ATFARA S7A7E CDTI PRO.'ECT ORIGINAL: English COI,NTRYAIOTF.: NIGERIA ProiectNamez T.amfuz CDTI Prnject Anproval Year: 1998 Launchins vear: 1998 Reoortine Period (Month/Year): JAITIUARY TO DECEMBER 2007 Proiectvearofthisrenorf,(circleone) l2 3 4 5 67I 10 Date submittedz 2UD7 NGD(O partner: SIGHTSAVERS INTERNATIONAL NINETH YEAR ANNUAL PROJECT TECHNICAL REPORT TO TECHNICAL CONSULTATIVE coMMrrrEE (TCC) AFRICAN PROGRAMME FOR ONCHOCERCTASIS CONTROL (APOC) Sp** i.CI3 No)',ilra!, hi cstr CoD &l+ 4 B For l;x:,..--l'cr j i i To, Aip- I n I Stp. i!108 I I i n.tsok#, rt I I I ANNUAL PROJECT TECHNICAL REPORT SUBMITTED TO TECHNICAL CONSULTATIVE COMMITTEE (rcc) DEADLINE FOR SUBMISSION: To APOC Management by 31 Janu ary for March TCC meeting To APOC Management by 31 July for September TCC meeting AFRICAN PROGRAMME FOR ONCHOCERCTASTS CONTROL (APOC) - WHO/APOC, 24 November 2004 I ANNUAL PROJECT TECHNICAL REPORT SUBMITTED TO TECHNICAL CONSULTATIVE COMMITTEE (TCC) DEADLINE FOR SUBMISSION: meeting To APOC Management by 31 Januarv for March TCC meeting To APOC Management by 31 Julv for September TCC AFRICANPROGRAMME FOR oNCHOCERCTASTS CONTROL (APOC) - WHO/APOC, 24 November 2004 I ANNUAL PROJECT TECHNICAL REPORT TO TECHNICAL CONSULTATIVE COMMITTEE (TCC) ENDORSEME,NT Please confirm you have read this report by signing in the appropriate space. OFFICERS to sign the report: Country: NIGERIA National coordinator Name: Patricia ogbu Pearce Signature, .@'*o Date: .4.lPq. I { Zonal Oncho Coordinator Name:Dr' F I Signature Date: ...2* NGDO Representative Name Marthe Damina oxw-.*. ryf.?lev Date This report has been prepared by Name: Abdullahi Labbo Designation: StaterCoordinatoP ,,r,;;.' e-q'^o/- Date .tQ..-..7*9.A... - WHO/APOC, 24 November 2004 Table of contents Acronyms vii Definitionsviii FOLLOW UP ON TCG REGOMMENDATIONS Executive Summary v SEGTION {: Background information vii VII GnNenalINFoRMATIoN.......'...' 1.1. vii Description of the project (brieJly) 1.1.1 .ix 1.1.2. Partnership 1.2. PoPulertoN.....'..'..... ....1 SEGTION 2: lmPlementation of GDTI i 2.1 Truer,rNe oF ACTIVITIES ............ 2.2. Aovocncv ::;.-;J B;;id;; ;;;il';: 2.3. MoatltzRttoN, SENSITIZATIONANDHEALTHEDUCATIoNoFATRISKCOMMUNITIES.II 2.4 Cotr4NaLNtrY INVoLvEMENT ..' 2.5 Cepncttv BUILDING ....1 2.6. TRnarN4eNTS ............... I 2.6.1 . Treatment figures 2.6.2 Wat are the causes of absenteeism? 2.6.3 What are the reasons for refusals? -.. (SAEs) that 2.6.4 Brie/ly describe all lcnown and verified serious adverse events to the current year 2.6.5, Trend of treatment achievement from CDTI project inception Ennon! BoorruaRK Nor 2.7. ORoERINc, sroRAGE AND DELIVERY oF IVERMECTIN DEFINED. MeerNC EnnOn! BooxUa'Rx 2.8. COtvttrttrNtrY SELF-MONITORING eNo SrereHoLDERS NOT DEFINED. 2.9. SupeRvlstoN............'.. 2.g.1. Provide aflow chart of supervision hierarchy....Error! Bookmark 2.g.2. Wat were the main issues identified during supervision? """""""' 2.9.3. Was a supervision checklist used?.-..."' supervision? 2.9.4. What were the outcomes at each level of CDTI implementation supervised? 2.9.5. l|ras feedback given to the person or groups performance of the project? 2.9.6. Hoi was the fiedback used to improve the overall ii SEGTION 3: SuPPort to CDTI Error! Bookmark not defined. 1 3.1 EeutptrlsNr COMMUNITIES 2 J.L FINaNCIaI CONTRIBUTIONS OF THE PARTNERS AND """""""""' J J.J Orupn FoRMS oF coMMUNITY suPPoRT.'.."""""" ,J 3.4. ExPr,NPtruRE PER ACTIvITY SECTION 4: SustainabilitY of GDTI Error! Bookmark not defined' EveluarloN.'....'..'...'.'......' 3 4.1. INrnnNel; INDEPENDENTPARTICIPATORY MoNIToRINc; the reporting period? (tick any 4.1. t Was Monitoring/evaluation carried out during .............4 of thefollowingwhich are applicable) """" "' not deJined' 4.1.2. Wat were the recommendations? "' .Error! Bookmark not defined' 4.1.3. How have they been implemented? " .Error! Bookmark SusreNeslLITY oF PRoJECTS: PLAN AND 4.2. 1 Yn 3)... :*l:::::::Y)::l:::ll: :: ,...4 4.2.1, Planning at oll relevant levels 4 4.2.2 Funds........ 4 4.2.3 Transport (replacement and maintenance) - WHO/APOC, 24 November 2004 .....5 4.2.4. Otherresources.. .....5 4.2.5. To what extent has the plan been implemented"""""""" .....5 4.3. INrscRArloN............ .....5 4.3.1. Ivermectin delivery mechanisms"""""""" 4.3.2. Training.... .....5 progroms........... .....6 4. 3. 3. Joint supervision and monitoring with other .....6 4.3.4. Release offunds for project activities "' .....6 4.3.5. Is CDTI included in the PHC budget? """"""' how 4.3.6. Describe other health programmis that are using the CDTI structure and .....6 this was achieved. What have been the achievements? """""" ,.....6 4.3.7. Desffibe others issues considered in the integration of CDTI' ......6 4.4. OppnerloNAl RESEARCH. 4.4.1. Summarize in not more than one half of o page the operational research ......6 undertaken in the project area within the reporting period....... ......6 4.4.2. How were the results applied in the project? SEGTION 5: Strengths, weaknessesr challenges, and opportunities 6 sEGTION 6: Unique features of the proiecuother matters 8 - WHO/APOC, 24 November 2004 Acronyms APOC African Programme for Onchocerciasis Control ATO Annual Treatment Objective ATrO Annual Training Obj ective CBO Community-Based Organization CDD Community-Directed Distributor CDTI Community-Directed Treatment with Ivermectin CSM Community Self-Monitoring FLHF First Line Health Facility IEC Information Education and Communication LF Lymphatic Filariasis LGA Local Government Area LOCTs Local Onchocerciasis Control Teams MOH Ministry of Health NGDO Non-Governmental Development Organization NGO Non-Governmental Organization NOTF National Onchocerciasis Task Force PHC Primary health care REMO Rapid Epidemiological Mapping of Onchocerciasis SAE Severe adverse event SHM Stakeholders meeting SOCT State Onchocerciasis Control Team TCC Technical Consultative Committee (APOC scientific advisory group) TOT Trainer of trainers I.INICEF United Nations Children's Fund UTG Ultimate Treatment Goal wHo World Health Organization - WHO/APOC, 24 November 2004 Definitions (i) Total population: the total population living in meso/hyper-endemic communities within the project area (based on REMO and census taking). (iD Eligible population: calculated as 84o/o of the total population in meso/hyper- endemic communities in the project area. (iii) Annual Treatment Objective: (ATO): the estimated number of persons living in meso/hyper-endemic areas that a CDTI project intends to treat with Ivermectin in a given year. (iv) Ultimate Treatment Goal (UTG): calculated as the maximum number of people to be treated annually in meso/hyper endemic areas within the project area, ultimately to be reached when the project has reached full geographic coverag_e (normally the project should be expected to reach the UTG at the end of the 3'' year ofthe project). (u) Therapeutic coverage: number of people treated in a given year over the total population (this should be expressed as a percentage). (vi) Geographical coverage: number of communities treated in a given year over the total number of meso/hyper-endemic communities as identified by REMO in the project area (this should be expressed as a percentage). (vii) Integration: delivering additional health interventions (i.e. vitamin A supplements, albendazole for LF, screening for cataract, etc.) through CDTI (using the same systems, training, supervision and personnel) in order to maximise cost- eifectiveness and empower communities to solve more of their health problems. This does not include activities or interventions carried out by community distributors outside of CDTI. (viii) Sustainability: CDTI activities in an area are sustainable when they continue to function effectively for the foreseeable future, with high treatment coverage, integrated into the available healthcare service, with strong community ownership, using resources mobilised by the community and the government. (ix) Community self-monitoring (CSM): The process by which the community is empowered to oversee and monitor the performance of CDTI (or any community- based health intervention programme), with a view to ensuring that the programme is being executed in the way intended. It encourages the community to take full .esponribility of Ivermectin distribution and make appropriate modifications when necessary. - WHO/APOC, 24 November 2004 FOLLOW UP ON TGG REGOMMENDATIONS Using the table below, fill in the recommendations of the last TCC on the project and describe how they have been addressed. TCC sessionz 24th Number of TCC RECOMMENDATIONS ACTIONS TAKEN FOR TCC/APOC Recommendation in BY THE PROJECT MGT USE ONLY the Report o Explanation for the The project has a 258. UTG (97% of total population of 181,177 population) as the UTG, which is 84% of the total population (215,685) of treatment area a Why was training The appointment of conducted in new Onchocerciasis September after coordinator and the funds had become Director Public Health available when and Disease Control distribution had been was in April, 2006, completed in June? therefore the change of the B signatory was finalised by September, which resulted to conducting training late. The project did this ensuring that knowledge learnt would be used in the next and subsequent treatment rounds. a Why was only a The training was minority of CDDs conducted by health included in the staff in some facilities training? without any fund by the LGAs. a Less than 20% of The fund released was 259 funds budgeted by a total monthly impress the state were from the PHC released (95 000/500 department, which was 000) not part of the counterpart fund budgeted for the proiect. - WHO/APOC, 24 November 2004 U It still has not been Based on the people possible to train tradition and religion female CDDs and female were not females still do not allowed to participate participate as CDDs despite the significantly in sensitisation. Effort meetings. through advocacy would continue to ensure this is achieved. a Late financial The bank approved for returns to APOC the project in most have made it occasions does refer the impossible for request (financial APOC to release statements) to be funds in a timely forwarded to the manner.