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6 Months Report On AFRICAN PROGRAM FOR ONCHOCERCIASIS CONTROL (APOC) 6 MONTHS REPORT ON COMMUNITY DIRECTED TREATMENT WITH IVERMECTIN (cDrr) BORNO STATE, NIGERIA JUNB, 1999 TO NOVEMBER, tgg9. BORNO ST TE SECTION 1: INTRODUCTION +ACKGROUND - Borno is located in tnffiffi p".t of Nigeria where the country shares boundaries with the Republics of Cameroon, Chad, and Niger. The State ha9 a surface area of approximately 69:$6 kq. Km and is composed of 27 Local Government fueas' The population of the State is 2,596,589, (National Population Census results), over 80oZ of whom are rural dwellers. The rural infrastructure of Borno and that of its Onchocerciasis endemic areas, is one of the least developed in the State. The State is endowed with seasonal and perennial fast flowing rivers which serve as breeding sites for black fly, the vector for river blindness. Treatme SA{ LGA Hyper Meso Endemic Commties under Communities Endemic Communities Treatment included in nt Communities before APOC APOC Round I BIU 90 90 90 4 I HAWUL 82 82 82 4 ) SHANI 50 50 50 J 4 4 KWAYA KUSAR 53 53 53 38 4 5 BAYO 38 38 6 DAMBOA 66 66 75 3 I 7 GWOZA 60 0 60 3 8 CHIBOK 67 67 48 9 DIKWA 120 0 50 I l0 ASKIRA UBA 77 77 80 3 TOTAL 703 523 626 t-4 SECTION 2: ST sn{ DistricUI-GA #of #of #of #of #of #of #of Commtie Comms/Y Comms/V CommslYillag comms/Yilla Comms/vil Comms/Yilla s/Yillages illages illages es that ges which lages with ges paying which which decided on the decided on trained CDDs in selected Collected mcthod of the months CDDs Crsh or CDDs Drug Distribution of Treatment kind. I BIU 90 90 90 90 90 90 L.a HAWUL 82 80 80 80 80 80 J SFIANI 52 50 50 50 50 50 4 KWAYA - K 53 53 53 53 53 53 5 BAYO 38 38 38 38 38 38 6 DAMBOA 75 75 75 75 75 75 GWOZA 60 60 60 60 60 60 8 ASKIRA UBA 80 80 80 80 80 80 9 CHIBOK 48 48 48 48 48 48 l0 DIKWA 50 50 50 50 50 50 TOTAL 626 626 626 626 626 626 Note: Some communities have expressed willingness and have started suPPorting their CDDs, however, we are yet to determine how many supported them either in cash or hnd. I or No of Health No of SN DISTRICT/LGA No of No. of No. of District Training TOT LGA Staff Trained in Centres/Post Staff CDDs Trained Undertaken Trained CDTI Trained in CDTI Yet to be trained tl4 I Bru I 4 Yet to be trained aa aa 162 ) HAWUL 1 J aa <a 72 3 SHAM I 4 a< aa 49 4 KWAYA KUSAR I 4 a< aa 30 5 BAYO I 4 C( a< 107 6 DAMBOA I 4 <a t43 7 GWOZA I 4 aa aa 75 8 CHIBOK I J aa aa 82 9 DIKWA I 3 <1 a< 104 l0 ASKIRA UBA I 3 TOTAL I 36 93E workers' Out of 2.1 The annual training objective was to train programme staffand PHC this,974 were trained for ivermectin distribution' Flipchart, 2.2 The materials used were Training Manual, cDD Guide (Brochure), and provided by Helen Keller worldwide and APOC Respectively. and better 2.3 There is need to increase training of trainers, more training materials scheduling of time and venues close to the treatment communities. N MOH No of NGDO DISTRICT/LGA No. of No. of No. of Advocacy No. of S/N staff Comm./V Commits/Villages Visit to State or Staff involved in illages which received HE Regional Dircctors involved in Mobilized about Importance of of Eealth mobilization Mobilization Ertended Treat I DIKWA 50 50 2 3 2 ) 3 2 GWOZA 60 60 aJ 2 3 ASKTRA UBA 80 80 2 3 4 CHIBOK 48 48 2 2 3 2 5 BIU 90 90 3 2 6. I{AWUL 82 82 2 3 2 7 KWAYA-KU 53 53 2 3 2 8 BAYO 38 38 2 9 DAMBOA 75 75 2 l0 SHAM 50 50 2 3 a TOTAL 626 626 at 30 t2 personal face- 2.2.1 During community mobilization and education of target communities, to-face contact as well as town criers were used to mobilize the people' L be 2.2.2 Mobilization exercise was satisfactory, however, more intensive efforts need to done to increase awareness and involvement of the community members in the CDTI implementation. 2.2.3 Most communities have responded fovourably. 2.2.4 More time is required for Community mobilizationand Health Education in our timeline of activities. Emphasis during training of health workers will continue to be support. stressed in this area to improve awareness and further increase community LGA staff need to step u[ efforts in mobilizing leaders and their subjects on regular basis. *Training materials produced by HKI to supplement those already produced by the State BALAI\CE S/N ITEM QUAI\TITY QUAIITITY PRODUCED ISSUED I Household Cards 20,000 19,000 1000 7 1,000 584 416 3 Community Summary Treatment Form Big 2,000 1000 1000 Small 3,000 1500 1500 1000 4 Communit Treatment Form 2,000 1000 1000 5 Adverse Reaction Form 2,000 1000 500 6. LGA Mectizan Treatment Form 1,000 500 1000 7 State Mectizan Treatment Form 1,000 1500 8 Mectizan Form 2,O00 500 9 Posters 2,000 961 1039 990 10 Information Brochure 2,000 l0l0 ll HKI Training Manual 186 80 106 SECTION 3 ACHIEVEMENTS @ementshavebeenrecordedeventhoughwehavejuststartedCDTI implementation (about six months ago). l) Have been able to trained 36 trainers and 938 CDDs in CDTI. 2) Mobilized and health educated 626 communities. 3) Drugs have been collected by the communities and treatment is on going. Coverage cannot be determined now of No. of s/ DistricULGA No of Target No. of Cost No. of No. Distributions Treated N Communities eligible per Comm./Yillages Communities /Villages persons Person which CDDs is a supervised with Trcated Treated treated health worker by health /villages workers summsry forms. None 4 1 BIU 90 aa ) HAWUL 82 4 <a 3 3 SHANI 50 aa 4 4 KWAYA _ K 53 al 4 5 BAYO 38 aa 6 DAMBOA 75 3 C' 7 GWOZA 60 I aa I ASKIRA 80 J UBA a1 9 CHIBOK 45 3 aa l0 DIKWA 50 I TOTAL 626 t-4 Note: Treatment is on going, anduntil it is completedwe would not be able to Provide other information. SECTION 4: STRENGTES WEAKNESSES SUGGESTIONS a made to TRAINING: Have been conducted for a PHC workers are yet to be Arrangement to be SOCTs, LOCTs, and trained in CDTI. train PHC staffon CDTI CDDs. HEALTH o Community particiPation a Inability to reach and fullY a More time is required for EDUCATION/MOBI was quite encouraging interact with all the community mobilization and LIZATION with state, LGA and communities on the health education. NGDO offrcials involved. concept of CDTI. a Need for adjustnent of a Some communities were perid of communitY inaccessible due to rains mobilization. and flooding rivers. a Need to centralize Production a Inadequate IEC materials of IEC and raining materials for the State. a : of STAFT'ING: a Sigr of Commitrnent by a SOCT members Increase the number SOCTs and LOCTs inadequate. SOCT. a Some SOCT members are a Encouraged the SOCT to yet to fully accept change work as a team. to CDTI implementation. a Co-ordinator to be a No spirit of working as a encouraged to be more team. committed to the COMMUNITY a Most Communities have a Community Base Bamako a Involve Community Based PARTICIPATION accepted the programme. Initiative Committees not Bamako Initiative the a Selected CDDs. involved in the Committees in programme. progralnme. a Encourage communities to accept and support the prografllme. a Encouraged them to suPPort their cDDs. 4 a advocacY LGA a Have recogilzed the a Financial support to the Need to intensiry PARTICIPATION problems of Oncho in progr:rmme is inadequate. visits to the LGA executives. their areas. a Willingness to suPPo( the LOCTS. a should be LOGISTICS Availability of vehicles a No motorcycles, which State and LGCs from M.O.H., APOC and could be used in areas encouraged to suPPort the and NGDO. where vehicle could not programme with vehicles reached. motorcycles. a Inadeguate logistics support by LGCs. a time and attention SUSTAINABILITY a Involvement CommunitY a Limited time and attention Adequate Based Bamako lnitiative to communities during should be glven for Committees would ensure mobilization interaction with the sustainability. a communities when visited. a Emphasis on shifting the ownership of the programme to communities. 4.2 CDDS PERFOR]VIANCE OF TASK The CDDr irained have shown interest and commitment towards the programme. However their performance would be determined when first treatment report using CDTI approach have been collected. 4.3 WILLIGNESS OF COMMUNITIES TO PARTICIPATE IN CDTI: tt4ost of the communities have indicated willingness to participate and support the programme. This was shown by selection of CDDs and collection of drugs for distiibution. Intensive mobilization is however required in future to increase their level of awareness on the need to be fully independent in choosing their most appropriate treatment periods as well as going to collect their drugs at agreed upon .bit""tion points. The Community Based Bamako Initiative Committees (CBBI) should be incorporated into the programme like it is being done in Adamawa State. 4.4 INVOLVEMENT OF THE NOCP ontrol Programme (NOCP) has been very supportive' They were actively involved in the training of trainers, advocacy to the SMOH officials and facilitating the release of APOC funds to the project.
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