o"\ I I ATTcANPRocRAMME FOR CHOCERCIASIS CONTROL (APoC)

Year 2 CDTI Activities RePort

Birniwa

Sule Tan Guri

Garki

Taura

Miga

Dutse

Irm Kudu

For Actic= To: Cc,ttt c50 State ct u Jigawa CarP Orrn Ar-o AO September 2001 .-di* L4,4, For lnformotion \)+ Tor )t A

rrr'\r |.oZ AFRICAN PROGRAMME FOR oNcHocERClASls CONTROL (APOC)

IE(OND YEAR REPORT FOR COA/TA{UNITY DIRE(TED TREATMENT WITH IVERMECTIN (DTI

SEPTEMBEB 2OOO - AUGUST 2001

JIGA]UTA STATE NIGEP[4.. EX TIVE MMARY

1991' The State was curved out of Kano State in September Government Araes' presently fuas a total number of twenty seven (27) Local are endemic for oncho Seventeen (17) of these Local Government Areas , cerciasis. E,ight (8) Local Government Areas namely are meso endemic' , Birniwa, I(/Hausa, , Ringim and Taura and are ctrrrently implementing CDTI'

Hypo endemic' The The remaining Nine (9) Local Government Areas are with the state has been carrying out treatment in all the communities (CBM)' It was a cheerirrg assistance from the state and the supporting NGO treatment in all hypo- news that APOC is disposed to the idea of supporting endemic communities of the State'

zone. The terrain is generaliy Jigawa state falls in Sudan Savanna and Sahel hitls in some places flat or slight undulating with few rock out crops and Bauchi State' The State particularly the southern part of the State bordering , River chiyako and is drained by some major rivers such as River while the main Rivers their tributaries. The tributaries are largely seasonal, Hadejia contains have water year round. The flood plain of the River presence of some man maCe extensive wet land and swampy areas, and the flies. dams in the state provides breeding sites for black

in Jigawa State in 1996' Ivermectin distribution programmes (I.D.P) started was signed between immediately after the memorandum of understanding (C'B'M') of Germany' Ministry of Health and christpftel blinden mission

I from the inception in 1996 to Below are the results of IDP exercise since date

YEAR TnnnrnnENT FrGURES t996 T6,7sB (8 L.cAS) t997 37 ,820 (8 L.GAS)

1998 124,744 (17 L.GAS) t999 t44,324 (17 L.GAS)

2000 188,153 (17 L.GAS)

number of 200'000 rural The main goal of the Project is to treat a total of the disease by the year populace who are known to be infected, or at risk treatment with invermectin tablets' This 2OO3 in Jigawa state through annual under treatment by establishing task we hope to achieve in the 17 LGAs progralnme, owned by the effective and sustainable Community Directed and support' people through participation and effective implementation

the existing PHC services at both The project has integrated its activities into for the purpose of sustainability' the state and the Local government levels involved in the socT, LOCT and other Health workers are actively implementation of the Programme'

SECTION 1 BACKGR OUN D INF oRMATION 1.1 c ME I the 8 targeted CDTI There are '99 oncho endemic communities in The communities have a Local Government Areas in Jigawa Sate'

Z community size is approximately pattern of settlements. The average 2,,5oopersons.Thehouseholdsinthesecommunitieshaveanaverage have up to 20'30 members' of 5-10 persons each but some may

M ENT R oUND END EMIC L.G .A.S WITH TREAT for each endemic local The following ate the treatment rounds government area.

T AREAS DISTRIB UTION S/NO LOCAL GoVE,NNNIBN (L.G.A) ROUND 5 I BIRNIN KUDU 5 2 BIRNIWA 5 a DUTSE, 5 4 GWARAM 5 5 5 6 reuceue 5 7 RINGIM 5 8 TAURA

TheremainingNinehypoendemicLGAsareinthesameroturdsof treatment as above

3 P

1 TABLE ? NO OF NO. OF NO. OF NO. NO. OF NO. OF COMMUNITI ;/ L.G.A NO. OF COMMUNITIES coMMLllllrl COMMUNITI COMMI,]h{ITIES PAYING COMMU COMMUNI THAT Df,,CIDES ESWITH ES ES TIIAT DECIDES ON NITIES TIES TIIAT ONTHE TRAINED CDDSIN COLLECTED MONTHOF IN /YIt,LIA SELECTED OF CDDS CASH OR DRUGS DISTRIBUTION METHOD GES CDDS DISTRIBUTION KIND 32 38 t5 - 38 38 35 t BIRNIN 38 KUDU

5 ) 5 4 , BIRNIWA 5 5 5 7 5 6 7 i DUTSE 7 7 7 20 t2 20 20 20 4 GWARAM 20 6 1 3 7 7 6 5 7 HAUSA ) 6 8 8 8 6 6 AW 8 A l0 l0 ll 5 RINGIM 1l ll ll j J 3 TAURA 3 J 3 88 99 44 )TAL 99 99 99 91

CDDs receive is difficult because of Getting to know the sort of support that the community members' our conflicting claims between the cDDs and should not concern themselves with suggestion is that project implementers community members during the support issue, but should only encourage, should be revised by APOC to allow mobilzation activities. The above table project share exPeriences more'

month of treatment in the project has Communities making decisions on the of the differences in opinion frotn not been too easy to report on, because is more feasibte is their choosing periods, one vilage to the other. what has prefer to be treated' This suits the which often is a range of months that they

tCt The reporting project,s planned activities and the logistics that are available' experiences' table should permit for more discussion on some conflicting I NI F IFF T Et t IMPLEMENIAIION 2.1 Tratn ecti t of 300 The annual training objective was to train a total number using CDTI personnel for the ivermection distribution programme these 294 approach in the 8 APOC supported LGAs' Out of Workers and progratnme workers were trained (SOCT, LOCT' Heatth

CDD S) representing 98%o -

2.2 Develo Ded Material Used. was given a due Training being an integral part of the CDTI process Materials were consideration during the period 'under review. modification developed in line with the NOTF instructions. Little the posters and were made in some of the materials produced such as in line with the the T -Shirts to have some Arabic writings which is English CDD customs and believes of the people, currently the and produced' This brochure has been translated into hausa language

is to make comPrehension better'

2.3 Performance of CDDs was good, but in The perforrnance of the cDDs during the exercise number of cDDs some communities, it is diflicult have required during distribution thereby increasing the work - load of the few understanding of activities. Many of them have demonstrated a good Records weie the GDTI concept during training and mobilization'

5 properlykeptbymostoftheCDDs,withmectizandrugswell

managed. 2.4 Im the of health workers have \ The quality of training has improved since more The traditional Hausa been trained to assist the LOCT in this task. during training' Language has been the main means of communication translated from The Health education and training flip chart have been way in increasing English to Hausa language. This will go a long trainers in order to understanding. TOT has been conducted for progralnmes' The very faci strengthen their abilities during training in this past. years' that the project conducted training and re-traitting for both the trainers and has made training activities more enjoyable

the trainees.

to devolve As the projects starts activities for year three, we hope standarc' training responsibilities to the LGAs without compromising 'fo that inexperienced' putting more emphasis only on the new cDDs PHC workers involved will increase the confidence level of the LGA in the programme.

€ TABLE II DTI NING OF DIFFERE TEVE oFsTAFF I VOLV rNc IMPLENTAIION

NO. OF NO. OF NO. OF L.G.A NO. OF s/N L.G.A NO. F TRAINING HEALTH CDDS UNDERTAKEN TOT DISTRICT TRAINED STAFF FACILITY TRAINED TRAINED STAFF TRAINED 76 2 4 15 t. BIRNIN :(locr FUWORKE RS KUDU & CDDS 2 4 4 l0 2. BIRNIWA 3(LOCT & CDDS ') 4 7 t4 J DUTSE 3(LOCT FYWORKERS & CDDS ) 4 l0 40 CWARAM 3(LOCT FIlWORKERS & CDDS ) 4 7 l4 KAFTN 3(LOCT HAUSA & CDDS 4 5 l6 KANGAWA 3(LOCT H/WORKERS 2 & CDDS ) 4 8 )) RINGIM 3(LOCT rvwoRreRs & CDDS 4 J 6 TAURA 3(LOCT 2 & CDDS l6 32 59 198 TOTAL

rl TABLE III IO D o R

NO. OF NGDO NO. OF NO. OF NO. OF MOH s/l{ L.G.A NO. OF STAFIT ADVOCACY COMMUI\ITI STAFF COMMUNITIES INVOVED IN INVOLVED THAT RECEIVES VISIST TO ES STATE OR MOBILIZED MOBILIZATI H/EDUCATION ON ABOUT THE REGIONAL IMPORTANCE DIRECTORS OF EXTENDED OF HEALTH. TREATMENT I 2 38 5 I BIRNIN KUDU 38 I 2 5 5 ) BIRNTWA 5 I 2 7 5 DUTSE 7 3 I 2 20 5 4. GWARAM 20 I ) 7 5 KENIN HAUSA 7 8 5 I 8 ) 6. KAUGAMA I 2 1l 5 7 RINGIM ll I 2 3 5 TAURA J 8. I 2 99 I TOTAL 99

that they were * The team visited all the communities to ensure implementation mobilized in readiness for the second year CDTI

exerclse. implementation period' * To guarantee success in the second year of the mobilization the SOCT and the LOCT team carried out community It was a rewarcling activities twice during the period under review' year. To avoid duplication' the experience in preparation for the thild activity' project did not present two separate tables for this

2.2.0 Advocacv Visit

6 period under review t'r Advocacy visits was carried out during the Executives before state and Local Government Areas (L.G.A) chief state has been able to and during the take -off of the project. The leaders, arrd carry out this exercise jointly with other opinion health as well as programme supervisors in the state ministry of Affairs' ministry for Local Government and Chieftaincy

2.2.1The Use of Media In mob'iltzation to the success utilising the media for mobilization is very important these days' of the programme, but it is becoming very expensive media houses' They have especially with the commercialisation of the GDTI occasions of been of great importance to the project in covering The project utilizes other ceremonial nature, such as CDTI including. people, mostly the face to f'ace means of getting the information to the

education and mobilisation'

following channels of Communities were mobilized using the communication

* TraditionaVReligions Leaders members ,k Face to Face discussion with community

*( Town cries

2.2.2 Result of Mobilisatiou Effort groups outlined above has The mobitization effort carried out by the greatlyincreasedpeoptes,awarenessontheneedtotakethedrugs community membel's are continuously for the next 10 - l5years. The and responsibilities as it increasingly becoming aware of their roles

3 the concerns CDTI implementation' They also aPPreciate anrl involvement of the community members in the Planning

implementation Process.

2.2.3Mobilization of Materials used as aids in community mobilisation posters and flip charts were The state creating awareness among the community members' equipment being government has recently procured more mobilization

used during activities 2.2.4 Resnonse of the communitv to the The various communities have demonstrated their commitment contentious is the implementation of GDTI. However, what remains differcnt level and relativity of support to cDDs, which bears community membcrs dehnitions and interpretation on the part of the group, they have done and the CDDS who are the recipient. To one done. The project wish to enough, and to the other, not much has been support and leave the suggest to APOC to de-emphasise the issue of be paid to coverage' matter to the communities. Keen interest should community and tireir participation and CDD continuity to Suggest that CDDs doing well.

women in purdah is of The quality of information that gets down to The project serious concern in predominantly muslim communities. members to be part intends to address this problem by getting female the state levels to open of the teams at both the local govemment and

to important group of up better and easier ways of interacting with this people.

Theprojectshalltrytoidentifffemalecommunitybased of the prograrrune' organizations to work with in the implementation are distributed are This will go a long way in ensuring that drugs that a success' swallowed by all to make he control programme

them on the The project intends to also target the Men too to educate prograrnme either as need to have the women to be involved in the The quality of distributors or as mobilizers without contradictions' and will encourage information to given to them will be necessary the years by all participation and the need to take the drugs over without breaking the cYcle.

TABLE IV G E 2001

NO OF NO OF NO. OF COST PER ,. NO. OF SAI L.G.A NO. OF COMM/YILL 'TREATED ELIGIBLE PERSON DISTRIBUTION TARGET BY AGE IN lILLAGERS COMMUNI PEOPLE TREATED SI.JPERVISED HEALTH WHICH CDDS WITH TIES TREATED WORKER ARE SUMMARY FORMS * I 0 38 I BIRNIN 8 30428 KUDU I I 0 5 2 BIRNIWA 5 3368 + 0 7 ll 108 3 DUTSE 7 20 * I 0 4 GWARAM 20 22304 0 7 8868 + 5 KAFN 7 HAUSA 0 14751 I I 6 KAUGAMA 8 0 il510 {r 7 RINGIM ll

lt of them again are involved other areas during raining seasons. some during distribution activities' in dry season farming, taking them away

3.6 Plans to Reduce Number of

1. Intensive CommunityMobilizat\on 2.AdvocacyvisittoEmirs/districtheadsandReligiousleaders 3.AdvocacymeetingwithL.G.AChiefexecutivesonrolesand responsibilities as project partners' 4.Treatingthepeopleatthemostappropriatetimerequiredbythem. appropriate for every body However, no time/period can ever be residing in the villages'

of Heal 3.7 Contri tion ot

the government of Jigawa State The following are the contribution of

to the Project.

I 3.5millionascounterpartfundingwasapprovedascashcontribution totheproject.Asatthetimeofwritingthisreport,thereleasehasr^ot commitment on the part of the yet been effected but there was strong goveillmentwhoarepleasedwiththeCDTIimplementationinthe soonest' The development state to release the money for activities next report' shall be communicated to you in our

2 One electric tYPewriter'

3 Purchase of office equiPments'

rf )

STREN GHTS , WAEKNESS ,ANDSUGGESTIONS

STREN HTS

in the area of I very high government commitment to the programme release of counter part funding to the project'

participation due to 2 A reasonably good cbmmunity commitment and

logistics to the J prompt delivery of livermectin supplies and other communities.

closest to them has 4 Training of CDDs at their communities or centres development reduced the burden of travelling long distances, and this and gain has enabled community members to watch training events more knowledge of the CDTI strategies'

dedicated and committed 5 The prograrnme enjoyed the services of a SOCT and PHC staff.

WEAKN ESSES /CONSTRAI NTS: This too is quite I lnadequate support to cDDs by the communities. controversial and relative to the village in question. Detennining accurate support data and its sufficiency is rather difficult' workers due mainly to 2 Low level of supervision by the LocT/Health the current political situation where almost all the LGAs are

t3 federation account' complaining about the zero allocation from the the LOCT during making it almost impossible for them to sponsor supervision activities.

by other programes durir^g 3. Payment of incentives to village workers The culprit is the activities has greatly affected the principle of GDTI' to have federal National Immunization progralnme which seemed polio at the expense of goverrrment commitment for the eradication of

other control Progralnmes' progralnme is still not 4. Participation of women group in the CDTI and religious believes of encouraging. This has to do with the culture

the PeoPle. flood disaster in its 5. Jigawa state witnessed one of the worst natural where cDTl is history this year. This affected some communities for their treatment implemented. Two communities cannot account The cDDs are being records which were destroyed in the process' update treatment records traced to conduct another census as well as

for the Year.

SUGG TIONS:

executives shoutd be held at ministry 1 Advocacy meeting with L.G.A of the for Local Government Affairs. This necessary because who are their irnmediate importance that LGAs attach to that office supervlsors-

th peopre and interest groups should 2 communityi M.rb..s, influentiar women group shall be a target to be mobitized to support cDDs. The get particiPate more' participate fully in all the stages of' 3 LOCT/Health workers should by continuous devolvement of implementation. This we intend to do responsibilities to them'

4 Theprojectappreciatemovesatthehighestlevelofgovernmenttct stopthepaymentofallcommunityprogralnmesinthenearfuture. there will be no longer basis This will help CDTI implementation, as for comParison. of the Technical and Financial period 5 APOC should harmonize from January of every year and operation of the projects to take effect toendinDecember.Thiswilthelpustoprovidecorrectdata,which to our supporting NGO at tire will be consistent with those to provided

end ofevery Year-

5