Benue State Notf/Who-Apoc Project

BENUE STATE NOTF/WHO-APOC PROJECT.

ANNUAL REPORT OF CDTI ACTIVITIES IN BENUE STATE PROJECT

OCTOBER 2OO1- SEPTEMBER 2OO2

SUBMITTED TO:

THE AFRICAN PROGRAMMD FOR ONCHOCERCTASTS (APOC)

BY F,Jr ./tc.ll^r CHINWEUZOAMAKA TERNA io: -L e t'l -8,r. 'Trl'4'/ M Wo t,.FYaw

For lnformotion Tor btet IN NOVEMBER 2002,AT KADUNA, NIGERIA. kc

llltLlAI I

Treatment with ivermectin has been on since 1991

23 . . 1 . Total No. of LGAs . .

2.TotalNo.ofLGAswithlvermectinffeatment 18 4,035,563 3. Total State PoPulation...... ' 3942 4. Total No. of communities. . ' ' ' '

5. Total No. of Communities receiving treatment 2049

266,47 4 6 Total population of communities receiving treatment. l,

6500 7 Carry over drug from 2001 . . . . .

2,800,000 8 Drug received for 2002.....

9. ATO for 2002 1,000,000

10. Treatment figure for 2002(so far)..... 692644

1,850,060 1 l. No. of table used for the same period

t2. No. Of CDDs ffained/retrained in2002..... None 13. Projected ffeatmed target for 2003 1,000,000

4 EXECUTIVE SUMMARY In of about 4 m,rion, with about 3942 communities' Benue State has an estimated population population was we treated in r759 communities whose the first year of .DTI, in 199912000, statistics for program expanded to 4 more LGAs' The about 1083793 persons. Last year, the thesenewLGAshavenotbeenfullycollated.Itishopedthatwhenthisisready,itwouldbe we have a treating community population made available in subsequent reports. Meanwhile, of about 1.2 million.

was a bottlenecks in the year under review' There Benue CDTI was faced with numerous Enugu' in the ministry, the Unicef project officer in change in the headship of the department the program was another big problem lack of political will of the government to sponsor None payment of salaries of LGA and state faced by the project in the year under review. fund release faced by the project at all staff made matters worst. The slow processes of

contact points, in the Ministry and the Unicef office'

year under review by APOC' The No funds were officially released to the project in the five hundred and sixty thousand project had in her accounts the sum of about three million payment of the second year project naira, which was the balance of the first installment

funds. were not able to do However, we have been able to train/retrain 11 SOCTs, l80LOCTs.We staff and the CDDs for lack the other trainings, that is, the Health facilities staff, other LGA 296 traditional rulers' we of funds. An advocacy workshop was also organized for about were conducted' Some replenised our supplies, printed some posters with which the trainings in those communities in community registers were also printed to enable us replace registers could not carry out the other Ukum and Guma LGAs where communal crisis took place. We came and the CDTI activities for same reason of lack of fund, since APOC funds never counterpart funds were not equally present' training it got in May The SocTs got a new lese towards the program through the composite got any training as 2002 from the Imo/Abia GRBp facilitated by Dr E. Emuka. we never passed on to the 180 clear and rich as this in the past. The acquired knowledge was equally went out a few times trained LOCTs trained in 5 different locations in the State' The SOCTs bulk of the for supervision before the cash squeeze experienced in the project. The LGA' It was supervision done at this time was in the last communal crisis area of Ukum

2 I

lost to the crisis' and most other GDTI materials were found out that about 79369 tablets in place to do GDTI related assignments' Some of our cDDs were no longer

in the year under review' which we had There were series of NocP involved activities and support for the program' NOCP arranged thought, would revive the govemment's in LGAs in February' The Zonal office in Enugu' organized csM/sH meetings in selected ized aone-day advocacy workshop' sponsored collaboration with the State Oncho team organ byUnicef,fortheStatepolicymakersandtheLGAchairmeninFebruaryalso. in was very poor' only 2 chairmen attended Unfortunately, the tum up from the LGAs their others were being represented by either person, that of oju and ushongo, while most in their LGA' The decision reached as to the oncho coordinators or the councilor for Health by any of the LGA so far; it was LGAs' input to the program has not been implemented control' It was also agreed that in order agreed that all LGAs should support onchocerciasis counterpart fund be deducted at source from to sustain the control program in all such LGAs, their revenue allocation. with 1850060 tablets treatment is still However, we have been able to treat 692644 people make our one million target' of the 2'8 on-going and by the time we are through we would 350,000 are in our store here, million tablets collected for the year under review only about

which will exPire next Year a total of 160,000 tablets due to explre ln August, the rest are on the field. we are returning Dec. of this year to NOCP

J al

SECTION ONE

Nigeria. unicef had been endemic with onchocerciasis in Benue State is one of the states 1991, using first' the mass Distribution project (IDP) since assisting her with ivermenctin (GBTI) in 14 0f Based rreatment with Ivermectin distribution method, then the community and joined Unicef since october lggg, in introducing the Z3LGAs in the state. Apoc (GDTI). The Directed rreatment with Ivermectin successfully taking off the community 18 LGAs which means the program is on going in program has expanded to 4 more LGAs; of census figures in these 4 new LGAs' now. we have not commenced cross-validation follows: in 1991, the treatment figures are as Since the incePtion of the Program Y AT OF N TREATED PEOPLE TABLETS TREATED USED POPULATION

1 000 77 00 1 99 1 77 , 00 t07 1 92 3 0 -68,ooo120,3 2 7,948 1 J 110 124,982 3 578 t994 1 0 517,578 1995 r97, 234,000 ---84frr 579,5 1 1996 61,99 5 1997 7,354 301,942 5 334,787 1 , 4,353 ,000 1 7,428 6 000 - 7',7=11r3$ I J 1 ,630 I 8,030 500,000 2000 595,047 1,535 800, 2001 696,460 1,746 3,347, 34 2002 692,644 1,850,060 Treatment is still on going

of the idea of ATO into the From the above report it is clear that since the introduction over shot our target' However' it is project in 1998, it is only in 2000 that we met and even

4 l

treatment figures, at least since have remained steady in the note worthy that Benue CDTI

1997.

and mobilization' have done training' advocacy' supervision For the period under review we the program visit in January by the team that monitored There was a follow-up supervisory

last year

long while in project for the first time in a very very The National coordinator visited the after advocacy with the ministry's top management September (O[z.There was a high level whichtheaugustvisitorleftwiththeHon'commissionerofHealth'thePermSec''Zonal pay a in company of the State coordinator to coordinator and some members of the socT visit to the State Governor' TheNationalCoordinatorhighlightedthereasonforhisvisitandpromisesweremadebythe the program' Governor to look into the issues of supporting

activities in the LGAs in areas of collection and The LGA strike actions affected the program collation of treatment rePorts'

and withheld salary payment to the Lack of project funds hampered effective supervision for the socrs to follow their usual habit of civ, servants at a time made it very impossible later when there is fund in the going for supervision from their pockets and being reimbursed project account.

5 r

ENTATION OF GDTI 3 COMMUNIry IMPLEM NO OF NO of PeoPle NO. OF NO. OF NO OF NO OF ttO Of I i/N LGAS NO. OF NO. OF registered COMM. COMMS. I COMM. COMM COMM COMM.W COMM. DISTS. Paying Which hich That Which with GDDS iN selected collected decided decided Trained or lcoo drugs Method ot Rx CDDS cash of Rx [time kind

53168 142 1 GUMA 10 142 38495 2 BURUKU 12 64 64

1 01649 3 GBOKO 15 105 102 37791 4 KONSHISH 12 71 71 104741 5 USHONGO 12 1 7 1 167 54400 6 KWANDE 14 335 335 41178 7 I

66970 10 OTUKPO 12 106 106

58118 11 OJU 13 124 124

117232 12 ADO 14 184 184

30586 13 OKPOKWU 11 73 73

65627 14 OGBADIBO 12 167 167

36726 15 TARKA 8 65 65

40564 16 LOGO 7 86 86

48952 17 OHIMINI 9 72 72

56439 18 oBl 7 67 67

1266474 Tota 18 208 2049 2040 TABLE SHOWING PERGENTAGE ACHIEVEMENT OF TRAINING CARRIED OUT SO FAR'

% ACHIEVEMEN T WPE OF TRAINING ATO ACTUAL

SOCT 11 11 100o/o

LOCT 180 180 100o/o

HEALTH FACTLITY STAFF 540 NONE Oo/o

OTHER LGA HEALTH 540 NONE 0.00% STAFF

CDDS 3000 NONE OYo

COMPUTER TRAINING 1 NONE Oo/o

ATO 1,000,000 692644(still treating) 69%

7 TABLE SHOWING TRAINING OF THE DIFFERENT LEVELS OF STAFF INVOLVED IN CDTI IMPLEMENTATION

NO OF NO OF S/NO LGAS NO OF NO OF TOT NO OF LGA CDDS TRAINING TRAINED STAFF HEALTH TRAINED/R UNDERTAKEN TR.AINED ON CENTRE CDTI STAFF ETRAINED TRAINED ON CDTI

SOCTs 1 11

10 1 GUMA 1

2 BURUKU 1 10

3 GBOKO 1 10

4 KONSHISH 1 10

5 USHONGO 1 10

6 KWANDE 1 10

7 I(ALA 1 10

8 UKUM 1 10

I G^/vEST 1 10

,| 10 OTUKPO 10

11 OJU 1 10

12 ADO 1 10

13 OKPOKW 1 10

14 OGBADIB 1 10

15 TARKA 1 10

16 LOGO 1 10

17 OHIMINI 1 10

18 oBt 1 10

TOTAL 18 5 180

E Section 3

NG'OCTO BER 2OO1 -SEPTEM BERaOO2 TABLE SHOWI NG TREATM ENT COVERI

OF NO OF t'ro or rnenreol -ouu.e NO OF NO OF COST/PE NO NO OF I S/N LGA COMM. I RSON Rx COMM.IN DlSTs. WITH COMM. oPULArl ELIGIBLE TABS I WHICH SUPERVISE SUMMARY ON PERSONS USED TREATED FORMS TREATED ICDD IS A DBY lsealrn HEALTH lwonxen WORKER

142 69 27603 64000 1 GUMA 142 531

118179 64 2 BURUKU 64 38495 45967

44298 105 3 GBOKO 105 1 01 649 1 7693

71 4 KONSHISHA 71 37791 29071 76179

167 5 USHONGO 171 104741 38745 99664

335 6 KWANDE 335 54400 91683 2641 99

57 7 I(ALA 57 41178 59320 156024

65 8 UKUM 65 258880 3523 8962

93 I G^It/EST 95 54958 45870 118823

106 10 OTUKPO 106 66970 51 925 1 29030

'124 11 OJU 124 58118 53954 131022

79 12 ADO 184 117232 14649 35487

73 13 OKPOKWU 73 30586 70257 214805

167 14 OGBADIBO 167 65627 42581 117541

65 15 TARKA 65 36726 28164 72799

86 16 LOGO 86 40564 11989 32055

65 17 OHIMINI 72 48952 18734 54954

67 18 oBt 67 56439 1 9083 45352

19 FERRAL CENTRE 21 833 66687

20 WASTAGE 531 I

1 931 Tot 18 2049 1266474 692644 1 850060 3 TherewasnotmuchmobilizationsessionssincewecouldnotgoouttotheLGAsandcould notpayforairtimefortherelayofourjingles,forthesalnereasonearliergiven.

SECTION 4

STRENGHTS AND WEAKNESSES

team know that we have not been The program is assessed to be a failure but we in the State We may act dumb sometimes supported by all the partners to fully bring out the best in us' but that dose not make us dummies

WEAKNESSES: Our weaknesses seem to be many and include: 1. Lack of commitment of all implementers of CDTI 2. Inadequate grasp of cDTI implementation processes by SocTs 3. Lack of support for CDDs 4. Inadequate support by policy makers 5. Frequent change of policy makers 6. Inadequate community involvement 7. Inadequate counterpart funding by all tiers of government 8. Non involvement of CBOs and lack of collaboration 9. Poor tVEducation and mobilization

10. Poor supervision hence poor reporting and record keeping funds, among 1 1. Inability to collect drugs early from Lagos due to delay in release of other things. It may be necessary to change the Coordinator of the State team just so that we will see if things could move ahead for the benefit of the masses at the end of the line in the communities. I hope this may relax the already very tense state in the project. Though the

'/o dose not See any as being incompetent' She' however Coordinator dose not assess herself Though a few of the the inception of the new Director' clear success of the program since the articulation and success of the program they lack SOCTs are enthusiastic about the complete overhaul of the requires. There might be need for stamina that the .DTI program

State team. on oncho LGA of Health are mobilized to participate The principar officers in the state Min and are have understood the concept of the .DTI mobilization exercises. More communities morewillingtosupporttheprogram,seeingtheusefulnessoftheirfullparticipationinthe

success and sustainability of the program' from an agreed center, help in distribution' More communities now collect their drug the CDDs by giving them various incentives' supervise all IDp related activities and support

make funds available for the collection of The state govenrment is still making plans to capital equipment that have been lying in Lagos' include: Some of the major achievements of the project to determine ownership of the program * Creation of more awareness of communities the CDTI LGAs' through the initiation of the cslu/sH meetings in needs' they can now come * Empowerment of communities to determine their health consider other health needs' together and through dialoguing for GDTI activities also to more effectively execute * Empowerment and motivation of the SOCT and LOCT their assignment.

The constraints and challenges of the next treatment cycle are:

4t AREA OF IMPROVEMENT

o There is need for increased advocacy to all tiers govemment by the extemal parfrrers and the NGDOs. This it is hoped would increase the political will of the govemment.

0 More supervision of the community activities of Oncho control by the SOCTs. t Increased mobilization and tV Education of the communities. o There should be early and faster means of release of fund to the project. t The Directors of PHC or Medical and Health Services should be made to attend

review meetings or other meetings where the program's implementation is deliberated. r The Unicef Project Officer in Enugu, in charge of Oncho, should be made to better understand Apoc's philosophy, mode of operation and the difference between Unicef J and APOC technical approach to implementation and accounting system.

Coordinator: u (

Director:

SlGt{EO tuZ Perm.Sec. t --,-. ,EiMrr*r r. el Hr' "r Iltc i/,02

..t I lo( I

(o FU s8r=aElt A lrl ir -.tr (D A o i. E5 g H s.E E*3 ori L/I T! o Fi Fl Fi o F EcHee+rF$6EH=BE*Eg. z tal \Jt cr) V) - a { EE oo o Irt E trl ooFl Fl Fl o (A '\ I z z -t / El t!, g) o FU F( ? f 'E I tr z- El o U \J z g r=B**lJ ()p= l-l E bv)5=. t o E s i; iJ l-h 13 i. ,-a' r+ (,) gASFT H c ''l--lV urO o F l) t, Fr') 'Hf F ll E H llr ta, E FU o c o d llF o\ (, iEg *rH O o\ E E' o o oI tr FJ \, Ft Fl z D - o U F' o c)o P F o\ t, I O o\ H oll F

t3 I

E'ilE 118 E EHt-Fm* '

ro p g) iI o. {E E + **'€ f a'.+ H. f € ' 9 F$FA 7=HgEF B E$gFE*a: F q8 6, 0 fca fra FN Ql o) qJ A) (D U)>6 '-\ .a>6 .\

z U o (D >PZ t) qf (D Ari A.)Fh, $rgil Eg= $[ pFA o

*E,*,rEEu[$.$[g;+g

(,r 5 5 o 6 o

t5 I