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OGUN STATE CDTI PROJECT
OltlClNAL : Linglish COUNTRY/NOTF: NIGERIA lroigct Nilnte: OGUN STATE CDTI PITOJECT
Aprlroval year: FEBRUARY ,2000 Launching year: NOVEMIIE It, 2001 Reportine Period: From: January, 2006 To: December, 2006. Month/Ycar Month/Yca Proiect year of this repo (circleone) I 2 3 4 (5\678910 Date subrnitted: December, 2006. ITGDO partner: IFESHi UNIVA.
ANNUAL PROJBCT TBCHNICAL IIEPOITT SUBMITTED TO TECHNICAL CONSULTATIVE COMMITTEE (TCC) Ac-icn ' .i'j) I er TEL 6sb c€\l BIM coq AHE DEADLINE FOR SUBMISST ON: BfO u0 To APOC Management by 3l January fbr March TCC rneeting i:or ltfornuiion Tor To APOC DiR Management by 31 Julv fbr Septernbcr'l'CC ntecring ho frAlt4w n-kk;Ld
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ONCHOCERCIASIS CONTITOL (APOC) |
Wl-lO/n l'OC. 24 Nove rnber'2()04 2 o iUlL, 2007
\
A]\[NUAL PROJECT TECHNICAL REPORT TO TECHNICAL CONSULTATIVE COMMITTEE (TCC) ENDORSEMENT
Please confirm you have read this report by signing in the appropriate space.
OFFICERS to sign the report:
Country: NIGERIA
National Coordinator Name: Mrs- P- Ogbu Pearce
Signature: ... Yk /- Date: 1....J.\*{5
Zonal Oncho Coordinator Name: Otunba A- Jaiyeoba
Signature: .
NGDO Representative Name: Dr. R. A. Aderinoye
Signature, ...&r::.)..-i.. :... .:. * >it r{. d ,, j- ;':'r 4 -t' Date: . r../ :\*<. ..':<.\ .'
This report has been prepared by Name : Mr- V. O. Osikoya
Designation : Project Coordinator
Signature, ..,&rf:1.F -l:{:.o ' ,')fL' Date ..5...... J.r.q.r.*L.. ?..t:-i / Table of contents
ACIIONYMS...... 5
DEFINITIONS...... 6
FOLLOW UP ON TCC' RECOMMENDATIONS... 7 BXECUTIVB SUMMARY...... u SECTION I : BACI(GROUND INFOT{MATION ...... 9 t. Ct,NnrtnL lNt.ortMn't'toN ...... ,9 I I De sc r ipt ion oJ' t he proje c r ( b r i eJty) .9 I I 2. Purtnership...... l0 2. Pot,uLnt'toN ll SECTION 2: IMPLEMENTATION oF CDTI .... r3 2.1. Tttr.tt L.tNu orr Ac't-tvtfiljs...... ,...... , ...... l.l 2'2' A'vocacv ...... rj 2.3. Mogtt,tza'rloN, sENStt-tzATloN AND IiliAL'n-rDDUCn roN oF A'r'r(rsr( corvlMUNuu_s r7 2.4. CoulruNrry TNVoLVEMENI-...... lg 2.5. C,npncn'y BUILDINC...... 19 2.6. TnuelveN-ts ...... 2 t 2.6.1. Treatnent/igures...... 2t 2.6.2 l[/\rcil are the cquse.s of absenteei.sm? ...... ]1 2,6.3 What ure tha rau,,;on,sfor rc./irl*rl.t,?.....,...... , ll 2.6.1 tlricJly describe ull known andveriJied.s'erioLts'udvcr,vc c,,,crt,\. 1s:AL,s1 rrtut... )J 2'6'5' Ttcnd of treutnrcnl ac'hievenrcnlJi'om CDTI prttjcct itrception !o tlta c,t,rrrcnt yas11.l11 2.7. OtroERrNG, s't'oRACE nND DELIVET{y ot, rvDr{MECt-rN ...... 27 2.8. corvvuMry SELF-MONI]'oRrNC AND sTAKET]oLDErts Mutr.tNc 2,9. Sut,8RV1s1oN...... 2g ...... 29 2.9.1. Provide aflotv chart of supervision hierarc,hy...... J9 2.9.2. lvhut were the moin issues identiJiet) cluring supervisittrt.)...... lg 2.9.3. lI/o.t a supen,i:;ion checklist u:;ecl?...... _ . .. 2g 2'9'1' l'l/hul were lha ottlcontes ttt euch lcvcl oJ L'DI'l itttplctttan!uttt)n.tLrltct.t,r.ttrtrt, -i() 2 9 5 ll/asfeedback givcn ro rhe per:sott or groltps:;upervi,sad).. _j0 2'9'6' How wtrs thefeedback usecl to tnrproie th'c ove:rall perJt-trtrturtc.a oJ the prolcct/J0 SBCTTON 3: SUPPORT TO CDTI 3.1. EqrrrpvnNr 3.2. FtNnNctel coN'rRrBUr-roNS orr pAllr.Nlrr{s r.rE AND coMMuNr.r.rrrs 2 3.3. OlnsR Fot{MS oF coMMUNt-ty suppor{.t...... 3.4. Exl,[NDlt'utrtrputlnct'tvr.l.y 2 SECTION 4: SUSTAINABILITY oF CDTI
4.1, II.IT'IITTNEI; INDEPIINDENT PAI{]-ICIPAI'ORY MONI'I-OI(IN(;; EVNL,UIT'IICIN. 1' l' l Ll/al; Monitorirtg/cveiluation curriacl oul durirtg llta reltot.ttttg 1tct.iotl',) (ltcA rttt.r' oJ tlrc which ttrc ul4tlicetbla)... /itllorvtrtg ...... ,, -iJ 1.1.2. U/hetl wcre tltc recttntntcntlctlittn:;'!...... i/
3 Wll()/n l'()( . l.l Nrrisnll)st jOO-l 1.1.3. How have they been intple ntented'?...... , 31 4.2. SusrntNnntLITy otr I,RoJECt's: PLAN AND sET t'Alr.clll's (MANDA'l'or{y Ar'. 34 Yrr 3) i+ 1.2.1. Plunning ett ull relevant levels...... jl 1.2.2 F'und:;...... jJ 1.2.3 Transporl (replacemertl and mairttcnartc.a) _l-t 1.2.1. Other resources _i-t y,hut 1.2.5. To exlenl ha:s the plan been irupleruente(1...... j.t 4.3. IN'rticlrrvrtc)N..,...... 35 1.3.1. Ivernrcctin dclivery nrcchanisnt.r...... ,...... jj 1.3.2. Trutning..... _ij 1.3.3. Joint supervi.ti'n and nrcniloringwilh other 1trogr,m,\ ...... _lj 1.3.1. lle lausa oJ'JiltulsJitr prtlcc.t ttclivittal;.... ,..,...... Jj 1.3.5. l.s CDTI inc.lutlccl pHC in the hudgcr'?... . . -i., 1.-1.6. Dc};c'rilrc otlrcr ln'ttlllt l)rout'uuunt,s'lltttt ttt't, rrsitty llrc,('l)'l't \lt'uL,tyt.(,t1ttl lrrtr tlti:s tvtr:; crchievad. I{hql huve bccn the erchievetnutl.t,,? .... . -i-, 1.3.7. Dc:;cribc orhar.s ilsl;trc,;' con.sidcrcd irt rlrc ittlcgretrictrt of L'D:L _jj 4.4. Opnnn'troNAt_ nllsEAr{cr-t ...... 36 1'1'1. Strtttttturizc in trut ntora lhutr onc lur(/'ty''(t pul1c tlta r.4tartrttottttl rc,satrt.t,lt ttndcrtqke n in the pro.ject cucct tyilhin the repctrlittg pariocl. . ... _j6 1.1.2. I lttrv tvcra tlrc ra:;trlt:s c44tlicd irt tlrc prqjc-cl'/...... ,..,. j6 SECTION 5: STREN GT}IS, WEAKNESSES, CHALLENGBS, ANI) OPPOTTTUNITIBS ... .. Jo sEc'tloN 6: UNIQUE FEATURIS olr rHIi PROJIICT/OrHER MA'r.I.t us...... J6
4 Wl'lO/n I'OC', 24 Nor,cntbcr. 2004 Acronyms
APOC Aliican Programnre lbr Onchocerciasis Control ATO Annual Treatnrcnt Obj ective ATrO Annual Training Objective CAN Christian Association of Nigeria CBO Conrnr un ity-Based Organ ization CDD Cornm un ity-Directed Distri butor
CDTI Cornnr u n ity-Di rected Treatmetrt w ith I vcrntcctitr CSM Corrnrun ity Sel l'-Mon itoring ITGN Federal Governmcnt of Nigeria FM Irrequerrcy Modulation CCCC Covernurent Cash Counterpart ContribLrtion II.-ESFI International Foundation tbr Education & Sell-Help LC Local (loverntrent LCA Local Covernrnent Area
LOCT Local Covernment Oncliocerciasis Control Teanr MOH Ministry of Flealrh NCDO Non-Governmental Development Organization NCO Non-Governmental Organ ization NOTItr National Onchocerciasis'fask Force NPI National Progranrme on Immunization NTA National Television Authourrity OCBC Ogun State Broadcasting Corporation OCRUMED Ogun State Rural Medical Schetne OGTV Ogun State Television PHC Prirnary Health Care PHC & DC Prinrary Health Care & Disease Control RBM Roll Back Malaria REMO Rapid Epidenriological Mapping of Onchocerciasis SAE Severe Adverse Event SHM Stakeholders rneeting SOCT State Onchocerciasis Control Tcarn
TB 1'uberc u losis 1'B/L Tuberculosis and Leprosy Progratnme 'l-cchnical TCC consLrltative cornrnittcc (AIroc scicntillc aclvisorl gr.uLrp) TOT Trainer of traincrs UNICEI.- Urrited Nations Children's Fund
IJN IVA University Vi I lage Association
UTC U I titn atc'frcatnte.rrt Coa I wHo World Health Organizatiorr
5 WllO/n l']OC. 2J Norurrbe r l(X).1 .i. Definitions
(i) Total population: the total populatiorr liviug in nreso/hyper-endenric conruir-rrritrcs within the project area (based on REMO and cerrsirs taking).
(ii) Eligible pop,rrlatiorr: calculated as 84o/u ol'thc tottrl populatiort rn rrrcsoilryper- errdertric corlnrunities in the project area.
(iii) Anrrual Tre ent Obiective (ATO): tlre estimated nurnber o1'persons lrvins irr nleso/lryper-endcntic areas that a CD'l'l project intcrtds [o Lt'ci,rt witlr rvut.rle!:trr rr a given year.
(iv) lJllitttittc Trclt.!!rrcrrt Goill (tJ'l'C): cirlculirtccl as tlrc rrr:rxirrrrrrrr rrrrrrrtrer ol';leoPl,., lo be trcatcd attrtually irt rttcso/ltypcl crrelcrtrie arcas witlrrrr Ilre l)r'()]eel .lre(r. ultirrrlrtcly tt.t bc t'eitcltecJ rvhcn thc plojcct has lcachecl lirll geogr.lrl-rhic ctrvcr.lge (norrlrally the project should bc cxpcctcd Lo leaclr thc U'l'C at Lhe crrcl ol'tlrc -j',r year ofthe project).
(v) Tllerapeurtic coverage: nutlber of people treatecl irr a glvc'n _vear ovet thc tptirl population (this should be cxltrcssecl as a pcrce nLage ).
(vi) Geographical coveraqe: t.ttttnber of corlrnunities treatecl in ir grverr ycar ovcr.tlre total number of meso/hyper-endernic conrmunities as identiliecl bv REMO rrr rlre project area (this should be expressed as a percentage).
(vii) Ittlctlt'ittitltt: clclivcring aclclitional hcalth irrtclverrtiorrs (i.c. viLuntilr A sultlllcrlcrrts. albenc!-."zole fbr LF, screening fbr cataract, ctc.) [hl.oLlgh cDll (r_rsrr.rg Ilre :.rrrre systellls, trairling, supervision and pelsorrncl) in order'to rnaxirnrse cost- efl'ectiveness and empower cornrlrunities to solve rlole ol'thcir health pr-oblcr;s. This does not include activities or irrterveutions carricd or-rl. by cornrrurrity distribLrtors oLrtside of CD'II. (viii) SLrstainability: CDTI activities in an area are sulstainable,,vhen they coptrprrc ro futrction efl'ectively for the lbreseeable firturre, with high Ircatr)rr:nt covcrlgc. integrated into the available ltealthcalc service. *,11, )rlorrg eL)r11rgr)rr-\ ownership, using resources rnclbiliscrl by the conlnrLurty ancl thc gu*r,,,,,.,.,t. (ix) CornmLrnity self:rnonitorins (.CSM): The process by which tlre cor.nrlurrtrrl, is etnpowered to oversee and tnonitor the perlbrmance ol'CD1'l (or alry conllr)L;lrt_\- based health intervention programme), with ii view to.,,sr-,,:i,-,g rlrrrr Llre programme is being executed in the way intendecl. It encourages the ct-rrr,1rLr1it1 to take full responsibility of ivernrectin distribution and rnal 6 Wl-lOiA POC', 2.1 Novcnr ber. 2004 FOLLOW UP ON TCG REGOMMENDATIONS Usirrg the table below, fill in the recomrnendations ol' thc last 'l'CC orr tlre projcct irrrd descrihc how they have been addressed, TCC scssiorr Numher of TCC ACTIONS TAKEN BY TIIE FOR T('-('/..t P( )( llcc'onnc trktt ion RECOIzIIUIENDATIONS PIIOJECT t\l(i'l'L'5'l;t)\l ) tn thc lleport I -_l (Plcusc uclcl norc rows f'nccessury) 7 Wl lOin l')()('. 2J Nor errrlrur' ltt{).1 Executive Summary Prepure un Executive summury of the report in not more lhutt one puge Ogun State is one of the 36 States in the Federal republic of Nigeria. Located in the South Western part of Nigeria, it is made up of 20 local government areas with a plo.jectecl population of 3.3 million. The greater proportiorr of the State lies in the tropical rairr fbrcsr zone with a sizeable featuie of Guinea Savannah in the northenl parr. The people in the Statc are predominantly Yorubas of which there are ljebus, Yewas, Egbas, Aworis, Egr.rns, arrci Remos. The prevalence survey of 1994 and the subsequent REMO refine of 1997 ancl 2000 revealed that the State is endentic for Orrchocerciasis. Mectizan distributiorr in thc Sturc started in year 2001 with suppott from IFESH and APOC. CDTI is beirrg inrplernenred in 952 cotntnunities in 8 LCAs. The total population ol'the cndcmic areas is 312,406. l)tlpttlutiott lllovclllcl'lts occttr witlt tltc ntigratiorr ol'yt.turrg ones lit-rrrr tlre 1u1al irr,cits Ir*rIrirrr centers in search of greener pastLlres. There are also movenrents whep I'alrncrs ancl particularly flshermen move temporarily to new areas during particular seasons. pcstivc seasons (religious or traditional) provide opportunity fbr movenrent of per.sops 1i9qr comtnunity [o colnlnunity and lionr urban ilrcas to tlrc corlnrur-ritres. ancl vicc vcr.sa. During thc pcriod being reportcdg3T conurunitics wcrc covcrccj and 258,359 pcrsons Lrcarcd thus achieving 98%o geographical coverage and 83oh therapeutic coverage. The treatntenrs nlcallt a covcrage rate of 99%o ol' thc Ultirlatc'frcatntcnt Coal ol-202,422 and l0l,)i, ul rlre Annual Treatment Objective of 255,233. 768 health workers (280 new and 488 relieslrer) and 2,000 CDDs (192 pew apcl l,g0ti refresher) were trained during the reporting period thus achieving l00Zoof A'l-rOs fbr hellth workers and CDDs respectively. 153 State and LGA policy nrakers were nrobilized as rvcll as 285 village heads, 148 women leaders and 133 religious leaders to sLrpporr CD'l'1. The strengths of the intplementation process include thc involvcrncnt gl're ligigus organizations and chulches in the CDTI process, high oornrnr.rnity awalcrrcs.,-,1'rhe br-rrcllrs Mectizan of treatlnent, willingrress of conrrrrunity rnenrbcrs to cornply with annr.ral trcatlrupt, availability of trained health staff at all levels, willingness of rnost CDDs 19 co.tinue with Mectizan distribution despitc lack of or inadequatc inccntivcs, prcscncc ol'a cerlrrrir.tcrl supporting NGDO' and release of funds by the State governnrent annually since progr-arlprc inception. Weaknesses experienced are non-release of counterpart funding by LCAs especially duripg this campaign period preparatory to the general elections, non-institution ol'.ornrr.,Li,rit; ,.il'- monitoring and inadequate involvement of the FLHF staff in the GDTI process. Challenges tircing the project include instability ol-political appointees/c1rt'r1l 8 WLIO/n l)OC',24 Norcntbcr, 100.1 SEGTION {: Background information \ 1.1. General information l.l.l Description of the project (brielly) - Geographicallpcation,topograplry,climate Ogun,State, otherwise known as the Gateway State, was carved out of the clelirnct Wcsterrr Statc on 3'd February, 1976by the Federal Military Government of Late Ceneral Murtala Itarn ar Mohanrmed. lt lies within the tropics. It is bound in the West by the Benin RepLrblic; irr the' south by Lagos State and the Atlantic Ocean; in the East by Ondo State; and irr the North b1, Oyo and Osun States. Ogun State occupies a total areas of 16,409,26 scltrare l - Population: activities, cultures, languargc. projected 'l-lic The population for the State is 3.3 rnillion. major ethnic groLrps are the Egbas, Aworis, Eguns, Ijebus and Remos. These all belong to the main yoiuba ethlic groulr. -Y:*o.t, -l-hc Nigerians from other parts of the country as well us also live in the State. "*put.Ltes languages spoken are mainly Yoruba (language of the inajority) and Englislr (thc ol-ficial language). There are several dialects of the indigenous tairguage, inclLrcling l.jebu, Repro, Egba, Yewa, Awori, Egun, lkale and Ilaje. fhe rnajoru.rrprtirn ol'rhe ptrpr,taLion is farming. Fishing, weaving of traditional cloth (Aso--Oke), and production of traditional dresses, 'tie and dye' (kampala and adire) are practiced. Settlement pattern is largely dispersed. - Communication systems (roads...) Roads bctwccn tttajorcities are in good condition, but acccss roacls Is rrrrst .l'tlrc crclcrrrii communities are ilt poor shape. Some are not passable during the rainy scason. Despitc thrs. transport by road remains a major means of communication among the conrmunities.'l'hc electronic and print rnedia are also veritable channels of communication. - Administrationstructure. The State consists of 20 Local Government Areas that are headed by Chairmen - poliricians elected by the people. There is a legislative arm made up electeij Councilors liorn varioLrs -l'hcrc.r.c wards' At the State level, the Executive Covernor is the l-lcad of administration. lhc Legislative and Judicial Arms. There is also the traditional administrative system which has the district and community leaders in charge, They surpport the rnodern aclniinistrativc ser up. The capital of the State is located in Abeokuta. - Health system & Health Care Delivery (provide the number of health posts/centers in the project arca if thc inlbrnration is available). There is an official PHC policy and structure in the Project area. It is a syslem of health care services where community participation fbrms the rnainstay with ,rppori fiop rhe Srare, Local Government and NGOs. Level of functionality however varies across t6e State. 'l'1e health facilities in the State are spread and located in variours LCAs, and thcy rarrge frsrrr Health Posts to Hospitals. There are 426 Health Clirric/centers/ posts arrd g I:lospiisls ip thc Project Area. 9 WIlO/n l)OC. 2.1 Nor crlbcr l()()J Table l:Numberof health staff involved in CDTI (Plea,te utlcl ntore row:; i/'nece.\,\,ary)) ( Numbor of health stalT involvcd in CD'l'l activitrcs. l'otal Nurnbcr of Nunrbcr ol'hcalth Pcrccntirgc hcalth stall'in thc stll'l'involvcd in cntiro projoct at'ea cD't'l l)islrict/l,GA ' t|, li.1=ll2l ll1 *100 Abeokuta Nonh 185 1)6 520 Abeokuta South 205 96 47'/" Ewekoro r85 96 a10/ ilb 127 96 760,,,, lnrcko-Ailtr I t6 96 83yu ( )baf'cnr i-Orvrxjc L)6 190 5 lut,' Odeda l4l .)() 68% \ cwa-Not'th t32 96 'l'otal 128 I 76tl 0ul, 1.1.2. Partnership The partner involved in project implenrentation in Ogun State are IFESFI/UNIVA; IrCN &Zonal {NoCP-National offices}, State covernment,larioLrs Local Govenlrrenr.s ancl the Endenric Comnrunities. Sonre religious Orgarrizations are assisting in thc distribLrtiop.l' lvermectin. These include such bodies as CAN, Bible Sociel.y of Nigeria, N,{SljA l. DAwAI-1, NAwA-ltU-DEEN and Christiatt Corpcrs' Fcllowship. ionic Muiltcr Assgciar.isrrs and commcrcial rnotorcycles riders' associations are also involved in the CDTI process. IFESH/UNIVA is mainly involved in planning, occasional advocacy and also assisrs in providing technical aid in Training, cortunun-ity mobilization, co-i'inancir-rg l)r-egr.lrpprc activities, monitoring, encouraging in Mectizan treatrnent. The NoCI, zonal olflcc pr.oviclcs the enabling and favourable environment fbr project implernentatiou, ancl gives supporrivc supervision of CDTI in ogun State. The State, LcA and eridernic com,lunit! carry our rhcir various responsibilities under CDTI. The religious groups assist in.o,r,1.,r,.,ity rnobilization and creation of awareness. Partners are working together in harmony to achieve a successfirl iurplelrcrlLation ol'the Programme. There are plans to sensitize and rnobilize 2local NGOs pcr LCA as well as rhe new politieal cffice holders that will come in after the country's geneial elections April- May 2007. l0 WI-lO/Al,OC, 24 Novenrbsr. 2004 *q q I rrl A I tr o I rD a- C' d 6 ! l-' (D 5 I -JLV (\ \ o FO o (D .D rD +AJ-- lu N (\ l)' ) a il tJ F) o- ?D, T 2f o rl{--. F 16- I A) o I o x x f) 3 l'-irE o ls-r (\ -J z o- '-f--'v ! - -i ,+ o I FD FD R; o sPs' > 3 o' U) ,:.-*^ri-@v ^' F o z L.+ =-r- :l ! (a 3: G o I tr Oa \ o- +(,t:tDx -a o \ AI .?B.=e Z-t\ ?q ;l > € G 9-9E ?rD o Q (, .d (!; x Sh f O:i \ F 5 5 u) NJ g o \o ;'g tr FD ;:fi o h.) A J' )o N I;lalD (\ d \ l.J UJ \o { o\ ! o- (1 5 UJ UJ ! N) UJ A :rdo EE { o\ (+J oo o Oa o\ -] A ni= ,oo oGE=' D)-. i t^ $. G o (\ FD _J o Ir \ El;' FO l* - \o 60l l> Oo o \ Ul { \o oo IG G t.) 5 o\ NJ oo \o ;+='= F De*P x (\ ,o\ o z $ (! t E'i, (\ .! E e q : G rD os tD r! OO rt (\ o a) (! I \ a D+ 1- 2 I I I I \ :.i 6 I Q 6 I 6 tD I \ o .) o o \ q (D (n i o .D I 19 I I z sG o rl 6 D9 - o o \o il o CJ s \o oo o V. Ut { {! t D b.) (+) A o\ IJ oo \o o o + N a0 n G o d o a ! FD I 6 t (A .D fo \ I o \=.^{- \= rD .) ti '1 o )(\ (, ErF a- .-\ A A N) ul I 5 (J) v t\) o N) "l.J J^' "ro )o ia -J UJ ! o\ ;+='5 - 5 (JJ UJ \] NJ UJ { I A D-= o q\ o\ ! o\ @ ! A -,S o- dF \ i.l = =. si Yr UA e.3 3 o o o<- rD G I I I I 3;'3E - 'o.D a f ' o s. $G=a 3. F9 d ga a r\1 (, o - 5 UJ L,I 5 |JJ t\) UJ *3 -r IJ >t b.J 5 J, u.) \o )o N o=. .l. -l o { tJ UJ '.o o\ GI 5 tJJ UJ (JJ{ { + \l { l'.J A N'6=.>s o\ { o\ UJ oo { A oor =' C r\ (!r = ac- \ IJ i.J NJ s N) N) UJ N) o\ oo o\ b..) I I 9o F P ;J ! \o u) 5 A \o (}J 5 o\ \o \o oo O ^Li = i.J o\ oo l+) o\ A 5 N) o o FF 3P .s=\\ ;s^\ (D!/ o\=N ris O'G )E si A)-{s --= Ss dg r€ !.G=s j0 Oq oa\ iooFe O. :1 G=. =. !aDr :fi 6b J'D G H: t/, O- :r At Ov, oSrs. :,e:oa ! r.o 'o 3=. =\)(\ o v(\ o ^ ='\- o dtrA)\ 'lJ +s. (} rD: Oo ;'\ N o \ <^>s o o*clX G e otr DO s. F) g:=. 3. (1 c) F=' ;i E.i -o IJ B- l\ 6\ .) .a (T |\ s. -i i, o Iso:' a\ D) vl\+tr o' .\e o I 9') il\ o = ^ =.6 3 o - rD^=' =. J oa (D Oo o F :4" oc 9' a. A) \ a=' \, a'=. t(|\Pq r) A: 5' F G o- \- DO a? p) 6 o- u F J ^ o v) L G DO I rD \ a) Fo o j o 2 ) ,S IJ C ! o (\> * SEGTION 2: lmplementation of GDTI ( 2.1 . Timeline of activities Fill in table 3, linteline of activitiesfor areas teated in currenl ycar, indicating when the kcy activities were implemented by the month they began and the month they ended., r3 WllO/n l'O('. l.l Norcrrrlrcr ]tttt{ I JI t, o lT1 t-.,r o c. C a' C l!D @ p o @ o (, r o I L,) !) D T 7i -l ,z 3 ? C ! la! > p D o l- oa6 F f o 7a (-/) z ca o - p- & I ; (!) o o rD )o a- .D o o .+) o TD o- o J o p p p) D F) D p 0) I P -U) o IJ IJ IJ IJ IJ IJ IJ N 7 F) o' o\ o\ o, o\ o\ o\ o\ QO I o- ==oe C o trD9 o FO E o 5+ J a o- o o o o o o o o DJ FO =l rD IJ l9 IJ IJ t9 IJ IJ IJ lna o o o. o\ o. o. .D FO o o o C t .7 _a =' NJ 19 IJ IJ l.) t.J IJ N) i' .D o\ o\O o\ o\ o\ o\ o\ o o =='oa rJ ? a o- o 0a (F (,a (p Uq 0a 0a rra xa o FD N) IJ IJ l.J NJ N) IJ IJ O O - J. o\ 6, o\ o. o\ o\ tr\ 4 z z -4 G 4 1 _a = = = o x- .D ia =t 0q A) \ C \ 4 1 4 1 o- = = = = 33 q (D s{ o q q a a 'rl n1 T' .n 'n o o o o .D .D-) rD a0 g s, g g I g Jt _(, N l! tsJ IJ t.J IJ IJ t! s- O o\ 0a o. o\ o\ o\ o\ =J 0e (a z z z z z o o oz oz z o s -s s ts l= io OF o tJ l! N) IJ IJ IJ l! o, o\ o\ o\ o\ o\ o\ a .n .n ?l Tl -f) T1 'TJ IJ o o o -) o (D r o' (t o- o- q ./_ 19 N) la N NJ t-J b.J ; (t) o\ o\ o\ o\ o\ o\ o\ - =aoe tD z z z z z z z z o o o _e .l- s 5 J s 3E o NJ t'.J N lu |..) NJ IJ l9 Oi4 o o o\ o\ o\ o\ o\8 o\ o\o t=, 2.2. Advocacy s/N LCA VILLAGB WOMIiN l{liLI(; lous HEADS LE,ADIiTT LIIADIiIT I Abcokuta North 50 rft l2 2 Abeokuta South 74 23 30 3 E,wekoro 23 l9 20 4. lfo 22 t7 l0 5 lmeko/Afon 30 l5 t7 6. Obafemi/Owode 3l 14 t4 7 Odeda 29 r8 t8 8. Yewa North 26 24 t2 TOTAL 285 148 133 ADVOCACY AT STATB AND LCA LEVBLS x/s STATE NO LGA NO I l'lonourable Commissioner for Health I Chairnran Local Covernrnent Service Comrnission. 2 Chairman, llouse Colnrnittee on Flealth I Chairmcn ol' LCA 2t) 3 Permanent Secretaries 5 a. Health. Tleas Lrrers b Hospital Management Board SLrpervisory Counci lors fbr llealth. 4 Directors I LC Oncho Otl'iccrs 20 a PHC & DC. Department b. Training. c Hospital Services Dept. d Nursing Services Department. l e. Planning, Research & Statistics Depart. l Pharrnacy Department o Finance and Adrninistration 5 Principals t2 a School of Nursing 3 b. School of Midwifbry 2 c. School of Health Technology I d Reproductive Health Centre I 6 Programme Officers l0 a NPI unit I b. Roll Back Malaria unit I c TB/L unit. I d HIV/AIDS unit. I e. Health Education unit. I f. School Health Service unit. I (, b Reproductive Health unit h Monitoring & Evaluation unit I I Women - ln - Health unit. Total 52 l0l l5 Wl'lO/APOC. l.l Novcrnbe r'200,j // Reasons for the sensitization: o To fgrther sensitize policy rnakers on their responsibilities fbr CDTI execution and sustainability, especially in the area of financial support' o To encourage their participation in Cotnmunity scll'Morritorirrg. o T share ideas and encourage participation of the decision maliers in the CD'l'l pr'occss o To encourage giving of appropriate incentives to CDDs. Outcomc: - The State has continued to release counterpart tunds - Some of the LGAs have also continued giving counterpart tunds - CDDs in a number of communities are being motivated. Constraints: - Changes of policy makers at the LCA level - lnadequate logistics - Lack of tunds to ensure proper fbllow up To improve advocacy: o Sensitization in media houses should increase. . Personalities with high-level contact to Statc and LCA clricl'crce utircs rrcerl to be iderrtified and mobi lized. . High level advocacy visit to the Executive Covernor will strengthcn govenlrent cotnmitnretlt to the CDTI process, particularly i1'thcrc is a chaugc ol-guard aliul thc 2007 general elections. r6 Wl lOln I'](X'. 24 Nor,errrlrg l,ttO-l 2.3. Mobilization, s6nsitization and health education of at risk communities Mobilization meetings were also held with Religious Leaders fbr supporl irr the aspect ol- giving incentives and ensuring a paradigrn shifi in the lackadaisical attitude of CDDs torvards Mectizan distribution. Mobilization of Community Development Associations arrd Landlords Associations were carried out with Local Government Coordinators to achieve better covcrilgc and boost conrnrunity participation. Regular meetings with Christian Association of Nigeria {CAN) resulted in rrore Churches being involved in selection and support of CDDs. This is particularly the case in Abeoliuta North and Abeokuta South I-GAs. Such churches have declared l-lealth Weeks dr.rring whiclr communities are mobilized, registered and treated. Some religious associations (both Christians & Moslerns) lil Use of Media Houses: The State Ministry of Health has inaugurated, and organized a legular Progranrme tagged OGRUMED for various health activities (including Onchocerciasis) that are itnplenrented in the rural conlnunity. Airing ol'rhis in OC'fV, OCUC, N'l'A and lrM News was regularly done. The Onchocerciasis Programme was also aired in the fbllowing Media: ,/ 'Eto Ilera ni Ipinle Ogun' in Paramount FM 94.5. r' OCBC -'llealthy, Living Segmenr'. ,/ Mid-day News on Health and Environment [Oncho Day] ./ OCTVNTA News in Yoruba, English arrd Egun. l.E'C rnaterials e.g. posters, handbills, calendars and photograph were Response of target communities/village: Cornrnurtities have been demanding fortheir Mectizan drugs, and there arc trccasions whclc the drug is dernanded for a second tilne in a particular year. Accomplishments: lncrease in therapeutic coverage and geographical coverage, lncreased involvement of opinion leaders in the CDTI process Ways to improve mobilization and sensitization of the target comnrurrities: / Greater interaction with the community members by health workers to increase tlreir' awareness of their roles and responsibilities ,/ Identification and mobilization of more local NCOs and CBOs / Increased media campaign for continued individual courpliance to Mecliziur treatrrenl. r' Involvenrent of elected politicians at the local level in the mobilization o1'their people l7 Wl-lO/APOC, 2.1 Novcnrbcr' 2004 2.4. Gommunity involvement Table 4: Conrmunities participation irr the CDTI (Pleasa udtl ntore rotts tJ ttac'a.s:;crt'1') N unrbcr ol' conrntuniticVvilhgcs rv ith Numbcr ol'CDDs and thc contnrunitics N urnbcl ol' corttrrturrrtrcs comnrunity mcnrbcrs as supcrrisors involvcd /villagrs rvi(h lcrnrlc ('l)l)r ,l'utot- Total no. Numbcr with l'crccn tagc Malc CDDs I,'cnralc Nurrrbcr ol' l)c rcc n 1:r gc conrnrunities cqmnrunity CDDs corr rrr rrrt ilrcs in thc entire mcmbcrs as rvith lcrnirlc project area supcruisors ('Dl)s Ba= Br r= DistricULCA llr B. Bs/ Br *100 l], l]* l],,= l]r+l]* l],,, llrr/llr* l0t) Abeokuta n9 238 95 28 24Yo North JJJ Abeokuta ll0 210 105 3r5 45 4t% South Ewekoro 88 t46 87 /.) ) JJ i ti9u Irb lr0 138 75 213 25 23yu lrneko-Afon 92 t46 88 234 35 3 [JOZ, Obafemi- 176 159 64 223 20 I I .3u,,u Owode Odeda .AU/ r04 123 57 180 25 la /0 t)lJ Yewa Nomh I53 t73 2 6t) 28 I 6.-i",r Totnl 952 I 333 667 2000 239 25.t'r',) Comment on: ' Altendunce offemule members of the communily ul lrculllt educutiott nrcatings 'l'his is lairly satislactory - In general, lrow do you rute the parlicipution oJ'Jemule nrcmbers oJ lttc urmmuniry meetings when CDTI issues are being discusses: Some fbmales are recognized community title holders e.g. Iyaloja/lyalaje, ancl are opportunc to raise issues at community nreetings. Their opinions are norrnally souglrt on somc issues and can be inf'luential. In some cases fenrale participation at comnlunity nrcetings dcpcnds on decisions of the elderly rnale mernbers. - Atlrition of CDDs. Is attrition a problemJitr the pnlect'l I/'yes, ltow is it utltlressed? 'l'lris is not a rnajor problcrn in thc projcct. Other issues Nil. t8 WFIO/n l'}Oc.24 Novcmbcr 2004 2.5. Gapacity building - Describe lhc udequacy of availuble knowlctlgeuble nru;tpttwcr ut ull leve ls. Adequate trained staff is available but most of these need to be trained. Whercfrequant transfcrs of lrained sluff occur, slute whut thc projcct is tloittg, or itilends Io do, lo rentedy lhe situution. (The nnsl intportanl issue lo clc.scribe is' yvhett mcusLtrcs were luken to ensure uclequale CDTI implenrcntutnn whcrc nut anoLtglt knctw'la"lgcttblc tttcutltolct rvrr.v uvailubla or if stulfs urcJicquenlly lreml;J'crrecl during llrc c The project organizes in-house training fbr all hcalth staff newly posted.'lhe traincd health staff are encouraged to do a brief training for successor while handing-over, irr casc ol'rc- deployments. l9 Wl lO/n l')OC'. 2,{ Novcrnbcr' l(X)4 Fl rn l-l 6 o- o= a o- a' ls .s- o o @ G o G x F o o lo' a E D a ? o r 7i :. tE -i 'z C C lo i D lur J a a F r o o & E ; \ G P. s = oq o o\ o\ o\ o\ o\ o\ o\ o\ e 6' & O O O z a 6 o a o -a 6 c a 5 o s s o tD A o =(a' a i \o l.J NJ NJ l.J l.J t.J NJ t9 (D \ l.J 5 5 J. 5 s 5 +- J. :' trio l' o o o.) h, o-3 rD \ 6 o\ o\ o\ o\ o\ o\ ; o 6 l;i - o +) rc 0 o 5 U ni co o\ o\ o\ o\ o\ o\ o\ o, ,?^r \| O o O O A? -J c\ oll { j ? = l.J 6- UJ UJ qJ .l co o\ o\ o\ o\ o\ o\ o\ o\ l- a t\) 6 6 (D z t: Fr) 0a G € s' o = l" tD E l e o ha DT (\ t'.J l.J h.J NJ t.J r.J IJ b + ul ? (D q \ !9 G r=' o hJ -l lra rLs E a LI ^ € o\ o\ o\ O\l o\ o\ o\ o\ gi Oa orl I (\ lr .t d \o o i z U1= = iiD S D,t 6 AZ (b .'r o : 6O qG a! q N IJ .lD ! - !l 'z $ s- Ei 0='-l t: ; o o- a e o ilE lJ N) l..J l.J t'.J N NJ l'.J T'J b.J o o i o A o\ z N) tJ 1...J NJ l! IJ N) 5 5 A A 5 A 6 ! + -l \o (\- N o l o : i.J NJ NJ NJ N ,.1 tJ N) l..J t9 NJ 1...) IJ rJl NJ l! 6 o\ o\ o\ o\ o\ o\ 6 'l e. l'.J N l! p N F.J IJ hJ 'UI tD o O \c o =l o ID Table 6: Type of training undertaken (Tick the boxes where specific training was carried out during lhe reporttng perutd) Trainees Other l-lcalth Community Workers rnernbers e,g. ( fiont line MOH IFESI-llle ld Type ,Community health statf or Political Of ficer' of training CDDs supervisors facilities) Other Leaclers Others(specil'v ) Prograrn managernenI How to conduct r lcnltlr cducation Mltnagcrncnl of SAEs CSM SHM Data collection Data analysis Report writing Others (specify) Any other comments 2.6. Treatments 2.6.1. Trcatmcnt figurcs lf the project is not achieving 100% geographical coverage and a nrinirnurn ol'6502 therapeutic coverage or the coverage rate is f)uctuating, srtte the reasons ancl the plans being rnade to remedy this. 2t WflO/AI'}OC, 24 Novcnrbcr' 200.i -t z< \J oo ll-l a> z> oo o- {Y ocr o -J .D o'rD d La (D i A) i o :1 a I 5FD rD' F CD a a I !o o- I (D= o o -F -* A) o -o - .-. o ^et;. = A) A) 3 n2 !) rD i-o vO A) e o r) o E x,id E o t)t \o @ i.=!? 9lI o- o - (,J { NJ oo = U) (,a h.-) 5 o\ o \o ",z -.5 + ID rrc o H E:.; S a I =.o O) B,dq ID- t- a -r -l o o a \o Ca P tj \o oo a El - o5= = J le -J NJ co J. o. \o 7'c f, il oJ- A' = =' ID) rD lT EZ o, oi z o-l \o eaSc q (, \o @ D' = NJ oo o- d { (,J s o \o Ffi 5 E' l a ; .0 o C - o - o:a v) = o o tn J o a o = \o \o - 6 O a O A O O R8 - = o- \o ^>rl9 = C o o' o o' d\ o\ d$€ c5 a a lt'.==. rD D ! l. J =a l= O UJ ^' Ir,- a +, 5 t') (/J o* t! tu j, oi],^- = o }J i t, )o )o le 5 A O { tJ \o { o\ 6,rF!=e+! o Y O UJ UJ -J N.) (JJ A { = { o\ ul oo { HH'F ) rD 5 J H? t a - o-= UJ l.-) 5 trJ NJ t'.J (JJ = O .D N) t\) L,'I { J-.t \,1 = 9l "5 F sJ I --l P C u\ \o { NJ UJ ! Ca 6' L/r c\ N) UJ \o \o o\ =N5 = N) (Jj u) UJ o== r) (, o\ NJ O 7oD a' U (, (Jt oJ- A) ID IJJ t,.) o o- b.J N.) 5 N) NJ UJ t.J z o t)t 9 9 F J. ;.J (, L,t 3. 6 co UJ tJ o\ = a t)) \o{ { ilsi u) oo 5 oo \o oo inSlo =' t_)\ { o\ o\ o { (J) *t fv o aJ o- =' 6 oo \t oo @ oo @ oo { -, UJ UJ \o (JJ A \o oo o=. \o \o .o \o 1O \o \o O6 o\ o\ o\ s o\ o\ o\ rn .D s sq€ 7 -o YN (IatrO o o =' z z z a Z Z -lf rD- z EF,E5 AJ = = = 8-*8 r 2. 3= e- ts I a -6 a o) UJ \o z o\ tr_z a- 7 NJ 7 Z AJ c E a5 IJ ! a z z z v z z z Z = ae>a",2. a rd 16 = ro IJ z z z z !o1 4 1 7 7 9 ;5e -. z i e == 3 X o = t'J tBsAI E l. =Fr1 .J :- \o :-l \ eci o o--J ftttll({\ -J .) s L) /-: o -s:G G 1 a- FO ^Yo f : t; r) :.il iD :. UA E 6' .D ,=s. a .D S: \ o- 3 \:c{ i a tg ir ss+!.s is€ F* I lt \i>e{- + .: Nc cQ r: s' \\ I :i z >lz E fItr \\ 3 nr 3 i lo- AS. S ] o lo s: \; c. I :la=- rD q 3 o ;'lo QY- ( \1 .tJ l'n FJ td (-.:- i q o ,.]\i t o Jlo=|tu cis : a o .!ttr r,i E' ! o 3 =1. Si s .D c\ 'o pr ^t= sI. a^N 6- .E ls! E: o S o- --.1lla q- .i = I - E. j t, r_l I t- 2,6.2 What are the causes of absenteeism? Absentees recorded went to the neighbouring cornurunities to utlcnd to cnre rgcncy citlls c.g traditional meeting at the next village, relatives on sick beds or wives/f-ernale relations tlrat put to bed. Some workers were transferred. 2.6.3 What are the rcasons lbr refusals? The project did not receive any information indicating relusals. There coulcl have been inirial rcfusals, but these wcre followed up arrd trcatcd Iatcr. 2.6.1 Bricfly describc all known and verilied serious adversc evcnts (SABs) that occurred during the reporting period and provide (in tablc 8) the rcquircd inlbrmation when available. Nil case. ln case the project did not have any cases olserioLrs adverse evcnts (SAE) durirrg this reporting period, please tick in the box. No case to report 24 WLlO/Al'()t . 2.1 Novcnrbcr' 20().1 -r (n C^ -l |\. 2 o-DJ \ rD oo 0ao o V) !D (t o I .D o a1 (rq o G JOQ= I \ o 5' = fv FJ G i'1 a pI - fr .D o =)tl o or- FJ a= o (r) o-iA9 rrl z 0 FD 1'= o o = o I- .0 o- o- = q :. -ai o- :E I a 7i.'4, IJ o 0a= IJ o ='o' C, !L ir'o d fD .D :f I -oo T,=p - f. f dTa^ C,Q _,_ 'o (n 3 - o =' o- D'r'= v aOop t 11 3 a G .l ,2 I 'oq-=G'o (\q z +. a ='a \ J aG o\ I o6 q- _ -o- G o 4 4 aa@= IJ L oor- .. --? =4t G J-.C oo-= :!9= oJr,o lJ a(ro ^l al t ; -= o -o c o IJ IJ IJ IJ IJ IJ tJ IJ IJ lJ t.J t..) o \o \o F] .? IP O O \o \o l-tct oo -J o\ +- l-) \o @ { l, lrD tD l.o"o\ P \o \o \o \o .o @ o J A o a) ul IJ NJ N) t.) NJ 5 G= .D ?1,s,?d A) o)rl o ati--l Y ea + oi, ET- / V d q " <-=,^ tD 6=o. V)= HT D DJ 00 i )+ tD a \o \o \o o\ OL: -.1 \o o; t9 N) r-J NJ { oJ- .d6 P qd rt., o o 0a6 ) o=- rD .0 3= .l lcr ?) k=l-. \o ca { Ol E: (! l.)o O \o u,3 z rD IJ NJ .i l=- a! -) -l lr e = r IJJ a.; a t l+ro = .D qt .J (laF- Ja+ =, o i,; + \o \o t- @ [.J U co lo E-] U) FlaO o\ \o \0 \o [.J \o l.o o\ o\ v o\ trtrG6 lrri \ I (_,1 t\) -v =oq- tw rDr.') ----t ts tD \o - O O O lE O O O O O o- .L. o\ \o o\ o\ o\ o\ o\ ,r t" -?, (u lD1tr j lt 9r(la- d .D v; o IJ (u (Do o. UJ O IUJ t/J N) +ro IJ o o -t..1 P 'tJ ig L t.J IJ t-) 9 A= oo \.t { \.1 (D o\ +- .l: +\ .J:{ a.= o DI F.6 q2 e= a? N; IJ tJ t.J TJ NJ N) Fa 5 O tD !^ 'i .9, J. P ^J tJ -r l.J t.J O l-J .deiP UJ FI d2C IQ 5{ =6 o=-=op lDr l\rri3 tJ NJ IJ IJ IJ t- o G @ UJ j-J jJ E 'a F IJ L, ! J- co O oo dz. \o ! \o CD \J @ "'q o .J pcec s o oo oo ! o\ O -l UJ -l --i tD O .o{ o5 o' -o o\ = F' F' ')a ) r,q c (a o @=, a. a) IJ \o oo @ @ o\ .a- I o\ \j 7 o\ t\) L: \o o- \o o\ r'1 !'l o\ o\ o\ gB,^:\oo J o qa- f o U) T 7 \o IJ \o Ooo @ @ o\ o-- T o\ <;. -€o - (ro o 2.7. Ordering, storage and delivery of ivermectin Mectizan@ ordered/applied firr by - Qtlcu:;e tick tlrc (tpprol)nute utrs'tvar) MOH [] WHO[] UNICEFI II,.IISII/UNIVA j Otlrer (please specify) Mectizan@ delivered by - Qtleul;c tic!1he uppropriale an.ttver) MOHE 'wHoU UNICEF.N IF'ESII/UNIVA Other (please specify) Plcasc dcscribc ltow Mcctiz:ut@ is ordcrcd antl horv it gcts to thc corrurruuitics IFESI-l / UNIVA lbrwards cotrpletcd Mectizarr Application lbrnt Lo Mcctrz.arr l-)onarron Program through the NOTF. 1'he completed form is based on drLrg requirenrents calculatecl based on total populatiorrs received fiorn the community levcl through the Fl.llFs arrd l-CAs to the State, On approval, consignrnent is received through UNICEF and sLrpply is nrade ro the State Ministry of Health by rhe assisting NGDO. How it gcts to tlrc cotrrrnurritics. State Coordinator collects Mectizan liorn IFESI-I lrield Ot'llcer Lo replcnish statc storr: . LC Coordinatorapplies fortotal recluiled by thc Frontline Ilcalth Facility Stal'1, ancl rlal 'i-able l0: Mectizan lnventory State/District/ Numbcr ol'Mectizlrr ta blcts LGA Requested Ilcceivetl Uscd Lost \\:rstc [,)r;rr rctl Abeokuta 200,000 85,000 80,049 J North .{beokuta 2 10,000 100,000 88,01 g I South Ewekoro 105,000 70,000 62,650 2 Ifo 100,000 90,000 r88 4 Irneko-Afon r20,000 t00,000 89,465 Obafemi- t50,000 130,500 ll2,ll3 J Owode Odede 100,000 90,000 80,391 2 Yewa North I 10,000 100,000 91,463 2 TOTAL 1,095,000 765,000 686,3J7 l{ 7 27 WllOin l,O('. l{ Nur,crrrbcr lr)0J / l-low are the renrerining iverrnectin tablets collectcd and rvhere are tlrey licpt'/ l-G Coordinator retrieve left over tablets and distribute to other cornrnunitics, but statc distrihutc to stiltic centcrs lbr clinic based treatrncnts. / l.ist arrd hriclly clcscribc the activitics undcr ivcrrrcctirr clclivt'ry'that are lrcing cun'iccl otrt by health care personnel in thc project area. - Requisition, Collectiorr and supply to endcrric couurunitics. - Keeping of Mcctizan lnventory, - Updating Registers and supply of Mectizan. - Notilrcation to the conrrnurrity of availability o1-drLrg. - Monitoring and supervision of Mectizan distribution. r' Any other cornlnents 2.8. Gommunity self-monitoring and Stakeholders Meeting Has any lruining (of truiners) lbr commtnity self-ntonitoring becn done in thc projad urea? IJ'stt,ll/hen? Tablp I I: Cornrnunity self--rnonitoring and Stakeholders Meeting (Ar)tl rov.t i/ neaclcd) District/ LCA l'otal # ol- courrtrunities/vi I lages No ol'Cornntunttics that No ol' CorurnLrrritrcs tlrat in the entire project alea carriccl out se ll' cor tel uctecl stakclro Itlcls rnonitolirrg (CSM) rnccting (SHM) TOTAI, Describe lnw tlte results of the community se$- monitoring und stukcholilcrs nrcetiilgs have uffected projecl intplementution or how they woultl he ulilizctl tluring tltc next lrealment cycle. CSM & SHM were not done due to unavailability o1'lirncls lirl this pLup\)Se WlIOzi\l'(X . 26 Scpte rubur 30tt.i Z8 2.9. Superwision 2.9.1. I'rovide a flon'cltart of su;rcrvisiurt lticrarclty. Scc thc llr.rrr chrrrl orr 1rg 25. l)[il. r^lg_l( STATE COORDINA'IO R & SOCI- LG COORDINATOI{ & LOC'I IIRONTLINE I IEALTI-I ITACILI'|Y S'I'AIrI' COMMUNITY DIRECTED DISl'ITIIJ UTOR 2.9 2. What were thc main issucs identilicd during sullcrvision? lnadequate numbcr of CDDs in some areas lntcrnlittcnt posting of stall'at health fbcility lcvcl rcsultccl in lacl. ol'continuiry. Low level ol-irrtegration ol'CDl-l activities into l'l-lC ir.r sonre I-ocirl Coverunenr Ar.c1s lnadcquatc cotntnitntetrt ol- sonre FLI lF stall- to Mcctizan clistributtgp. Late submission of sLrmmary tbrrns to LC coordinators by l--LFll- stal'1. Inadeclttale invcllvenlent ol'sonre cotnrnunitics duc [t'r lacli ol- unclcrstanrl itrg ol'thuir. rglcs 2,9.3. Was a supervision checklist used? YES 29 Wl l()/Al'(X'. 2.{ Norcnrhcr 2(tll..l 2.9,1, What rvcre the outcomes at c:rch lcvel of CDTI implcnrcntation supcrvision? LGA l.cvcl:- / FLIIF Stal'fencouraged to see CD'l'l as part ol'tlreir routinc activitics, ancl sonte havc adopted tlris. r' Ncrvly posted stall'havc bccn given oricntatiou and latcr tlaincil on CD'l I r' l.OCTs have becn retrained on record keepirrg ancl rcporting in orcler to assisL thc lrt.lll stal'l'in carly data collation and reportirrg. Community Level: / Comnlunities are being re-rnobilized on their roles and responsibilitics.'fherc is cviclcpec of high commitntetrt towards Mcctizan distribution by sorne opinion lcaclers. r' Cornmurrities have been sensitized to select more CDDs. 2.9.5 Was fccdback given to the person or groul)s su;tcrvisctl? YES. 2.9.5. llow w:ts thc ll'cdback usccl to iurllrovc thc ol,crall perlbrrrralcc ol't1e project? Some commtrnities selected nrore CDDs, and tlrere was irrcreased conrmitnrcnt by health stal'f to ensure that all those needing treatments got thern. Tlris resulted to rnclcasc rn totzri nLrrnl"rer people of treated and coverage of more cornnrunitres as opposed to the 2005 trcatprcrrl. cyclc. 30 Wl lO/n l'O('. 2-{ Nolcnrbcr'100.1 SEGTION 3: Support to GDTI 3.{. Equipment 'l'ablc l2: Stalus ol'ccluiprnent (l'laet,,;a utltl tttora rutw.s'i.f'ttccas',sctt-v) Status of equipnrent (Plea.se udd nore row.s iJ necessury) APOC MOII DISl'RIC'f/L IFESII/ ()thc Source CA UNIVA Is 'l'ypc ol' * ut Conditiorr of thc cquipment Plcasc statc l, Vehicle Stolen I old 2 Nil IrLrnctional 2 2. Motor cycle Functional 8 Nil I"unctional IJ l''lrnct rrtnal 3. Computers Functional I Functional I Nit 4. Printers Written I I Functional Nrl I 5. Fax Machines Functiorral I Nil Nit 6. Air Conditional Functional 2 Functional J Nit Lap Top i') Fulrctiorral I Nit Nil b) Cenerator Functional I Functional I Nir I c) Bicycles Functional Nit Functional Nit d) Public Functional 4 Nil Nit Address System e) Television Functional I Nit Nit 20" ., i) Money Sal'c Functional I Functional N I g) Reliigerator Functional I Nit Nit h) UPS Functional 2 Nit Nit i) Stabilizer Nil 2 Functional Nir j) -l Photocopier Functional I Nit Nit k) Slide Functional I Nit Nit Projector l) Storage Boxes Functional 4 Functional I Nit n1)Vt 'lt l:u rrct ionirI I Nit Nit rr) Ovcr llearl Irunctionu I I Nit Nit l)rt-l.iccttlr o) Writing Board FLrnctiona I I Nil Nil ---l p) lnfbrnratiorr Nit Functional 2 I"Lrn c t io na l I Board *Conclition of the (F-:1.-unct equiprrent ional, CNF'lt=currently non-firnctionaI bLrt rcpairable, WO:Written off). 3I WI lO/n l'OC',2.1 Norerrrber 100.{ llow tkrcs lhe pnlecl itttctttl lo tttuittluitt utttl rapluca a-ristirtg aquiptttcttl utrtl otltar nrule riuls? The project intends to nraintain existing equiprnent froln the coLlnterpart contribr.rtions at thc State and [.CA levels, This calls fbr increased and continr,rous advocacy to polic-l'r)ral\cls. Replacetnertt, it is hoped, will be ell-ected in the interim liorn the Al)OC'l-rust l.und. Equipnrent needing replacement have been included in the rcvised worli plans and buclgcts subrnitted to APOC Management. The pro.icct also hopes tlrat IFESI'l/UNIVA will suppor-t in this case. 3.2. Financia! contributions of the partners and communities l'able l3: Financial contributions by all partners fbr the last three years Ycar J 1J \car5 'l TO1'AL TO'TAL 1'O1'Ar- ]'O',t'Ar_ 1'O't'At, o'tn I_ Ca;lr Caslr Cash Caslr Cash ('us lr Buclgctctl Ile le asccl lJudge ted [{e lcirse tl l) urlge tr;tl l(eiu.r:rrl Contributor US$ US$ US$i ( u:;$ t_rs:b ) (tr\S) MOi-l (Central * [rpsy;ncial/State) 52,860 52.250 60,340 l -s,680 e,319 L)fl9 t-GA I 25,000 s,ooo 20,560 r0,200 2.200 2,200 [,ocal NCI)O(s) ( Church Sociery) Nil il0 Nit 98 0 (.) IFESH/UNIVA 35,000 i rs,oso 25,4t 5 r3,250 r6,020 I6,020 Nit Othcrs Nir Nrl Nrl Nit Nrl Nit i a) Nrl Nrl Nrl Nrl I Nrl Nrl b) i Nrl Nrl Nrl Nrl Nrl Nit c Nrl Nrl Nrl Nrl Nrl Comrnunities Not 45 Not Not -50,000 r r .200 visible c; uanti tic , guarrtilic d APOC Trust Fund 25,000 (.) s7,4t5 82,030 -t2.44-5 2 5..+6 -i .TOTAL 15,7780 I I l3,gl9 167,795 39,229' tJ0,0J{ I (rJ,2(rJ If there urc pruhlcttts witlt rcleuse oJ' co u t t lc rp u rl Jit t t tl s', I t ow wc rc I I t t 1' tt tl il re,s,s a d,? CCCC is oftcn approved and released. Ad d il itt ttu I c 0 rnilre nls - APOC should not hesitate to release Iund prornptly 3.3. Other forms of community support / Dascriba (inilicute Jbrms o/'itt-kinl crnilrihutiotts' tl'cotttrtturtitias, i/ urqr) 'Purchase of more register notes fbr registration of the population. - Venue allocated for training i.e. palace, Torvn Hall. 32 WllO/n l)OC', 24 Nor crtrbe r. 200-l 3.4. Expenditure per activity r' lndicate in table 14, the antount cxpcrrdcd durirrg thc reportiug pcriocl lirlcach iletivit), listed. Write the arnount expended in US dollars using thc cullenr Uurrr;el Nltiorrs exchange rate to local currency. lrrdicate exchangc ratc used here_$_ l:N 126 , Table l4: lndicate how much the project spent lbreach acrivity listed bclorv durirrg tlre reporting period Expenditure (S Activify us) Sr-ru rcc(s) r.rl' lirrrdi rrg Drug delivery liorn NOTF HQ area ro central 280 collectiorr oint of communi ll.t.sil/uNt!",\ rSl l lrl l/tlN l Vn.lvtOl Mobilization 7t\32 l/' and health education of communirics n l)( )(' Train of CDDs 4859 AI)OC/MOH Trainin of health staff at all levels 4235 AI)OC/MOII lsl 3938 CDDs and distribution I-C \ /A POC' Internal monitori of CDTI activities r 842 MOil.lt-'tislt/ Advoc visits to health and litical authorities 4812 MOII,LCA/APO(' IEC materials 0 Summa forms for treatrnent t463 LCJA. MOI] g 10,41 MOI I.I,GA.II.'DSI I/UN I V'A Vehicles/ M les/ bic s maintenance Maintenance of Office Equiprnent (e.g. corn puters, r3,305 t\,1( )t I \lr(x' illlcrs I)hott cr ctc ll,l,slt,uNtVr\ TOTAL 52,991 Total number of rsons treated 258,359 ,/ conullents rlr() 33 WI I(),,'\l'()( l,l Nr)\!rrl)r'r l / SEGTION 4: Sustainability of CDTI 4.1. lnterna!; independent participatory monitoring; Evaluation 4.1.1 Was Mouitorirrg/cvaluatiorr clrrictl out tlurirrg the rcllortirrg ;rcriod'l (ticli any of the folkrwirrg wlrich are apgrlicirble) Year I Participatory lrrdepcndcul. monitoring Mid Term Sr,rstairrability Evaluation 5 year Sustainability Evaluatiorr Intclnal Monitoling by NO'l'l' Other Evaluation by other partncrs None was carried out during the reporting pcriod 4.1.2. What were thc rccorntncn(lations? 4.1.3. How have they been int;llerncntcd? 4.2. sustainability of projects: plan and set targets (mandatory at Yr 3) Was the project evaluated during the reporting period? _No Was a sustainability plan written'? Yes When was the sustainability plan subnritted? 2006 --July What arrangements havc bcen m:tde to sustain CDTI atler AI,OC lirrrtling ccascs iu terms of? 4.2.1. Plunning ul ull relevunt levels, After the evaluation stakeholders were invited to a plannurg and clcbr re lr)g nlccturll rvlrere tentative 3-year worl< plans were developcd lbr both Statc & L,(i,\ lcvels.'l'hc annual work plans are refined tbreach year.'l'he rnost intportant thing is that a cultulc ol' planning is being cultivated in health w,orkers. 4.2.2. Funds releuse The State government has a history of releasing counterpart contriburions. J'his is expected to continue. Sotne LCAs lrave becn releasing lirncis bLrt othcls have rrclt. Eflbrts are being made to use the Local CovernmcnL Departrncnt ancl lorr-rnr ol LL;\ Chairmen to lobby those that are not releasing tirnds. in aclclition, thc ol'llec'ol'the 34 Wl lO/n l'( )( . 24 Novcnrbr:r. 2004 Deputy Governor is to be approached to be ol'assistance irr this rcspect as it has oversiglrt lor the LGAs. 4.2.3 Transport(replucemenlundnruintenunce) Using the counterpart funds released by governrnent transport rvill bc rnaintained. l'lre rc are instances where old vehicles in the department are released fbr CD'fl activities. IFESI-l/UNIVA is supportirrg witlr 2 vclticlcs. I:or rcplacerrrcnt Ihc prqcet u\peets APOC to come to the rescue. 4.2.4. Otlrcr resources '[he project hopes to rnobilize funds fionr governnlent at all levels lor lhc prr)cLllcntcnl. of needed resources. The project intends to approach sornc local NCOs ro assrst in Sctting some of the matcrials needcd, parl.icularly at thc LCA ancl ct-rrrrrturritl, lcvcls. 4,2,5, To wlrut exlent hus tltc plun bcen implcnte tiled over 80% of planned activities for the year havc bccn irnplcn-rcntcd. 4.3. lntegration Outline the extent ol'integration of CDTI into the PllC structure anil tlre plans lbr corrrplcrc integration: 4.3.1. Ivermectin dclivery mcchanisms There is a sharing of transport and storage f?rcilities lbr lvernrectin.'l'his is lrore pronounced at the LGA and health facilitv levels. 1.3.2. Training Progranrme staff benellt fiom joint training such as I{rJM, Nl)1, Illv/AlDS, TB/LEPROSY and Health Education Prograrnrnes. 4.3.3. Joint supervision and rnonitoring with othcr prr_rgranrs Usage of Progratnnre logistics fbr othcr hcalth activitios and usagc ol'Nl)l rr.rotolcl,clcs for CDTI supervision are the vogue within the project area. This is rnolc pronouncccl at the LCA and FLHF levels. 1.3.4. Release of funds lbr project activitics Funds release follows the normal channels within the Ministry 4.3.5. Is CDTI included in the PHC budget? GDTI activities are reflected in the health plans for the Srate and LCAs 4.3,6. Dcscribe other health programnrcs tlrat arc usilrg thc ('l)'l'l str.rrt.trrrt.rrrrrl how this was achieved. What have becn the achicvcnrcrrts? Some Community Based Organizations are using the CD'l-l strLrctLrres ro assist in lhc Roll Back Malaria[RBM], TB/L and NPI. 1,3.7. Dcscribe othcrs issucs considcrctl in thc ilrtcgration ol'('l)'l'1. 35 WI lO/,^l'( )('. 2.1 Noi,cnrbcr l(X)-l 4.4. Operational research. .1.4.1. Sumntarize iIt not ntore thirn one hall'ol'a page thc ollenrtional rcscarclr undertaken in the project area within the rc;lorting llerir-rd. None was carried out during the period of reporting 4,4.2. How were the' results apl;rlicd in the project'l SEGTION 5: Strengths lltvtllvctttcttt ol'rcligiotts orgitttizittiorrs arrcl churclrcs in thc ('D'l'l l)r'()ecs\. I-l igh conltlunity awareness olthe beneflts ol Mectizan treatntetlt, ancl ir illirrgrress tp conrply with annual treatlnent. Availability of trained health staff at all levels. Willingness of most CDDs to continue with Mectizan distribution despirc lacl< o1'or inadequate incentives. Presence of a comrnitted supporting NCDO Release of funds by the State governrrent annually sincc progranrnc irrcc;.ltiorr Weaknesses Sorne LCAs are yet to release their counterpart firnding. Non- institution of com rn un ity sel f-nron itori ng Inadequate involvetnent of the FLHF stafl- in the CDTI process Ghallenges - Instability ol'our political appointees/caretaker/transition corlrril.tees ar thc l-ocal Government Levels. - Non -release olfund afier several approvals by the LG poricy rnakcrs. - Quality olrecord keeping still needs to be irlproved. - Number of CDDs is reducing in some comnrunil.ies. Opportunities Regular advooacy arrd sensitivity to the decision mal\crs. Targeted training of personnel. (New Staff). Intensify rnobilization in the conrmunity. * SEGTION 6: Unique features of the proiect/other matters 36 Wl lO/n l'O('. 24 Nrri r:rrrbe r 100.1