ZIKA RESPONSE IN ECUADOR AND PERU ANNUAL PROGRESS REPORT USAID ZIKA PROGRAM Period: Y2 – October 1, 2017 to September 30, 2018
Submission Date: December 26, 2018
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Contents ACRONYMS AND ABBREVIATIONS II ACTIVITY OVERVIEW V ZIKA PROGRAM ACTIVITY DETAILS V ANNUAL HIGHLIGHTS/EXECUTIVE SUMMARY VI ACTIVITY IMPLEMENTATION IXIX PROGRESS NARRATIVE X COLLABORATION XVIII COLLABORATION WITH OTHER USAID OR USG ACTIVITIES XVIII COLLABORATION AND/OR KNOWLEDGE SHARING WITH PARTNER ENTITIES IN HOST GOVERNMENT AND OTHER DONOR AGENCIES XX LEARNING XXII LIST MAJOR ASSESSMENTS / INTERNAL EVALUATIONS AND LESSONS LEARNED XXII RESEARCH AND PUBLICATIONS XXV ACTIONS AND WAY FORWARD XXV PLANNED ACTIVITIES FOR NEXT REPORTING PERIOD XXVI COMMUNICATIONS AND DISSEMINATION XXVIII KEY COMMUNICATION ACTIVITIES - PROJECT PROMOTION, PUBLIC OR MEDIA EVENTS/ENGAGEMENTS FOR THE PAST YEAR XXVIII CALENDAR OF PLANNED PROJECT PROMOTION SUSTAINABILITY AND EXIT STRATEGY XXXII ANNEXES XXXIV ANNEX IA. PERFORMANCE INDICATOR REPORTING SHEET XXXIV ANNEX 1B. OTHER ZIKA ACTIVITY INDICATORS XL ANNEX II SUCCESS STORIES – ECUADOR AND PERU XLV ANNEX III TRAINING REPORT LV ANNEX IV PICTURES (EVENTS, TRAININGS ETC.) LXIV ANNEX V SUB-GRANTS UNDER THE ACTIVITY LXVI ANNEX VI INTEGRATION OF CROSS-CUTTING ISSUES LXX A. GENDER EQUALITY AND FEMALE EMPOWERMENT LXX B. ENVIRONMENTAL COMPLIANCE LXXIII C. INSTITUTIONAL STRENGTHENING AND LOCAL CAPACITY BUILDING LXXIII D. YOUTH (IF APPLICABLE) LXXIV E. DISABILITY (IF APPLICABLE) LXXIV F. SCIENCE, TECHNOLOGY, AND INNOVATION (IF APPLICABLE) LXXIV G. POLICY AND REGULATORY REFORM (IF APPLICABLE) LXXV ANNEX VII RESEARCH AND PUBLICATION TRACKER LXXVI ANNEX VIII MANAGEMENT AND ADMINISTRATIVE ISSUES LXXX A. MODIFICATIONS AND AMENDMENTS LXXX ANNEX IX ENVIRONMENTAL MITIGATION AND MONITORING REPORT LXXXI
ACRONYMS AND ABBREVIATIONS
AMELP Activity Monitoring, Evaluation, and Learning Plan
AOR Agreement Officer Representative
COR Contract Officer Representative
IP Implementing Partner
M&E Monitoring and Evaluation
MEL Monitoring, Evaluation, and Learning
USAID United States Agency for International Development
CARE Cooperative for Assistance & Relief Everywhere
CBSS Community-Based Surveillance System
C4D Communication for development
DRR Disaster Risk and Recovery
EW Epidemiological Week
EBA Evidence-Based Analysis (ABE)
EMMR Environmental Mitigation and Monitoring Report
EMMP Environmental Mitigation and Monitoring Plan
FY Fiscal Year
HC3 Information, communication, education and health (USAID)
KAP Knowledge, Attitudes and Practices (KAP)
MoH Ministry of Health (MINSA- Peru, MSP – Ecuador)
PAHO Pan-American Health Organization
SBCC Social and behavior change communication
SRMH Sexual, Reproductive and Maternal Health
SRH Sexual and Reproductive Health
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | II WHO World Health Organization
UNFPA United Nations Populations Fund
UNICEF United Nations International Children’s Fund
USAID United States Agency for International Development
MC Community monitors CBSS (Monitores comunitarios)
ECUADOR
DDS Dirección Distrital de Salud (District Health Department)
DDE Dirección Distrital de Educación (District Education Department)
GADM Gobierno Autónomo Descentralizado Municipal (Decentralized Autonomous Municipal Government)
MIES Ministry of Economic and Social Inclusion
MINEDU Ministry of Education
MSP Ministry of Public Health
UTM Universidad Técnica de Manabi
UTMACH Universidad Técnica de Machala
ULEAM Universidad Laica Eloy Alfaro (Manta)
US Unidad de Salud (Health Unit)
PERU
ACS Agentes Comunitarios de Salud (Community Health Agents)
CAD Ciudadanos al Día (Citizens Informed, Peruvian Non-Governmental Organization)
COEL Centro de Operaciones de Emergencia Local (Local Emergency Operations Center)
COER Centro de Operaciones de Emergencia Regional (Regional Emergency Operations Center)
C.S Centro de Salud (Health Center)
CUNA MAS Social program of the Ministry of Development and Social Inclusion
III | USAID ZIKA ANNUAL REPORT USAID.GOV DIRESA Dirección Regional de Salud (Regional Health Department)
DISA Dirección de Salud (Health Department)
GERESA Gerencia Regional de Salud (Regional Health Agency)
HCE Health Care Establishment
IEF Individuos en edad fértil (Individuals of Childbearing Age)
MIDIS: Ministry of Development and Social Inclusion
MIMP: Ministry of Women and Vulnerable Populations
MINSA: Ministery of Health
PREVAED: Programa Presupuestal Estratégico Reducción de la Vulnerabilidad y Atención de Emergencias por Desastres - PREVAED - 068. (Strategic Budget Program: Vulnerability Reduction and Disaster Response – PREVAED-068)
PPR Programa Presupuestal por Resultados (Budgeting Result Program),
P.S: Puesto de Salud (Health Post)
UGEL: Unidad de Gestión Educativa Local (Local Education Management Unit)
UPCH: Universidad Peruana Cayetano Heredia
SAT-C Sistema de alerta temprano comunitario (Community early warning system)
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | IV ACTIVITY OVERVIEW
ZIKA PROGRAM ACTIVITY DETAILS The project seeks to contribute by strengthening local actors and communities in the control and prevention of the Zika Virus by influencing the knowledge, attitudes and practices of communities, agents, and community health workers. It recovers the best practices and experiences to strengthen and or develop communal mechanisms of monitoring and control. The project has emphasis on pregnant women, women in reproductive ages and adolescents. It proposes to involve communities in an active manner, recovering or strengthening the population’s participation on their own health care and empowerment. To this end, it promotes the generation of alliances with competent local and regional government organizations (Peru) and Municipalities.
Objectives to achieve in two phases over three years: 1. To increase community, local and national capacities to deliver efficient and timely response to the Zika virus outbreak and other vector prone diseases through Disaster Risk Reduction (DRR) and Human Rights approaches based on CARE’s experience in SRMH (Sexual, Reproductive and Maternal Health), sustainable community health systems and empowerment to strengthen the direct involvement of communities, by community health agents, in Zika priority areas (prevention, and vector control).
2. To enhance regional and national efforts to help decrease the rates of Zika transmission by sharing findings, impact results and influencing bi-national policy making through a deep and rigorous evidence-based approach of best practices and lessons learned in community mobilization and participation, to allow fast track, gender sensitive implementation strategies in diverse social and cultural contexts, increase coordination and planning capacities, refine an accurate monitoring system and a well-developed communication and dissemination strategy.
Geographic Focus:
Ecuador: 10 cantons belonging to 3 provinces in the coastal region of the country, two of which suffered from varying degrees of damage from the April 2016 earthquake: Esmeraldas (1), Manabi (6) and El Oro (3) Peru: 20 districts in the northern section of the country: Tumbes (4); Piura (11); Lambayeque (3) and Cajamarca (2)
Beneficiaries:
The following chart details beneficiaries taking part of CARE’s monitoring platform:
V | USAID ZIKA ANNUAL REPORT USAID.GOV Table 1. Beneficiaries Y1-Y2
Reached Y1 Reached Y2 Total Country Total project Total Women Men Total Women Men
Ecuador 128,944 5,969 3,520 2,449 30,037 19,161 10,876 36,000
Peru 263,009 33,606 21,844 11,762 24,234 15,745 8,489 57,840
Total 391,953 41,026 25,364 14,211 54,271 34,906 19,365 93,840
Source: CARE ZIKA monitoring platform, 2018
Additionally, 186,000 individuals of reproductive age in project areas received Zika messages in Peru and 109,000 in Ecuador.
ANNUAL HIGHLIGHTS/EXECUTIVE SUMMARY Highlights
• Increased knowledge about Zika prevention in people of reproductive age, adolescents and pregnant women.
• In Peru, the Good Practices on Zika prevention and control Award, allowed to identify and implement the best practices in the project areas.
• The Community Based Surveillance System (CBSS) developed, implemented and evaluated a pilot study in Tumbes, Peru, and four pilots in Esmeraldas, Manabi and El Oro in Ecuador. The project scaled the experience to 12 districts in Peru.
• The project developed the communication strategy for social and behavior change (SBC) with intercultural and gender approaches. The work developed with adolescents in educational institutions is relevant in the second year.
• Sensitization and involvement of the regional governments (Peru) and municipalities (Ecuador and Peru) in the actions of the Zika response, was achieved through the budget program in Peru, and health municipalities strategy in Ecuador.
• The Project developed the Edu communication strategy with gender and intercultural approaches, and implemented it through methodologies and messages appropriate to the age of the people.
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | VI • The project led community participation strengthening on Zika prevention and vector control with different actors, activities and spaces. Project worked jointly with leaders, families, communities, and community monitors or agents.
• The project strengthened the binational intervention on the border - Huaquillas -Tumbes. To this end, binational actions were carried out. Such as a fair, a binational communication meeting and support activities for the Binational Plan implemented by the governments of Ecuador and Peru.
Summary of Results for the Reporting Period and Key Achievements
In Ecuador, four pilot experiments of the CBSS were implemented and which allowed identifying the diversity and viability that a community epidemiological monitoring system can have according to the geographical reality, characteristics of the communities, community participation, and other factors. In total 1,125 homes were visited, and 2,286 families, 8,469 people were sensitized and participated in prevention actions. Through the CBSS, 8,893 deposits were inspected and 431 deposits with larvae and pupae were found. A number of 221 monitors participated in the monitoring system. The monitors are people from the community, high school students or university students, depending on each local experience.
In Peru, the piloting took place in the Campo Amor community in the District of Zarumilla, in the Tumbes Region. The experiment was scaled to 12 Districts of the four regions, in which the project was executed. For this, the project advocated with local governments for the inclusion of the budget program (PpR017) in the 12 municipalities. Exceeding the target of 10, which will favor the sustainability of the project's actions. Ninety-Eight (98) community monitors participated.
In order to promote the prevention of Zika in adolescents, individuals of reproductive age and pregnant women, the Edu communication strategies were adapted with the respective Ministries of Health and Education. With these interventions in Peru, knowledge about the Zika virus, prevention practices and preventive measures in adolescents improved. Indicator I.28 - 82.5% in the population intervened in the educational units. In Ecuador, the KAP study evidences that 45% in the population of the project intervention area knows about Zika virus and risks.
In Peru, the project implemented a training plan in Zika counseling for facilitators of health services. Two- hundred-sixteen health care providers were trained, attended 4,835 pregnant women and delivered 4,667 condoms in the three regions. In Ecuador, 468 officials from the health districts were trained. Peru reached 94.33% and Ecuador 81% of the indicator 1.24. The established project goal of 80% was reached and exceeded.
The capacities of local health workers were strengthened in clinical epidemiological management, vector control, Zika prevention and Congenital Zika syndrome. In the case of Indicator 1c, the goal of 2,000 people trained in vector control was reached and exceeded in both countries. In this activity 62% women and 38% men participated (Graphic 1). In Ecuador there is even an important increase in this indicator, due to the fact that the health personnel at the local level are mostly from the year of rural medicine and rotate twice a year. For this reason, there is an important escalation in this indicator. Through these trained people, the incidence of training processes is extended to other territories.
VII | USAID ZIKA ANNUAL REPORT USAID.GOV
Graphic 1: Number of people trained in vector control (I 1c) Ecuador ‐ Peru. 2017 ‐2018
4000 3509
3000 1931 2000 1578 1023 680 1000 343 0 Ecuador Peru Total
2017 2018 Women: 62% Men: 38%
The positive impact of having school guides and manuals was evidenced, which increased the knowledge levels in schoolchildren and adolescents. Additionally, constant feedback to the health workers whom provide Zika counseling, allowed satisfactory results in relation to prevention practices of the Zika virus in pregnant women (> 10%). This activity was implemented in the Lambayeque region, and will be replicated in the rest of the regions in the coming months.
In Ecuador, to strengthen the relationship and motivate the participation of local governments, the Project promoted the Ministry of Health ‘Healthy Municipalities’ strategy, incorporating Zika and other Vector- Born Infectious Diseases prevention in the strategy. In the municipalities of Arenillas and Las Lajas, capacities were strengthened, and action plans were rolled-out so the Ministry of Public Health can certify these municipalities as health promoters. The Municipality of Arenillas, incorporated a GBV prevention strategy as part of its action plan.
Finally, coordination with other USAID-funded projects, such as the ASSIST project and the Globe Mosquito Project (Peru), has strengthen interventions with pregnant women and adolescents. Health personnel were trained in counseling for women and the Globe Mosquito Project methodology was transferred to work in education units and schools.
Problems Encountered/ Lessons Learned
In Peru in the last quarter of year 2, the electoral process to appoint local authorities generated interference with the project's actions. Faced with this, the project strengthened community base interventions to ensure sustainability at the community levels, by improving references, monitoring and prevention actions.
In Peru, the extension of the KAP study scope of the four regions of the project allowed for greater knowledge of the territory. The study identified the need for a strategy that addresses interpersonal communication and greater efficiency in the transmission of information.
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | VIII The diagnosis carried out on the community monitoring systems revealed the four basic characteristics that a Community Monitor must have, which are communication skills, recognition of the community, ability to use information technologies and basic knowledge of the main health problems of their communities. This lesson learned will be applyed during the next months and will be collected in future guidelines.
In Ecuador, it is necessary to work on strengthening community participation in health, especially in consolidated urban areas and in the border regions. In these areas, the project faced difficulties in involving volunteer community monitors and in engaging the community in general. Because of this situation, the project adapted the methodology for the participation of university students.
Furthermore, in Ecuador the municipalities do not have specific health competencies. Thus, it was decided to link them to Zika prevention through the ‘Healthy Municipalities’ strategy and implement them according to the Ministry of Health norms.
Finally, in the context of project intervention, gender inequality, patriarchal behaviors, and gender violence that affect autonomy and the possibility of women deciding on pregnancy, continue to persist in all localities. Men have little participation in preventive actions, especially regarding sexual transmission and maternity protection. The project continues to develop strategies to transform gender dynamics in the participating communities, recognizing that this process will require greater resources and long-term actions.
In Ecuador, there is an increase in teenage pregnancy. This problem in children under 14 is associated with sexual violence. The project developed a communication strategy to prevent gender violence and teenage pregnancy, as part of the prevention actions of Congenital Zika Syndrome.
The evaluation of the community epidemiological monitoring system showed that its implementation favored community organization, except in the Canton of Huaquillas, in El Oro, where there is a differentiated dynamic for being a source zone of commercial exchange and human mobility, being on the edge of the border with Peru. In Esmeraldas and Manabi, the project found that the System favored the empowerment of the participants, in all the defined elements of the theoretical model. The results of the analysis show that there were significant changes in knowledge, attitudes and practices. In Muisne, however, the project detected the need to reinforce the change of practices. For scaling, the proposal is being adapted according to the dynamics and characterization of the territory, and the lessons learned.
ACTIVITY IMPLEMENTATION
In implementing the project in year 2, the focus was on deepening actions to influence social and behavioral change; ensuring adequate implementation of the community epidemiological monitoring system; developing research and collecting evidence and strengthening the capacities of partners and counterparts through political advocacy.
IX | USAID ZIKA ANNUAL REPORT USAID.GOV PROGRESS NARRATIVE Communication for social and behavioral change
In both countries, the project implemented the communication strategy with adaptations to the context and local language. Indicators 1.6 (strategy) and I.20 were met.
In Peru, the “El Zikario" campaign continued. Material was prepared for pregnant women and women of reproductive age, and communication pieces for the dissemination of two key behaviors related to the prevention of Congenital Zika Syndrome - previously validated with the target population. The project elaborated nine new messages, totaling 19 produced messages produced so far.
In Ecuador, the campaign "Todos contra el Zika" [All against Zika] was developed. The project developed educational and communication products and 10 messages with a gender, intercultural and age-appropriate approach, aimed at involving men in prevention activities and in the protection and care of pregnancy. These messages were disseminated through radio spots, digital media and in the project's community activities. Public events were held in three cities, in coordination with the Ministry of Health and the Municipalities and with the support of the Provincial Governments, to position the issue and disseminate messages and communication products to the population. Digital media reached 30,000 people of reproductive age, 69.4% women and 30.6% men. The project launched radio spots and mass media messages, reaching the population of the 10 cantons through radio coverage.
In both countries, the project carried out community activities to raise awareness, encourage participation and involve people. The project promoted various events with messages on Zika prevention, risks for pregnant women, prevention of sexual transmission, with playful methodologies to involve families, adolescents and people of reproductive age. In Peru, 172 events were held and in Ecuador, 74 in all intervention locations (indicator 5c).
The results of the KAP study in both countries show that people has improved their levels of knowledge, especially with respect to transmission by mosquito bites and risks for pregnant women. In Ecuador, knowledge of the sexual transmission of the virus has improved, while in Peru the perception of risk is greater.
Table 2: KAP Studies Results in Ecuador & Peru. 2017-2018
ECUADOR PERU
2017 2018 2017 2018
ZIKA TRANSMISSION
Mosquito Bite 85,8 93,9 98,3 88,1
KNOWLEDGE Sexual Relations 5,2 13,9 17,7 7,3
Zika - an important community 85 82,7 84,2 92,5 problem
Risk of getting sick 71,1 70,7 64,6 90,3
ATTITUDES Women should avoid pregnancy 74,8 77,16 to prevent Zika
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | X Has taken preventive measures to 74,2 64,9 91 74 PRACTICES avoid getting sick (personal and familiar)
• Intervention in the the educational community
The project developed edu communication tools in both countries, with pedagogical contents appropriate to each context. In Peru, technicians from the Ministry of Education worked on the "Comprehensive Guide for the Promotion of a Culture of Prevention and Control of the Zika Virus in Schools", aimed at children and adolescents. The project trained 1,429 people, including facilitators, teachers and peer educators. The trainees led and replicated messages at school fairs. There is evidence of an important increase in the knowledge of adolescents, from 46.78% (2017) to 82.50% (2018), in the participating schools. In Ecuador, the project prepared two guides on Zika prevention, which include contents of disaster risk prevention. Namely "Edu communication tools for children to be protagonists in the prevention of Zika" and; "Educating trainers: education, art and culture" – specifically to work with adolescents using theater, photography, video and social networks. The project trained 301 teachers in the contents of the two guides - who carry out the activities in their schools - as well as some local artists and young people. The project coordinated this strategy with the National teenage pregnancy prevention campaign launched during the third quarter.
• Journalists and communicators were trained on the Zika virus. The project trained 40 journalists from intervention locations in order to strengthen knowledge about the risks of the Zika virus and to provide communicative guidelines to improve information on the subject. In Peru, the project convened events with communicators from the regional health directorates and health promotion specialists from health facilities in order to establish communication strategies to improve knowledge and understanding of the key risks of the Zika virus. The strategies were implemented throughout the year, as part of the national campaign Mi casa sin zancudos [My house without mosquitoes] implemented by the Ministry of Health.
Difficulties and Challenges • Gender and cultural conceptions and patterns persist which charge women with the responsibility of avoiding pregnancy, preventing Zika and its complications during pregnancy and to care for and protect children. It is also assumed that women are the only ones responsible for unplanned / unwanted pregnancies. There is little participation of men in prevention actions.
• There is little adherence to the use of condoms to prevent transmission through sexual intercourse of Zika virus. It is wrongly assumed that protection is not necessary during pregnancy.
• Faced with this situation, messages aimed at transforming gender dynamics have been worked on, fostering the responsibility of men in health care, preventive measures, as well as the need to promote autonomous, informed and consensual decisions between men and women, regarding their sexual and reproductive health. In the third year, emphasis will be placed on messages and strategies to influence changes in these mindsets and behaviors.
XI | USAID ZIKA ANNUAL REPORT USAID.GOV • In the KAP study, there are low percentages regarding the implementation of prevention practices in the last 30 days (I 6e). The study confirms that there is an increase in knowledge. However, the same does not occur with the practices. It is still necessary to work with the population in general, so that people may adopt prevention practices. So far, the elimination of breeding grounds, covering of tanks and the use of mosquito nets are the most common practices. The project has foreseen a sustained accompaniment directed to modify and sustain adequate practices in communities and educational centers during the third year.
• In Peru, the main challenge was to encourage the adoption of good practices in the population - with a community approach - using interpersonal communication to impact on the increase of knowledge and behavior change. It was possible to reach 5,100 people with key messages about preventive measures against the Zika virus. In Ecuador, these messages were working since Y1. To date 9,993 people have received interpersonal messages. (I 6.e). In the third year, it is necessary to strengthen the strategy to achieve behavior change.
• The project used the technical guide produced by USAID’s Global Health. Its application allowed to simplify the materials and focus the communicational messages based on the most "effective" and evidence-based behaviors identified in the guide (of 13, 3 were prioritized).
• The development and implementation of community communication plans has had little progress in the two countries, indicator 5b, as it requires the involvement of community leaders, the commitment of local actors, municipalities, and health services to develop an articulated work at the community level. In the third year, the project will strengthen actions and incidence to comply with the indicator.
Vector Management
Results
The implementation of the community epidemiological monitoring system in both countries was the main area of emphasis. The system was implemented considering the regulations of each country, institutional competencies and vector management methods defined in each country. In Peru, the system uses ovitraps; in Ecuador, the system uses inspection of houses and containers to determine vector indices.
In Peru, the project piloted the experience in the community of Campoamor, in the District of Zarumilla, and in Tumbes with the participation of five community monitors (MCs). This experience was evaluated and the relevance of the MCs intervention was demonstrated. The experience was later scaled with 98 MCs to 12 districts in three of the four project intervention regions.
The project developed a training plan with 13 modules, and implemented it with CBSS facilitators. For the escalation of the pilot, the project advocated with local governments (GL), for the inclusion of the budget program (PPR 017) in the 12 municipalities, exceeding the goal of 10 localities. This will thus favor the sustainability of the actions of the CBSS at the end of the project. (Graphic 3)
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | XII
Graphic 3. % Municipalities with plans in Budget Program (PpR 017). Peru 2017 ‐ 2018
120 100 100 75 81,8 80 63,6 66,7
% 60 40 25 20 0 0 0 Tumbes Piura Cajamarca Lambayeque Region
2018 2019
The project team strengthened capacities of key actors of the CBSS and multi-regional committees. These commitees launched the campaign "10 minutes against Zika" to ensure safe and hygienic practices at houses and the elimination of breeding sites at the community level.
There is a decrease in the indicators of vector presence, 1d (43.99%) and 1e (26.15%) in all trimesters. This shows a positive impact of the intervention. The project goal of 10% was exceeded in each trimester.
In Ecuador, the project piloted experiences in four cantons of three provinces. Training was given to the community monitors through practical workshops with the community to supervise and reinforce the development of the skills and abilities required. The project developed the guide: "The community promoter and the approach with the family”. A vector control kit for community monitors was designed and distributed to all the MCs participating in the project. In addition, the project carried out monthly monitoring workshops for the actors involved in the CBSS. The project developed three exchange workshops on socialization of results and analysis of experiments, and two workshops to share learning among community monitors.
The 221 community monitors are formed-up of 56 people from the communities, 29 high school students, 129 university students of medicine and nursing, and 7 volunteers from the Red Cross. All of them received training and kits for vector control in the community. The MCs visited 2,634 homes and a provided information to 10,705 participants.
The evaluation showed there to be a verifiable positive impact in the communities where the pilot experiments were carried out, as reflected in the decrease in the Breteau indices in each of the localities. The Breteau index showed a decrease of > 10% (indicator I.e). Changes in practices were also evident, except in the locality of Muisne. Community participation was strengthened except in the town of Huaquillas.
Messages on prevention, family and community responsibility to protect pregnant women and the protection of women of reproductive age, especially girls and adolescents, were also strengthened in all communities, with emphasis on prevention of gender-based violence.
XIII | USAID ZIKA ANNUAL REPORT USAID.GOV Furthermore, 190 vector control brigades from the Ministry of Public Health were trained in and received work kits for vector control.
Difficulties and Challenges
The main challenges are related to the sustainability of community epidemiological monitoring experiments.
• In Peru, it is necessary to strengthen the community base of community health workers in the 4 regions where the project is implemented. It is also necessary to work with local governments to incorporate the CBSS, and to ensure that they incorporate in their annual budget the resources necessary to pay stipend to monitors, according to budget program 0017.
• The electoral situation (regional and municipal governments) and internally the change of the majority of officials in the local governments prioritized by the project, influenced the work in the 4 regions. For this reason, only in the regions of Piura and Lambayeque was it possible to advance with the training of the technical teams of 10 municipalities. Nine municipalities of Piura carried out the incorporation of PpR017 and one municipality of Chiclayo assigned S/. 5000 for the year 2019.
• In Peru there is less progress in indicators I.18 and I.19, on the number of MCs and health personnel trained in the functioning of the CBSS. Likewise, almost a third (33%) of the valid references originated in the CBSS are missing, while the number of communities with members that actively participate in Zika monitoring, prevention and support activities is 25 (16.67%). The percentage of communities where physical-vector monitoring activities are implemented is 33%. Indicator I.12, referring to the number of community monitors that periodically provide monitoring reports to local health services, is 108 (out of the 500 goal). In the third year, the actions to reach the defined goals will be strengthened.
• In Ecuador, the evaluation showed that the CBSS favored community organization. As already indicated, in the Huaquilllas Canton, due to the challenges presented by the context of urban and border population, with different relationship logics, a new experiment with an adaptation of the model will be carried out with greater involvement of the Ministry of Public Health and the Municipality to analyze the viability of the System.
• The results of the "Difference in Differences" analysis show that there were significant changes in knowledge, attitudes and practices, except in the town of Chamanga, in the Muisne Canton, in the Province of Esmeraldas. The results of the KAP study carried out in the population of the intervention zones of the project were compared with the results obtained in the population that participated in the pilotage. Given that in the population of Chamanga there is significant presence of Afro-Ecuadorian population, the project will work in greater detail on the intercultural approach, and direct more appropriate and validated messages to the population in this area.
• Considering the need to ensure the sustainability of the System and coordination with the Ministry of Health, the Project used forms and indicators from the Ministry for evaluation. The project promoted the coordination of the work of the community monitors with the vectorial control brigades of the Ministry of Health. The Monitors were linked to the local health committees in each Canton. The Health Committee is a coordination space promoted by the health system at the cantonal level. The
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | XIV project has planned to accompany the consolidation of the health committees through mechanisms of accompaniment, reporting and feedback.
Sanitary Interventions and Service Provision for Mothers and Children
Accomplishments
The project has strengthened the capacities of health service personnel in clinical epidemiological management (Ecuador) and counseling for pregnant women and women of reproductive age in both countries. In Peru, 20 facilitators from the four regions were trained in counseling for pregnant women and women of reproductive age. In coordination with the health directorates and their executing units, the facilitators trained 263 obstetricians and physicians (indicator 2a). A guide was designed for this process. Service was provided to 4,835 pregnant women, and 4,667 condoms were delivered. Collaboration with the sanitary strategies of STD / HIV / AIDS, Maternal Perinatal and SRH has made it possible to incorporate the sexual prevention of Zika into regular counseling sessions. In Ecuador, a total of 468 professionals were trained to provide counseling in health services, thus complying with indicator 2a. To strengthen the work at the community level, in agreement with the Ministry of Health, the following two manuals were prepared: 1) Manual for health workers on counseling on Zika risks in pregnant women and psychosocial support for pregnant women at risk, and; 2) Manual on the best practices for the prevention and control of Zika aimed at households and communities with emphasis on pregnant women and women of reproductive age. In coordination with the Ministry of Public Health, in Ecuador, officials were trained in epidemiological clinical management. High training coverage was achieved as the staff rotated serving in rural health units in the intervention area twice a year.
Difficulties and Challenges: • In Peru, to strengthen the training of health personnel in prevention counseling for pregnant women, health personnel were trained as facilitators in counseling in Zika, based on the training materials of the ASSIST Project. Furthermore, diptychs for counseling were also developed.
• The lack of formats for records of health promotion activities was identified. As a result, checklists were developed and applied by regional teams during visits to health facilities and by officials from the Regional Sexual and Reproductive Health Strategy (ERSSR).
• In Ecuador there is a high turnover of personnel, which corresponds to the year of rural medical service, so the need for training is ongoing in the areas of clinical epidemiological management, Zika prevention, sexual health and reproductive health.
Research
As established in the R1, three studies were carried out in each country, fulfilling the project goal defined for the year.
XV | USAID ZIKA ANNUAL REPORT USAID.GOV Country PERU
Investigation Synthesis Type Evidence-Based The second Good Practices Competition was implemented, for which the alliance with Analysis (EBA) CAD was renewed. A joint presentation was made between CARE and the Ministry of Health at the national level and the contest was disseminated through mass and virtual media. The award ceremony had significant coverage in the national and virtual media. A summary of this contest can be found at: http://www.care.org.pe/wp- content/uploads/2018/09/PremioBuenasPracticasZika2018.pdf In addition, in the regions, local acknowledgements were made to the Winning Practices and/or Honorable Mentions were awarded with interviews in the media and social networks. Knowledge, An agreement was signed with the Cayetano Heredia Peruvian University Foundation Attitudes and (FUPCH) to carry out the KAP study, including both quantitative and qualitative Practices components. The sample for the 4 regions was 400 households, 40 pregnant women and (KAP) 40 adolescents for each region. In total, there were 1,600 homes, 160 pregnant women and 160 adolescents (quantitative component) and 40 in-depth interviews and 12 focus groups from the 4 regions.
Ovitrap Studies An ovitraps efficiency study was conducted, comparing a community that intervenes (CBSS) with the CBSS and a control community, concluding that their IPO and HDI indices can be considered an effective method for community monitoring of Aedes aegypti. Despite not finding significant differences between the localities studied, it is recommended, however, not to abandon the traditional indicators as they are a good complement and could be used as a basis for a community early warning system. ECUADOR
Investigation Synthesis Type Best Practices The implementation of best practices of prevention and control of Zika was carried out on Control in the 10 cantons where the project has coverage. and Prevention The Zika prevention behaviors matrix provided by USAID and EBA 1 was used as a / Evidence reference, to elaborate the best practices systematization matrix. The implementation Based Analysis process was analyzed, as was the power of the activities developed and / or effect of (EBA) those on the stated behaviors. Interviews with key actors were carried out, and also direct observation visits were held. Knowledge, A number of 668 KAP surveys were carried out in the 10 cantons of intervention. In Attitudes and addition, 28 focus groups (6 with adult men, 8 with women of reproductive age / Practices pregnant, 7 with female adolescents and 7 with male adolescents) with a participation of (KAP) 2nd 324 people were held. For the results to be comparable, the surveys were gathered in Year the same areas in which the KAP I was carried out. A report was also prepared comparing the results of years 1 and 2.
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | XVI Systematization The CBSS proposal was updated, the experiment was systematized and results of the and evaluation CBSS pilots implemented in communities of 4 cantons were evaluated. This study also of CBSS pilots. conducted an analysis of the impact of these experiments on the KAP of the participating population. To this end, the project compared the results of the pilots with those of the general study. The study made it possible to positively assess the work developed directly with households and communities.
Others
• Healthy Municipalities
By constitutional provision in Ecuador, municipalities do not have specific health competencies. Their competencies are defined for the provision of water services, sewerage, solid waste management, public space management, cemeteries, plazas and markets. The importance of its actions in the promotion of health and the prevention of diseases such as Zika are generally not visible.
Thus, the project works with the municipalities carrying out advocacy, negotiation and argumentation to highlight their role within the framework of the Healthy Municipalities Strategy, defined by the Ministry of Public Health. The project seeks to incorporate the matter in their plans and budgets, and to commit to the prevention of Zika. In year 1, all the municipalities signed a commitment to work to become healthy municipalities with the Ministry of Public Health. In year 2, the municipalities of Arenillas and Las Lajas - with the support of CARE - carried out the process to become certified as Health Promoting Municipalities. For this reason, the municipal team was trained, technical assistance was provided, and indicators and means of verification were selected. Indicators that have an impact on the prevention of Zika and gender violence were incorporated. As a result of this process, cantonal plans were drawn up and the ‘Healthy Municipality Certification’ Guide was created, for the prevention of diseases such as Zika, Dengue and Chikungunya.
The Municipality of Portoviejo is already certified as a health-promoting municipality. The project was able to coordinate actions to strengthen vector control activities and community epidemiological monitoring with its promoters. The Municipality of Muisne in the Province of Esmeraldas has begun the process to become a certified promoter.
Moreover, the project trained the technical teams and authorities of six other municipalities: Esmeraldas (Muisne), Manabi (Jama, San Vicente, Sucre and Pedernales), El Oro (Huaquillas) in the strategy and committed itself to joining it, which should be consolidated in year 3.
Difficulties and Challenges
There are difficulties in three Municipalities to incorporate Zika prevention into their local plans. Namely: Huaquillas, Manta and Sucre. Therefore, in year 3 we will continue to advocate with the authorities and strengthen the capacities of the technical teams and partner with community organizations, especially in Jama.
XVII | USAID ZIKA ANNUAL REPORT USAID.GOV The work with the Municipalities in Ecuador will be made more complex in the first semester of year 3 because of an electoral campaign to designate new local authorities. Therefore, advocacy and a work plan will be carried out with elected candidates to position the issue.
COLLABORATION
COLLABORATION WITH OTHER USAID OR USG ACTIVITIES K4Health
Participation in the international workshop "Stronger Together: Engaging Communities in the Response to Zika"1 made it possible to gain knowledge, exchange experiences, identify methodologies and tools developed by other USAID partners to promote social and behavioral change in the prevention and control of Zika, as well as to identify challenges in the issues discussed during the workshop. This workshop positioned the need to coordinate the work of Zika prevention with sexual and reproductive health, prevention of gender-based violence and in Ecuador, with the prevention of teenage pregnancy.
It also allowed for: the sharing of innovative actions developed in Ecuador and Peru; the use of traditional Afro-Ecuadorian music and dance in the construction and dissemination of prevention messages of Zika in Ecuador; and the communication campaign "Zikario" and the messages developed to influence behavior change, especially among men in Peru.
Embassy of the United States of America in Ecuador
In Ecuador, information on the project is coordinated with the official appointed as the main representative of the U.S. Embassy. Periodic information is provided on the most relevant actions developed and planned. In year 2, the U.S. Ambassador to Ecuador visited project activities in the Province of Manabi (San Vicente). This was disseminated through the media and the embassy's website.
ASSIST- ZIKA Project
Financed by USAID, working meetings have been held with the ASSIST-Zika Ecuador Project. During the meetings, information was exchanged on work plans and joint lines of cooperation or coordination were
1 The workshop was held from April 24 to 26, 2018, in the city of Antigua Guatemala and was attended by technicians and civil society delegates from projects funded by USAID, in the Americas and the Caribbean.
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | XVIII identified among the projects and with the Ministry of Public Health of Ecuador to coordinate the components of community work (JAZ) and improve of the quality of health care (ASSIST). The authorities of the Ministry of Public Health value this action as positive because it strengthens the capacities and knowledge of health personnel and the population.
In Peru, coordination takes the form of a work plan that includes technical assistance to the Regional Health Directorate of Tumbes to strengthen the capacities of obstetricians and health workers in the comprehensive approach to pregnant women with Zika and to children with microcephaly; as well as technical assistance to develop a counseling manual in Zika aimed at pregnant women and women of reproductive age.
Globe Mosquito Project / The Globe Program. Peru
Cooperation with the Globe mosquito Project, allowed to expand the didactic options that teachers and "peer educators" have to disseminate knowledge and practices about the prevention of Vector-Born Infectious Diseases. In this context, 40 kits were distributed for work in schools and for 26 teachers and school peer educators. Health personnel and project specialists of the ‘All against Zika’ project of Piura, Tumbes and Lambayeque were trained as coaches of the Globe Mosquito Project.
CDC Atlanta-USA
In Peru, in coordination with the CDC of Atlanta, the use of two of their free and open-use android mobile applications were implemented. These are: EPI-INFO – used for vector control and EPI-INFO - used for questionnaires. Both have a friendly information system, and are used by community monitors, health personnel and local governments. The information generated by the system is analyzed by authorities, technicians from the health and education sectors and the population of the localities. With this information, timely decisions are made to reduce the vector rates in the project’s intervention territories. The project team in Peru trained the Ecuadorian team to use the platform in the implemented community monitoring system.
Results and Challenges of Cooperation:
• The “Stronger Together Workshop” identified the need to include messages and activities aimed at strengthening reflection within adolescent and reproductive-age women and men on masculinities, sexual and reproductive health and prevention of gender violence. • Coordination with Globe Mosquito Project / The Globe Program allowed for the strengthening of capacities in pedagogical techniques to train in control and prevention of Zika, especially in educational units. • Cooperation with the Zika Assist Project allowed for the strengthening of the capacities of the health personnel and the cooperation of the community components with health services.
XIX | USAID ZIKA ANNUAL REPORT USAID.GOV • Collaboration with the CDC of Atlanta reduced the programmatic costs of the project, as the CDC platform was used to enter information from the community monitoring system.
COLLABORATION AND/OR KNOWLEDGE SHARING WITH PARTNER ENTITIES IN HOST GOVERNMENT AND OTHER DONOR AGENCIES • In Ecuador and Peru, the main partners in the project implementation are: 1) the public institutions of the social sector at the national and local level. These include the Ministries of Health, the Ministries of Education and the Ministry of Economical and Social Inclusion in Ecuador; 2) the Municipalities or local governments, and 3) the Regional Governments in Peru.
• With the Ministry of Health, coordination is ongoing. Efforts are being made to strengthen the capacities of health personnel in clinical and epidemiological management. As well as in vector control, in comprehensive care and counseling for pregnant women and / or women of reproductive age, in prevention and promotion actions and in the CBSS.
• The work carried out with teachers and adolescents in educational institutions is relevant in the second year.
• Sensitization and involvement of the regional governments (Peru) and municipalities (Ecuador and Peru) in the actions of the Zika response, was achieved through the budget program in Peru, and the Healthy Municipalities strategy in Ecuador.
• The cooperation agreements with the Ecuadorian Universities: “Laica Eloy Alfaro de Manabi" (ULEAM); and, with the “Técnica de Machala" (UTMACH), made it possible for the participants of Programs, with linkage to the Community of the Universities, to intervene in an active way in the implementation of the Community Epidemiological Monitoring. Furthermore, it allowed for the dissemination of messages to the community about the risks of Zika in mass events; and the training of teachers, adolescents and young people about Zika.
• In Peru, the agreement with the Peruvian University “Cayetano Heredia" contributed to the development of the KAP study and the efficiency of the ovitraps study.
• The strengthening of cooperation with PAHO / WHO, UNICEF and UNFPA has been relevant for the Project in both countries, as these entities have participated in work meetings in the discussion of gender equality issues. Moreover, PAHO has facilitated workshops aimed at health personnel.
• In Ecuador, Zika prevention was coordinated with disaster risk reduction through collaboration with the project Building Resilience in Disaster Risk Management in peripheral urban areas and rural communities of Manabi and Esmeraldas of CARE Ecuador. This project is financed by DIPHECO European Union.
• The prevention of gender-based violence is coordinated with CARE’s “Mujeres con Voz” [Women with a Voice] Project, sharing actions and learning experiences on the prevention of gender violence, especially in Muisne (Esmeraldas). In Huaquillas (El Oro) this work is carried out in partnership with the UNFPA and the intersectoral roundtable for the prevention of gender-based violence.
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | XX Project Steering Committee
The Steering Committee met to assess the results and issue recommendations for the third year and to promote the sustainability of the actions. Participants: Directors of CARE Peru, Ecuador and the Regional Director for Latin America and the Caribbean, delegates from the Ministries of Health, delegate of Regional UNICEF, and delegates from civil society.
The Committee suggested to implement actions to strengthen the sustainability of the proposals developed by the project. The most important of which are as follows:
• To socialize success strategies and actions, especially linked to the elimination of breeding sites and care for pregnant women, which can be applied to other experiences. • Officially deliver the acquired knowledge and good practices (studies, protocols, proposals, tools, etc.) to the Ministries of Health and Local Governments for their use, according to their competencies. • Train health sector technicians, in the implementation of each of the developed accomplishments in order to achieve replication and inclusion in institutional norms and guidelines. • Identify joint strategies and actions to involve an axis of human mobility within the risk factors and be able to link migrants and refugees (given the important flows that the region has lived lately) within the implementation. • Strengthen the communication actions for the change of behaviors, and reproductive and maternal sexual health. • Articulate the messages that the project has regarding prevention of adolescent pregnancy and gender-based violence; issues that are linked to the risks of Congenital Zika Syndrome and transmission of the virus through sexual relations. • Consider working at the community level to support families affected by Congenital Syndrome associated with Zika.
The reports of the Steering Committee meeting can be found on the ZIKA network platform. Here is the link to the diffusion on the “Facebook” social media platform: https://www.facebook.com/ajax/sharer/?s=2&appid=2305272732&id=1042989819208123&p[0]=1042989 819208123&sharer_type=all_modes&av=893876814119425
Lessons Learned
• The cooperation with other projects in Ecuador allowed for the strengthening of the disaster risk reduction approach, the incorporation of gender-based violence prevention and exchange of knowledge and experiences.
• The Ministries of Public Health of Ecuador and Peru value as positive the relationship and coordination between the projects financed by USAID. They also recognize that this allows for the strengthening of technical assistance and the capacities of health personnel.
XXI | USAID ZIKA ANNUAL REPORT USAID.GOV • The Steering Committee highlighted the progress and results of the project management during these 2 years of execution, and issued recommendations for the sustainability of the actions, especially those regarding the community epidemiological monitoring system, as well as for the institutionalization of manuals, guides and other tools developed in the health ministries. These recommendations will be implemented in the coming months and monitored at the next Steering Committee meeting in 2019.
• The alliance with the Universities allows for strengthening actions at the community level in Ecuador and contributes to sustainability, especially in Manabi, Manta, El Oro, and Huaquillas, as linking projects are part of the curriculum of the universities.
LEARNING
LIST MAJOR ASSESSMENTS / INTERNAL EVALUATIONS AND LESSONS LEARNED • The results obtained in the KAP studies of year 2,2 3 indicate that there is progress in knowledge regarding Zika, its risks and prevention actions, especially in pregnant women and adolescents. However, there is an important gap regarding practices to prevent sexual transmission and the risk of Congenital Zika Syndrome in pregnancy. Adaptations were made, and the Edu communication strategy will be strengthened in year 3 to influence behavior change.
• In Ecuador, the risk perception decreased while in Peru it increased. This could be associated with the fact that in 2017 the population in Ecuador was still in the post-earthquake phase (2016), in which Zika cases increased. In contrast, in 2018, cases decreased significantly. Since April, the Ministry of Health has not reported new cases of Zika in Ecuador. In Peru, the increase of Zika cases in the project intervention zones can be due to ‘El Niño’. Thus, emphasis was put on prevention actions and strengthening of the prevention messages developed by the project.
2 Fundación Universidad Peruana Cayetano Heredia -FUPCH- (2018). Study of Knowledge, attitudes and practices against the Zika virus in Peru.
3 Novillo Rameix, Nathalia (2018). Comparative analysis of the results of the KAP I and II studies and proposals to adjust the intervention. Ecuador
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | XXII Graphic 2: % of WRA who can identify the potencial risks of ZikaV during prenancy (I 2b). Ecuador ‐ Peru. 2017 ‐ 2018
90% 82% 100% 70% 58,90% 50% 0% 2017 2018
Ecuador Peru
• In Ecuador and Peru, cultural and gender conceptions and patterns persist, assigning women the responsibility of care to avoid pregnancy, to prevent Zika and its complications in pregnancy, and to care for and protect children. There is little participation of men in prevention actions. In addition, in Ecuador it is assumed that women are the only ones responsible for unplanned / unwanted pregnancies.
• In Ecuador, the study showed worrisome findings regarding gender-based violence, especially in the focus groups: it is accepted and in a certain way justified. Sexual, physical, psychological or economic violence is naturalized to the point that it is conceived that women themselves are responsible.
• A more in-depth study of the gender approach is needed so that the conceptual approach can be translated into an integral application in public management.
• The practices carried out most frequently are the elimination of breeding sites, cleaning and covering of tanks and the use of mosquito nets. In Peru, the spiral mosquito net is used and in Ecuador fire is used to repel mosquitoes.
• In Peru - in Tumbes, Piura and Cajamarca - fumigation was not considered effective, while in Lambayeque it was. In Ecuador, fumigation is considered to be the main method of prevention.
• The activities carried out to strengthen the institutional management and the processes of sensitization oriented to results, have allowed to reduce the density of the vector in the intervention locations. The role of the community in the prevention and execution of planned activities with the support of the related entities is highlighted. 4
4 Bajaña Loor, Franklin (2018). Final reporte of the EBA II study. Ecuador.
XXIII | USAID ZIKA ANNUAL REPORT USAID.GOV • The actions developed through the sensitization and training methodologies contributed positively to the acceptance of the messages by the populations. According to health personnel, this allowed for improvement in family planning,
• The increase in knowledge about Zika among adolescents in educational units was enhanced by the design and implementation of appropriate methodologies. In Peru, manuals and a friendly guide on the methodology to be applied, and the activities that can be carried out for the prevention and control of this virus were made. 5 In Ecuador, the guides were developed with playful and differentiated tools for children and adolescents.
• In the Award for Good Practices in prevention and control of the Zika virus, most of the applications submitted were from the health sector. However, it has been shown that local government leadership is more effective due to its proximity and greater access to communities. Likewise, educational institutions play a fundamental role. It is necessary to strengthen the actions of local governments to promote sustainability and further impact the intervention from a territorial approach. 6
• In the Lambayeque region (Peru), monthly meetings with health teams where challenges and difficulties are addressed, has represented an increase in the participation of pregnant women in prevention activities.
• As part of the implementation of the community monitoring system, in Peru the main characteristics that the community monitor should have were identified. Namely: communication skills, recognition of the community, knowledge of computer systems, as well as knowledge on health issues. 7
• The strengthening of community participation in health and recognition of the work of community monitors is key to ensure the sustainability of the monitoring system in both countries. In Ecuador, because the community monitors are volunteers and their commitment is confronted with their personal and family needs. In Peru, because monitors receive a stipend that, according to the plan, must be assumed by local governments. In addition, it was identified that there is a high rotation of ACS in monitoring actions in an urban area, due to labor commitments. As already indicated, the permanence of community monitors can be improved through the recognition of their work through stipends.
• The ovitraps efficiency study showed that it is necessary to extend the temporality of the study, as this lasted for one month. The term of the study did not allow to establish a trend on the behavior of Aedes aegypti nor for vector prevention or developed control actions.
5 FUPCH (2018). Study of Knowledge, attitudes and practices against the Zika virus in Peru. 6 CAD (2018). Award for Good Practices in prevention and control of the Zika virus. (Peru) 7 Diagnosis on the monitoring systems of Aedes aegypti in the Tumbes region (2018). (Peru)
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | XXIV • The diagnosis of Aedes aegypti monitoring systems in the Tumbes region identified the strengths and challenges of community-based monitoring systems. In this regard, four characteristics that the community monitor should have were identified. Namely: communication skills, recognition of the community, skills in the use of computer systems and knowledge of health issues.
RESEARCH AND PUBLICATIONS The main studies and evaluations carried out during year 2 are as follows: Award for Good Practices in prevention and control of the Zika virus. (Peru) Systematization of the implementation of the best Zika prevention and control practices in the selected areas of the project coverage cantons. EBA II (Ecuador) Study of Knowledge, attitudes and practices against the Zika virus (KAP), year 2. (Peru) Study of Knowledge, attitudes and practices against the Zika virus (KAP), year 2. (Ecuador) Ovitraps efficiency study. (Peru) Diagnosis of Aedes aegypti monitoring systems in the Tumbes region. (Peru) Systematization and evaluation of the implementation of pilot projects in the community epidemiological monitoring system in Ecuador. Pilot experiment report of the Community Epidemiological Monitoring System. (Ecuador) Four (4) reports: 1) Esmeraldas: Muisne, 2) Manabi: Manta, 3) Manabi: Portoviejo and 4) El Oro: Huaquillas Prevention of gender-based violence, with the Teams of the Decentralized Autonomous Municipal Governments of the cantons “Arenillas" and “Las Lajas”, of the Province of El Oro, in Ecuador. Healthy municipality. Proposal committed to the prevention of diseases such as Zika, Dengue and Chikungunya: action plan and strategies for implementation. Arenillas Canton. Healthy municipality. Proposal committed to the prevention of diseases such as Zika, Dengue and Chikungunya: action plan and strategies for implementation. Las Lajas Canton.
ACTIONS AND WAY FORWARD
• Based on the results of the KAP study, the following priority actions were identified in the third year:
• Adapt the communication strategy and define the messages to influence the key behaviors identified and prioritized. • Continue working with the prioritized population groups, especially with adolescents in educational establishments. Strengthening the messages to influence the practices. • Identify key messages to work on interpersonal communication with adolescents and pregnant women, doing the following: • Strengthen specific messages about the co-responsibility of men in sexual and reproductive health, including the prevention of pregnancy and the care and protection of it.
XXV | USAID ZIKA ANNUAL REPORT USAID.GOV • Continuity and sustainability must be given to the actions developed, which are evidenced to have contributed to increase the preventive culture at the community level, reinforcing in turn the levels of articulation and intersectoral linkage.
• It is necessary to strengthen work on gender equality, interculturality (taking advantage of local culture to disseminate messages and learning techniques), territorial relevance (involving local actors) and intergenerational relevance (directing contents according to the age groups of the population).
• Design strategies to influence the new authorities that take office in 2019. In Peru, advocacy will be held with the new authorities in January 2019 to achieve their involvement in the actions developed, promoting the use of the CBSS, as this is necessary for the sustainability of the project's actions. In Ecuador, a strategy will be established to influence finalist candidates and authorities who will take office in May 2019.
• Within the framework of the Healthy Municipalities Program, the technical capacities of the personnel will be strengthened for the implementation of the program and to strengthen the leadership of the Municipal Governments in the processes of health promotion, prevention of gender-based violence and involvement in the Zika prevention actions.
PLANNED ACTIVITIES FOR NEXT REPORTING PERIOD
For year 3, the activities implemented in year 2 are maintained.
TABLE 1: ACTIVITIES PLANNED FOR THE FISCAL YEAR
Planned Activities from previous fiscal year Country Actual Status Explanation Proposed Date: for Activities for September 30, Deviations the next fiscal 2018 year
Date: October 1, 2017 - September 30, 2018 Date: October 1, 2018 - September 29, 2019
A.1.1. Evidence-Based Analysis of community-based Peru Completed N/A Idem Y2 systems on roles and performance of vector control at household and community levels. Ecuador Completed N/A
A.1.2. KAP studies in selected areas on individual and Peru Completed N/A Idem collective behavior change regarding prevention, care giving to childbearing age women and pregnant Ecuador Completed N/A women.
A.1.3. Evidence-Based Analysis on inter-sector and Peru Completed N/A Idem community participation, roles and performance of community-based surveillance systems. Ecuador Completed N/A
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | XXVI A.2.1. Training of local health and municipalities Peru Completed N/A Idem personnel, and community health agents in protocols or guidelines (news or updated) based on EBA and Ecuador Completed N/A KAP findings on vector control best practices and lessons learned.
A.2.2. Based on EBA and KAP findings, develop and Peru Completed N/A Idem validate communication messages to improve knowledge and understanding on key risks of zika, especially on microcephaly in babies of infected Ecuador Completed N/A women, and key prevention and care giving practices.
A.2.3. Applying best practices for integrated vector Peru In process N/A Idem control involving families, communities, municipalities, health systems, community water management Ecuador In process N/A organizations.
A.3.1. Friendly information system (CBSS) linking Peru Completed N/A Idem health, local government and community services for registration, monitoring, analysis, planning and action, Ecuador Completed N/A developed and validated (Pilot study)
A.3.2. Friendly information system (CBSS) scaled-up in Peru In process N/A Idem the intervention areas Ecuador In process N/A
A.3.3. Training of local health services personnel, local Peru In process N/A Idem governments and community health workers on community-based follow-up and monitoring systems Ecuador In process N/A
A.4.1 Develop and validate a communication strategy Peru In process N/A Idem (based on EBA and KAP findings) for improving knowledge and understanding on key risks of Zika, especially on microcephaly in babies of infected Ecuador In process N/A women, and key prevention and care giving practices.
A.4.2. Within the framework of the communication Peru In process N/A Idem strategy, identify the roles of stakeholders (community, local government and health services) and tools to be used for influencing knowledge building and behavior change. Ecuador In process N/A
A.4.3. Implement a communications strategy aimed to Peru In process N/A Idem women of reproductive age and pregnant women, addressing Zika prevention, health and personal care, vector control practices and surveillance practices Ecuador In process N/A
A.5.1. In selected areas, train local government staff in Peru In process N/A Idem managing the budgeting system to include activities against Vector-Born Infectious Diseases in their regular planning processes (including stipend for Ecuador In process N/A animators).
A.5.2. Technical support to local governments to Peru In process N/A Idem promote and enhance local inter-sector and community coordination platforms for joint planning of community health plans. Ecuador In process N/A
XXVII | USAID ZIKA ANNUAL REPORT USAID.GOV A.5.3. Support bi-national mutual learning and Peru In process N/A Idem exchange of experiences, results and recommendations of the EBA and KAP studies through joint field visits, discussion events and Ecuador In process N/A documentation to adjust national and local plans of action to the proven best practices and protocols.
A.5.4. Organize at least one international event, with Peru In process N/A Idem other countries to share the results of the Evidence Based Analysis and KAP study, as well as successful experiences of adjusted implementation strategies and Ecuador In process N/A their results impact on the virus outbreak in community health care systems.
COMMUNICATIONS AND DISSEMINATION
KEY COMMUNICATION ACTIVITIES - PROJECT PROMOTION, PUBLIC OR MEDIA EVENTS/ENGAGEMENTS FOR THE PAST YEAR
Strategies and communication plans:
The strategies and their communication plans for behavior change have been strengthened in both countries. In Peru, the implementation of the Zikario campaign continued and three new messages were developed.
In Ecuador, in the "Todos contra el Zika” [All against Zika] campaign, 10 messages and pieces of communication were developed, incorporating project approaches (gender, interculturality, participation, intergenerational). The messages were constructed with the participation of health personnel, teachers, municipal government technicians, community leaders, adolescents, young people and pregnant women.
Public events to disseminate the project activities or key messages for the prevention and control of Zika:
In both countries, events of: dissemination and promotion of activities have been developed at the local, regional and binational level; including information about the Zika virus, as well as training in Edu communicative tools. The activities are also disseminated through digital media, especially Facebook. In the different public events and press releases on social networks, the USAID brand was positioned through graphic elements of visibility and the reference in the spokespersons to the project representatives, thus complying with the specific regulations in this area.
Fairs or awareness and dissemination activities: In each of the territories of the project execution, recreational and Edu communicative fairs are held in educational units and in community spaces. In these, Zika control and prevention contents are addressed and emphasis is placed on the importance of personal and community participation to eliminate Aedes aegypti mosquito breeding sites.
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | XXVIII These events made the project more visible at the regional, local and national levels. It also positioned the importance of preventing Zika and strengthened coordination with regional and local governments and the Ministries of Education and Health. Below are the links where the information of the activities carried out in Ecuador and in Peru can be found: https://rpp.pe/peru/piura/realizan-peculiar-campana-para-prevenir-el-zika-en-piura-noticia-1110167 https://diariocorreo.pe/edicion/piura/implementaran-estrategia-para-erradicar-criaderos-de-zancudos-en- el-alto-piura-798324/ https://youtu.be/RahSNtJgRmA https://www.facebook.com/ajax/sharer/?s=22&appid=25554907596&id=953670424806730&p[0]=893876 814119425&p[1]=953670458140060&sharer_type=all_modes&av=893876814119425 https://www.facebook.com/ajax/sharer/?s=2&appid=2305272732&id=10155531579277183&p[0]=101555 31579277183&sharer_type=all_modes&av=631992913 https://www.facebook.com/ajax/sharer/?s=2&appid=2305272732&id=1850276545065596&p[0]=1850276 545065596&sharer_type=all_modes&av=631992913 https://www.facebook.com/ajax/sharer/?s=2&appid=2305272732&id=956438124529960&p[0]=95643812 4529960&sharer_type=all_modes&av=893876814119425 https://youtu.be/K2dUiZjJdjQ (www.todoscontraelzika.com)
Training events for journalists and communicators about the Zika virus:
This training was aimed at strengthening knowledge about the risks of the Zika virus and at providing communicative guidelines to disseminate accurate information on the subject. In Ecuador, 3 local and 1 binational workshops were held. 40 local journalists and communicators participated in the local workshops. And 30 in the binational workshop of Ecuador and Peru.
Binational communication workshop to change behavior with the participation of communicators, promoters and community monitors: This workshop was held in Arenillas, in the month of September. Participants consisted of 80 communicators, monitors and community promoters from the Ministries of Health and Education of Ecuador and Peru, the Ministry of Economic and Social Inclusion of Ecuador, technicians of the Binational Project "All against Zika" from both countries and, the PAHO / WHO communication specialist in Ecuador, who also facilitated the workshop and acted as a delegate of UNFPA Ecuador. In the workshop a Binational Plan for the prevention and control of Zika was elaborated, with Edu communicative actions to be developed in the border area. Public events in 3 cities to position Zika risks, prevention actions and disseminate messages and communicative products to the population: These events took place in Ecuador, in coordination with the Ministry of Health, the Municipalities, and the support of the Provincial Governments. The Huaquillas event (Province of El Oro) was a binational event in which the project team and delegations from Tumbes, Peru, participated.
XXIX | USAID ZIKA ANNUAL REPORT USAID.GOV Dissemination of the Award for Good Practices in prevention and control of the Zika virus in the state’s channel (Peru): This event attracted significant media interest at the national level. https://careperumy.sharepoint.com/:v:/g/personal/ranguis_care_org_pe/ESTzKWRroHRMnO3IyeKoqS4B FUlj9K-VRUBBRi-onGX_lA?e=YA0yKb Presentation of the comprehensive guide to prevent the Zika virus in schools situated in the northern part of the country (Peru): In this event, recognition was given to the teachers who were part of the guide production. http://www.piuranews.com/eventos/6434-sector-educaci%C3%B3n-y-care-per%C3%BA-presentaron- gu%C3%ADa-para-prevenir-el-virus-zika-en-las-escuelas-del-norte-del-pa%C3%ADs.html Dissemination of key messages through media and social networks: The communicative actions of greater incidence developed during the second year of project management were the dissemination of project activities and messages about personal, family and community responsibility in the prevention and control of Zika. The most used media platforms were: printed media and mass radio formats, as well as social networks, especially Facebook.
Some of these messages can be accessed through the following links: https://www.facebook.com/search/str/CARE+ECUADOR+ZIKA/media-social?epa=SEE_MORE https://youtu.be/RahSNtJgRmA
Training for teachers and local actors in Edu communicative tools so that girls and boys become protagonists in Zika prevention and control: The training of teachers and local actors in Edu communicative tools was a strategy that was used in both countries, but with pedagogical proposals that respond to the context in each country and to the processes of construction and validation of the communication strategy. These tools were validated at the territorial level with the actors involved. The training provided teachers with Edu communicative tools, which they can use to train their peers, children, and adolescents about the Zika virus.
In Peru, the methodology and texts to incorporate the Zika content into the curriculum were designed together with technicians from the Ministry of Education.
In Ecuador, two guides with innovative methodologies were developed to work with children and adolescents, including content on Zika and risk reduction regarding natural disasters. Namely: “Edu communicative tools for children to be protagonists in the prevention of Zika”; and, “Preparing of Trainers: education, art and culture for work with adolescents”.
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | XXX
CALENDAR OF PLANNED PROJECT PROMOTION, PUBLIC OR MEDIA EVENTS FOR NEXT YEAR
Event Name Objective Date Participation Levels
Binational Event with Promote the replication of the Bi-national Local Authorities Community Based Monitoring Participation of representatives of Peru and System in the intervention February, Ecuador from the health sector and local districts of the project. 2019 governments at the subnational and national levels, as well as their peers from Ecuador.
National Meeting of Exchange experiences on the Sub-national Community Monitors operation of the Community March 14 & Participation of Health representatives, and Based Monitoring System. 15, 2019 local governments of the intervention areas, of the project.
“Informed Citizens” Recognize good practices in National Awards Event the prevention and control of May 15 & Participation of representatives of the health the Zika virus. 16, 2019 sector at the local, regional and national levels.
International workshop Reflect on the best practices International on community for linking and empowering Participation of representatives of projects participation in the the population in the control May 21, 22 financed by USAID from the countries of the control and prevention and prevention of Zika. & 23, 2019 Americas and the Caribbean. of Zika in coordination with USAID
Bi-national Education Exchange experiences about Bi-national Event the promotion of a culture of Participation of representatives of Peru and prevention and control of the May 30 & Ecuador from the health sector and local Zika virus in schools. 31, 2019 governments at the subnational and national levels, as well as their peers from Ecuador.
Bi-national Exchange learning about Bi-national Communication Event communication strategies June, 2019 Participation of communication experts and implemented to promote communicators from the health sector of both social and behavioral change countries. (Peru and Ecuador)
National closing Identify the lessons learned National workshops (Ecuador and and recommendations Participation of experts in communication, Peru). Evaluate the acquired through the project epidemiology, biology and officials of the health execution and identify implementation and education sector. local actors that, due to July, 2019 their competences, can give continuity to the proposal.
Meeting of the Steering Evaluate the results and Bi-national Committee sustainability actions Senior officials of the Ministry of Health of both July, 2019 countries, CARE: Peru, Ecuador, and regional LAC-C, UNICEF and representatives of civil society from both countries.
XXXI | USAID ZIKA ANNUAL REPORT USAID.GOV SUSTAINABILITY AND EXIT STRATEGY
• Developed actions that contribute to sustainability
Considering the temporality of the Project, the implementation of actions with the governing bodies was coordinated with the implementers of the public policies and programs, related to the response to Zika. Coordination is made with the Ministries of Public Health, Education, and with local governments: such as the Regional Governments in Peru, Municipal governments in both countries, and other allied institutions at the territorial level. In Ecuador, the Ministry of Economic and Social Inclusion are joined.
In Ecuador, all actions to be worked on health issues are regulated by the Ministry of Public Health. Contents regarding: training, Edu communication materials, guides, and manuals are approved by this institution. Coordination meetings are held and the results of the interventions are socialized. This allows for the authorization from the local level of the Ministry of Health to implement the concerted actions. The same applies to the Ministries of Education and Social Inclusion. Additionally, the Ministry of Health must approve actions with the Ministry of Education. This allows for the developed contents to be incorporated into the work of these institutions.
In Peru, there is a decentralization of competences, which gives autonomy for actions to be implemented at the territorial level. In this context, actions carried out in coordination with regional and local health, education and risk management bodies, contribute to the sustainability of actions and institutionalization. The training, technical assistance and articulated monitoring (DIRESA-CONECTAMEF and CARE PERU), of health care establishments personnel and the authorities and municipal officials involved in aspects of health, population and risk management, have been key in obtaining funds for the 017 Budgeting Program for Vector-Born Infectious Diseases and Zoonoses, in the year 2018.
The training of facilitators for the training processes in institutions is relevant because this allows for the appropriation of actions and multiplies the work of subjects related to the change of behaviors for the prevention of Zika. The trained facilitators replicate the contents with their peers.
In Ecuador, efforts are being made to strengthen the capacities of Municipalities, within the framework of the ‘Healthy Municipalities’ Strategy, to incorporate actions and indicators linked to Zika Prevention. This requires an initiation strategy to enhance the involvement of the DAGs in the program.
It is crucial to share information, findings and discuss the importance of interventions and benefits for the population. With these actions the involvement of the authorities, the commitment of a joint work, and the collaboration for the development of joint actions are achieved. The project developed these actions with all the actors involved in health, education, and risk with regional and municipal governments. This action must be carried out with community organizations.
The intervention in the educational field for work with adolescents is fundamental to influence the behavior change. Edu communicative tools were developed for the promotion of a culture of prevention and control of the Zika virus in schools, aimed at children and adolescents. The strategy of peer educators with adolescent males and females has been a success since it contributes to their empowerment and the perspective of execution. The intervention confirms that working with adolescents is more welcomed when working with peers.
Strengthening of community participation by motivating involvement in community actions to control the vector, in the modification of gender behaviors and roles, in home care tasks, and in couple’s relationships as well as in patriarchal relationships.
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | XXXII
Recommended actions for government institutions
It is necessary to strengthen the work on gender equality, interculturality and intergenerationality in Zika response interventions. Especially in the policies, programs and services of the Ministries of Health and Education. Furthermore, work is needed to empower women and girls, and to involve men in prevention actions in the care and protection of pregnancy. In addition, individual, couple, family and community actions are necessary for the prevention of Zika. o In general, health services reinforce gender roles traditionally assigned to women in the care and protection of health, home and pregnancy. Strategies must be developed to effectively involve men. o Adapt strategies for the prevention of risks linked to Congenital Zika Syndrome in adolescents, and even more so in those who are pregnant. o Consider the actions and indicators to prevent Congenital Zika Syndrome, and the sexual transmission of the virus. It is necessary to work collaboratively in the prevention of gender-based violence, sexual violence and prevention of teenage pregnancy. o More in-depth actions of risk prevention of Congenital Zika Syndrome in high-number of teenage pregnancies contexts.
It is necessary to develop strategies for the execution of actions in electoral periods, which can have an impact on the delay of the execution. For strengthening relationships and motivating the participation of local governments in the Zika response, it is advisable to strengthen the capacities of the municipalities, considering that differentiated strategies should be developed in 2 scenarios: 1) decentralization of health and education competencies, and 2) concentration of decisions on the national level. Among the alternatives identified, are: the budget program (PpR), applied in Peru and, the ‘Healthy Municipalities’ strategy, in Ecuador.
XXXIII | USAID ZIKA ANNUAL REPORT USAID.GOV ANNEXES
ANNEX IA. PERFORMANCE INDICATOR REPORTING SHEET ECUADOR Reporter: (Please provide contact informationCecilia Tamayo /Alex Portilla Submission Date: 28/1/2019 Definition of Community in Country: ECUADOR Approximate # of Persons in Community: Ecuador 128.944 Type of Index for Indicator 1 e (e.g. house index, container index, Breteau index, or Stegomyia index), oviposition indices, or via pupal demographic surveys: FY 2017 FY 2018 FY 2019 Cumulative Life of Life of Results to Project Project Comments Partner Country Indicator Number INDICATOR Year End Q1 Q2 Q3 Q4 S1 S2 Q1 Q2 Q3 Q4 S1 S2 Date Target Results Numerator ‐ number of communities reached with any This data is not cumulative physical vector control activities within the targeted CARE Ecuador 143624910 93 Information from the Ministry of Health 1a geographic area was incorporated
Denominator ‐ number of communities in the targeted CARE Ecuador 1a geographic area, per 100. 43 43 43 43 43 215 This data is not cumulative
Percent (%) of communities where physical vector control CARE Ecuador 32,56% 83,72% 55,81% 20,93% 23,26% #¡DIV/0! 80% The goal of the Project is placed 1a activities are being implemented
Numerator ‐number of communities conducting vector This data is not cumulative CARE Ecuador 1b surveillance and/or monitoring activities within the targeted 10 6 24 28 7 75 Information from the Ministry of Health geographic area was incorporated
Denominator ‐ number of communities in the targeted CARE Ecuador 1b geographic area 43 43 43 43 43 215 This data is not cumulative
Percent (%) of communities in which vector monitoring CARE Ecuador 1b activities are being implemented 23,26% 13,95% 55,81% 65,12% 16,28% #¡DIV/0! 80%
Number of people trained in vector control CARE Ecuador 1c 343 250 332 599 750 2274 2000 Data of the monitoring platform
Baseline total number of eggs CARE Ecuador 1d NA NA NA NA NA NA NA
Current total number of eggs CARE Ecuador 1d NA NA NA NA NA NA NA
Percent (%) change in mosquito egg density, from baseline, CARE Ecuador 1d in targeted geographic areas (Baseline‐Current/Baseline)% NA NA NA NA NA NA NA
CARE Ecuador 1e Baseline Index Value 0 5,45,405,405,40 5,4 Q1 report updated
CARE Ecuador 1e Current Index Value 0 4,75,215,344,63 4,97
% change in mosquito frequency, from baseline, in targeted geographic areas CARE Ecuador 1e #¡DIV/0! 13,0% 3,5% 1,1% 14,3% 8,0% 10
Number of health providers trained to provide Zika prevention counseling to Women of Reproductive Age (WRA) CARE Ecuador 2a 480 49 112 189 169 519 500
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | XXXIV Numerator: Number of women of reproductive age surveyed No CARE Ecuador 2b within the targeted project areas who can identify the 370 317 correspond 687 potential risks of ZIKA infection during pregnancy. e
Denominator: Total number of women of reproductive age No CARE Ecuador 2b surveyed within the targeted project areas. 531 541 correspond 1072 e
% of WRA in project areas who can identify the potential CARE Ecuador 70% 59% 80% 2b risks of ZIKA infection during pregnancy
Numerator: Number of women of reproductive age No Report updated with review of the KAP CARE Peru surveyed within the targeted project areas who can identify 107 199 correspond 306 2c study at least one sexual transmission prevention method e
No Denominator: Total number of women of reproductive age CARE Peru 531 541 correspond 1072 2c surveyed within the targeted project areas. e
% of women of reproductive age in project areas who can CARE Ecuador 20,2% 36,8% 80% 2c identify at least one sexual transmission prevention method
# communities with members actively participating in Zika Information from the Ministry of Health CARE Ecuador monitoring, prevention, and/or support activities 3 17 11 5 4 31 35 5a was incorporated in Q1‐Q2
5b: # communities with community plans for the prevention CARE Ecuador 13 3347 20 40 5b and control of Zika
# Zika events that involve families, schools, municipality CARE Ecuador 5c governments, or community organizations 25 12 10 4 8 59 100
The coverage achieved is greater because Total # of individuals of reproductive age in project areas through the radio and digital media CARE Ecuador 5000 1172 873 1598 98371 2045 99969 107014 3250 6a who have received Zika messages messages reached out to more people. Goal adjustment will be requested
# of FEMALE individuals of reproductive age in project areas CARE Ecuador 3200 40960 0 40960 44160 6a who have received MASS MEDIA Zika messages
# of MALE individuals of reproductive age in project areas CARE Ecuador 1800 23040 0 23040 24840 6a who have received MASS MEDIA Zika messages
# of FEMALE individuals of reproductive age in project areas CARE Ecuador 0 0 22442 0 22442 22442 6a who have received DIGITAL MEDIA Zika messages
# of MALE individuals of reproductive age in project areas CARE Ecuador 0 0 8534 08534 8534 6a who have received DIGITAL MEDIA Zika messages
# of FEMALE individuals of reproductive age in project areas CARE Ecuador 6a who have received INTERPERSONAL COMMUNICATION Zika 3200 837 670 1081 2092 1507 3173 7880 messages
# of MALE individuals of reproductive age in project areas CARE Ecuador 6a who have received INTERPERSONAL COMMUNICATION Zika 1800 335 203 517 1303 538 1820 4158 messages
XXXV | USAID ZIKA ANNUAL REPORT USAID.GOV # of FEMALE individuals of reproductive age in project areas CARE Ecuador 386 307 693 KAP study 6c who can name one vector transmission prevention method
CARE Ecuador 6c Total # FEMALES of reproductive age surveyed 531 541 1.072 KAP study
% of FEMALE individuals of reproductive age in project areas CARE Ecuador 72,69% 56,75% KAP study 6c who can name one vector transmission prevention method
# of MALE individuals of reproductive age in project areas CARE Ecuador 114 112 226 KAP study 6c who can name one vector transmission prevention method
CARE Ecuador 6c Total # MALES of reproductive age surveyed 129 126 255 KAP study
% of MALE individuals of reproductive age in project areas CARE Ecuador 88,37% 88,89% 53,4% KAP study 6c who can name one vector transmission prevention method
% of individuals of reproductive age in project areas who can CARE Ecuador 6c name one vector transmission prevention method. 75,76% 62,82% 57,7% 70% KAP study
# Has this country developed a Strategic Zika Social Behavior Change framework as part of their Zika response? Enter Yes CARE Ecuador No No No No No No No No 6b or No
New Report obtained from the pilots of CBSS CARE Ecuador # of referrals to clinical services 48 0 38 23 109 4a indicador and the Ministry of Health
New CARE Ecuador # of referrals to non‐clinical services 0000 0 4a indicador
# (total) of referrals of affected individuals to care and New CARE Ecuador 48 0 38 23 109 100 4a support services indicador
# of Female individuals of reproductive age in project areas CARE Ecuador 6e who have taken at least one action within the lasta mont to 394 351 745 KAP study prevent Zika infection or its consequences
CARE Ecuador 6e Total # females of reproductive age surveyed 531 541 1.072
% of Female individuals of reproductive age in project areas CARE Ecuador 6e who have taken at least one action within the lasta mont to 74,20% 64,88% KAP study prevent Zika infection or its consequences
# of Male individuals of reproductive age in project areas CARE Ecuador 6e who have taken at least one action within the lasta mont to 96 93 189 prevent Zika infection or its consequences
CARE Ecuador 6e Total # Males of reproductive age surveyed 129 126 255
% of MALE individuals of reproductive age in project areas who have taken at least one action within the last month to CARE Ecuador 74,42% 73,81% 6e prevent Zika infection or its consequences.
% of individuals of reproductive age in project areas who have taken Ecuador 6e at least one action within the lasta mont to prevent Zika infection or 74,24% 66,57% 70% its consequences CARE
Number of volunteers working to support community-level Zika New CARE Ecuador 519 519 response indicador New indicator
Number of schools with tools and methods to address New CARE Ecuador 76 76 arboviruses indicador New indicator
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | XXXVI PERU
XXXVII | USAID ZIKA ANNUAL REPORT USAID.GOV
Numerator: Number of women of reproductive age surveyed CARE Peru 2b within the targeted project areas who can identify the potential 261 604 865 risks of ZIKA infection during pregnancy.
Denominator: Total number of women of reproductive age CARE Peru 2b surveyed within the targeted project areas. 291 740 1031
% of WRA in project areas who can identify the potential risks CARE Peru 90% #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! 82% #¡DIV/0! #¡DIV/0! #¡DIV/0! 80% 2b of ZIKA infection during pregnancy
Numerator: Number of women of reproductive age surveyed The correct number for the numerator is 164, not 127. By mistake we took the total number CARE Peru within the targeted project areas who can identify at least one 164 503 667 2c total of negative responses instead of the positive ones. sexual transmission prevention method
Denominator: Total number of women of reproductive age CARE Peru 291 740 1031 2c surveyed within the targeted project areas.
% of women of reproductive age in project areas who can CARE Peru 56% #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! 68% #¡DIV/0! #¡DIV/0! #¡DIV/0! 2c identify at least one sexual transmission prevention method
# communities with members actively participating in Zika CARE Peru 5a monitoring, prevention, and/or support activities 51 4 24 25 35 139 50 The goal of the Project is placed
The correct number of plans produced is 5 in Y1 5b: # communities with community plans for the prevention and CARE Peru 5 0404 13 50 5b control of Zika The data (3) is in the indicator matrix of the annual report Fy17.
# Zika events that involve families, schools, municipality CARE Peru 5c governments, or community organizations 154 41 34 97 52 378 100 The goal of the Project is placed
Additional to the 167540 beneficiaries reached through Zika prevention or Total # of individuals of reproductive age in project areas who CARE Peru 162440 47160 0 0 209600 3250 control messages, we had 5101 persons reached in community awareness 6a have received Zika messages building fairs.
# of FEMALE individuals of reproductive age in project areas CARE Peru 71851 2287 5111 5493 34269 0 0 0 0 0 71851 6a who have received MASS MEDIA Zika messages
# of MALE individuals of reproductive age in project areas who CARE Peru 81500 0 0 81500 6a have received MASS MEDIA Zika messages
# of FEMALE individuals of reproductive age in project areas CARE Peru 5036 461 1572 1315 1723 5071 10107 6a who have received DIGITAL MEDIA Zika messages
# of MALE individuals of reproductive age in project areas who CARE Peru 4053 461 1572 1315 1723 5071 9124 6a have received DIGITAL MEDIA Zika messages
# of FEMALE individuals of reproductive age in project areas CARE Peru 6a who have received INTERPERSONAL COMMUNICATION Zika 0 1152 1754 2343 16982 22231 22231 messages
# of MALE individuals of reproductive age in project areas who CARE Peru 0 213 213 520 13841 14787 14787 6a have received INTERPERSONAL COMMUNICATION Zika messages
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | XXXVIII
# of FEMALE individuals of reproductive age in project areas CARE Peru 236 667 903 6c who can name one vector transmission prevention method
CARE Peru 6c Total # FEMALES of reproductive age surveyed 291 740 1031
% of FEMALE individuals of reproductive age in project areas CARE Peru 81% #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! 90% #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! 6c who can name one vector transmission prevention method
# of MALE individuals of reproductive age in project areas who CARE Peru 100 227 327 6c can name one vector transmission prevention method
CARE Peru 6c Total # MALES of reproductive age surveyed 125 270 395
% of MALE individuals of reproductive age in project areas who CARE Peru 80% #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! 84,07% #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! 6c can name one vector transmission prevention method
% of individuals of reproductive age in project areas who can CARE Peru 6c name one vector transmission prevention method. 81% #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! 88,51 #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! 70% The goal of the Project is placed
# Has this country developed a Strategic Zika Social Behavior Change framework as part of their Zika response? Enter Yes or CARE Peru no yes 6b No
CARE Peru 4a # of referrals to clinical services 0 5 60 2 0 60 67 CARE Peru 4a # of referrals to non‐clinical services 0 0 0 0 0 0 0 # (total) of referrals of affected individuals to care and support CARE Peru 0 56020 0000 67100 The goal of the Project is placed 4a services # of FEMALE individuals of reproductive age in project areas who have taken at least one action within the last month to The annual report FY‐17 considers 91.5% as a total value, which must be 90.4%. CARE Peru 276 563 839 6e prevent Zika infection or its consequences. The figures changed when segregating the data @sex
CARE Peru 6e Total # FEMALES of reproductive age surveyed 302 740 1042 % of FEMALE individuals of reproductive age in project areas who have taken at least one action within the last month to CARE Peru 91% #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! 76,08 #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! 6e prevent Zika infection or its consequences.
# of MALE individuals of reproductive age in project areas who have taken at least one action within the last month to prevent CARE Peru 82 184 266 6e Zika infection or its consequences.
CARE Peru 6e Total # MALES of reproductive age surveyed 94 270 364 % of MALE individuals of reproductive age in project areas who have taken at least one action within the last month to CARE Peru 87% #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! 68,15 #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! 6e prevent Zika infection or its consequences.
% of individuals of reproductive age in project areas who have taken at least one action within the last month to prevent Zika CARE Peru 90,40% #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! 73,96% #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! #¡DIV/0! 70% The goal of the Project is placed 6e infection or its consequences.
Number of volunteers working to support community-level Zika CARE Peru 177 177 300 New indicator response
CARE Peru Number of schools with tools and methods to address arboviruses 92 92 120 New indicator
XXXIX | USAID ZIKA ANNUAL REPORT USAID.GOV ANNEX 1B. OTHER ZIKA ACTIVITY INDICATORS
Progress of Indicators Result 1.- Best practices in community participation and mobilization on prevention, promotion and practices regarding Zika identified. 2017 2018 % of % of Cumulative Indicator Y1 Progress Planned Y2 Y2 Progress Completion Indicators PAIS Goal Completion progress Comments Number Achieved Target Achieved of total of Y2 Target achieved project goal Number of EBA reports on best practices on PERU 3 1 1 1 100% 2 66,67% I.1 vector control. ECUADOR 3 1 1 1 100% 2 66,67% Number of KAP studies implemented and shared at PERU 3 1 1 1 100% 2 66,67% I.2 local and national levels ECUADOR 3 1 1 1 100% 2 66,67% Number of EBA reports on community surveillance PERU 3 1 1 1 100% 2 66,67% I.3 practices ECUADOR 3 1 1 1 100% 2 66,67%
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | XL Result 2.- Best practices and lessons learned against Zika found through the EBA and KAP implemented immediately in priority risk areas
2017 2018 % of % of Cumulative Indicator Y1 Progress Planned Y2 Y2 Progress completion of Indicators PAIS Goal completion of progress Comments Number Achieved Target Achieved total project Y2 Target achieved goal I.4 Number of local health and local government PERU 2000 680 1000 1448 144,80% 2128 100,00% Goal achieved and scaling indicator (municipal) personnel, and community monitors from selected areas trained in protocols or ECUADOR 2000 343 1657 1663 100% 2006 100% Goal achieved guidelines based on EBA and KAP findings on vector control
I.5 Number of local health and local government PERU 500 50 300 255 85,00% 305 61,00% (municipal) personnel, and community monitors from selected areas implementing protocols or ECUADOR 500 0 332 411 123,80% 82% 100% Goal achieved guidelines based on EBA and KAP findings on vector control I.6 Number of communication messages developed, PERU 10 15 10 4 40,00% 19 100% Goal achieved and scaling indicator validated or updated (9 additional messages)
ECUADOR 10 5 10 10 100,00% 10 100% Goal achieved I.7 Improve the efficiency of ovitraps in at least 10% PERU 3 0 2 1 50,00% 1 33,33% CDC platform is used to improve the for vector control and community surveillance performance of this indicator (Peru - Pilot study) ECUADOR NA NA NA NA NA NA NA I.8 Number of vector control and community PERU 100 154 100 195 195,00% 349 100% Goal achieved and scaling indicator surveillance events implemented involving families, (249 additional events) communities, municipalities, health systems, ECUADOR 100 42 46 40 86,96% 82 76% community water management organizations
I.9 Number of local governments (municipalities) in PERU 20 3 10 12 120,00% 15 75,00% selected areas that implemented action of zika ECUADOR 10 8 6 6 100,00% 8 80,0% prevention and control as planned
XLI | USAID ZIKA ANNUAL REPORT USAID.GOV Result 3.- System (Community Based Surveillance System) for local governments and community use to enable a continuous gathering and analysis of best practices at community level in use.
2017 2018 % of % of Cumulative Indicator Y1 Progress Planned Y2 Y2 Progress completion of Indicators PAIS Goal completion of progress Comments Number Achieved Target Achieved total project Y2 Target achieved goal Community Based Surveillance System (CBSS) PERU 1011100,00%1100,00%Goal achieved I.10 developed, validated (Pilot study) ECUADOR 1011100,00%1100,00%Goal achieved Goal achieved and scaling indicator Number of local governments (municipalities) PERU 10 0 5 12 240,00% 12 120,00% Additionally 2 municipalities using I.11 using the CBSS in the planning of actions against Advocacy through Healthy Zika and make decisions ECUADOR 10 0 8 4 50,00% 4 40,00% Municipalities strategy The actions were strengthened to Number of community monitors dully providing PERU 500 0 500 195 39,00% 195 39,00% reach the defined goal I.12 periodic surveillance reports to local health services. ECUADOR 500 0 340 411 120,88% 411 82,20%
% of community monitors who collect information Goal achieved PERU 80% 0 80,00% 85% 106,25% 85,00% 106,25% I.13 and generate valid reports of community surveillance through the CBSS ECUADOR 80% 0 80,00% 61,54% 76,84% 61,54% 76,84% CBSS was strengthened to reach the PERU 80% 0 80% 9% 11,25% 9,00% 11,25% % of people (Health Workers, Local Authorities) defined goal I.14 who have (provided) used information valid from CBSS ECUADOR 80% 0 70% 75% 107,14% 75,00% 93,75%
% of Health Services that issue and receive PERU 70% 0 70% 44,74% 63,91% 44,74% 63,91% I.15 information to-from other stakeholders for its use in the planning of actions against Zika (Peru) ECUADOR NA NA NA NA NA NA NA
% of community members who have received The actions were strengthened to information from other stakeholders (Community PERU 60% 0 60% 40% 40% 40% 40% reach the defined goal I.16 Health Agents, Community Monitors, Health Personnel, local authorities) for its use in the Goal achieved ECUADOR 60% 0 50% 67% 134,00% 67,00% 111,60% planning of actions against Zika Proportion of local authorities/ Community Health PERU 100% 0 100% 100,00% 100,00% 100,00% 100,00% I.17 Agents/community monitors/ who have received feedback through the CBSS ECUADOR 100% 0 80% 97,42% 121,78% 97,42% 97,42% The actions will be strengthened to Number of health personnel trained in CBSS. PERU 500 0 300 163 54,33% 163,00 32,60% I.18 reach the defined goals (Peru) ECUADOR NA NA NA NA NA NA NA CBSS was strengthened to reach the PERU 250 0 200 85 42,50% 85 34,00% Number of local governments and community defined goal I.19 monitors trained in CBSS. Goal achieved and scaling indicator ECUADOR 250 125 200 223 111,50% 348 139,20% Additionally 98 people were trained USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | XLII Result 4.- Communication strategy for behavior change among women of reproductive age, pregnant women and adolescents implemented using formal and informal means
2017 2018 % of Cumulative % of Indicator Y1 Progress Planned Y2 Y2 Progress Indicators PAIS Goal completion of progress completion of Comments Number Achieved Target Achieved Y2 Target achieved total project Communication strategy developed, validated or PERU111001100%Goal achieved I.20 updated ECUADOR 1 0 1 1 100,00% 1 100% Goal achieved Number of Local Communications Plan PERU 20 0 15 4 26,67% 4 26,67% The actions will be strengthened to I.21 implemented by key stakeholders ECUADOR 10 0 5 3 20% 3 20% reach the defined goals
% of communities (localities) that recognize the role PERU 60% 0 60% 89,83% 100,00% 90% 100% I.22 of key stakeholders (community organizations, local The actions will be strengthened to governments and health services) ECUADOR 60% 29,24% 40% 17% 100,00% 46% 46% reach the defined goals The actions will be strengthened to Number of communication kit to promote PERU 300 0 200 98 49,00% 98 32,67% reach the defined goals I.23 prevention and control of Zika delivered to Goal achieved community health workers ECUADOR 260 0 260 260 100,00% 260 100%
% of women of reproductive age and pregnant PERU 80% 50% 80% 94,33% 100% 144,33% 100% Goal achieved I.24 women informed on prevention and control of Goal achieved Zika. ECUADOR 80% New 60% 81% 135% 81% 100% % of women of reproductive age and pregnant PERU 60% 54% 70% 13,23% 18,90% 67,23% 67,23% I.25 women who increased awareness/knowledge on prevention and control against Zika infection. ECUADOR 70% 64% 60% 18% 30% 82,00% 82%
% of women of reproductive age and pregnant PERU 60% 54% 60% 17,89% 29,81% 71,89% 72% I.26 women, who apply better practices in prevention Be reviewed and will adapt other and care-giving against Zika ECUADOR 60% 0 30% 48% 160% 48% 48% communication messages for teens Goal achieved % of adolescents who increased their PERU 70% New 70% 76,35% 100% 76,35% 100% I.27 awareness/knowledge on prevention and control The actions will be strengthened to against zika infection. ECUADOR 70% New 60% 28% 47% 47% 47% reach the defined goals PERU 80% 60% 80% 82,50% 100% 142,50% 100% Goal achieved % of adolescents who knows prevention practices I.28 The actions will be strengthened to against Zika infection. ECUADOR 80% New 30% 45% 150% 45% 56% reach the defined goals PERU 60% 40,49% 60% 76,88% 100% 76,88% 100% Goal achieved % of adolescents who apply better practices in I.29 The actions will be strengthened to prevention and care-giving against Zika ECUADOR 60% New 30% 28% 93% 28% 47% reach the defined goals
XLIII | USAID ZIKA ANNUAL REPORT USAID.GOV Result .5.- Extend the strategies and protocols developed and applied locally to other areas of the country. 2017 2018 % of Cumulative % of Indicator Y1 Progress Planned Y2 Y2 Progress Indicators PAIS Goal completion of progress completion of Comments Number Achieved Target Achieved Y2 Target achieved total project Number of local governments (municipalities) in Goal achieved selected areas trained in annual budgeting PERU 20 15 15 6 40% 21 100% I.30 processes to allow for planning and budgeting against Zika (Peru) ECUADOR 10 5 4 4 100% 8 60%
% of local governments (municipalities) in selected PERU 80% 80% 80% 16,67% 20,84% 96,67% 20,83% I.31 areas that include planning for Zika prevention actions and control as part of annual budget. (Peru) ECUADORNANANANANANANA
% of local governments in selected areas implementing joint inter-sector coordination and PERU 90% 62% 90% 56% 62,22% 146% 61,73% I.33 planning of Zika prevention and control, involving other stakeholders and communities ECUADOR 90% 40% 30% 30% 100% 60% 77% Number of activities implemented to achieve PERU 6 1 2 4 200% 5 83,33% I.34 mutual learning, experience exchanges, results and recommendations discussion, etc. ECUADOR 6 2 4 4 100% 6 100% Goal achieved PERU 3 1 2 2 100% 3 100% Goal achieved ECUADOR 3 1 2 2 100% 3 67% Number of exchange and learning meeting held at PERU3111100%266% I.35 local, national, bin/national and international levels ECUADOR 3 Y3 2 2 100% 2 100% Goal achieved PERU 1 1 1 1 100% 1 100% Goal achieved ECUADOR 1 Y3 1 1 100% 1 100% Goal achieved
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | XLIV ANNEX II. SUCCESS STORIES – ECUADOR AND PERU STORIES ECUADOR
Prevent Zika to the rhythm of the marimba Esmeraldeña
“Yo vengo de Guadurnal, el mosquito nos picó Oigan todos mis mensajes, el mosquito nos picó Pónganse todos repelente, que el mosquito nos picó” “I come from Guaduranal, where the mosquito bite us Listen to my messages, the mosquito bite us Use repellent, since the mosquito bite us”
With this composition began the “Marimbeo” or Music School Festival, in which children attending seven schools in the community of Chamanga, from the Muisne Municipality, exposed, to the rhythm of the marimba esmeraldeña a typical rhythm from Esmeraldas, messages to prevent the Zika virus. Working with the children and the teachers was an enriching experience, explains Linver, who promoted this process.
"The verses were created by educators. The youngest created verses of one stanza and the largest ones of up to two. With this exercise, they were also helped to develop creativity and thinking and to learn to reason. Remember that the verse is in our entire universe, our life. " "The songs, -called arrullos- are part of our culture, are a very easy way to get to the community with the message about how dangerous Zika is." This was stated by Fabricio Montesdeoca, who was a community promoter of the “Zika response in Ecuador and Peru” Project, and responsible for the formation of children. Fabricio is also a member of the music group that plays Marimba, called Flor de Mangle de Muisne.
"The best thing about this work was that I understood the richness of the Esmeralda´s Fabricio, in the bombo and Linver in the marimba with culture, the great creativity that children have their classmates of the Flor del Mangle marimba group, and how we can educate the population with in the Marimbeo Escolar event. music", he reaffirms.
The marimba, which is in the heart of the people from Esmeraldas, is part of the intangible heritage of Ecuador. People play and sing arrullos to the saints, or chigualos when children die, are some of the religious expressions that have been built around this instrument.
The marimba arrived to Ecuador with the first slaves that came from the African continent. In Esmeraldas the marimba is made with wood that is cut according to the moon cycles. The wealth of marimba sounds, the creativity to build verses and the rhythmic dance came together to create messages of prevention against Zika.
XLV | USAID ZIKA ANNUAL REPORT USAID.GOV “Oye mosquito condenado búscame la paz Porque aquí en Muisne con el Zika vamos a acabar” “Hey condemnes mosquito, find me peace Here in Muisne with the Zika we are going to finish”
“Using culture, the marimba, the verses, allows us to recover our culture and summon the whole family to listen and learn about the Zika virus and the dangers it poses to their health." Says Martha Ortiz, a professor at the 6 de Mayo School in the community of Chamanga, who closes our dialogue by reminding us one of the verses built by the children:
“Allá viene el Zika, allá viene el Zika” Oiga mi compadre use protección, Que allá viene el Zika” "There comes the Zika, there comes the Zika" Hey, my friend, use protection, there comes the Zika”
Erika Márquez, technician of the Direction of the Martha Ortiz with the children of the school "6 de Ministry of Public Health, recognizes that the Mayo" receive from Alexandra Moncada, Director of greatest achievement of the joint work with CARE CARE, who were recognized and congratulated for in the prevention of Zika has been the recovery of their participation in the process of "Marimbeo Escolar" Afro-Esmeraldas culture and the participation of the population to carry out control actions and Zika prevention. “The important thing is that the Zika response in Ecuador and Peru project continues with this process of recovery of the Afro-Esmeraldas culture”, says Linver. “More schools should be included in the educational process of incorporating music and singing for the prevention of Zika. We must recover the value of respect, of teaching” he concludes.
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | XLVI Community empowered with Zika prevention
"When I was invited to participate as a community promoter of the Los Cerezos neighborhood, where I live, I was not interested. Then, when I was learning about Zika and learning how to make home visits, how to inform people so that they would listen to us and not close the doors. I was motivated and one day I said to myself 'let's start this adventure' “.
This is the testimony of Marcos Chinga, a 17 years old young man, with a deep and smart look. He is one of 251 community promoters of the Community Based Epidemiological Surveillance System - CBSS or SVBC - for its acronym in Spanish.
The group of promoters integrated by adolescents, young people and / or adults from the neighborhood where Marco lives, as well as those from other communities where the binational "Zika response in Ecuador and Peru" Project is implemented, were motivated and trained. As Community mobilizers, they promote knowledge and change in people´s behaviors so that, in a personal, familiar and community level, they are active in the prevention of Zika and the elimination of mosquito breeding sites.
The promoters are actors of the community itself. "We visit every week the houses in the block they assigned us. Some are friendly and open the door; others raise the volume of the radio and pretend to be deaf. Once, a lady got very angry and ordered us to leave." Says María José, promoter of La Piñonada neighborhood.
The group of promoters from each community meets once a week to share their experiences, Community promoters in a home visit to the La inform the group coordinator about the number of Piñonada neighborhood, Cantón Portoviejo. breeding sites they found, the number of pregnant women they identified, the problems they had; and to define strategies to address those challenges.
"After talking, we set ourselves new challenges for the following week. Even if someone cannot do his information work, another person replaces him/her. We all support each other", says Mario.
The CBSS is a process in which citizen participation is strengthen and this has been precisely the greatest of its challenges, since, at present, the Ecuadorian population is disjointed and little committed to social action. The system is a strategy of the Zika response in Ecuador and Peru project, through which it seeks to promote the empowerment of people about their responsibility in the care of their health and their community well-being, focusing on human rights, equity and diversity, as well as the prevention and control of health promotion.
XLVII | USAID ZIKA ANNUAL REPORT USAID.GOV Promoters have greater acceptance and credibility in the population. With USAID funding, promoters were endowed with backpacks, vest, T-shirt and identification card. In addition, they have access to all the communicative and educational material produced by the project.
The community promoters weekly visit the homes to do a physical check, that is, the verification and elimination of breeding sites. They also generate personal or community spaces to inform, to communicate and to educate the population through home visits or neighborhood fairs "Against Zika". They also organize bicycle tours to disseminate the actions that each person, family and community must take to protect themselves against the Zika virus. These actions contribute to the behavioral change in the populations in the perspective of the prevention and elimination of potential mosquito breeding sites.
By September 2018, the work and the permanent commitment of the community promoters has made it possible to reduce to 6.3% (the goal is 10%) the presence of mosquito breeding sites in the homes of the communities in which the "Zika response in Ecuador and Peru" project intervenes.
Eduardo Galeano, the Uruguayan writer asks "Where are the dreams and hopes?". Marco Chinga gives us a possible answer:
"Being a community promoter has changed my life. When I return to the houses and see that they have fewer breeding sites and less trash inside the house and in the yard, I feel that what I do is worth it. I feel useful; I feel that I have become a better person. "
The children, who have seen their brothers and sisters in action, have also joined the health promotion and monitoring activities. This is the case of Mijael Bravo, a 10-year-old boy, for whom the most important thing is:
"…to inform pregnant women that they should use repellent and nets to protect themselves from mosquitoes. Also, we must tell them how they should
Michael (the shortest in the photo) and his group wash the bins, the wells and cover them well so that the explain through poetry and dance how to prevent mosquito does not enter". Zik In the last year of execution of the project it is expected to strengthen the work and articulation with the neighborhood leaders, local authorities of the Ministry of Public Health and with the Decentralized Autonomous Government, with the purpose that their actions and reports are a basic input for decisions.
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | XLVIII No cobwebs in the eyes: teenagers learn about sexuality and the prevention of the Zika virus
Paraphrasing the writer Eduardo Galeano we can affirm that adolescents and young people are able to see the world without cobwebs in their eyes. The adult and mediated world blurs and makes up reality, preventing them from managing adequate information, and taking safe decisions.
Talking about sexuality with adolescents in the prevention of Zika is an adventure that aims to promote that they recognize, accept, take care of; and learn about the importance of building their life project and of fulfilling their goals and interests in a responsible way. It is a strategy to invite them to be agents of change in their families and in their communities.
The "Zika response in Ecuador and Peru" Binational Project, implemented by and funded by USAID, includes four axes when working in sexuality: a) Learn to know; b) Learn to do; c) Learn to live together; and, d) Learn to be. These axes are based on UNESCO's integral education proposal, says Amanda Quiroz, a consultant responsible for this process.
With teen agers and young people, Project team reflects and analyzes contents related to self-esteem and values; gender; sexual and reproductive rights; pregnancy rates in adolescents (as well as the use of contraceptives); sexual transmission and prevention of Zika virus in pregnancy.
The next step is to provide them with tools and motivate them so that, when adolescents realizing as subjects of rights, they generate proposals for specific actions aimed at their personal and collective protection and care, especially in situations of violence. An important time is devoted to teaching them useful communication tools to promote dialogue and training with other groups of people, taking as an example the prevention and control of the Zika virus.
Prior to working with adolescents and young people in each community, it has been necessary to meet with neighborhood leaders and / or parents -especially- to inform them about the project and request authorization for their daughters and sons to participate in the weekly Zika training meetings.
XLIX | USAID ZIKA ANNUAL REPORT USAID.GOV
Young people and adolescents have collectively constructed messages to prevent sexual violence and the transmission of Zika. They have become multipliers of knowledge with other young people, adolescents and even adults. An innovative experience is information and training for men and women who attend football matches. This happens in the community of Pueblo Nuevo, in Portoviejo. While the spectators and players enter the field and prepare for the game, the group of young people and adolescents who fight against Zika organize their materials and provide short speeches.
Teenagers and young people from the community of Pueblo Nuevo, Canton Portoviejo report on the Zika virus and its risks during the football game.
The comprehensive education on sexuality and prevention of Zika aimed at adolescents and young people is a strategy through which the "Zika Response in Ecuador and Peru" Project promotes a training process. The project provides key information, knowledge and tools that allow them to look without shadows at the reality and the world that surrounds them. The project promotes adolescents to be critical of the information they receive in a globalized world, where ethical and moral values are sometimes jeopardized by obtaining material and economic goods. Training also aims to empower adolescents as protagonists of their lives.
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | L STORIES PERU
Anti-ZIKArios teams in action at the “JUAN MEJIA BACA” school in Lambayeque
The "Juan Mejía Baca" school Administrator, aware of the risk posed by the Zika virus in the community convened teachers, students, and parents to produce a comprehensive prevention strategy for the school. "I suggested to clean-up the garbage and waste thrown from the restaurants near the school. We coordinated with the parents, neighbors, the health center and the municipality; to eliminate those infectious foci and potential mosquito breeding sites”. ... ”We achieved to jointly eliminate those garbage sites and improve the collection and disposal of garbage”, said Loida Delgado Vargas, School Administrator. In the pictures you can compare the situation before and after the community decided to mobilize and managed to change not only the landscape of the community, but also generate new habits regarding health prevention through safe disposal practices." The project has developed campaigns of collection and elimination of breeding places. The project also delivered copies of the "Integral Guide of the promotion of a culture of prevention of Zika in schools". Before and After: Mejía Baca school in Chiclayo. Collage: Matilde Jimenez Teacher and adolescent peer educators received new information. This has allowed for the development of different awareness actions within the school, aimed at the promotion of social and behavioral change. During the intervention in the school, the educational community participated in theater plays, sketches, learning sessions and educational projects, to raise awareness about the Zika virus. The AntiZIKArios teams, (Los comanditos AntiZIKArios), are groups of first grade students who learned about prevention strategies against Zika by enacting a make believe game, in which they pretend to form a brigade, are taught simple songs or harangues about the subject, and form themselves in line holding buckets with lids, repellents and mosquito nets. "This idea was born, from watching the local civic parade. We think that there are many ways to stand for our community and the one that is now more significant for us is by preventing the spread of the AEDES zancudo that transmits Zika." claimed Rosa Bances Albañil, teacher of the innovation classroom pedagogical level (AIP). The "comanditos" have been invited to several events and activities outside the school, and have been praised nationwide, throughout social networks and other web platform of a popular media, as a valuable
LI | USAID ZIKA ANNUAL REPORT USAID.GOV strategy to communicate awareness about Zika to early childhood. (RPP)8. Hence, the positive impact of these "comanditos" has become a powerful tool for keeping on spreading key prevention messages. Thanks to the leadership of the school administrator plus the involvement of parents, teachers, students and the local government, we have establish a working table named "Comandos AntiZIKArios".
Stronger Against Adversity (Piura Region) During the year 2017, Peru had outbreaks of metaxenic diseases were the Piura region was one of the most affected, as there were about 48,675 cases of dengue, 140 of Zika, and 827 of Chikungunya.9 Moreover, we have taken account of many cases that were not considered in any of the statistics previously mentioned. A significant element in the arise of infection probability was the increase in atmospheric temperature, and the incessant rains caused by the “El niño” coastal phenomenon, which hit that summer, and created the ideal conditions for the virus transmitters to reproduce exponentially Hence, the authorities declared an emergency in the region. In this context, Olibia Pulache Jiménez, Specialist of the Project “Together against Zika” (Piura), and Mary Espezúa Rivera, specialist of the Regional Bureau of Education in Piura, started holding meetings with teachers to inform them about the risks of epidemic outbreaks of Dengue, Zika and Chikungunya. In these meetings, it agreed to form a commission to produce classwork materials for teachers. Once the first Zika cases were known in Peru, the commission designed a work route for producing a guide and manuals aiming to improve the behavior of the school population regarding the prevention and control of the Zika virus. On the basis of the the commission mentioned before, and in coordination with the Ministry of Education and CARE Peru, Mary Espezúa formed a technical team of specialists to develop learning sessions that would incorporate topics of prevention and control of the Zika virus. This process lasted for about six months and, thanks to USAID funding, the “Together against Zika” team gave technical assistance to this integrated initiative. Teachers and health sector officials validate the materials produced. A guide and seven modules were render, under the name
8 Source: RPP News. Videoreport https://rpp.pe/peru/lambayeque/premian-buenas-practicas-de-prevencion- y-control-del-zika-noticia-1145959 9 Source: National Center for Epidemiology, Prevention and Control of Diseases of the Ministry of Health.
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | LII “The Comprehensive Intervention Guide for the Promotion of a Culture of Prevention against Zika in Educational Institutions”. Watch: https://www.zikacommunicationnetwork.org/es/resources/guia-de-intervencion-integral-para-la- promocion-de-una-cultura-de-prevencion-ante-el-zika "At the beginning, the idea was to develop learning sessions that teachers could use in the classroom, however, thanks to the support of the project and USAID funding, we have managed to expand the range of application of this guide, so now it can also serve to the purposes of directors, peer educators and the educational community. The use of the materials in the Piuran schools, during the first semester of the year, has had successful developments, which can be verified in KAPs results ", indicates Mary Espezúa. In Piura, adolescents have increased their knowledge of Zika virus prevention and control practices by 64%, surpassing the other regions. To date, the project “Together against Zika” has trained 1,199 teachers and 214 peer educators in the use of the aforementioned educational materials.
The "ZIKArias" fight the ZIKA in Campo Amor (Tumbes) Alicia Dávila, 57 years old, community monitor 10, is one of five women that, since February 2018, have been monitoring the presence of the mosquito Aedes aegypti in their community through ovitraps. They have also been guiding families on actions to prevent and control the Zika virus and to participate in spaces of multisectoral coordination with local authorities. Because the data from the ovitraps reading has to be entered into a mobile application, one of the first challenges Alicia assumed was to learn how to use smart phones and tablets. Alicia then has to share this information by WhatsApp to community leaders, representatives of the municipality and health officials, for them to take timely actions. This has been a great opportunity for her to learn how to use these new technologies.
10 The Project "Together against Zika" has been intervening in the community Campo Amor of the District of Zarumilla in the Tumbes region. This community has approximately 10,000 inhabitants and is an area where dozens of cases of dengue have been reported together with a few Zika cases.
LIII | USAID ZIKA ANNUAL REPORT USAID.GOV Alicia says: "when we started, we always had the problem of two ovitraps that were positive, that is, with the presence of mosquito eggs. Thanks to the training we received from the project, we also learned how to make an entomological fence, that allows mosquito breeding sites identification. " "Together with my partners, we began to visit houses with our flipcharts to create awareness among the families, so they know they have to cover their tanks and eliminate the possible breeding places in their homes. Likewise, we Home visit to Alicia Dávila. Picture: Jaime Chang inform them about what was happening to the Zarumilla district health committee. " Representatives of the municipality, prefecture, health center, and other institutions participate in the Zarumilla district health committee, and together produced campaigns to collect breeding sites in their community aiming to increase prevention and control of the Zika virus. "For 7 months the two ovitraps were coming out positive, and it was from the month of August and later on that they came out negative constantly. This made us happy because we realized that the work we do in guiding the families and working together with the authorities has all proved effective. " said Alicia. The MCs continue to monitor the ovitraps. Till now they continue to be negative. Finally, the MCs have managed to be recognized for their work by the members of the community. They are now accounted as the main source of information on whatever arises regarding the viruses.
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | LIV ANNEX III. TRAINING REPORT
Annex III Training Report ECUADOR # of Total Training (Short Name) Curricula (Long name) Training Dates F M Days Trained Training in clinical and epidemiological management, actions of surveillance and 1 October 13, 2017 Clinical and Epidemiological prevention of Zika virus infection and its complications. Local health personnel, rural 35 27 62 manegement of Zika Training in epidemiological and clinical management of Zika infection and its 1 October 19, 2017 complications. Muisne Prevention and control of Zika, aimed at community leaders who support health units at Zika Prevention 1 October 20, 2017 53 45 98 work with priority groups. Muisne Methodologies for Working Training to promote the use of innovative methodologies to work with children oriented 1 November 6, 2017 20 15 35 with Children to the prevention of Zika, aimed at teachers in the Educational Institution "20 de Marzo". Healthy Municipalities and Training aimed at health officials, municipalities and academies to promote advocacy 1 November 7, 2017 94 70 164 Zika Prevention strategies in the articulation of intersectoral actions that contribute to the prevention of
Counseling on Risks for Training on counseling protocols on the Zika risk in pregnant women in health centers 1 November 15, 2017 13 6 19 Pregnant Women and "CNH". Communities of Arenillas
Innovative Methodologies for Training with innovative educommunicative methodologies to work with adolescents 1 November 21, 2017 52 27 79 Working with Teenagers directed to officials of the MoH and municipality. Huaquillas Training: strengthening of the capacities of local governments to influence the articulation Zika prevention plans 1 November 21, 2017 43 37 80 of intersectoral actions to prevention of Zika. Huaquillas Risks and Complications of Training in Zika risks and complications in pregnant women. Health network of district 1 November 22, 2017 32 27 59 Zika in Pregnant Women 13D11 San Vicente-Sucre, H. Alcivar hospital and rural social segurity. Sucre Clinical and Epidemiological Training in clinical epidemiological and management: integral actions of surveillance and 1 November 23, 2017 113 55 168 manegement of Zika prevention of Zika virus infection and its complications. Health district 13D11. Sucre Vector Control and Training to officials of the MoH on the best practices for the integral vectr control and 1 November 24, 2017 15 18 33 Prevention Practices health promotion at community level in the cantons of Sucre and San Vicente. Sucre Vector Control and Training of reproductive age people to promote activities of control and elimination of 1 November 28, 2017 76 37 113 Prevention Practices mosquito breeding sites as a good practice for the prevention of Zika. San Vicente Sexuality and Zika Risks Training directed to pregnant and reproductive age women on responsible sexuality, 1 December 1, 2017 49 11 60 Prevention prevention and risk of Zika. Sucre Methodologies for Working Training in education tools for teachers of basic education, directed to incentivize 1 December 4, 2017 21 9 30 with Children children to be protagonists in prevention of Zika. Sucre Innovative Methodologies for Training with innovative educommunicative methodology for the Zika prevention aimed 1 December 5, 2017 26 20 46 Working with Teenagers at teachers of the education circuit 13 D11 San Isidro. Sucre Risks and Complications of Training to improve knowledge and understanding of the main risks of Zika especially 1 December 5, 2017 14 7 21 Zika in Pregnant Women microcephaly in newborn children, directed to the school of citizen participation. Sucre
Training workshop for journalists media: The role of communicators in the prevention of Social Communicators Rol 1 December 6, 2017 7 8 15 Zika Innovative Methodologies for Validation workshop of the innovative methodologies guide for the prevention of Zika 1 December 14, 2017 24 26 50 Zika prevention Innovative Methodologies for Replica of the Training with innovative methodologies for the prevention of Zika, aimed 1 December 15, 2017 102 105 207 Zika prevention at adolescents. Fiscal education institution "25 de Mayo" Innovative Methodologies for Training of innovative methodologies for the prevention of Zika, aimed at adolescent 1 December 15, 2017 102 105 207 Zika prevention women and men of the "Guayaquil" and "Hugo Villacrés" educational units. Portoviejo
Training with innovative methodologies to work with adolescents in the prevention of Innovative Methodologies for Zika, health and personal care, vector control practices and prevention of Zika´s sexual 1 January 16, 2018 102 105 207 Zika prevention transmission. Portoviejo Innovative Methodologies for Training in healthcare and Zika prevention training, aimed at the population of 1 January 19, 2018 102 105 207 Zika prevention reproductive age of the Felipe Saul Morales educational community. Portoviejo
LV | USAID ZIKA ANNUAL REPORT USAID.GOV # of Total Training (Short Name) Curricula (Long name) Training Dates F M Days Trained Innovative Methodologies for Training in healthcare and Zika prevention training, aimed at staff of the 1 January 26, 2018 102 105 207 Zika prevention "DECE" department of the "Tiburcio Macias" Educational Unit, teachers Community Based Workshop to exchange knowledge and pilot practices of the community 1 January 26, 2018 45 40 85 Surveillance System (CBSS) based surveillance system against Zika Innovative Methodologies for Zika prevention workshop, aimed at the health volunteering community 1 January 28, 2018 34 31 65 Zika prevention of the Municipality of Portoviejo Innovative Methodologies for Workshop with educational units of "San Placido": to replicate 1 February 7, 2018 34 32 66 Zika prevention workshops of Zika prevention with innovative methodologies. Community Based Workshop to exchange experiences with community health volunteers 1 February 15, 2018 34 31 65 Surveillance System (CBSS) for the CBSS pilot, health authorities and other local actors. Huaquillas Innovative Methodologies for Innovative communication methodology workshop aimed at staff 1 February 16, 2018 15 17 32 Zika prevention working with adolescents of the Municipality, district of Health, and Masculinities and Zika Development of masculinity, sexuality and zika prevention workshop for 1 February 16, 2018 20 22 42 Prevention young people representing the youth leadership program. Portoviejo Safe water and Zika Strengthening workshop directed to members of the "Junta del Agua" 1 February 20, 2018 45 40 85 prevention on water safe issues, Zika's Prevention and vector control. Portoviejo Safe water and Zika Strengthening workshop directed to members of the "Junta del Agua" 1 February 23, 2018 13 15 28 prevention on water safe issues, Zika's Prevention and vector control. Portoviejo Innovative Methodologies for Workshop on methodology with educommunicative pedagogical tools 1 February 24, 2018 7 19 26 Zika prevention directed to health technicians, Municipality and community monitors. Safe water and Zika Strengthening workshop directed to members of the "Junta del Agua" 1 March 2, 2018 26 8 34 prevention on safe water issues, Zika's Prevention and integral vector control. Innovative Methodologies for Workshop of implementation of training guide with innovative 1 March 6, 2018 33 4 37 Zika prevention methodologies for Zika prevention Innovative Methodologies for Zika's Prevention workshop with innovative methodologies. Portoviejo 1 March 8, 2018 16 22 38 Zika prevention Training - validation of the guidance for counseling in homes and Zika Prevention 1 March 17, 2018 12 21 33 communities Training workshop - validation of the psychosocial support guide with Psychosocial support guide 1 March 17, 2018 3 5 8 health personnel of the assigned areas for the project in the health Training workshop - validation of the psychosocial support guide for Psychosocial support guide 1 March 21, 2018 1 5 6 pregnant women Zika Prevention Workshop aimed at young people in the "El Floron" Zika Prevention 1 March 23, 2018 54 45 99 sector. Portoviejo Training workshop of Zika prevention for adolescents in the parish Zika Prevention 1 March 26, 2018 44 32 76 "Andrés de Vera" . Porotviejo
Zika Prevention Workshop on Zika virus disease with neighborhood presidents 1 March 26, 2018 49 24 73
Innovative Methodologies for Training in innovative communication methodologies for the prevention 1 March 28, 2018 2 17 19 Zika prevention of Zika focused in territories with disaster risk, directed to teachers. Clinical and Epidemiological Training in clinical and epidemiological management of Zika infection 1 April 2, 2018 25 60 85 manegement of Zika and its complications, addressed to physicians of the health units in Risks and Complications of Training aimed at pregnant women on the risks of the Zika virus and 1 April 5, 2018 2 20 22 Zika in Pregnant Women prevention Innovative Methodologies for Training aimed at teachers of the Pedernales´s Educational Units, to 1 April 7, 2018 11 34 45 Zika prevention promote the use of innovative methodologies to work Zika prevention Training directed to young people of Jama on the risks of the Zika virus Zika Prevention 1 April 8, 2018 36 12 48 and prevention of sexual transmission. Jama Innovative Methodologies for Training aimed at teachers to promote the use of educational tools to 1 April 9, 2018 14 9 23 Zika prevention encourage children to be protagonists in the prevention of Zika. Innovative Methodologies for Training aimed at teachers to promote the use of tools and education 1 April 10, 2018 16 14 30 Zika prevention to encourage children to be protagonists in the prevention of Zika Clinical and Epidemiological Training workshop in clinical epidemiological and management integral 1 April 12, 2018 65 45 110 manegement of Zika actions of surveillance and prevention of Zika virus infection and its Safe water and Zika Training workshop on safe water, Zika's Prevention and integral vector 1 April 12, 2018 19 10 29 prevention control, aimed at members of the "Juntas de Agua" Clinical and Epidemiological Training workshop for local artists on innovative methodologies for 1 April 12, 2018 10 15 25 manegement of Zika working with children Water safe and Zika Safe water management and prevention of Zika and other diseases 1 April 17, 2018 5 6 11 pprevention caused by Aedes in the community of Mache. Jama Training for children and adolescents of "Tamarindo" to develop actions Zika prevention and control 1 April 17, 2018 16 16 32 for the prevention and control of Zika, recovering their own cultural Training in vector control strategies and health care aimed at Zika Prevention 1 April 19, 2018 42 33 0 adolescents from educational units in Pedernales
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | LVI
# of Total Training (Short Name) Curricula (Long name) Training Dates F M Days Trained Training in vector control strategies and health care aimed at adolescents from Zika Prevention 1 April 23, 2018 42 33 75 educational units in Pedernales Training in strategies and practices for vector prevention and control with community Zika prevention and control 1 April 24, 2018 43 36 79 participation directed to the technicians of the Municipality. Training in the development of Zika prevention and control actions, promoting health Zika Prevention 1 April 27, 2018 16 16 32 and personal care Training for children and adolescents of "Tamarindo" to develop actions for the Zika prevention and control 1 April 28, 2018 16 16 32 prevention and control of Zika, recovering their own cultural manifestations. Portoviejo Healthy Municipalities and Training workshop in Healthy Municipalities, methodological transfers with 4 1 May 2, 2018 25 18 43 Zika Prevention municipalities from Manabi and 1 from Esmeraldas and Districts of Health Replica workshop with young people trained on sensitization and prevention of Zika Zika Prevention 1 May 8, 2018 34 24 58 risks. Pedernales Safe water and Zika Strengthening workshop directed to members of the "Juntas de Agua" in safe water 1 May 10, 2018 19 10 29 prevention management, Zika's Prevention and integral control of the vector. Pedernales Innovative Methodologies for Training workshop for local artists on innovative methodologies for working with 1 May 10, 2018 10 15 25 Zika prevention children. Pedernales Workshop for the development and implementation of preventive measures for integral Vector control 1 May 10, 2018 19 10 29 vector control of Zika at the community level directed at local health personnel. Jama Community Based Introductory workshop for young people on the community surveillance pilot 1 May 10, 2018 125 162 287 Surveillance System (CBSS) Innovative Methodologies for Workshop to validate the implementation of a training guide with pedagogical tools on 1 May 11, 2018 13 13 26 Zika prevention Zika vector prevention and control Community Based Training to volunteer community monitors of the community surveillance system. The 1 May 16, 2018 0 0 0 Surveillance System (CBSS) Piñonada. Portoviejo Manabí Community Based Training in vector characteristics, risks, control and prevention of Zika to teachers of the 1 2018-05-31 0 0 0 Surveillance System (CBSS) Leonidas Proaño school. Huaquillas Zika Prevention in Workshop in prevention of Zika, "Es mi deber" (it is my task) and the importance of a 1 June 2, 2018 26 32 58 adolescents responsible sexuality to prevent risk of Zika and unplanned pregnancies in adolescence. Zika Prevention in Zika Prevention Workshop aimed at parents of the "Antonio Elias Cedeño Jerves" School, 1 June 2, 2018 8 24 32 adolescents San Isidro. Sucre Zika prevention workshop for parents of the CDI of the "Santa Teresa" community in the Zika Prevention 1 June 5, 2018 1 14 15 "Charapoto" parish. Sucre Zika Prevention in Training workshop on Zika prevention and unplanned pregnancy in adolescents. 1 June 5, 2018 19 13 32 adolescents "Gonzalo Cordova" Educational Unit. Sucre
Zika Prevention Workshop on Prevention and risks of Zika. San Vicente 1 June 6, 2018 17 17 34
Zika Prevention in Training workshop on Zika prevention and unplanned pregnancy in adolescents. 1 June 13, 2018 25 17 42 adolescents "Gonzalo Cordova" Educational Unit. Sucre Risks and Complications of Workshop: sensitization and prevention of Zika virus and risk on pregnant and 1 June 15, 2018 20 27 47 Zika in Pregnant Women reproductive age women. To volunteers in risk management. Jama
Community Based Workshop and exchange experience between community monitors of Chamanga and 1 June 18, 2018 17 19 36 Surveillance System (CBSS) vector control brigades of district 08D03. Muisne Training in Clinical and epidemiological and management of the Zika virus in the manual Clinical and Epidemiological of "SIVE ALERTA", directed to rural professionals of health units. San Vicente. District 1 July 7, 2018 12 10 22 manegement of Zika 13D11 Training in Clinical and epidemiological management of the Zika virus in the manual of Clinical and Epidemiological "SIVE ALERTA" directed to rural professionals of health units. San Vicente. District 1 July 12, 2018 9 20 29 manegement of Zika 13D11 "Hablemos sobre el Zika, es algo serio" (Let's talk about Zika, it is something serious). Zika Prevention 1 July 13, 2018 32 53 85 Parents of the school "6 de Diciembre". San Isidro. Sucre Sexuality and Zika Risks Informative session about sexual and reproductive health and prevention of Zika, in the 1 July 23, 2018 4 8 12 Prevention educational unit Cesar Delgado Lucas. Portoviejo Training in Prevention and control of Zika, aimed at community leaders who support Zika prevention and control 1 July 27, 2018 0 0 0 health units Muisne
LVII | USAID ZIKA ANNUAL REPORT USAID.GOV
# of Total Training (Short Name) Curricula (Long name) Training Dates F M Days Trained Clinical and Epidemiological Training in epidemiological clinical management of Zika infection and its complications. 1 August 4, 2018 13 12 25 manegement of Zika Muisne Risks and Complications of Training on the counseling manual of the risks of Zika in pregnant women with health 1 August 5, 2018 5 19 24 Zika in Pregnant Women centers and "CNH" directed to communities in Arenillas Innovative Methodologies for Replica, with young people, of the training in innovative methodologies. Pedernales 1 August 20, 2018 3 2 5 Zika prevention Community Based Workshop to inform and present progress of the pilot project and CBSS for vector 1 August 22, 2018 11 17 28 Surveillance System (CBSS) control aimed at neighborhood leaders (pilot phase). Muisne Training for adolescents in "Los Cerezos" Educational Unit for mural construction Zika prevention and control 1 September 28, 2018 20 12 32 processes. Portoviejo Vector Control and Training to local committees of Health on the best practices for the integral vector 1 September 20, 2018 87 20 107 Prevention Practices control at community level. Muisne
2.563 2.376 4.939 TOTAL ECUADOR
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | LVIII Annex III Training Report PERU
# of Total Training (Short Name) Curricula (Long name) Training Dates F M Days Trained Training with "10 Minutos Contra el Zika" (10 Minutes Against Zika) in Healthcare Center "Monte Vector Control Protocols 1 October 3, 2017 12 4 16 Sullon Catacaos". ACS Training with "10 Minutos Contra el Zika" (10 Minutes Against Zika) in Healthcare Center "Monte Vector Control Protocols 1 October 10, 2017 22 22 Sullon Catacaos". ACS Vector Control Protocol Workshop on "10 Minutos Contra el Zika" (10 Minutes Against Zika) for Vector Control Protocols 1 October 12, 2017 270 134 404 Teachers in "Ugel Sullana" Communication strategies for Educational Workshop for Couples on Zika Prevention, Educational Institution "Enrique Lopez the Zika prevention 1 October 14, 2017 30 18 48 Albujar"
Prevention, Personal Care, Face‐to‐face Course to strengthen Knowledge, Prevention and Protection Tactics for Dengue, Zika, 1 October 14, 2017 258 68 326 Vector Control Surveillance and Chikungunya Prevention, Personal Care, Face‐to‐face Course to strengthen Knowledge, Prevention and Protection Tactics for Dengue, Zika, 1 October 15, 2017 134 54 188 Vector Control Surveillance and Chikungunya ACS Training with "10 Minutos Contra el Zika" (10 Minutes Against Zika) in Healthcare Center Vector Control Protocols 1 October 23, 2017 22 22 "Consuelo de Velasco" Prevention, Personal Care, Training for Pregnant Women on Zika´s Prevention, Healthcare center "Monte Sullon" 1 October 23, 2017 90 4 94 Vector Control Surveillance Training on "10 Minutos Contra el Zika" (10 Minutes Against Zika) Strategy for the Directors of Vector Control Protocols 1 October 24, 2017 62 26 88 the Educational Institution "San Gabriel" Prevention, Personal Care, Formative Workshop on Zika´s Prevention to the Teachers in Educational Institution "UGEL 1 October 26, 2017 11 11 22 Vector Control Surveillance Zorritos" Communication strategies for Workshop for Teachers in Pairs , Educational Institution " MONTE CASTILLO CATACAOS" 1 October 26, 2017 24 20 44 the Zika prevention Vector Control Protocols Workshop on Training for New Vector Control Protocols 1 October 27, 2017 12 12 Prevention, Personal Care, Workshop on Teacher´s Formation in Zika Prevention, Educational Institutions "Ugel Tumbes" 1 October 27, 2017 26 5 31 Vector Control Surveillance Communication strategies for the Zika prevention Workshop for Teachers in Pairs , Educational Institution "Divino Maestro Sechura" 1 October 27, 2017 16 16 32
Communication strategies for the Zika prevention Training for Teachers, Educational Institution "Micaela Bastidas Mancora" 1 October 30, 2017 34 18 52
Communication strategies for the Zika prevention Training for Teachers, Educational Institution "Micaela Bastidas Mancora" 1 October 31, 2017 38 6 44
Communication strategies for Workshop for Teachers in Pairs for Zika Prevention, Educational Institution "SAN RAMON the Zika prevention 1 November 3, 2017 20 18 38 CHULUCANAS"
Worshop on Protocol "10 Minutos Contra el Zika" (10 Minutes Against Zika)", Healthcare Center " Vector Control Protocols 1 November 9, 2017 26 4 30 ORGANOS" Training for Social Organizations in "10 Minutos Contra el Zika" (10 Minutes Against Zika)", Vector Control Protocols 1 November 13, 2017 82 14 96 Healthcare Center " COMUNIDAD SALUDABLE SULLANA" Budget program (PpR) Training Workshop in PPR017 for CHICLAYO Public Workers 1 November 14, 2017 8 9 17 Vector Control Protocols Workshop on Training for New Vector Control Protocols for the Personel of DES, Tumbes 1 November 23, 2017 30 4 34 Communication strategies for Final Revision Workshop and Adjustments in Zika´s Prevention Guide, "CASA CLUB SULLANA" 1 November 24, 2017 12 20 32 the Zika prevention Vector Control Protocols Implementation of New Vector Control Protocols 1 November 24, 2017 29 6 35 Training Workshop on the Implementation of New Vector Control Protocols for DESA personnel in Vector Control Protocols 1 November 24, 2017 29 6 35 "TUMBES" Communication strategies for Educational Workshop in Pairs , Educational Institution "MARiA CoRDOVA DE TALLEDO 1 November 27, 2017 24 30 54 the Zika prevention BELLAVISTA SULLANA" Training Workshop on the Implementation of New Vector Control Protocols for DESA personnel in Vector Control Protocols 1 November 28, 2017 23 11 34 "TUMBES" Communication strategies for Workshop for Teachers in Pairs , Educational Institution "SANTA TERESA DE JESuS SULLANA" 1 November 28, 2017 54 22 76 the Zika prevention Prevention, Personal Care, Elaboration of 2018 Working Plan of the Multisectorial Committee "SECHURA SALA DE 1 November 29, 2017 16 12 28 Vector Control Surveillance REGIDORES MPS" Vector Control Protocols Training Workshop on the Implementation of New Vector Control Protocols for DESA personnel 1 November 29, 2017 30 2 32 Communication strategies for Training for Teachers, Educational Institution "Micaela Bastidas Mancora" 1 November 29, 2017 40 32 72 the Zika prevention Vector Control Protocols Implementation of New Vector Control Protocols 1 November 30, 2017 25 25 Training Workshop on the Implementation of New Vector Control Protocols for DESA personnel in Vector Control Protocols 1 November 30, 2017 25 25 "TUMBES" Communication strategies for Workshop for Teachers in Pairs Educational Institution " LOS ORGANOS" 1 November 30, 2017 28 30 58 the Zika prevention Training Workshop on the Implementation of New Vector Control Protocols for DESA personnel in Vector Control Protocols 1 December 1, 2017 6 16 22 "TUMBES" Vector Control Protocols Workshop on Handling and Use of Portfolios with ACS 1 December 4, 2017 44 20 64 Vector Control Protocols Workshop on Handling and Use of Portfolios with ACS 1 December 6, 2017 23 4 27 Vector Control Protocols Workshop on New Vector Control Protocols 1 December 7, 2017 18 9 27 Community Monitoring System Workshop on Diagnosing and Validating Community Monitoring System "BOCAPAM" 1 December 13, 2017 6 5 11
LIX | USAID ZIKA ANNUAL REPORT USAID.GOV # of Total Training (Short Name) Curricula (Long name) Training Dates F M Days Trained Prevention Counseling and Care Counseling Workshop on ZIKA for Pregnant Women and Fertile Age Women. 1 January 25, 2018 21 1 22 Provision Vector Control Protocols Training Worshop to Help in Protocols and Vector Control 1 January 29, 2018 17 12 29 Vector Control Protocols Training Workshop on Vector Control Protocols 1 January 31, 2018 28 32 60 Prevention, Personal Care, Workshop on Protocol Replication 1Y2 DISA CARE JAeN 1 February 6, 2018 30 6 36 Vector Control Surveillance Vector Control Protocols Training for Community Health Agents 1 February 16, 2018 17 13 30 PPR Technical Assistance for Local Governments for PPR Articulation 1 February 16, 2018 23 20 43 Atention Protocols Workshop on Clinic Handling of Zika for Healthcare Personnel 1 February 17, 2018 27 3 30 Vector Control Protocols Workshop on Vector Control Protocols for Sanitary Inspectors "SRSLCC" 1 February 19, 2018 22 18 40 Community training workshop in maps of risks aimed at community monitors of the project and Community Monitoring community leaders of the Campo Amor locality of the district of Zarumilla 1 February 20, 2018 21 11 32
Training workshop in ovitraps directed to community monitors of the project and community Community Monitoring 1 February 21, 2018 14 2 16 leaders of the campo Amor district of Zarumilla Prevention, Personal Care, Training Workshop on Zika Prevention 1 February 21, 2018 5 16 21 Vector Control Surveillance Vector Control Protocols Workshop on vector control protocols for personnel of health promotion 1 February 22, 2018 16 5 21 Workshop training in the campaign "the 10 minutes against the zika", directed to community Vector Control Protocols 1 February 23, 2018 10 1 11 monitors of the project and community leaders of "Campo Amor" of the District of Zarumilla Vector Control Protocols Training workshop in vector control protocols directed to sanitary inspectors SRSMH 1 March 1, 2018 23 5 28 Workshop of protocols of the 10 minutes against the zika and collection of breeding sites directed Vector Control Protocols 1 March 3, 2018 18 2 20 to ACSs Prevention and Care Provision Workshop on Clinic Handling of Zika for Healthcare Personnel 1 March 3, 2018 22 7 29 Workshop of protocols of the 10 minutes against the zika and collection of breeding sites directed Vector Control Protocols 1 March 3, 2018 32 2 34 to ACSs Communication strategies for Training workshop for teachers in handling the zika prevention guide 1 March 5, 2018 13 9 22 the Zika prevention TECHNICAL ASSISTANCE WORKSHOP FOR THE PROGRAMMING OF RESOURCES OF THE BUDGET Budget program 1 March 6, 2018 10 7 17 HEALTH PROGRAMS IN THE MUNICIPAL BUDGET Information System PRESENTATION OF THE PROPOSAL OF INFORMATION SYSTEM BASED ON THE COMMUNITY 1 March 9, 2018 6 7 13 Communication strategies for Training workshop for teachers in handling the zika prevention guide 1 March 9, 2018 26 23 49 the Zika prevention Communication strategies for Training workshop for teachers in handling the zika prevention guide 1 March 15, 2018 21 9 30 the Zika prevention Counseling, Prevention, and Training Workshop to Counseling Assistants on Zika for pregnant and fertile Women 1 March 16, 2018 13 4 17 Care Provision Counseling, Prevention, and 1 March 17, 2018 22 2 24 Care Provision Communication strategies for Training Workshop for Teachers and Directors 1 March 17, 2018 63 22 85 the Zika prevention Communication strategies for Training Workshop for Teachers and Directors 1 March 19, 2018 18 18 36 the Zika prevention Counseling, Prevention, and Training Workshop to Counseling Assistants on Zika for pregnant and fertile Women 1 March 21, 2018 26 4 30 Care Provision Communication strategies for Training Workshop for Teachers and Directors 1 March 22, 2018 11 3 14 the Zika prevention Communication strategies for Training workshop in use of the guide and modules of prevention of the Z+B16ika 1 March 23, 2018 20 6 26 the Zika prevention Vector Control Protocols Training workshop in vector control protocols directed to sanitary inspectors 1 March 23, 2018 19 11 30 Communication strategies for Training Workshop for Teachers and Directors 1 March 23, 2018 19 14 33 the Zika prevention Communication strategies for Training Workshop for Teachers and Directors 1 March 24, 2018 44 25 69 the Zika prevention Communication strategies for Training Workshop for Teachers and Directors 1 March 25, 2018 11 3 14 the Zika prevention Communication strategies for Training Workshop for Teachers and Directors 1 March 28, 2018 27 16 43 the Zika prevention Prevention and Care Provision Counseling worksohp in Zika 1 April 2, 2018 11 11 Communication strategies for Training workshop for teaching staff in use of the Zika guide 1 April 4, 2018 25 4 29 the Zika prevention Vector Control Protocols Workshop on Training on Vector Control Protocols 1 April 4, 2018 28 2 30 Vector Control Protocols Workshop on Training for New Vector Control Protocols 1 April 6, 2018 469 469 Communication strategies for Training Workshop for Teachers and Directors 1 April 7, 2018 10 10 20 the Zika prevention Vector Control Protocols Workshop on Training for New Vector Control Protocols 1 April 7, 2018 11 10 21
Vector Control Protocols 1 April 10, 2018 10 2 12 Training of ACS in the "10 minutes against Zika" protocol Training of monitors of Aguas Verdes in protocols of vector control, ovitraps and the "10 minutes Vector Control Protocols 1 April 10, 2018 32 4 36 against Zika" Communication strategies for Personal training workshop in use of the Zika prevention guide 1 April 11, 2018 16 14 30 the Zika prevention
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | LX Annex III Training Report PERU
# of Total Training (Short Name) Curricula (Long name) Training Dates F M Days Trained Workshop replica for local level people to implement new protocols about vectors, prevention and Vector Control 1 April 12, 2018 20 3 23 control of Zika Counseling, Prevention, and Training Workshop to Counseling Assistants on Zika for pregnant and WRA 1 April 13, 2018 20 20 Care Provision Counseling, Prevention, and Training Workshop to Counseling Assistants on Zika for pregnant and WRA 1 April 14, 2018 19 19 Care Provision Vector Control Protocols Workshop on Training for New Vector Control Protocols 1 April 14, 2018 29 8 37 Counseling, Prevention, and Training Workshop to Counseling Assistants on Zika for pregnant and WRA 1 April 16, 2018 11 11 Care Provision Counseling, Prevention, and Training Workshop to Counseling Assistants on Zika for pregnant and WRA 1 April 17, 2018 11 11 Care Provision Communication strategies for Training Workshop for Teachers and Directors 1 April 18, 2018 16 11 27 the Zika prevention Counseling, Prevention, and Training Workshop to Counseling Assistants on Zika for pregnant and fertile Women 1 April 19, 2018 17 17 Care Provision Workshop of training in prevention of zika, dengue and chikungunya and in the protocol of the 10 Vector Control Protocols 1 April 20, 2018 2 20 22 minutes against Zika Vector Control Workshop on Training for New Vector Control Protocols 1 April 21, 2018 8 2 10 Prevention and Care Provision Training Workshop to Counseling Assistants on Zika for pregnant and fertile Women 1 April 24, 2018 18119 Vector Control Training event in community maps 1 April 24, 2018 161834 Community workshop training in maps of risks directed to community monitors of the district of Information System 1 April 25, 2018 9 3 12 "Aguas Verdes" Vector Control Training workshop in ovitraps management 1 April 25, 2018 18 13 31 Training of monitors of Aguas Verdes in protocols of vector control, ovitraps and the "10 minutes Vector Control 1 April 26, 2018 11 4 15 against Zika" Information System Training and induction workshop to community monitors 1 April 26, 2018 16 4 20 Prevention, Personal Care, Training workshop directed to promoters of health in sexual health and reproductivity 1 May 2, 2018 15 15 Vector Control Surveillance Vector Control Ovitraps training workshop to community monitors 1 May 2, 2018 16 1 17 Communication strategies for Workshop for Teachers and Directos in the Use of Zika´s Guide 1 May 4, 2018 11 11 the Zika prevention Communication strategies for Workshop for Teachers and Directos in the Use of Zika´s Guide 1 May 4, 2018 2 21 23 the Zika prevention Communication strategies for Workshop for Teachers and Directos in the Use of Zika´s Guide 1 May 9, 2018 15 4 19 the Zika prevention Communication strategies for Workshop for Teachers and Directos in the Use of Zika´s Guide 1 May 10, 2018 17 9 26 the Zika prevention Prevention, Personal Care, 1 May 17, 2018 24 7 31 Vector Control Surveillance Zika Training Workshop for Community Agents Communication strategies for Training workshop for couple educators for the prevention of Zika 1 May 19, 2018 25 18 43 the Zika prevention Communication strategies for Training Workshop for Teachers and Directors 1 May 21, 2018 45 20 65 the Zika prevention Counseling, Prevention, and Training Workshop to Counseling Assistants on Zika for pregnant and fertile Women 1 May 23, 2018 13 1 14 Care Provision Information System Training workshopto implement the community‐based surveillance system (CBSS) 1 May 23, 2018 18 9 27 Communication strategies for Training workshopto implement the community‐based surveillance system (CBSS) 1 May 23, 2018 35 35 70 the Zika prevention Communication strategies for Training workshop for couple educators for the prevention of Zika 1 May 24, 2018 12 14 26 the Zika prevention Vector Control Protocols Workshop on Training on Vector Control Protocols to monitors 1 June 1, 2018 14 1 15 Communication strategies for Training workshop for facilitators in educational guides of ZIKA 1 June 6, 2018 39 6 45 the Zika prevention Counseling, Prevention, and Training Workshop to Counseling Assistants on Zika for pregnant and fertile Women 1 June 13, 2018 16 2 18 Care Provision Training workshop for health personnel in the mobile application for the community‐based Information System 1 June 13, 2018 8 10 18 surveillance system Vector Control Protocols Training Workshop on Vector Control Protocols for camp inspectors 1 June 13, 2018 29 8 37 Communication strategies for Workshop on promotion of prevention measures about Zika 1 June 18, 2018 63 22 85 the Zika prevention Vector Control Protocols Training for local actors to implement new protocols for the control of vectors and prevention of th 1 June 19, 2018 38 9 47 Training of monitors of Aguas Verdes in protocols of vector control, ovitraps and the "10 minutes Vector Control Protocols 1 June 20, 2018 8 2 10 against Zika" Communication strategies for Workshop on promotion of prevention measures about Zika 1 June 20, 2018 10 3 13 the Zika prevention Communication strategies for 1 June 20, 2018 21 12 33 the Zika prevention Training workshop for patient educators for the prevention of Zika Vector Control Protocols Workshop on Training on Vector Control Protocols to monitors 1 June 27, 2018 13 1 14 Information System Induction , risk maps and sectorization CBSS workshop 1 June 27, 2018 16 1 17 Information System Training workshop in the 10 minutes against Zika 1 June 28, 2018 13 1 14 Vector Control Protocols Training workshop of community agents in the 10 minutes against Zika 1 June 30, 2018 10 3 13 Communication strategies for Workshop of training to the teachers on promotion of a culture of prevention against the Zika 1 July 3, 2018 6 6 12 the Zika prevention Workshop on basic knowledge of zika, ovitrampas and protocols of control vector directed to Community Monitoring 1 July 4, 2018 9 3 12 monitors CBSS of Castilla and Sechura Information System Workshop of the use of the application directed to CBSS monitors of "27 de Octubre" 1 July 5, 2018 15 3 18 Information System Workshop of the use of the application directed to CBSS monitors of "27 de Octubre" 1 July 6, 2018 12 12
LXI | USAID ZIKA ANNUAL REPORT USAID.GOV # of Total Training (Short Name) Curricula (Long name) Training Dates F M Days Trained Vector Control Protocols Training workshop on breeding sites elimination protocols with Jaen and Bellavista´s health 1 July 7, 2018 26 4 30 Training workshop on general aspects of Zika, community participation and Community Vector Control Protocols 1 July 9, 2018 19 3 22 Monitoring directed to community monitors of the District of Zarumilla and Tumbes Communication strategies for Training workshop pair educators 1 July 9, 2018 17 16 33 the Zika prevention Training of monitors of Castilla and Sechura in protocols of vector control, ovitraps and the "10 Community Monitoring 1 July 10, 2018 10 1 11 minutes against Zika" Community Monitoring Training workshop in traps, dialogue and community participation protocol 1 July 10, 2018 14 2 16 Communication strategies for Training workshop for pair educators 1 July 10, 2018 12 6 18 the Zika prevention Communication strategies for Training workshop to educators in promotion of a culture of prevention "Together against Zika" 1 July 11, 2018 8 4 12 the Zika prevention Community Monitoring Training for monitors de Castilla and Sechura in rol and community dialogue. 1 July 11, 2018 15 2 17 Prevention, Personal Care, Training workshop for the correct management of ovitraps to community monitors of the District 1 July 11, 2018 13 7 20 Vector Control Surveillance of Tumbes Communication strategies for Training workshop for teachers in handling the Zika prevention guide 1 July 11, 2018 13 10 23 the Zika prevention Information System Workshop of the use of the application directed to CBSS monitors of "San Antonio" 1 July 12, 2018 7 4 11 PPR WORKSHOP OF MANAGEMENT OF BUDGET PROGRAMS IN HEALTH 1 July 12, 2018 12 9 21 Communication strategies for Training workshop for teachers in handling the zika prevention guide 1 July 12, 2018 54 26 80 the Zika prevention Information System Workshop of the use of the application directed to CBSS monitors of "Los Organos" and Mancora 1 July 17, 2018 8 311 Community Monitoring Training to community agents of health in registration, training and views to families 1 July 18, 2018 10 2 12 Communication strategies for 1 July 18, 2018 9 7 16 the Zika prevention Training workshop to educators in promotion of a culture of prevention "Together against Zika Communication strategies for Training workshop for teachers in handling the zika prevention guide 1 July 19, 2018 19 11 30 the Zika prevention Communication strategies for Training workshop for teachers in handling the zika prevention guide 1 July 19, 2018 20 11 31 the Zika prevention Vector Control Protocols Protocol 3: collection and elimination of nests 1 July 23, 2018 12 1 13 Training course in protocols: collection and elimination of breeding sites or potential breeding Vector Control Protocols sites of mosquitoes. Protocol 4: ten minutes against zika and sectorization and communal 1 July 25, 2018 11 3 14 mapping for the implementation of the community‐based surveillance system To Monitors of the Vector Control Protocols Training workshop on breeding sites elimination protocols with Jaen and Bellavista´s health 1 August 7, 2018 26 4 30 Sensitization workshop with presidents and mothers of the "club de la leche" of the chiclayo Prevention and Care Provision 1 August 17, 2018 21 4 25 municipality Information System Workshop Replica of Training to Health Personnel in a Community Based Surveillance System 1 August 18, 2018 21 7 28 Prevention and Care Provision Training for Teachers in Educational Institutions 1 August 21, 2018 14 19 33 Prevention and Care Provision Training for Teachers in Educational Institutions 1 August 22, 2018 10 11 21 Replication of Training and Formative Workshop on the development of Strategies to Promote a Prevention and Care Provision 1 August 23, 2018 12 3 15 Prevention Culture against ZIKA Prevention and Care Provision Training for Teachers in Educational Institutions 1 August 23, 2018 17 3 20 Communication strategies for Training for Teachers in Educational Institutions 1 August 23, 2018 28 14 42 the Zika prevention Replication of Training and Formative Workshop on the development of Strategies to Promote a Prevention and Care Provision 1 August 24, 2018 5 6 11 Prevention Culture against ZIKA Prevention and Care Provision Training for Teachers in Educational Institutions 1 August 24, 2018 29 11 40 Replication of Training and Formative Workshop on the development of Strategies to Promote a Prevention and Care Provision 1 August 25, 2018 5 6 11 Prevention Culture against ZIKA Prevention and Care Provision Training for Teachers in Educational Institutions 1 August 27, 2018 13 10 23 Communication strategies for Training for Teachers in Educational Institutions 1 August 27, 2018 15 11 26 the Zika prevention Workshop replica of the r3 in the district of Tumbes to health personnel in the community‐based Information System 1 August 28, 2018 10 3 13 surveillance system Replication of Training and Formative Workshop on the development of Strategies to Promote a Prevention and Care Provision 1 August 28, 2018 14 3 17 Prevention Culture against ZIKA Prevention and Care Provision Training for Teachers in Educational Institutions 1 August 28, 2018 24 21 45 Information System Workshop replica of the R3 to community monitors in the mobile application 1 August 29, 2018 19 1 20 Reinforcement workshop of community monitors of the localities of "Cuchareta Baja", "28 de Information System 1 September 3, 2018 10 1 11 Julio" and "Campo Amor" in the implementation of the GR codes in the mobile application
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | LXII # of Total Training (Short Name) Curricula (Long name) Training Dates F M Days Trained Information System Community crochis codification workshop 1 September 3, 2018 10 1 11 Prevention and Care Provision Training for Teachers in Educational Institutions 1 September 3, 2018 6 22 28 Information System Community crochis codification workshop 1 September 4, 2018 9 1 10 Prevention and Care Provision Training for Teachers in Educational Institutions 1 September 4, 2018 7 5 12 Replication of Training and Formative Workshop on the development of Strategies to Promote a Prevention and Care Provision 1 September 4, 2018 8 8 16 Prevention Culture against ZIKA Information System Workshop of risk map with community monitors INDECI 1 September 4, 2018 18 2 20 Replication of Training and Formative Workshop on the development of Strategies to Promote a Prevention and Care Provision 1 September 5, 2018 7 7 14 Prevention Culture against Zika Communication strategies for Binational workshop communication for social change in the prevention of zika 1 September 5, 2018 13 4 17 the Zika prevention Prevention and Care Provision Training for Teachers in Educational Institutions 1 September 5, 2018 22 21 43 Counseling, Prevention, and Training Workshop to Counseling Assistants on Zika for pregnant and fertile Women 1 September 6, 2018 18 1 19 Care Provision Replication of Training and Formative Workshop on the development of Strategies to Promote a Prevention and Care Provision 1 September 7, 2018 9 3 12 Prevention Culture against Zika Prevention and Care Provision Training for Teachers in Educational Institutions 1 September 7, 2018 8 9 17 Prevention, Personal Care, Educational session to community Brigades of disaster risk management 1 September 9, 2018 44 40 84 Vector Control Surveillance Prevention and Care Provision Training for Teachers in Educational Institutions 1 September 10, 2018 7 23 30 Prevention and Care Provision Training for Teachers in Educational Institutions 1 September 11, 2018 16 19 35 Replication of Training and Formative Workshop on the development of Strategies to Promote a Prevention and Care Provision 1 September 11, 2018 24 11 35 Prevention Culture against Zika Replication of Training and Formative Workshop on the development of Strategies to Promote a Prevention and Care Provision 1 September 13, 2018 8 7 15 Prevention Culture against Zika Communication strategies for GO MOSQUITO Workshop, GLOBE Zika education and prevention 1 September 17, 2018 16 10 26 the Zika prevention Information System Training workshop to MC of the CBSS in Castilla and "26 de octubre" 1 September 19, 2018 11 11 Information System Training workshop to MC of the CBSS in Castilla and "26 de octubre" 1 September 20, 2018 12 1 13 Vector Control Protocols Workshop to evaluation of the vector control protocol 1 September 20, 2018 20 5 25 Information System Workshop of training to MC of the CBSS in Castilla and "26 de Octubre" in handling of the 1 September 21, 2018141 15 Information System Training workshop on the use of the CBSS application 1 September 28, 2018 17 7 24 PERU: TOTAL TRAINED 4222 2359 6581
LXIII | USAID ZIKA ANNUAL REPORT USAID.GOV ANNEX IV PICTURES (EVENTS, TRAININGS ETC.)
ECUADOR PICTURES
Link: https://drive.google.com/drive/folders/1rN0llFaURxW8X4-L03VXWq7Qf7YcP78t
Children and teenagers build up prevention messages about Zika with verses, songs and dance of the cultures Afro-Ecuadorian and Montubia. Health personnel are trained in methodologies to improve counselling and containment of pregnant women. In the Project Zika Reponse in Ecuador and Peru, in coordination with women's organizations, it carries out informative activities to prevent violence in the context of the sexual transmission of the virus. In the cantons recreational fairs are held to inform the community about Zika virus Journalist and communicators were trained in prevention and control of Zika. Meeting of the Binational Health Committee. Zarumilla – Tumbes - Perú Huaquillas – Ecuador Messages and pieces of communications of the campaign “Todos contra el Zika” were build up with the participation of local people. Pregnant women receive information in their residence during the elimination of hatcheries of mosquito Aedes aegypti. Teenagers were trained in sexuality, violence prevention and sexual transmission of Zika. Technicians and authorities of the Authonomous Governments of Portoviejo, Arenillas, Las Lajas, Pedernales y Sucre recept advisory to fulfill with the “Programa de Municipios Saludables del MSP”. Teachers and local people were trained in literature, theater, art, video, photography and brain gym so that through culture and art raise up children and teenagers about Zika and how to delete proliferation of hatcheries. The project Zika Respond in Ecuador and Peru hold fairs in schools to inform about the Zika virus. Vector control in residences are in charge of the community promotors. This activity is done once a week. The reports are delivered to the nearest health unit. Workshop with pregnant women about Zika risks and the personal protection measurements to prevent the mosquito bit. Zika sexual transmission is diffused trough massive events and training workshops with women and men in reproductive age.
PERU Pictures
Link: https://drive.google.com/drive/folders/1EDJoJX8DNm2NNCLDA15oMH_da84C-eoN
Award for Best Practices in Prevention Zika Virus Edition 2018 Community health agents receive recognition of their work. Tumbes - Peru. Mobile ZIKA campaign in the Piura region. Men disseminate messages of Zika prevention. Peru. School fair for the prevention of Zika-Piura virus Villagers in the community carry out the control and destruction of hatcheries. This activity has a lot of emphasis at the community level
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | LXIV Community health monitors and agents periodically conduct home visits to inform families about the prevention of Zika virus. Campo Amor-Tumbes Observation of Ovitraps. Campo Amor-Tumbes. Recognition of the Ministry of Education Project Zika Respond in Ecuador and Peru. "Allies for Education" Trainings for teachers and teenagers as peer educators has been a cross-cutting strategy in the intervention of the entire project. Workshop with specialists in health promotion and educational management for validation of the comprehensive guide to promoting a culture of prevention Zika virus in schools. Link: https://drive.google.com/drive/folders/1EDJoJX8DNm2NNCLDA15oMH_da84C-eoN
LXV | USAID ZIKA ANNUAL REPORT USAID.GOV ANNEX V SUB-GRANTS UNDER THE ACTIVITY
Awardee Name: CARE Country: Ecuador & Peru
Cooperative for Assistance & Relief
Everywhere
Award Name: “Zika Response in Ecuador Award Number: AID-OAA-A-16-00078 and Peru”
Start Date: 30/ 09/ 2016 End Date: 29/ 09/ 2019
Submission Date 15 / 12 / 2016
Total Amount $ 7,000,000.00
Reporting Period: October 1, 2017 - September 30, 2018
Awardee HQ Contact Name and Title: Alexandra Moncada
Country Director, Ecuador
Awardee HQ Contact Address: El Nacional N39-111 y El Telégrafo, Quito, Ecuador
Awardee HQ Contact Telephone +593 9 8 8388766 Number: +593 2 2433069
Awardee HQ Contact Email Address: [email protected]
Zika Response in Ecuador and Peru Two objectives to achieve in two phases over three years: To increase community, local and national capacities to deliver efficient and timely response to the Zika virus outbreak and other vector prone diseases through Disaster Risk Reduction (DRR) and Human Rights approaches based on CARE’s experience in SRMH (Sexual, Reproductive and Maternal Health), sustainable community health systems and empowerment to strengthen the direct involvement of communities, by community health agents (animadores), in Zika priority areas (prevention, and vector control).
To regional and national efforts to help decrease the rates of Zika transmission by sharing findings, impact results and influencing bi-national policy making through a deep and rigorous evidence-based approach of best practices and lessons learned in community mobilization and participation, to allow fast track, gender sensitive implementation strategies in diverse social and cultural contexts, increase coordination and planning capacities, refine an accurate monitoring system and a well-developed communication and dissemination strategy.
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | LXVI Geographic Focus
Ecuador: 10 cantons belonging to 3 provinces in the coastal region of the country: Esmeraldas (01), Manabi (06); El Oro (03).
Peru: 20 districts in the northern section of the country: Tumbes (04); Piura (11); Lambayeque (03) and Cajamarca (02).
Results and activities
Result 1.- Best practices in community participation and mobilization on prevention, promotion and practices regarding Zika identified.
Activity 1.- Evidence-Based Analysis of community based systems on roles and performance of vector control at household and community levels.
Activity 2.- KAP studies in selected areas on individual and collective behavior change regarding prevention, care giving to childbearing age women and pregnant women.
Activity 3.- Evidence-Based Analysis on inter-sector and community participation, roles and performance of community-based surveillance systems.
Result 2.- Best practices and lessons learned against Zika found through the EBA and KAP implemented immediately in priority risk areas.
Activity 1.- Training of local health and municipal personnel, and community health agents on new protocols based on EBA and KAP findings on vector control best practices and lessons learned.
LXVII | USAID ZIKA ANNUAL REPORT USAID.GOV Activity 2.- Based on EBA and KAP findings, develop and validate communication messages to improve knowledge and understanding on key risks of Zika, especially on microcephaly in babies of infected women, and key prevention and care giving practices.
Activity 3.- Applying best practices for integrated vector control involving families, communities, municipalities, health systems, community water management organizations.
Result 3.- System (Community Based Surveillance System) for local governments and community use to enable a continuous gathering and analysis of best practices at community level in use.
Activity 1.- Friendly information system (CBSS) linking health, local government and community services for registration, monitoring, analysis, planning and action, developed and validated (Pilot study).
Activity 2.- Friendly information system (CBSS) scaled-up in the intervention areas.
Activity 3.- Training of local health services personnel, local governments and community health workers on community-based follow-up and monitoring systems.
Result 4.- Communication strategy for behavior change among women of reproductive age, pregnant women and adolescents implemented using formal and informal means.
Activity 1.- Develop and validate a communication strategy (based on EBA and KAP findings) for improving knowledge and understanding on key risks of Zika, especially on microcephaly in babies of infected women, and key prevention and care giving practices.
Activity 2.- Within the framework of the communication strategy, identify the roles of stakeholders (community, local government and health services) and tools to be used for influencing knowledge building and behavior change.
Activity 3.- Implement a communications strategy aimed to women of reproductive age and pregnant women, addressing Zika prevention, health and personal care, vector control practices and surveillance practices.
Activity 4.- Implement a communications strategy aimed to primary and secondary school students addressing Zika prevention, health and personal care, vector control practices and surveillance practices.
Result .5.- Extend the strategies and protocols developed and applied locally to other areas of the country.
Activity 1.- In selected areas, train local government staff in managing the budgeting system to include activities against metaxenic diseases in their regular planning processes
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | LXVIII (including stipend for animadores).
Activity 2.- Technical support to local governments to promote and enhance local inter- sector and community coordination platforms for joint planning of community health plans.
Activity 3.- Support bi-national mutual learning and exchange of experiences, results and recommendations of the EBA and KAP studies through joint field visits, discussion events and documentation to adjust national and local plans of action to the proven best practices and protocols.
Activity 4.- Organize at least one international event, with other countries to share the results of the Evidence Based Analysis and KAP study, as well as successful experiences of adjusted implementation strategies and their results impact on the virus outbreak in community health care systems.
Initial Target Beneficiaries:
The total number of direct target beneficiaries of the project is 391,953 people
Ecuador 128,944
Peru 263,009
Total beneficiaries: 391,953
LXIX | USAID ZIKA ANNUAL REPORT USAID.GOV ANNEX VI INTEGRATION OF CROSS-CUTTING ISSUES
A. GENDER EQUALITY AND FEMALE EMPOWERMENT
In Ecuador and Peru, gender inequality persists, affecting mainly women. In Ecuador, 60% of women survive GBV (gender-based violence) and in Peru 30%. In Ecuador, 587 femicides happened during law implementation (2014) and 1,100 femicides in Peru since 2006. Every 12 minutes to women is abused, every 3 days, to women is murdered in Ecuador. Girls and adolescents under the age of 14 are the main victims of sexual violence, including incest, forced pregnancies and child maternity.
In Ecuador, the KAP study showed worrisome findings regarding gender violence, especially in the focus groups: findings point out that violence is accepted, and in a certain way justified. Violence, whether sexual, physical, psychological or economic, is naturalized to the point that it is conceived that women themselves are responsible.
Women who live in situations of violence have limitations to make autonomous decisions about their sexuality and reproduction; barriers to the use of male and female condoms; the lack of information on sexual and reproductive health care. Additionally, they are exposed to unintended pregnancies (non- consensual). Girls and adolescents are exposed to forced pregnancies, Late prenatal check-ups and increased risk.
Another critical situation to consider is teen pregnancy. In Peru, 13% of all pregnancies correspond to adolescents between the ages of 15-19 and it is estimated that every day, 4 adolescents under 15 years of age become pregnant. In Ecuador, in 2015, 26% of deliveries corresponded to adolescents from 10 to 19 years old. Of these, 7% are girls under the age of 14. Every day, 7 girls under 14 become mothers. Pregnancies in children under 14 in Ecuador are classified as sexual violence.
In Ecuador and Peru, cultural and gender conceptions and patterns persist, assigning women the responsibility of avoiding pregnancy; to prevent Zika and its complications in pregnancy, and to care for and protect children. There is little participation of men in prevention actions. In addition, in Ecuador it is assumed that women are the only ones responsible for unplanned / unwanted pregnancies.
There is little adherence to the use of condoms to prevent Zika. Faced with this situation, messages aimed at transforming gender dynamics have been worked on, fostering the responsibility of men in health care, preventive measures, as well as the need to promote autonomous, informed and consensual decisions between men and women regarding their sexual and reproductive health. The messages have been aimed at encouraging the participation of men in the prevention of Zika and in the protection and care of pregnancy. It is wrongly assumed that protection is not necessary during pregnancy, and during the third year of implementation of the project, emphasis will be placed on messages and strategies to influence changes in these mindsets and behaviors. In Ecuador and Peru, these reflections have been incorporated into educational and communicative actions aimed at teachers, health personnel, technicians and municipal authorities, groups of young people and adolescents. As well as people who, due to their role, may have a greater incidence in the population, as is the case of the training of "motorcycle taxi drivers" in Peru.
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | LXX In the training of adolescents and young people about the risks of Zika, the following topics are incorporated: self-esteem, sexual transmission of the Zika virus, and building relationships of respect between women and men.
Teachers include topics on how to prevent violence among girls, boys and / or adolescents. Thus, edu communicative tool manuals include brain exercises which are very useful to reduce stress and violence.
In the edu communicative messages and pieces, messages have been created aimed at questioning the traditional roles of women and men, and the need for each one - from their role and association with the community - to act in the prevention of Zika. Also, messages were created to invite men to commit themselves and participate in the elimination of mosquito breeding sites and in the protection of their partners and their future daughters or sons from the Zika virus.
Perceptions and language of young people in the production and dissemination of Zika prevention messages, especially in sexual relationships, has been incorporated. These messages were published on posters and in notepads, which are given to adolescents, youths and adults who participate in workshops. In Peru, in counseling men and women about the prevention of Zika transmition through sexual relations, messages are disseminated to enhance the knowledge that women and men can make informed decisions about the prevention of the Zika virus infection and other sexually transmitted diseases. The methodology for counseling training for women and their partners has been revised (Guide for Counselors). The information and awareness events are focused on the communities where there is a greater presence of men.
Work will be strengthened in Zika prevention in collaboration with sexual health and reproductive health, prevention of gender violence, and in Ecuador, with prevention of pregnancy in adolescents with the aim of influencing the transformation of gender roles that perpetuate the inequality of women. Among other actions we can highlight the following:
To improve the level of knowledge among men about the transmission of the Zika virus, especially sexual transmission and the use of the condom as a preventive measure. To promote greater acceptance of the condom, even during pregnancy To promote greater approach of men to health services. To facilitate men to recognize the importance of caring for their partners. To promote better and equitable distribution of house chores and care roles within the household. Also, it is necessary to encourage the participation of men in community work to prevent Zika To distribute accurate and accessible information, the use of affordable technologies and to ensure skilled health worker services to improve the health and well-being of women, girls and their communities. To develop messages for the prevention of gender-based violence, sexual violence and adolescent pregnancies.
LXXI | USAID ZIKA ANNUAL REPORT USAID.GOV Below are some of the messages created in Ecuador and Peru:
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | LXXII B. ENVIRONMENTAL COMPLIANCE
Considering the EMMR and USAID environmental regulations, in Annex VI. Environmental Compliance, the detailed report of the Environmental Mitigation and Monitoring Plan (EMMP) for the second year is presented.
In the actions developed by the project, the physical control of the vector, Aedes aegypti, is promoted, prioritizing the messages for change of behavior with respect to the maintenance of water containers, final disposal of unusable containers that can be potential breeding sites, campaigns of collection, elimination of unusable containers and elimination of breeding sites. Using the tools developed, especially the flipchart "Ten minutes against Zika". The aim is to minimize environmental impact by avoiding or reducing the use of disposable plastic containers that pollute the environment. Paper containers are used and in large events we try to provide water through stations installed for the effect instead of bottles. In regards food service, reusable dishes are requested. In Peru, digital formats are preferred, such as USB, links or QR cards and only a limited number of guides are printed at the training events. Before field visits, facilitators, researchers and project staff are advised of measures to prevent mosquito bites.
C. INSTITUTIONAL STRENGTHENING AND LOCAL CAPACITY BUILDING
The Project in Ecuador and Peru strengthened the intersectoral and interinstitutional coordination of the competent institutions at the national and local levels to work on the response to Zika. Coordination was fostered among the social sector: health, education, regional and local governments, municipalities and community social organizations. Through meetings or platforms for coordinating intersectoral plans and joint actions, the project influenced these coordination and articulation processes.
The design and implementation of communication strategies for behavioral change with the participation of citizen and institutional actors has enabled the construction of joint agreements for the implementation of communicative actions and the dissemination of messages. This is reflected in the local communication plans.
The strategy of strengthening the knowledge and skills of local actors, through training with contents validated by the corresponding authorities, contributes to generating standardized knowledge and strengthening institutional capacities for the response to the disease caused by the Zika virus. In addition, local governments were encouraged to identify their competencies in the response to Zika. All of this has also contributed to the strengthening of institutional coordination and articulation at the local level. In Peru, the district plans for the control and prevention of the Zika virus are a reference to give an immediate response through an Early Warning System that involves the local actors.
In Ecuador, universities, through the community outreach program, are important actors in Zika prevention. University teachers and students have been involved in actions to raise awareness of the Zika virus, especially those aimed at pregnant women, men and women of reproductive age, and community monitoring.
LXXIII | USAID ZIKA ANNUAL REPORT USAID.GOV Neighborhood women's, youth and adolescent organizations have been strengthened through a learning-by-doing process that begins with information on the Zika virus and is then complemented by reflections on self-esteem, leadership and the prevention of gender-based violence. This is a strategy to promote community participation in community epidemiological monitoring actions.
D. YOUTH (IF APPLICABLE)
In Ecuador and Peru, the project incorporates the work of young people in different activities as the population of reproductive age is a prioritized population. Therefore, young people, men and women, are direct beneficiaries of the actions.
In Ecuador, in some communities, activities are carried out to motivate the participation of young women and men in the Community Epidemiological Monitoring System. This is a strategy developed to strengthen the weakened citizen participation that was found in the territories.
Another strategy that is implemented is the incorporation of university students in Huaquillas (El Oro) and in Manta (Manabí), to strengthen community work. Articulating the curricular program of connection with the community with the component of community work of prevention and monitoring of Zika.
In the community of Pueblo Nuevo in Portoviejo, work with adolescents and young people is focused on providing them with knowledge and tools to spread the risks of zika and how to eliminate breeding sites. Also included are topics on self-esteem, leadership and sexual health. These messages are disseminated in sports and other community spaces where men can gather.
E. DISABILITY (IF APPLICABLE)
The training of teachers in edu communicative tools influenced a teacher in Ecuador to incorporate the techniques learned in the construction of messages about Zika prevention in the work with children with auditory and visual disabilities. This experience took place in the "Dos caminos" School of the San Isidro parish, Cantón Sucre, Province of Manabí.
F. SCIENCE, TECHNOLOGY, AND INNOVATION (IF APPLICABLE)
The project developed the monitoring platform for the collection, management and analysis of the data and information resulting from the activities carried out by the local technicians.
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | LXXIV Additionally, applications were developed for the community monitoring system in both countries. In Peru, with the support of the US CDC, the EPI-INFO platform was used, especially the vector monitoring module, and free software was developed to record the information resulting from monitoring with ovitraps and the presence of houses with mosquito breeding sites. The Community Monitors were trained in the use of the application and it was configured for use in charts or smartphones. With this tool, the Community Monitors registered the communities and issued several messages and information on the activities carried out with the population. In Ecuador, the format of Form AA-2 of the visitor vector control of the MSP was adapted to meet the needs of the project, in the collection of community surveillance data during home visits; without losing compatibility in the background or form, for the analysis of the information obtained with the MSP. This allowed the coupling of the data with the local health system and the optimization of time in the analyzes carried out.
G. POLICY AND REGULATORY REFORM (IF APPLICABLE)
In Peru, according to the regulations, in the budget program (BfR) item 017 can be found, to which regional and municipal governments can resort to allocate resources for the prevention of Vector- Born Infections Diseases. This item has been under-utilized. The advocacy work carried out by the project led eleven municipalities to include the program in their budgets, and one of them, the provincial government of Chiclayo, allocated USD5,000 in the 2019 budget.
In Ecuador, the project relied on the Healthy Municipalities strategy - an official program of the Ministry of Public Health. This strategy allows for the articulation of actions by municipal governments to promote healthy spaces, habits and lifestyles and for the prevention of major health problems. However, few municipalities have implemented this program and have been certified as healthy municipalities or territories. In the intervention cantons, only the Municipality of Portoviejo was certified as a health promoter (that is, it complies with indicators prior to its certification as a healthy territory or municipality). The advocacy work carried out by the project aided in helping the Arenillas and Las Lajas municipalities to meet the requirements to be certified as Health Promoting Municipalities. Soon the municipalities of Muisne, Jama, San Vicente and Pedernales will begin this process. The work of the project was oriented to promote actions and indicators linked to the prevention and control of Zika and other diseases transmitted by aedes aegypti.
LXXV | USAID ZIKA ANNUAL REPORT USAID.GOV ANNEX VII RESEARCH AND PUBLICATION TRACKER
RESEARCH AND PUBLICATION TRACKER ECUADOR
INVESTIGATIONS
Study of knowledge, attitudes and practices related to the control and prevention of the Zika virus, CARE Ecuador, September 2018. Link: https://partners.zikacommunicationnetwork.org/node/455
Comparative analysis of the results of the year 1 and year 2 KAP studies, CARE Ecuador, September 2018. Link: https://partners.zikacommunicationnetwork.org/node/478
PUBLICATION Methodological guide for the use of communication pieces of the “Everyone Against The Zika” (Todos contra el Zika) campaign, CARE Ecuador, July 2018. Link: https://partners.zikacommunicationnetwork.org/node/463
Methodological guide for the preparation of community plans for the prevention and control of the Zika virus, CARE Ecuador, August 2018. Link: https://partners.zikacommunicationnetwork.org/node/456
Methodological guide for the preparation of community communication plans for behavioral change and social action, to Zika virus prevention, CARE Ecuador, August 2018. Link: https://partners.zikacommunicationnetwork.org/node/457
Guide for the ‘community promoter’, CARE Ecuador, September 2018. Link: https://partners.zikacommunicationnetwork.org/node/464
GUIDES
Educommunicative tools for children to be protagonists in the prevention of Zika, CARE Ecuador, August 2018. Link: https://partners.zikacommunicationnetwork.org/node/479
Training of trainers: Art, education and culture for the prevention of Zika, CARE Ecuador, August 2018. Link: https://partners.zikacommunicationnetwork.org/node/480
COMMUNICATION PIECES
Posters Poster 1: Personal, family and community prevention measures, CARE Ecuador, July 2018. Poster 2: Recommendations to protect pregnant women from Zika virus transmission, CARE Ecuador, July 2018. Link: https://partners.zikacommunicationnetwork.org/node/466
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | LXXVI Diptych about protection to pregnant women from Zika virus, to avoid the risks of microcephaly syndrome in girls and boys. Link: https://partners.zikacommunicationnetwork.org/node/470
Comic book “To Which It Stings Loses” (Al que pica pica pierde), CARE Ecuador, July 2018. Link: https://partners.zikacommunicationnetwork.org/node/467
Notepad "To which it stings loses: if we all work, Zika we eliminate", CARE Ecuador, August 2018. Link: https://partners.zikacommunicationnetwork.org/node/473
Key messages (14 reasons) for Zika prevention with gender and intercultural approaches Link: https://partners.zikacommunicationnetwork.org/node/475
Board game "Everyone Against the Zika" (Todos contra el Zika), CARE Ecuador, July 2018. Link: https://partners.zikacommunicationnetwork.org/node/471
Hopscotch "Everyone Against the Zika" (Todos Contra el Zika), CARE Ecuador, August 2018. Link: https://partners.zikacommunicationnetwork.org/node/472
Portfolio of the Community Epidemiological Surveillance System: "10 minutes against the mosquito" (10 minutos contra el mosquito), CARE Ecuador, September 2018. Link: https://partners.zikacommunicationnetwork.org/node/465
RESEARCH AND PUBLICATION TRACKER PERU
INVESTIGATIONS
Report of the study on the efficiency of the use of ovitraps in the community-based surveillance system of Campo Amor (Tumbes). Lima, July 2018. Link: https://partners.zikacommunicationnetwork.org/node/482
KAP study. "Knowledge and perception of risk regarding the Zika virus (ZIKAV) and its transmission; as well as to explore the experiences, level of access and other determinants in adolescent men and women and adults of reproductive age in a risk context for ZIKAV.” Lima, August 2018 Link: https://partners.zikacommunicationnetwork.org/node/483
INVESTIGATIONS
Diptych aimed at individuals of childbearing age to promote the prevention of Zika virus in talks and counseling. Link: https://partners.zikacommunicationnetwork.org/node/481
Diptych for pregnant women to promote the prevention of the Zika virus in talks and counseling. Link: https://partners.zikacommunicationnetwork.org/node/477
GUIDES
LXXVII | USAID ZIKA ANNUAL REPORT USAID.GOV Comprehensive intervention guide for the prevention of Zika in educational institutions. (Includes 6 annexes) Directed to teachers, specialists and peer educators. Lima, May 2018. Link: https://www.zikacommunicationnetwork.org/es/resources/guia-de-intervencion-integral- para-la-promocion-de-una-cultura-de-prevencion-ante-el-zika
Informative diptych about the results of the project “Together Against the Zika”, Lima, May, 2018 Link: https://partners.zikacommunicationnetwork.org/node/484
Methodological guide in the context of Zika, for counseling facilitators for women of childbearing age and pregnant women. Lima, July 2018. Link: https://partners.zikacommunicationnetwork.org/node/485
Methodological guide in the Zika context, for participants on counseling for women of childbearing age and pregnant women. Lima, July 2018. Link: https://partners.zikacommunicationnetwork.org/node/486
Training Plan for local personnel of the Community Based Surveillance System. Lima, July 2018. Link: https://partners.zikacommunicationnetwork.org/node/487
Course Guide: The General Aspects of Zika virus infection, Lima, July 2018 Link: https://partners.zikacommunicationnetwork.org/node/444
Course Guide: The Role of the Community Health Agent in the Community Based Surveillance System. Lima, July 2018. Link: https://partners.zikacommunicationnetwork.org/node/445
Course Guide: Community Based Surveillance System, Lima, July 2018. Link: https://partners.zikacommunicationnetwork.org/node/446 Course Guide: Community Participation on Vectorial Control, Lima, July 2018. Link: https://partners.zikacommunicationnetwork.org/node/452
Course Guide: Sectorization and Community Mapping for the Implementation of the Community Based Surveillance System. Lima, July 2018 Link: https://partners.zikacommunicationnetwork.org/node/488
Course Guide: Early Warning System (SAT). Lima, July 2018. Link: https://partners.zikacommunicationnetwork.org/node/489
Guide for the course on the correct management of Ovitraps. Lima, July 2018. Link: https://partners.zikacommunicationnetwork.org/node/450
Course guide on the use of the Mobile Application for the Registration of Community-Based Vector Surveillance Information. Lima, July 2018 Link: https://partners.zikacommunicationnetwork.org/node/490
Course guide: pick up and elimination of breeding sites or potential mosquito breeding sites. Lima, July 2018. Link: https://partners.zikacommunicationnetwork.org/node/491
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | LXXVIII Course Guide: “Ten Minutes Against the Zika”. Lima, July 2018. Link: https://partners.zikacommunicationnetwork.org/node/453
Course Guide: Methodology for Citizen Dialogue "Together before the Zika." Lima, July 2018. Link: https://partners.zikacommunicationnetwork.org/node/492
Fact sheet on Good practices in prevention and control of the Zika virus, 2018-Edition. Lima, July 2018. Link: https://partners.zikacommunicationnetwork.org/node/493
LXXIX | USAID ZIKA ANNUAL REPORT USAID.GOV ANNEX VIII MANAGEMENT AND ADMINISTRATIVE ISSUES
A. MODIFICATIONS AND AMENDMENTS
Modification Description of Modification Date Number
1 Designate Nadira Kabir as AOR in the 3 /14/2017 procurement database
2 1. Add incremental funding in the amount of $4,754,296.00 2. Increase the total obligated amount from $2,245,704.00 to $7,000,000.00; and 3. Update the standard provisions of the award 3 1. Incorporate the name and contact information 12/21/2018 of the Agreement Officer's Representative (AOR), Jaime Chang; and 2. Update Attachment D - Standard Provisions for U.S. Nongovernmental Organizations
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | LXXX ANNEX IX ENVIRONMENTAL MITIGATION AND MONITORING Y2 REPORT (EMMR)
List each Mitigation Measure List any outstanding issues from column 3 in the EMMP Status of Mitigation Measures relating to required Remarks (EMMT Part 2 of 3) conditions 1. Education, Technical Assistance, Training
The methodological guides and The actions for the management of solid and education and training tools will liquid waste generated in the events are defined make explicit mention of the proper and are implemented in all activities. Also, these
management of solid and liquid actions are diffused by the technical team through wastes generated in these events. works with the stakeholders and with providers
During all the events, the good to guarantee compliance. The main In the municipalities, practices for Environmental recommendations are related to reduce, recycle differentiated waste management Mitigation will be followed, included and reuse. Specifically, we insist on avoiding or has not been implemented, so the Periodically, we insist with the technical in trainings, and reflected in a reducing the use of disposable and polluting separation in the source has little brochure or triptych. materials and on the differentiated collection of team on the importance of raising waste, for to facilitate recycling. impact on environmental awareness and positioning good waste protection. management practices for An important number of activities are developed Environmental Mitigation with partners in coordination with the municipalities. Waste management is a municipal competence, so one of In faraway places, providers may and local actors. the issues approached in the planning of activities be people of the community and is the cleaning and removal of waste during and usually they not have tableware after the events. available or resources to purchase it. In these cases, we We require food service providers not to use insists on the use of less polluting plastic containers and replace them with paper disposables. cups or sleeves. This material is biodegradable, less polluting for the environment. The reuse of educational and At fairs, open houses or other events realized in outreach materials will be actively public spaces and institutions, games or sets of An exception is the materials such as promoted, along with a limited use didactic materials are reused. The use of of disposable materials. stationery such as flyers is avoided. Only a diptych pens, entry and exit test forms and related to information about the ZIKV`s risks in
LXXXI | USAID ZIKA ANNUAL REPORT USAID.GOV pregnancy is distributed. event evaluation form that are Priority is given to the use of invitations to events delivered in each event. or activities, through digital media. The diffusion of relevant public events is done through loudspeakers, radios, press conferences, social The reuse of paper is promoted in the networks or other means available at the offices of the Zika Response Project in community level. Ecuador-Peru.
It will continue to raise awareness To reduce the use of paper, it is prioritized to among CARE workers and strategic deliver the electronic files of the contents analyzed to the participants of the training. These allies about the importance of are delivered through email or other mechanisms. rationalizing the use of paper in the reporting processes; for this purpose, In addition, the reports are worked on, it is mainly recommended to scan consolidated and delivered in digital files, to documents and they are sent to reduce the use of paper. different ways, such as mail and In our offices, the use of recycled paper for wetransfer. unofficial documents is implemented. The facilitators will be monitored to The project provides the didactic materials for ensure proper application of these the development of events or training activities.
guidelines. These are reused whenever possible. Additionally, the use of recycled materials in the elaboration of products during the training days is promoted. The content of vector control In the management of the project, the physical training for communities and control of the vector and the empowerment of the Educational materials on the importance technical staff must be in line with population are prioritized in order to influence the of solid waste management in the USAID (i.e. Zika PERSUAP), WHO, practices. This is evidenced in the tools and prevention of metaxegenic diseases and host country environmental methods developed for training officials, groups should be prepared. These materials regulations. prioritized for intervention and communities. would be directed to environmental managers or responsible for the Among the Zika preventive measures are the municipal service of solid waste elimination of breeding sites, the use of mosquito collection. nets, the practice of washing, covering and brushing containers where water is stored and collection from breeding sites and the use of wet sand in vases. The main tool developed is "10 minutes against Zika" and educommunication products with these messages.
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | LXXXII
Additionally, it is motivated to reduce the consumption of products packaged in other plastic containers, which affecting the environment and are potential breeding sites.
In Peru, the use of the improved tank cover of locality Cuchareta Baja as a measure to control Aedes aegypti as part of the training in new vector control protocols is promoted as a successful experience. 2. Research and Development NA NA NA
3. Public Health Commodities NA NA NA
4. Small-Scale Construction NA NA NA
5. Small-Scale Water and Sanitation NA NA NA
6. Nutrition NA NA NA
7. Vector Control
In coordination with UNICEF and In Peru, the Ministry of Health must PAHO, information will be In Peru, information on vector control activities determine the indicators to measure requested from the MOH regarding is requested every three months, in the areas of the effectiveness of the hormonal the use of chemical and/or biological project intervention. This information is inhibitor piriproxifen, since the existing pesticides, as well as the relevant recorded in the quarterly indicators reports. ones up to now refer to the use of the regulatory frameworks. Temephos larvicide. In Ecuador, PAHO works with the Ministry of Health to raise evidence regarding the use of larvicides Provide information to families on In Peru, integrated consent protocols were The use of Temephos ("abatización") potential harmful effects of incorporated into the Integrated Vector In Peru, institutionalize the is an activity widely known by the pesticides carried out by the MOH. Control Protocols for families to carry out focal informed consent as part of focal population and the reluctance to use treatment, perifocal treatment and spatial and perifocal treatment actions, it has to do, mostly, with erroneous
LXXXIII | USAID ZIKA ANNUAL REPORT USAID.GOV nebulization activities. This issue is addressed action that should be managed at beliefs or distrust of the population. during the training of health personnel and the national level. other stakeholders, reinforcing the need to It is necessary to strengthen the comply with this requirement during the capacities of community monitors for development of the work. the adequate management of information. In Ecuador, the vector control brigades, before the fumigation activities, if they are carried out, go through and inform the population, the precautions that must be taken, mainly to protect water and food for consumption.
Additionally, when the Temephos larvicide is delivered, it is reported on the water management and the safety of the product for human health.
The community monitors support providing information in their community, to reduce the number of unwilling houses.
Learning meetings will be held with The Ministry of Health has a governmental agencies and academia protocol for housing inspection regarding Evidence-Based Analysis and vector control and best practices in the application of these products. All applications recommended will be consistent with the Zika PERSUAP, international standards (e.g. WHO, PAHO, USAID) and host country regulations and policies. Guidelines will include national and In Peru, the topic is developed in vector control international standards on the protocols. These are implemented by facilitators proper handling and disposal of trained by the Project, who train health ovitraps. personnel, teachers, authorities, community leaders and community health agents.
Ecuador NA
USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | LXXXIV Ensure any reference on the disposal of traps follow the Zika In Peru, the contents related to the provision of PERSUAP requirements, ovitraps comply with the regulations defined by international best practices (e.g., WHO / PAHO and the national standards. WHO, PAHO) and host country requirements. ECUADOR NA 8. Emergency Response NA NA NA
LXXXV | USAID ZIKA ANNUAL REPORT USAID.GOV