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Republic of the Gambia Ministry of Health and Social Welfare REPUBLIC OF THE GAMBIA MINISTRY OF HEALTH AND SOCIAL WELFARE NATIONAL MASTER PLAN FOR NEGLECTED TROPICAL DISEASES 2015-2020 December 2014 1 Table of Contents LIST OF FIGURES ................................................................................................................................................. 3 LIST OF TABLES ................................................................................................................................................... 4 LIST OF ANNEXES ................................................................................................................................................ 5 LIST OF ACRONYMS ........................................................................................................................................... 6 FORWARD ................................................................................................................................................................ 9 ACKNOWLEDGMENT ........................................................................................................................................ 10 LIST OF CONTRIBUTORS ................................................................................................................................ 11 INTRODUCTION ................................................................................................................................................... 13 PART 1: SITUATIONAL ANALYSIS .............................................................................................................. 15 PART 2: NTD STRATEGIC AGENDA ........................................................................................................... 41 PART 3: OPERATIONAL FRAMEWORK .................................................................................................... 53 3.1 SCALING UP ACCESS TO NTD INTERVENTIONS, TREATMENT AND SERVICE DELIVERY CAPACITY .................................................................................................................................................. 53 3.1.1 Scaling up preventive chemotherapy interventions .............................................................................................53 3.3 PHARCOVIGILANCE IN NTD CONTROL ACTIVITIES ..................................................................... 60 3.4 STRENGTHENING CAPACITY AT NATIONAL LEVEL FOR NTD PROGRAMME MANAGEMENT AND IMPLEMENTATION .................................................................................................................................... 61 3.5 ENHANCING PLANNING FOR RESULTS, RESOURCE MOBILIZATION AND FINANCIAL SUSTAINABILITY ....................................................................................................................................... 63 3.6 STRENGTHENING GOVERNMENT OWNERSHIP, ADVOCACY, COORDINATION AND PARTNERSHIPS ........................................................................................................................................ 64 3.8. POST INTERVENTION SURVEILLANCE AND INTEGRATION WITHIN PRIMARY HEALTH CARE66 BUDGET JUSTIFICATION AND ESTIMATES ........................................................................................... 68 ANNEXES ................................................................................................................................................................ 69 PART I SITUATION ANALYSIS ................................................................................................................. 69 2 List of Figures Figure 1: Administrative Structures of The Republic Of Gambia……………………………………………………….16 Figure 2: Gambia Showing The Population Density. ………………..…………………………………………………..18 Figure 3: Population Size And Growth Of The Gambia ……..…………………………………………………………..18 Fiure 4: Map of PC-NTD coendemicity in Gambia…………………………………………………………….34 3 List of Tables Table1: National Population Data, Schools,And Health Facilities At District Level ………………..…………………..17 Table 2.1: LF Disease Distribution In The Country ………………..………………………………. ………………………29 Table 2.2: Trachoma Distribution In The Gambia………………..……………………………….. ………………………..30 Table 2.3: Known Disease Distribution Of Urinary Schistosomiasis In The Gambia ………………………………….30 Table 2.4: STH Distribution In The Gambia………………..………………………………………………………………...31 Table 2.5: Number of dog bites per region from 2011 to 2014. Source, HMIS/MOH&SW…...………....31 Table 2.6: Distribution Trends of Leprosy Cases According To Regions In The Gambia (2005- 2010) ………………32 Table 3: NTD Co-Enedmicity………………..……………………………………..…………………………………………...33 Table 4: NTD Mapping Status………………..……………………………………..…………………… ……………….……35 Table 5.1: Summary Of Intervention Information on Existing PCT-NTD Programmes……… …………….…………..36 Table 5.2: Summary Of Intervention Information on Existing CM Programmes ……………… ……………….………..36 Table 6.1: SWOT Analysis: STH / SCH / LF………………..…………………………………………………………….…...38 Table 6.2: SWOT Analysis: Trachoma………………..…………………………………………… ………………….….….38 Table 6.3: SWOT Analysis: Leprosy ………………..………………………………………………………………..……….39 Table 6.4: SWOT Analysis: Rabies………………..…………………………………………………………………….…….40 Table 7: Strategic Framework Summary………………..…………………………………………………………….……....42 Table 8: Summary of NTD Disease Specific Goals and Objectives………………..…………………………….……….44 Table 9: Types of Mass Drug Administration………………..…………………………………………………….………….54 Table 10: Activities For Strategic Priority 1- Scale Up Access To PCT Interventions………………………….…………55 Table 11: Activities For Case Management Interventions………………..……………………………………….…………56 Table 12: Case Management And Chronic Care………………..…………………… …………………………….………..57 Table 13: Intervention Packages For Transmission Control………………..…………………… ………………..………...58 Table 14: Activities For Disease Transmission Control………………..………………………………………….….….…..59 Table 15: Activities For Strengthening Pharmaco-Vigilance In NTD Programme………… ……………………..….……61 Table 16: Activities And Resources Needed For Strengthening Capacity For NTD Programme ……………...………62 Table 17: Scaling Up/Scaling Down Plan. ………………..…………………………………………………………..……….64 Table 18: Activities For Implementing Strategic Priority 1: ………………..…………………………………………………65 Table19: Activities For Implementing Strategic Priority 4: ………………..………………..…………………………….….66 Table 20: Activities For Surveillance And Sustainability………………..……………………………………….……………67 4 List of Annexes Annex 1.1. Populations, Villages/Communities, Children, Schools, and Health Facilities ……..…………………… ….69 Annex 1.2. : Distances Between Main Cities And District Headquarters of The Country………………………………….69 Annex 1.3: Organisational Chart of The MOH &SW and The NTD National Programme……………………………….70 Annex 1.4: Summary on Available Data Of PCT-NTD Distribution………………..………………………………………71 Annex 1.5: Summary on Available Data On CM-NTD Distribution……………..………………………………………. 71 Annex 1.6: Summary on Status Of Implementation of PCT- NTD Interventions In Districts……………………………72 Annex 1.7: Summary on Status Of Implementation of CM Interventions In Districts …………………………………….73 Annex 2. 1: Package of Preventive Chemotherapy (PCT) - Mass Drug Administration (Mda)…………………………..74 Annex 2.2: Package Of Case Management (CM) and Chronic Care……………………………………………………….74 Annex 2. 3: PCT Algorithm 1……………………………………………………………………………………………………..75 Annex 2.4: PCT Algorithm 2……………………………………………………………………………………………………..75 Annex 2.5: Algorithm For Co-Endemicity Of Cm-Ntds In Countries of the Who African Region…………..……………..76 Annex 2.6: Package Of Transmission Control - Vector/Reservoir Control………………………………………………….77 Annex 2.7: Package Of Improvement of Environment, Supply Of Safe Drinking Water, Sanitation, …………………77 Annex 2.8: What To Do” By District (Operational Unit) By Operational Package…………… ……………………………78 Annex 2.9: Drug Estimates And Logistics……………………………………………………………………………………..79 Annex 2.10: Drug Forecasting And Logistics……………………………………………………………………………………79 Annex 2.11: Summary Of Progressive Scale Up And Phase Out Of PCT Interventions Package ……………………….80 Annex 2.12: Results Framework For The WHO-HQ-AFRO-APOC Strategic Plan, 2010–2015 …………………….……81 5 LIST OF ACRONYMS CACs Catchment Area Committees CBI Community Based Initiatives CBOs Community Based Organizations CDCP The Centre for Disease Control and Prevention Atlanta CEO Chief Executive Officer CHNs Community Health Nurses CM-NTDs Case Management- Neglected Tropical Diseases CMDs Chief Medical Directors CRR Central River Region DHIS2 District Health Information System version 2 DHPE Directorate of Health Promotion and Education DHS Directorate of Health Services DRF Drug Revolving Fund DSW Directorate of Social Welfare EDC Epidemiology and Disease Control DPI Directorate of Planning and Information EPI Expanded Program on Immunization FSQHE Directorate of Food Standards, Quality and Hygiene Enforcement GAVI Global Alliance on Vaccine and Immunization GBoS Gambia Bureau of Statistic GDP Gross Domestic Product GFATM Global Fund for AIDS, TB and Malaria GRTS Gambia Radio and Television Services GHW General Health Worker HDI Human Development Index HIV/AIDs Human Immune Deficiency Virus HMIS Health Management Information System HMIS The Health Information System HND Higher National Diploma HRH Human Resources for Health 6 ICT Immunochromatography Test ICC Inter-Agency Coordinating Committee IDM Integreted Disease Management IDSR Integrated Disease Surveillance and Response IDSR Integrated Disease Surveillance and Response IEC Independent Electoral Commission IEC/BCC Information
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