MMDP PROJECT SEMI-ANNUAL REPORT October 1, 2017 – March 31, 2018 Prepared for: Emily Wainwright, AOR MMDP Project, USAID Submitted by: Helen Keller International Date: May 15, 2018 For more information: Stefania Slabyj, Project Director, [email protected] THE MMDP PROJECT The Morbidity Management and Disability Prevention (MMDP) Project is a five-year project funded by the United States Agency for International Development (USAID) with the goal of strengthening national ownership and capacity within a select number of countries to scale up the provision of quality services for the management of morbidity, disability and disfigurement related to trachoma and lymphatic filariasis in a manner that will help to meet disease elimination targets. To achieve this goal, the MMDP Project will focus on the following four intermediate results: 1. Strengthened MMDP data availability and quality for decision-making at the country level. 2. Strengthened support for MMDP implementation scale-up and quality improvement at the country level. 3. Strengthened capacity of MMDP systems within Ministries of Health. 4. Provision of global leadership through building-upon the knowledge and evidence-base for MMDP preferred practices and policy. The MMDP Project is a global project led by Helen Keller International in partnership with the African Filariasis Morbidity Project and RTI International. The project is funded by the US Agency for International Development under Cooperative Agreement No. AID-OAA-A-11-00054. The period of performance for the MMDP Project is July 22, 2014 through July 21, 2019. The authors views expressed in this publication do not necessarily reflect the views of the United States Agency for International Development or the United States Government. Cover photo: Mossi trichiasis patient in Burkina Faso being taken for surgery by son, 2017. (photo: HKI) MMDP Project FY18 Semi-Annual Report (October 1, 2017 – March 31, 2018) 2 CONTENTS ACRONYMS ................................................................................................................. 4 EXECUTIVE SUMMARY ................................................................................................. 6 KEY PROGRESS INDICATORS ....................................................................................... 7 BURKINA FASO ............................................................................................................ 9 TRACHOMA ........................................................................................................................................... 12 LYMPHATIC FILARIASIS ......................................................................................................................... 19 CAMEROON ............................................................................................................... 27 TRACHOMA ........................................................................................................................................... 30 LYMPHATIC FILARIASIS ......................................................................................................................... 36 ETHIOPIA ................................................................................................................... 40 TRACHOMA (Oromia) ............................................................................................................................. 43 TRACHOMA (Tigray) ............................................................................................................................... 55 LYMPHATIC FILARIASIS ......................................................................................................................... 63 GLOBAL PROJECT ...................................................................................................... 80 PROJECT ACTIVITIES ............................................................................................................................. 81 OPERATIONAL ACTIVITIES .................................................................................................................... 96 APPENDICES .............................................................................................................. 98 MMDP Project FY18 Semi-Annual Report (October 1, 2017 – March 31, 2018) 3 ACRONYMS AIM Accelerating Integrated Management CBHW Community Based Health Workers CDC US Centers for Disease Control and Prevention CNTD Centre for Neglected Tropical Diseases CSPS Center for Health and Social Promotion (Centre de Santé et de Promotion Sociale) DFID Department for International Development DGS Central Health Directorate (Direction Générale de la Santé) DMDI Disease Management and Disability Inclusion DMT Dedicated Mobile Team DQT Dedicated Quality Team DRS Regional Health Directorates (Direction Régionale de la Santé) ECU Eye Care Unit EMMP Environmental Monitoring and Mitigation Plan EMMR Environmental Mitigation and Management Report ESPEN Expanded Special Project for Elimination of Neglected Tropical Diseases FASTT Filaricele Anatomical Surgical Task Trainer FHF Fred Hollows Foundation FMOH Federal Ministry of Health FOG Fixed Obligation Grant FY Fiscal Year GAELF Global Alliance to Eliminate Lymphatic Filariasis HCWM Health Care Waste Management HDA Health Development Army HEAD START Human Eyelid Analog Device for Surgical Training And Skills Reinforcement in Trachoma HEW Health Extension Worker HKI Helen Keller International HMIS Health Management Information System HRD Human Resources Directorate IC/HCWM Infection Control and Health Care Waste Management ICTC International Coalition for Trachoma Control IEC Information, Education, and Communication IECW Integrated Eye Care Worker IESO Integrated Emergency Surgical Officer LF Lymphatic Filariasis LFTW Light for the World LSTM Liverpool School of Tropical Medicine MDA Mass Drug Administration MMDP Morbidity Management and Disability Prevention MMMM Monthly Morbidity Management Meeting MOH Ministry of Health MOST Ministry of Science and Technology NaPAN National Podoconiosis Action Network NGO Non-Governmental Organization NTD Neglected Tropical Disease MMDP Project FY18 Semi-Annual Report (October 1, 2017 – March 31, 2018) 4 NTTF National Trachoma Task Force ORHB Oromia Regional Health Bureau PFSA Pharmaceutical Fund and Supply Agency PHCU Primary Health Care Unit PNLCé National Blindness Prevention Program (Programme National de Lutte contre la Cécité) PNMTN National Neglected Tropical Disease Control Program (Programme National de lutte contre les Maladies Tropicales Négligées) QA Quality Assurance RHB Regional Health Bureau SAFE Surgery, Antibiotics, Facial cleanliness, Environmental improvement SECU Secondary Eye Care Unit SNNPR Southern Nations, Nationalities, and People’s Region SSE Surgical Society of Ethiopia STTA Short-term Technical Assistance TA Technical Advisor TAB Technical Advisory Board TAP Trachoma Action Plan TEC Trachoma Expert Committee TEO Tetracycline Eye Ointment TIS Trachoma Impact Survey TRHB Tigray Regional Health Bureau TT Trachomatous Trichiasis UIG Ultimate Intervention Goal UNC University of North Carolina USAID United States Agency for International Development WHO World Health Organization WoHO Woreda Health Office ZHD Zonal Health Department MMDP Project FY18 Semi-Annual Report (October 1, 2017 – March 31, 2018) 5 EXECUTIVE SUMMARY In the first half of FY18, the Morbidity Management and Disability Prevention (MMDP) Project continued to strengthen both national ownership and global capacity for the scale-up of trachoma and lymphatic filariasis (LF) care and treatment. During the reporting period, the project made significant achievements, leveraged on-the-ground experience, and strengthened capacity and lessons learned, to support Burkina Faso, Cameroon, and Ethiopia to move closer towards meeting the 2020 elimination goals for trachoma and LF. The MMDP Project supported 10,897 trachomatous trichiasis (TT) surgeries during the reporting period, advancing ministry of health efforts to meet the trachoma elimination goals. This required screening 224,031 individuals living in endemic areas, using a variety of community mobilization and new case-finding strategies. In addition to supporting intensive trichiasis management, the project also supported activities that improved the evidence base for trachoma elimination planning in the three countries. In Burkina Faso, the project supported the national program’s development of a Trachoma Action Plan (TAP). In Cameroon, the project contributed to the national program’s assessment of trichiasis burden through implementation of a TT-only survey in Mada district, and supported coordination between the national program and WHO to make available Tropical Data’s analysis of prior trachoma survey results. The project also increased the three countries’ capacity to provide high-quality hydrocele surgery and lymphedema management services. In collaboration with ministries of health, the project supported the training of 11 surgeons to provide high-quality hydrocelectomies using the MMDP Project-developed FASTT training package. In addition, the project trained 40 health staff on hydrocele surgery support and care. In the first half of the fiscal year, the project supported 536 hydrocele surgeries across the three countries and trained 717 lymphedema patients in self-care. The project also supported a range of activities aimed at ensuring a longer-term sustainability of LF morbidity management in project countries and beyond