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Reserwd for Peoject Logo/Iieading Africai{Programme RESERWD FOR PEOJECT LOGO/IIEADING COUNTBYINOTF: Pr,oject Name: SOUTH WEST I CAMEROON CDTI PROJECT Approval year: 1998 Launchinq year: MARCH 1999 Beportine Period: Mid From: January 2008 To: December 20O8 (MonthrYear) ( Montb/Year) Proiectvearofthisreport:(circIeone) 12 3 4 5 6 789 (fO) Date submitted: NGDO partner: December 2008 Sightsavers International ANNUAL PROJECT TECHNICAL REPORT SI]BMITTED TO TECHNICAL CONSIILTATI\IE COMMITItsE (TCC) DEADLINE FOB SUBMISSION: To APOC Management by 31 January for March TCC meeting To APOC Management by 31 July for September TCC meeting AFRICAI{PROGRAMME FOR ONCHOCERCIASIS COI{TROL GPOC) I I I I I I RECU tE n i} 'l ., I[ i] ,, i',illnt.t* ,- r i( AI{NUAL PRO.IECT TECHNICAL REPORT TO TECHMCAL CONSULTATIVE COMMITTEE (TCC) ENDORSEMENT Please confirm you have read this report by signing in the appropriate spaoe. OFF.ICERS to srgn the rcport: Country: CAMEROON National Coordinator Name: Dr Ntep Marcelline SiBnatrEr*--... Date .Q.hl.ilLl f, G Provincial Delegate Name: Dr. Chuw ngub l. aa,,,..' .'L ? . !. ), o l rl f c Signature { .r'' ) 'tt' '.r t, ,,.rLl-e-,'' i :) 3 il ( >rI i Date: I a B )1.= r) NGDO Representative Name: Dr. Oye J Signature: Date: ..t'..,9..'] i:1,.;t[iii,g... Provincial oncho coordinator Name: Ms,Iv{ah cecJa Signature: ... .&.^..!.::.:[..:.-*. Date: ....3.t. Vl 1.,;L.1. i This report has been prepared by Name: Ms Mah Cecilia Designation:i.. I i Signature: ......(. I Date ...?.).. L,l,?.1.I. Table of contents ACRONYMS V DEFINITIONS...-.. VI FOLLOW UP ON TCC RECOMMENDATIONS 1 DGCUTIVE SUMMARY 1 SECTION 1: BACKGROUND INFORI\{ATION......... ............3 I.1. GpNpnar,INFoRMATIoN 3 1.1.1 Description of the project (brieflil 3 1.1.2. Partnership 6. Population .8 SECTION 2: IMPLEMENTATION OF CDTI I 2.I. TNAPINIB OF ACTIVITIES. .10 2.2. Aovocacy 11 2.3. Mogu.zarroN, SENSITIZATIoN AND mALTT{ EDUCATIoN oF AT RIsK COMMUNITIES. 11 2.4. Connr,ruNrrY INVoLVEMEI\rr...... Ennon! Booravranx Nor DEFINED- 2.5. CapaclTyBUILDING 15 2.6. Tngarl,m]rrs.............. 19 2.6.1. Ibeatmentfigures.. 19 2.6.2 What are the causes of absenteeism?...... 22 2-6-3 What are the reasons for refusals? 99 2.6.4 Briefly descibe aII known and verified serious adverse events (s,qnd that......... 99 2.6.5. Trend of treatment achievement from CDTI project inception to the curren t year. - - - - -. - - - -. 24 2.7 . OnonnrNc, STORAGE AND DELTVERY oF IVERMECTIN......... 25 2.8. ComvrumTY SELF.MoNnoRING AND Star<CIgoIDERS Mpptwc 26 2.9. SuppnusroN.......... 27 2.9.1. Prouide a flow chart of superuision 27 2.9.2. What were the main issues identified during superuision 27 2.9.3- Was a superuision checHist used?.-.... ...............28 2.9.4. What were the outcomes at each level of CDTI implementation superwilon 2 28 2.9.5. Was feedback given to the person or groups 28 2.9.6. How was the feedback used to improve the overall performance of the project?............. ...........2g SECTION 3: SUPPORT TO CDTI .........28 3.r EqrrrrueNr 28 3.2 FruaNcrar, pARTNERS coNTRIBI-rrIoNS oF Trm AND coMMUNITms............. _ 29 3.3 Ortrpn FoRMS oF coMMUNITy suppoRT ............ 30 3.4 ExpnNorrunE pER ACTTvITy 30 SECTION 4: SUSTAINABILITY OF CDTI ...........32 4.I. INTPNNAT.; INDEPENDENT PARTICIPATORYMOMTORING; EVAT,UATTON........32 4.1.1 Was Monitoring/evaluation caried out during the reportingperiod? Gick any of the foilowing which are applicabhd......... .....32 4.1.2. What were the reconnendations. 32 4.1.3. I{ow have they been imp)emented?........ ,32 4.2. Sustaru,,rntllTy oF pRoJECTS: pLAN AND sET TARGETS (MANDAToRyAT Yn 3) 32 .2.L. PI,nruNINi] AT ALL RELEVA}III LEVELS 32 4.2.2. Funds 33 4.2.3 Transport (replacement and maintenance) 33 4.2.4. Otherresources- 33 4.2.5. To what extent has the plan been implemented..-....--. 33 4.3. IurncnarroN.......... 33 4.3.1. fvermectin deliverymechanisms 33 4.3.2. Training 33 4.3.3. Joint superuision and monitoring with other programs 33 4.3.4. Release of funds forproject actiuities. 33 4.3.5. Is CDTI included in the PIIC budget? 34 4.3.6. Describe other health progzammes that arc using the CDTI structure and how this was achieved- What have been the achievements?..34 4.3.7. Descibe others issues considered in the integration of CDft. ........34 4.4. OpERATToNALRESEARCH .................8b 4.4.1- Summarize ia not more than one half of a page the operational research undertaken in the project area within the reportingperiod-.-.-------.35 4-4-2. Ifow were the results appliedin theproject?............. .......35 SECTION 5: STRENGTI{S, WEAKNESSES, CIIALLENGES, AND OPPORTUNITTES .................35 SECTION 6: UNIQUE FEATIJRES OF THE PROJECT/OTHER MATTERS ...35 Acronyms ANC Ante Natal Clinic APOC African Programme for Onchocerciasis Control ATO Annual Treatment 0bjective ATrO Annual fl2lnin g Objective CBO Community-Based Organi zation CDD Community-Directed Distributor CDTI Community-Directed Treatment with Iverrnectin CSM Community S elf-Monitofin g HESAM Health education sensitisation advocacy and mobil i zation IT Information technology IWC Infant Welfare Clinic LGA Local Government Area MOH Ministry of Health NGDO Non- Governhental Develop ment Organiz ation NGO Non- GOvetnmental Organization NOTF Natiorral Onchocerciasis Task Force PHC Primary health care REMO Rapid Epidemiolo gical Mappin g of Onchocerciasis SAE Severe adverse event SHM Stakeholders meeting TCC Technical Consultative Committee (APOC scientific advisory group) TOT Trainer of tralners UNICEF United Nations Children's Fund UTG Ultimate Tleatment GoaI wHo World Health Organization Definitions (il Total population: the total population living in meso/hyper-endemic communities within the project area (based on REMO/REA and cerlsus taking). (iil Eligible population: calculated as 84% of the total population in meso/hyper-endemic communities in the project area. (ilil Annual Treatment Objective: (ATO): the estimated number of persons living in meso/hyper-endemic areas that a CDTI project intends to treat with ivermectin in a given year. (iv) Ultimate Treatment Goal (UTG): calculated as the maximum number of people to be treated annually in meso/hyper ehdemic areas within the project area, ultimately to be reached when the project has reached full geoSraphic coverage (normally the project should be expected to reach the UTG at the end of the 3.d year of the project). (v) Therapeutic coverage: nunr'ber of people treated in a given year over the total population (this should be expressed as a percentage). (vil Geographical coverage: number of communities treated in a given year over the total number of meso/hyper-endemic communities as identified by REMO in the project area (this should be expressed as a percentage). (viil Intesration: delivering additional health interventions (i.e. vitamin A supplements, albendazole for LF, screening for cataract, etc.) through CDTI (using the same systems, training, supervision and personnel) in order to maximise cost'effectiveness and empower communities to solve more of their health problems. This does not include activities or interventions carried out by community distributors outside of CDTI. (viii) Sustainability: CDTI activities in an area are sustainable when they continue to function effectively for the foreseeable future, with high treatment coverage, integrated into the available healthcare service, with strong community ownership, using resources mobilised by the community and the government. (ix) Community self-monitoring (CSM): The process by which the community is empowered to oversee and monitor the performance of CDTI (or any community-based health intervention programme), with a view to ensuring that the programme is being executed in the way intended. It encourages the community to take full responsibility of Ivermectin distribution and make appropriate modifications when necessary. FOLLOW UP ON TCC RECOMMENDATIONS Using the table below, filI in the recommendations of the last TCC on the project and describe how they have been addressed. TCC session 26 South-West I CDTI Project (9ft year report) No TCC recommendation / suggestion for Action taken / Management For TCC/APOC 78 writing better repoft response MGT use only The executive summary should The 2008 anhual report will show include total population, number of all necessary data in the persons treated and the therapeutic appropriate sections including the coverage in the meso-hyper-endemic executive summary and hypo-endemic areas; Reason why the column "community Last year community superuisors supervisors" is ticked in table 6 were really not trained. Hence it was by error that this column was ticked on table 6 of last year's repoft. Reasons for the drastic increase in The hypo-endemic areas are the number of CDDs in the hypo- generally more densely populated, endemic areas while it decreases in making up more than half of the the meso/hyper-endemic a reas; population of the entire project area. Also, because CDDs trained carry out not only CDTI, but also eye care and other community health intervention, they are trained equally in all areas irrespective of onchocerciasis endemicity. Reasons for the drop in the number of In the 2007 report unlike that of health personnel, as compared to 2006, only staff of frontline health figures in the previous report; facilities were considered. Health personnel of the provincial and district hospitals were not included. The 2008 annual report will take into consideration all health staff at all levels. After nine years of project IEC materials are produced at the implementation provide reasons for central level, and the quantity (a) IEC materials being not produced for all the projects is distributed at the right time, (b) great. This takes a lot of time in health education messages in local the course of production and languages were not developed (c) distribution to the various projects. dialogue structures are not fully Often they are not enough and involved; arrived late at the project zone.
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