Against Malaria Foundation LLIN Distribution Programme – Detailed Information Summary # of LLINS Country Location When By whom Sept- Oct 20,000 Nigeria Delta State NDDI/YDI 2010 Further Information 1. Please describe the specific locations & villages to receive nets and the number to each? Please provide longitude/latitude information. (Important note: If the distribution is approved, approval will be for the nets to be distribution to these specific locations. Location changes will only be considered, and may be refused, if due to exceptional/unforeseen circumstances.) The distribution is to take place in Delta State, Nigeria in the following Wards: (1) Ward in Ethiope East LGA (Orhuakpo Ward), (2) Ward in Warri South LGA (Bowen Ward),(3) Wards in Bomadi LGA WOMEN LGA (20%) settlements Wards REQUIRED 5YRS of < of (5%) population OF LLINs PREGNANT Name OF Total numbers TOTAL POPLN Total POPLN BOMADI Akugbene(1) 4 1695 339 85 678 Akugbene(2) 2 6110 1222 306 2444 Akugbene(3) 5 2833 567 142 1133 (Ijaw community) 4255 ETHIOPE 3067 767 EAST Orhaorpor 16 15335 6134 (Urhobo community) Isiokolo 2 9485 1897 474 3794 9928 WARRI SOUTH Bowen 9 14020 2804 701 5608 Total LLIN Requirement 19791 Page 1 of 6 2. Is this an urban or rural area and how many people live in this specific area? The areas represent Rural, Urban and Peri-urban environments with a total population of approx 50,000 (as in the Table) 3. Is this a high risk malaria area? If yes, why do you designate it as high? Accurate local statistics are scarce but empirical evidence suggests that the above environmental factors combined with a high population density and lack of adequate access to medical facilities increase the national statistical average. Typically according to the National Malaria Control Programme in Nigeria 2005 Annual Report the Prevalence Rate of Major causes of Morbidity for Malaria was 1858 per 100,000. Malaria constitutes a serious public health problem in Nigeria. It is responsible for 60% outpatient visit to health facilities, 30% childhood death, 25% of death in children under one year and 11% of maternal death (4,500 die yearly). In Nigeria, a child will be sick of malaria between 2 and 4 times in one year and 70% of pregnant women suffer from malaria; contributing to maternal anaemia, low birth weight, still birth, abortion and other pregnancy-related complications. 4. Baseline malaria case information. How many reported cases of malaria and malaria deaths were there in this specific area in the most recent period available? We are looking for data from health clinics in the area. Month by month information is strongly preferred. We are NOT looking for regional level/national level information. Please cite your source. Baseline malaria case information forms the basis of comparison post-distribution. There have been no specific surveys produced from the areas of the planned distribution. Any data that is available is patchy and inconsistent. There are small Health Centers in each of the wards as follows: Bomadi: Akugbene Health Center Ethipoe East: Ekrobo Health center Warri South: Pessu Health center 5. Is this distribution of nets ‘blanket coverage’ of an area/village or to a select/vulnerable group? If the latter, please describe this group. The distribution will aim for universal coverage. 2 Nets per Household, 5 persons per house. As agreed with Dr T Sofola, Head of NMCP. 6. What is the existing level of ITN use in this area? Are there existing bednet distribution programmes in this area? See attached: DELTA 2009 RBM GAP ANALYSIS Page 2 of 6 7. Why was the area/villages chosen for bednet distribution and who made this decision? Please provide the name, position and organisation of the person/s making the decision. The Wards were chosen to reflect vulnerability, needs and as being representative of a fair cross section of Delta society in a consultation meeting between YDI President, Chief Westham Adehor and: Dr Joseph Otumara The Commissioner for the Ministry of Health, State Secretariat Okpanam Road, Asaba. GSM- +234-8033862939 Dr Akporere Francis Onojeta Roll Back Malaria Coordinator Delta State Delta State Primary Health Care Development Agency, Asaba. GSM- +234-8035754820, +234-8051003434 8. Have you consulted with the country’s National Malaria Programme about this distribution and what was their response? Please provide the name, position and contact details of the person/s with whom you have liaised. The National Malaria Control Programme has been fully involved in the discussion and decision making process and is fully supportive of this activity. For any reference please contact: Dr T Sofola, Nigerian National Malaria Control Programme, Abuja GSM- +234-8033051149, Email- tosofola AT yahoo.com A letter of support for the distribution from Dr Sofola is attached to the proposal. The Nigeria National Malaria Strategic Plan (NMSP) is for Universal Coverage of the entire population with LLINs by the end of 2010. Universal Coverage is defined by the Nigerian National Malaria Control Program (NMCP) as 2 LLINs per household (average of 5 persons per household) in line with Roll Back Malaria guidance. This will be followed by a mop up campaign and replacement through to 2013. Scale Up for Impact (SUFI) began in Nigeria in Apr- May 2009 with the beginning of mass distributions, this will continue through to December 2010 until Universal Coverage is obtained. Up to date figures from Roll Back Malaria confirm there is a gap of 9,177,755 LLINs, See table below Page 3 of 6 Table 2 : Roll Back Malaria figures 2009 FUNDS SOURCE COMMENT AVAILABLE (US $) Mechanism and Available Total Need Gap when 140,000 LLINs FGN/MDG Campaign 2009 22,378,956 22,378,956 0 8,300,000 LLINs WB 1 Campaign 2009 3,966,786 LLINs WB 2 Campaign 2009 1,949,763 LLINs DFID Campaign 2009 590,000 LLINs USAID Campaign 2009 2,782,749 LLINs UNITAID/UNICEF Campaign 2009 1,259,048 LLINs GF R4 Campaign 2009 3,390,609 LLINs GF R8 Campaign 2009 629,533 LLINs USAID Mop-up 2009 629,533 629,533 0 3,717,251 LLINs UNITAID/UNICEF Campaign 21,525,209 21,525,209 0 May-Jun 2010 17,807,958 LLINs GF R8 Campaign May-Jun 2010 9,177,755 LLINs GF R8 Campaign 9,177,755 18,444,832 9,177,755 0ct-Nov 2010 53,800,775 LLINs TOTAL TOTAL 53,800,775 62,978,530 9,177,755 (4.4m were Distr. In Jun-Aug. 09) A list of time tabled distributions by State and number of LLINs to be distributed is attached at the end of the proposal. The mass distribution of LLINs in Delta State is planned for Nov-Dec 2010. NDDI/YDI are planning further distributions in partnership with Against Malaria as an integral part of the Nigeria National Malaria Strategic Plan. 9. Please give the name and contact information for the (government) head of the district health management team for the/each area. Please ensure you include contact information. Dr Akporere Francis Onojeta, Roll Back Malaria Coordinator Delta State, Roll Back Malaria LGA Coordinators: Ethiope East- Prince Tobor. GSM- +234-8085036847, Bomadi- Mrs Ndidi Nwachokor. GSM- +2348033434000 Warri South- Dorothy Eghuleighe. GSM- + 2348052227524 10. Please confirm the nets will be distributed free-to-recipients, a requirement for us to fund nets. Yes, all nets to be distributed free. As follows: Orhakpor Ward- 3834 Bowen Ward- 3505 Akugbene Wards 1,2 & 3: - 2660 Total: 9999 Page 4 of 6 11. Please describe all pre-distribution activity, including how the size of the target group and number of nets required will be ascertained and how the local community and leaders will be involved in this phase of the work? Prior to distribution NDDI/YDI Programme Liaison Officers (PLO) working with Local Government Authority (LGA), community based womens groups and Traditional Birth Attendants (TBA) will inform and identify households with under IO5 and pregnant women. Awareness and sensitisation meetings will be held in each ward to explain the need for everyone, and not just the most vulnerable, to protect themselves from malaria, the role of the vector and why LLINs work, when and how to use the LLINs correctly (in particular net hanging demonstrations) and recognizing the symptoms of malaria and the importance of prompt treatment. Qualifying recipients will be registered and receive a voucher to redeem during the actual distribution phase. 12. Please describe how the bednets will be distributed and by whom. Please give detail. Please indicate over what time period (typically, the number of days or weeks) the distribution will occur. PLOs will provide logistical assistance and working with Roll Back Malaria Coordinators in each LGA will carry out the distibution and ensure that recipients have an of how the nets are to be used. A select group of local volunteers will be given more detailed information and instruction through a ‘train the trainer’ programme in order to provide ongoing advice and assistance to the community. 13. Please describe the malaria education component of the distribution. Please give a detailed answer. Malaria education will be given at the pre-distribution village meetings and at distribution as detailed in the Nigerian Malaria Strategic Plan. This includes the need for everyone, and not just the most vulnerable, to protect themselves from malaria, the role of the vector and why LLINs work, when and how to use the LLINs correctly and recognizing the symptoms of malaria and the importance of prompt treatment. 14. Please confirm: a) you will conduct immediate post-distribution follow-up to assess the level of usage (hang-up %) of the nets; b) this take place within four weeks of the distribution; c) you will provide us with the findings.