Name: Dr.Grace Saguti Signature: Date: ... ... Zonal Oncho Coordinator Name: Dr. Daniel wtJtekela sisnature: S[/ RgGloliil. i[3i}1. fiFF]r"j;l ;,, iirrelq 1_h... arz. Date: . ..1.kv.9 ;.. .?g*, I, NGDO Representative Name: Dr. lbrahim Kabore / sion,ture Date b Thrs report has been prepared by Name . Mr. Nurdin tvlalloya Design ation ect Coordi Sign ature Date e?u.9 u)6Y-e 2 WI-lO/APOC. 24 Nor,crnbcr 2(X)-l Table of contents ACRONYMS 5 l.l. GeNBRar INFoRMATIoN ......... 9 t.2. PopurertoN ............ l0 2.2. Aovocecy ............ 11 2.3. MosIttzRtloN, SENSITIZATIoN AND HEALTH EDUCATIoN oF AT RISK coMMUNrrrES ........12 2.4. CourrluN IrY TNVoLVEMENT 13 2.5 Cnpacny BUTLDTNG. 13 2.6. TRrnturNrs.. t6 2.6.5. Trend of treatment achievementfrom CDTI project inception to the current year........ l9 2.7. ORDERTNG, sroRAGE AND DELIVERy oF IvnnurctrN .................20 2.8. ColruurNrry sELF-MoNIToRTNG eNo STRxTHoLDERS MgBrrNc.... 2t 2.9 SupeRvrsroN ....22 2.9.1. Provide aJlow chart of supervision hierarchy. ....22 2.9.2. W'hat were the main issues identified during supervision?.............. 22 2.9.3. l[las a supervision checklist used?......... .......... 22 2.9.4. lV'hat were the outcomes at each level of CDTI implementation supervision?.........22 2.9.5. Was feedback given to the person or groups supervised? ..................... 22 2.9.6. How was the feedback used to improve the overall performance of the project? .... 22 SECTION 3: SUPPORT TO CDTI........ ...........23 3.1. EeurpusNr........ 23 3.2. FrxaNcnr coNTNBUTToNS oF THE pARTNERS AND coMMtrNITrES...... 24 3.4. ExpgNoITuRE PER ACTIVITY... 24 SECTION 4: SUSTAINABILITY OF CDTI 25 4.1. INrnnner; INDErENDENT pARTICTpAToRy MoNTToRING; EvnruRttoN ,.,.25 4.1.1 Was Monitoring/evaluation caruied out during the reporting period? (Tick any of the following which are applicable) ...........,,..,..... 2 5 4.1.2. V[rhat were the recommendations? . ..................... 2 5 4.1.3. How have they been implemented?................. ....,..............,. 26 4.2. SusrerNesrlrry oF rRoJECTS: rLAN AND sET TARGETS (MANDAToRv AT ..................... 26 Ysen 3) ........ ..................... 26 4.2.1 Planning at all relevant levels ..................... 26 4.2.2. Funds. ,....,............... 2 7 4.2.3 Transport (replacement and maintenance).... ....... 27 4.2.4. Other resources ...,.., 27 4.2.5. To what extent has the plan been implemented......... .........27 4.3. INr8cnanoN................ ......27 4.4. OpBnerroNAL RESEARCH.. .......27 4.4.I. Summarize in not more than one half of a page the operational research undertaken in the project area within the reporting period. .............. 27 4.4.2. How were the results applied in the project? N/A ..............27 SECTION 5: STRENGTHS, WEAKNESSES, CHALLENGES, AND OPPORTUNITIES... 28 SECTION 6: UNIQUE FEATURES OF THE PROJECT/OTHER MATTERS....................28 3 WHO/APOC, 24 November 2004 4 WHO/APOC, 24 November 2004 I Acronyms APOC African Programme for Onchocerciasis Control ATO Annual Treatment Objective ATrO Annual Training Objective CBO Community-Based Organization CDD Community-Directed Distributor CDTI Community-Directed Treatment with Ivermectin CSM Community Self-Monitoring LGA Local Government Area MOH Ministry of Health NGDO Non-Governmental Development Organization NGO Non-Governmental Organization NOTF National Onchocerciasis Task Force PHC Primary health care REMO Rapid Epidemiological Mapping of Onchocerciasis SAE Severe adverse event SHM Stakeholders meeting TCC Technical Consultative Committee (APOC scientific advisory group) TOT Trainer of trainers LTNICEF United Nations Children's Fund UTG Ultimate Treatment Goal wHo World Health Organization 5 WHO/APOC, 24 November 2004 Definitions (D Total population: the total population living in meso/hyper-endemic communities within the project area (based on REMO and census taking). (ii) Elisible 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 coveraqe: number of people treated in a given year over the total population (this should be expressed as a percentage). ("i) Geographical coverase: number of communities treated in a given year over the total number of meso[typer-endemic communities as identified by REMO in the project area (this should be expressed as a percentage). (vii) Integration: 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 CDTI. (viii) Sustainability: CDTI activities in an area are sustainable when they continue to function effectively for the foreseeable future, with high treatment coverage, integrated into the available healthcare service, with strong community ownership, using resources mobilised by the community and the govemment. (ix) Community self-monitorine (CSM): The process by which the community is empowered to oversee and monitor the performance of CDTI (or any community- based health intervention prograrnme), with a view to ensuring that the prograrnme is being executed in the way intended. It encourages the community to take full responsibility of Ivermectin distribution and make appropriate modifications when necessary. 6 WHO/APOC, 24 November 2004 FOLLOW UP ON TCC RECOMMENDATIONS. Using the table below, fill in the recommendations of the last TCC on the project and describe how they have been addressed. TCC session 25th Number of TCC RECOMMENDATIONS ACTIONS TAKEN BY THE PROJECT FOR Recommen TCC/APOC dstion in MGT ASE the Report ONLY 323 TCC recommends for project improvement a More health stalf be More health staff has been trained and trained and involved in sensitized i.e. CHMT members, Co-opted CDTI members and various department heads of the Council hospital were sensitized and trained on CDTI philosophy in 2O'h November, 2007. a The Project should agree The comnrunities has agreed to distribute ' 'Mectizan' with communities to carry the drug ' in dry season , rn 200'/ out distribution outside the we distributed the d.ug from Hospital farming season, to reduce pharmacy to health facilities in September absenteeism and at Community level in October - November,2007. a Funds should be Funds have been internally mobilized to internally mobilized to cary out repairs of the equipment. carry out repairs on equipment, rather than using NGDOfunds a More mobilizqtion be Community members were mobilized prior carried out to remove to drug distribution hence the misconception on elfect of misconception on effect of Mectizan drug Mectizan@ has been minimized and in this report the therapeutic coverage is higher compared to the last distribution. People are willing to swallow the drug. Therapeutic coverage has raised from 7lo/o lhe previous year up to 77oh rn reporting year. a Prompt retirement of The project had managed to retire all allocated funds be canied allocated funds in time and in 2007 we oul to avoid late didn't experience any delay of funds from disburcement offunds by APOC Trust Fund. APOC a CSM and SHM should be Community self monitoring and SHM has introduced as soon as beerr conducted in December,200l in 531 possible communities. Up to now the project had received minutes of the meeting fronr 66 sub village. Still waiting from other sub village. a Operational research National Institute for Medical Research topics be identiJied and [NIMR] has been approached to assist in proposals written for same identifying topics and proposal writing as it is them who are dealing with vector control. 7 WHO/APOC, 24 November 2004 EXECUTIVE SUMMARY The report covers a period of 12 months starting from l't January, 2007 to 3lttDecember, 2007.Year 3 of the project saw many activities being implemented by the district council using funds from APOC, Council and Sight Saver's International all being directed at creating sustainability of the program by involving leaders at district level who are the policy makers and warrant holders. We held several sensitization meetings from the grass root of the community leadership up to District level i.e. Sub village leaders, village leaders, ward leaders, divisional leaders as well as Council [District] leaders. Independent Participatory Monitoring is one of the activities conducted in Tunduru CDTI in the year 2007.The activity was conducted with team from various institutions which was supported by APOC. The activity commenced on2 - l4 August 2007.