Project Period: Year Z0W-2A07
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West Wellega Zone Oromia Regional State FEDERAL DEMOCRATIC REPUBLIC OF ETHIOPIA Project Period: Year Z0W-2A07 For Action., Submitted to To: African Program for onchocerciasis Control TCCIT (APOC) faurlrJu.:r,9 COOf ! CSD CLV Btrr toP blo Revised July 2003 fior lt*fiorrnut{orr SECTION 1: BACKGROUND INFORMATION 1. INFORMATION ON THE PROJECT AREA FOR CDTI....................... I l.l. Geographical and administrative areas...... I Topography, | ? CIimare, Access ') 1.3 OnchocerciasisEndemicityLevels 8 1.4 CommunityStructure 9 2. PAST AND CURRENT STATUS OII CDTI IN PROJECT AREA .ll SECTION 2: PROJECT EXECUTION OUTLINE II 3. DESCRIPTION OF PROPOSED CDTI ll 3.1. Outline PIan and Timing ... lr 3.2.HealthEducationandCommunityInteractionandParticipation................ ri 3.3. Local Operational Research ......... l(r SUPPLY, IMPORTATION, STORAGE, INVENTORY AND DELIVERY MECTIzANTABLETs.............................. OF 5. SUPERVISION,MONITORINGANDEVALUATION......... r8 during : I -Supervision Evaluation t8 5.2. Monitoring CDTI 19 2t SUSTAINABILITY OF THE CDTI AFTER THE WITHDRAWAL OF EXTERNAL FUNDING .............. 2I g Integration of GDTI into other community pHC I Based of Systems .......... .. 23 6.2. Cost Recovery System during CDTI . ......._...... 25 6.3. .Other Issues 26 6'4' Methods of Measuring the progress Towards sustainabirity. ... 27 7. CROSS BORDER CONSIDERATIONS 28 8. SPECIAL RISK ISSUES 28 S ECT I ON 3 ADM I N ISTRATI O N/F INAN C IAL 9. ADMINISTRATION 'tg 9.1. Organisational Structure for CDTI 29 9.2. FinancialAdministration 3t 9.3. Timed Plan of Action i-; BUDGET IO. .'t / 10.1. Budget Estimate 37 10.2. Budget Justification 4U 10.3. Current Resources available in CDTI 4t LIST of MAPS: MAP 1: Onchocerciasis CDTI Zorrcs in Ethiopia (A?OC 2003) -) MAP 2: Oromia Regional State, Etltiopia 4 MAP 3 lltesr Wellega Zone, Orotria Regiort .5 MAP 4: Districts Selected for CDTI Project 6 MAP 5: Distribution of Health lnstituriorts & popuration Density (199a 1 Census) Wesr Wellega Zone LIST of FIGURES: FIGURE 1: Organisational Stntctttre of National Onchocerciasis Contrctl Program 2L) FIGURE 2: Recluest cutd Disbur's'entent oJ'APOC Fund FIGURE 3: Budget Input of Partners for rhe Project Years 4i FIGURE 4: Annual Treatment Objective b), Endemicity Level 44 LIST of 'IABLES Table I. Estimated Nuntber of Populariott, ATO and Status of REMO b1, District, West Wellegct Project Arect I Table 2. Classification Criteria of Endenticity Levels in Rural Communities .............. 8 Table 3. Criteria Issues in the Developntent of Health Education.for CDTI l4 Table 4. I mp le nte nt at i on T i nte F rct ne 3(r Table 5 Year one sumnrury Budget for onchocerciasis contor in ruest Wellega Zone 38 Table 6 Five Year Budget Suntntary for Onchocerciasis Control 39 LIST of APPENDTCES APPENDIX I: ESTIMATED NUMBERS OF COMMT]NITIES AND PERSONS TO BE TREATED EACH YEAR BY ENDEMICITY LEVEL ... 42 APPENDIX 2: I N D I CATOR.S FOR EVALI]ATION, S U STAINAB I LIY /INTEGMTION OF CDTI 4.5 APPENDIX 3.I: Budget Line ltent - Persontrcl 46 APPENDIX 3.2: Ihdget Line ltent - Capiral Ecluipment 17 APPENDIX 3.3: Budget Line ltem - Sttpplies J9 APPBNDIX 3-4: Budget Line ltem - Training 50 APPENDIX 3.5: Budget Line ltent - Health Educatiort & sociar Mobilizltrion .5t APPENDIX 3-6: Budget Line ltent - Travel .il APPENDIX 3.7: Budget Line ltenr - Comnrunicatiort .s3 APPENDIX 3.8: Budget Litte ltem - Consultants -5.:l APPENDIX 3.9: Budget Lirrc ltem - Recapitulatiort .55 APPBNDIX 3-10: Budget Lirte ltem - Operating Expenses -56 LIST OF ACRONYN{S APOC African Program for Onchocerciasis Control ATO Annual Treatment Objecti ve CDC Communicable Diseases Control CDD Community Drug Distri butor CDTI Community Directed Treatment rvith Ivermectin DHO District (Woreda) Health Office DOTF District Onchocerciasis Task Force EPI Expanded Program of Imnrunization GIS Geographic Information System KAP Knowledge, Attitude, practice. MIS Management Information system MOH Ministry of Health IVIO\/DCD Malaria & other vector-borne Diseases contr.or Department MOVDPCT Malaria & other vector-borne Diseases pre'ention & Contror ream NGO Non Govemmental Organisation NOCP National Onchocerciasis Control program NOTF National Onchocerciasis Task Force PHC Primary Health Care RAPLoa Rapid Assessment Protocol for Loasis REA Rapid Epidemiological Assessmenr REMO Rapid Epidemiological Mapping of Onchocerciasis RHB Regional Health Bureau ROCP Regional Onchocerciasis Control program ROTF Regional Onchocerciasi s Task Force TOT Training of Trainers ZHD Zonal Health Department SECTION I : BACKGROLIND INFORI\{ATION 1. INFORN,IATION ON THE PROJECT AREA FOR CDTI 1.1 Geographical and administrative area(s) Please tlescribc tlrc area(s) of the countr)' itt tryhich the proposecl CDTI u,,ill be carried out. (List the administrative units or parts thereof e.g., Lctcal Gorternrnent Areas, Districts, Arron disseruents, Health areas etc. that y'ill be coverccl atrcl provide a mop showing their lay-6y11 Oronria Regional State is one of the 9 National Regional States in the Fecler.al Democratic Republic of Ethiopia (Map l). West Wellega zone. tocated ar 80 l2r - 100 03t N latitucle and 340 08r- 360 t0rE longitude, in the *.ri..n part of Ethiopia, is one of the l2 zones in the Oromia Regional State (Map2). Based on the 1994 national census, the projecterl population of the zone in the year 2003 is estimated to be 1,941,430. The zone has a roral surface area of 23,980 sq. krn and is further divided into 20 districts and i4l villages. One district natnely Gidame shares a 76 km border area with the Sudan and the zone is also bordered by the Benshangul-Gumuz and Gambella National Regional Srate and East Wellega and Illubabor zones of the Oromia region. About 90.3 Vo oithe population lives in rural areas atid 9.7Vo live in urban area. The zone has a population density of 80 persons per square km. The zone is identified as Onchocerciasis endenric area and districts r.r'ith hy'per and meso levels of endemicitl' are proposed for the inrplemcntatigrr of CDTI activities. The project objective for Year-One is to conduct CDTI in six priority districts. The Annual Treatment Objective (AfO) for year-One is 563,909 and the Ultimate Treatment Goal (UTG) will be determined u,lren REMO refinement is completed in November 2003, in the other srx districts ol'East Wellega projecr area. Table 1: ' Estirnated Nunrber of Population, ATO and Status of REMO b1, District, \Vest \\/ellcg:r Proiectroiect area.area- 200200i S. No Estimated Total Annual Treatment REIr(0 Starus \\foreda CDD \rillages Population Objective (ATO) I Gimbi 521 130.327 104262 Year CDTI Arer 2 Gawo Dale 559 139.789 1 1 1831 Year CDTI Area 3 Dale Lalo 476 1 19.064 95251 Year CDTI Area 4 Anfilo 282 70,499 56399 Year CDTI Area 5 Hawa Welel 409 102.'t38 81710 Year CDTI Area 6 Sayo 572 143.070 1 14456 Year CDTI Area Subtotal 2819 704,887 563,909 7 Yubdo 144 36.008 28806 To be refined 8 Nole Kaba 538 134,529 107623 To be retined o Lalo Asabi 297 74,150 s9320 To be refincd 10 Haru 268 66,937 53550 To be retined 11 Aira Guliso 407 101.798 8't438 To be retined 12 Jima Horo 197 49,224 39379 To be rctined Sub Total 1 851 462.646 370.116 Grand Total 4670 1,167.533 934.025 L.2 Topography, climate, access. 1.2.1. Please describe the type of countrl, or bio-climatic zones that will be coverecl by rhe CDTI (e.g., rain forest, forest-savanna mosaic, Guines savatuta, sudan savattne, mountainous or flat), providing maps, t!' appropriate. The topo-eraphy of the zone is donrinated by hills and gorges that range in altitude from 600 m in the extrenre Western end to 2100 m above sea level in the eastern part of rhe zone. The zone has three big rivers namely Didesa, Birbir and Keto rivers tlrat drain in to the Blue Nile. The area has many other small rivers and srreams that drain in to rhe basin (Map 3). l'2'2' Cive the approximate tintes of the rainy and dry seasons and the monrlts covered by the fanning season. The climate of West Wellega is characterized by clistinct rainy ancl clry seasons. The major rain1, ss25.n months are from June to September with short rainy season from February to March. The mean annual rainfall varies from area to area ranging from g00 mm to 2000 mm. The mean annual temperature of the zone ranges from l0oc-30oc. Farming activities (clearing, farming, and herding) occur ail year round, but are most intensive during tlie rainy season. Harvesting occurs from November to January, leaving February - May as the optimum trcatment period. 1.2.3. Provide inJbrmatiort on the state of rhe roads and tlrc effect oJ'this on the ntovements of CDT\ persorutel in the area at difJ'eint tiies oJ'tlrc year. (A map nlay be usefut) The zone capital Gimbi is connected to 17 districts by all weather roacls while the three otherdistricts are only accessed during the dry season. All the CDTI districts selected are accessible by road all round the year. Two district, Dembidello and Begi are also linked by domestic aii transport service to Addis Ababa. All the districts have automatic and op"ruto, assisted telecommunication service and l0 of them have also postal Service stations. Road transportation is one of the wiclely used and most important mocle of transpoftation in the zone. The roads provide access to l7 districtcapitals, however most villages could be accessed only on foot or on pack animals while some villages could be reached by motorcycle. During the rainy season supervision and monitoring of CDTI may be difficllt due to flooding of rivers and roads. Thereiore, conducting Mectizan distribution during the dry season (February-May) is advisable.