Ogun State Cdti Project I
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STATE CDTI PROJECT I OGUN I ORIGINAL: English UNSTATE : NIGERIA Proiect Name: OG CDTI PROJECT Launching vear: NOVEMBER, Approval Year: FEBRUARY,2 000 2001 NOVEMBER,2002 -OCTOBER 2OO3 partner: IFESIVUNIvA Date submitted: DECEMBER,2003 NGDO i PROJECT TECHNICAL REPORT I ANNUAL .:)I TO I ! i'o: I I TECHNICALCONSULTATIVECOMMITTEE(TCC) T( ( ,'l uf ! :1. oupl i C.:,1 I I r- (ly i I C i-V i I Bt tvr : I : BT'-r I 0 t_ I r I I I I .LIP i A'') I I I I I i 'T* AFRICAN PROGRAMME FOR i bJlFk' 34. 0.r o1r oNCHOCERCTASIS CONTROL (APOC) H t't n 4..ir ffi,$ ffi Hi,f il ffi hfl T 2}JD Yffi/qffi, THfiil-flhME#Ail RffiPSRT' : l-l T ECHN ICAL C Oi{S U I.TAT [i','E COFfl II{ITT E E {1'C C} OFFICERS TO SIGT.I T[-:E !]EPC[.I-i COUhI-I'RY: ['IIGERIA f\tAT'A ONAL COORDE NATea ffi : q IinltE D* S.iIGhIATURE 7t [, 0'/ DATI: Z$NAt ONilCHO COORDiilIATQR: ir!r\ilnE Dmotsx A ftyEDoA SIGiiIATURE DATE: tll' Joc 2DD3 This repont has Ereen Prenared hY: liAflitL:..<>s I \-<.g:.Y h r., .V . Q.' t w ArR D ES tG NAT to ru : P Kp.+ Fl.S-r . .-q9t-K! S1GNATUp., ;A'.:$1'1.S..r:l .() . DATE:... .=.Sr$t".., .]..+s. ...,2..=^ L\3, " i ! Table of contenb v F'OLLOW tJP ON TCC RECOMMEhTDATIONS """'1 EXECUTTVE SUMMARY """"2 SECTION 1: BACKGROUND IIYFORMATION """"" """"""""3 ...J GENenal INFoRMATIoN..-....-...-... l.l. ...3 1. 1. l. Desciption of the proiect (brieJly) ...4 l. 1. 2. P artnershiP... - - - - - ...5 I.2. PopuLatrcu aNo [Isal-rH sYsrEM..""""' SECTION 2: IMPLEMENTATION OF CDTI"""" """""""""""6 6 2.1. fTRIoDoFACTIVITIES...-........-... 8 2-2. OnoERnG, sroRAGEAND DELryERYoF IvERMECTIN """""" 9 2.3. AovocncY aNo SrustrzATIoN 2.4. MosLzenOl.r AND HEALTH EDUCATION OF AT RISK COMMUNnES 2.5. COTUUTNITTIES INVOLVEMENT IN DECISION-MAKING........ 2.6. CapactrY BUILDNG 2.6.1. Training.... 2.6.2. Equipment and lrutnan resources + Couornou oF THE EQLIIPMENT PLsess srATE 2.7.1. Treatmenlfigures....-....-... 2.7.3. Trend of treatrnmt achievementfrom :,t, 2.8. SupeRvtsm :::::::: ::' ::' :::': :: ::::' :::: SECTION 3: SUPPTORT TO CDTI """""'22 22 3.1. FTNEruCNT CONTRtsUTIONS OF THE PARTNERS AND COMMUNITIES 23 3.2. Ornen FoRMS oF coMMUNITY suPPoRT. 23 3.3. E>cppNonune PER ACTIvITY SECTION 4: SUSTAINABILITY OF CDTI """""""24 24 4.1. INrpRruat_; TNDEpENDENT PARTICIPATORY MON ITORING; EVaLUanoN 24 4.2. COVNTAUNITY SELF-MONITORING ANO STAXEHOLDERS MPETNqC 24 4.3. SUSTaNASILITY OF PROJECTS: PLAN AND SET TARGETS (MANDAToRY Ar YR 3) 25 4.4. IIIEGRATIoN... 25 4.5 OpgnertoNAl RESEARCH....... 25 SECTION 5: STRENGTIIS, WEAKI\IESSES AI{D CHALLENGES AcronYms Control APOC African Programme for Onchocerciasis ATO Annual Treatment Objective ATrO Annual Training Objective CBO Com munity-Based Organization CDD Community-Directed Distributor ent with I v erm ect in CDTI Co m m u n ity- Direc'ted T r e atm CSM CommunitY Self-Monitorin g LGA Local Government Area MOH Ministry of Health NGDO Non-Govern m ental Develop m en t Organization NGO Non-Governmental Organ ization NOTF National Onchocerciasis Task Force PHC Primary health care Onchocerciasis REMO Rapid E p idern io lo gical M app ing of SAE Severe adverse event SHM Stakeholders meeting advisory group) TCC Technical consultative committee (APOC scientific TOT Trainer of trainers UNICEF United Nations Children's Fund UTG Ulti mate Treatment Goal wHo World Heahh Or ganization Definitions (i) Total population: the total population living in meso/hyper-endemic communities within ttle project area (based on REMO and census taking)' (ii) Elieible pooulation: calculated as 84%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 in a -ooAyp".-"n0".i" -*. that a CDTI project intends to treat with ivermectin givenYar. (iv) Ultimate Treatment Goal (UTG): calculated as the maximum number of people to b" t *t"d *"r"tt in meso/hyper endemic areas within the project areq ultimately to be reachod when the project has reached full geograph,: g.og: (normally the project should be expected to reach the UTG at the end of the 3' yar of the project). (v) Therapeutic coverase: number of people treated in a given year over the total population (this should be expressed as a percentage)' (vi) Geoqraphical coveraqe: number of communities treated in a given year over the total nu-bet of meso/hyper-endemic communities as identified by REMO in the project area (this should be expressed as apercnrfiage)- FOLLOW UP ON TGG REGOMMENDATIONS Using the table below, fill in the recommendations of the last TCC on the project and describe how they have been addressed. TCC session 16 Number of TCC ACTIONS TAKEN FOR TCC/APOC MGT Recommendation RECOMMENDATIO|,IS BY THE PROJECT USE ONLY in the Report 70 (i) To clarify the issue of The project meant registration and how this that; Census of all relates to the census ofthe those living in the endemic population. CDTI areas was conducted and their names registered accordingly in the community register. From this census a total of 300274 persons are living in the endemic areas of the State. 70(ii) Provide a plan of action to The detailed 2"d year increase therapeutic Plan of Action that coverage. showed how the rncreaSed number of people treated was achieved is attached in Appendix 1. (Please add more rows if necessary) WHO/APOC, 26 September 2003 Executive Summary Prepare an Executive summary of the report in not more than one page. Ogun State is one of the Onchocerciasis meso-endemic States in Nigeria. The State has a total of 20 LGAs with an estimated population of 3, 262,889 (Year 2002 Projected). CDTI is being currently implemented in 952 communities with a total population of 300,274 in 8LGAs but 1,028 is the total number of communities in CDTI LGAs. 705 communities have been covered and 2l0,}l7persons treated thus achieving a geographic and a therapeutic coverage of 74%o and70o/o respectively. The Ultimate Treatment Goal is 244,032 for this year while the Annual Treatment Objective is 221,908 which are 86%o and 79o/o respectively. When CDTI was introduced by APOC in 2001, about 157,858 persons were treated. By the end of 2003 , a total of 210,017 persons were treated. It is expected that by the end of the 3'd year in 2004, morc communities should have been covered while more than 300,000 people would have received treatment. With figures, it has been observed that there is a steady increase in the total number of persons treated each year. 10 SOCT members, 50 LOCT members, 200 Health Workers and 1330 CDDs have so far been trained. Almost all the health workers had a retraining work of CDTI implementation, targeted training of good record keeping at all level. 100% was achieved for the training of health staff while 670/o in the number of CDDs trained. The balance of the fund allocated for l't year Government Counterpart Cash Contribution was transferred to 2"d year CDTI implementation and used to carry out activities like commemoration of Oncho day to mobilize decision makers in the community, internal monitoring and supervision of CDTlactivities maintenance of some equipment. Political instability at the LGA, high turnover of political office holders and inadequate funding from APOC constitute the major challenges the project has been facing. 8CDTI Local Government Chairmen, Supervisors for Health, other political and top officials in the LG have been mobilized. These have led to release of counterpart funds in 3LGAs and increase in number of communities giving incentives to CDDs. 6l I village heads,283 women leaders and232 religious leaders have also been mobilizedto establish their responsibilities for CDTI execution and s'rstainability. Evaluation of project to assess quality of CDTI implementation and targeted training of personnel should be carried out in order to move the project forward. 2 WHO/APOC, 26 September 2003 SECTION'l : Background information 1 .1. General information 1.1.1. Description of the project (briefly) Geographical location, topography, climate Ogun State, otherwise known as the Gateway State, was carved out of the defunct Westem State on 3RD February,1976 by the then Federal Military Government of late General Murtala Ram at Muhammad. It lies within the tropics. Oyo and Osun States bound it in the West by the Benin Republic; in the South by Lagos State and the Atlantic Ocean; in the East by Ondo State; and in the North. Ogun State occupies a total area of 16,409,26 square kilometers. The climate follows the tropical pattern with the raining season starting about March and ending in November, followed by dry season. Population: activities, cultures, language The projected population from 2002 for the State is3,262,889. The major ethnic groups Are the Egbas, Yewas, Aworis, Eguns, Ijebus and Remo, they belong in the main to the Yoruba ethnic group. Nigerians from other parts of the country as well as expatriates also live in the State. The languages spoken are mainly Yoruba (language of the predominantly majority) and English (official language). There are several dialects including Ijebu, Remo, Egba, Yewa, Awori, Egun, Ikale and Ilaje. The major occupation of the population is farming, fishing, weaving of cloth (Aso-Oke), tie and dyeg (kampala and cadptl$ are practised. Settlement pattern is largely dispersed. Communication system (road...) Roads between major cities are in good condition, but access roads to most of the endemic communities are in poor shape.