The Zika AIRS (ZAP) Project Indoor Residual Spraying (IRS 2) Task Order Six ZAP GUATEMALA END OF YEAR REPORT JANUARY 1, 2018 – DECEMBER 31, 2018 Recommended Citation: Zika AIRS Project (ZAP). February 2019. ZAP Guatemala End of Year Report 2018. Rockville, MD. Abt Associates Inc. Contract No.: GHN-I-00-09-00013-00 Task Order: AID-OAA-TO-14-00035 Submitted to: United States Agency for International Development Submitted: February 14, 2019 Abt Associates Inc. 1 6130 Executive Boulevard 1 Rockville, Maryland 20852 1 T. 301.347.5000 1 F. 301.913.9061 1 www.abtassociates.com ZAP GUATEMALA END OF YEAR REPORT JANUARY 1, 2018 – DECEMBER 31, 2018 The views expressed in this document do not necessarily reflect the views of the United States Agency for International Development or the United States Government. 3 CONTENTS Contents Acronyms ii 1. Executive Summary ...............................................................................................................1 2. Progress and Outcomes.........................................................................................................2 2.1 Community Mobilization, Social and Behavior Change Communication .................. 2 2.2 Vector Control .............................................................................................................. 3 2.2.1 Larviciding and Source Reduction...................................................................................................3 2.2.2 IRS………… ......................................................................................................................................5 2.3 Entomological Monitoring ............................................................................................ 6 2.3.1 Entomological Monitoring for Larviciding and Source Reduction .............................................6 2.3.2 Entomological surveillance for IRS............................................................................................... 11 2.4 Environmental Compliance and Safety...................................................................... 14 2.4.1 IRS Campaign .................................................................................................................................. 14 2.4.2 Larvicide Campaign ........................................................................................................................ 14 2.4.3 Security…….................................................................................................................................... 14 2.5 Monitoring and Evaluation.......................................................................................... 15 3. Improving Zika Response ....................................................................................................17 3.1 Training and Institutional Capacity Building ........................................................................ 17 3.2 Government Engagement................................................................................................. 17 3.3 Innovations.. ................................................................……………………………………..17 3.4 Integration of Cross-cutting Issues .................................................................................... 18 3.4.1 Gender Equality and Female Empowerment.............................................................................. 18 4. Learning.................................................................................................................................19 4.1 Challenges and Lessons Learned ....................................................................................... 19 5. Sustainability and Exit Strategy ..........................................................................................20 Annex 1A. Monitoring and Evaluation: Zika Framework........................................................21 Annex 1B. Monitoring and Evaluation: ZAP M&E PLAN (MEP) ............................................22 Annex 2. Environmental Mitigation and Management Report ...............................................32 Annex 3. Selected Environmental Compliance Resources......................................................52 Annex 4. ZAP Security Resources .............................................................................................53 Annex 5. Training Report ...........................................................................................................57 Annex 6. BCC interventions in 2018..........................................................................................59 Annex 7. Collaboration ...............................................................................................................63 Annex 8. Aedes Indices from larviciding campaign in 2018 ....................................................65 i ACRONYMS AIRS Africa Indoor Residual Spraying BCC Behavior Change Communications BI Breteau index BMP Best Management Practices Bti Bacillus thuringiensis israelensis CDC Centers for Disease Control and Prevention CI Container Index COCODES Community Development Council EMMP Environmental Mitigation and Monitoring Plan EW Epidemiological Week HH Household HI House Index IRS Indoor Residual Spraying M&E Monitoring and Evaluation MOH Ministry of Health ODK Open Data Kit PAHO Pan American Health Organization PI Pupae Index PPE Personal Protective Equipment PROEDUSA Departamento de Promoción y Educación para la Salud (Department of Health Promotion and Education) USAID United States Agency for International Development VC Vector Control USAID United States Agency for International Development WHO World Health Organization ZAP Zika AIRS Project ii 1. EXECUTIVE SUMMARY This document is a compilation of the Zika AIRS Project (ZAP) in Guatemala’s key activities, progress, and lessons learned in 2018. Funded by the United States Agency for International Development (USAID), ZAP Guatemala aims to reduce the burden of vector-borne diseases by enhancing the capacity and supporting the efforts of the Ministry of Health (MOH) to control the country’s Zika outbreak. Table 1 lists the overall project objectives and highlights of 2018 results. Table 1. ZAP Guatemala Objectives and Highlights 2018 Project Objectives 2018 Highlights/Results Implement vector control activities, including larviciding with 87,369 households visited through Bacillus thuringiensis israelensis (Bti), environmental clean-up, and a total of 678,641 monthly visits reduction of breeding sites, as well as behavior change communication (BCC) for the elimination of mosquito breeding sites, through monthly visits in 70,000 targeted households. Conduct an indoor residual spray (IRS) pilot in one of the 5,500 structures sprayed in 2018 priority departments as recommended by USAID and the MOH In close coordination with the MOH, implement 3 sentinel sites with ongoing data entomological surveillance best practices and conduct vector collection and monitoring bionomic studies, routine monitoring, and data reporting to inform optimal cost-effective vector control interventions. In coordination with other USAID implementing agencies, contribute to strengthening the capacity and skills of the government of Guatemala at the national and sub-national levels and of other local counterparts to plan and manage vector control and entomological activities aimed to reduce transmission of Zika and other arboviruses. The geographical locations served by ZAP expanded from 11 municipalities in 2017 to 22 in 2018. The new municipalities are located in the same three departments (Chiquimula, El Progreso, and Zacapa) as the original 11; ZAP Guatemala selected these departments in coordination with the MOH and USAID Mission. This expansion involved training approximately 330 new seasonal workers for vector control and entomology work as well as the opening of two new entomological sentinel sites and entomology laboratories. Overall, in 2018, ZAP-supported larviciding and IRS reached 273,281 beneficiaries. Its community-level BCC interventions reached 34,488 women and 24,432 men. Significant effort went into implementing BCC interventions at the household level as well as strengthening the coordination with community leaders and MOH authorities in all three targeted departments. 1 2. PROGRESS AND OUTCOMES In 2018, in coordination with the Ministry of Health (MOH), the Zika AIRS Project (ZAP) in Guatemala continued implementation of vector control and entomological interventions initiated in 2017 and expanded key activities into an additional 15 municipalities. As of December 2018, ZAP Guatemala is implementing vector control intervention in 22 municipalities in three departments, Chiquimula, El Progreso, and Zacapa, entomological surveillance through sentinel sites in three municipalities, and community outreach and behavior change communication (BCC) interventions in 220 communities. 2.1 COMMUNITY MOBILIZATION, SOCIAL AND BEHAVIOR CHANGE COMMUNICATION Taking into account lessons learned from 2017, in 2018 ZAP Guatemala expanded its strategy to reach targeted beneficiaries and overcome the challenges posed by the low risk perception and awareness about Zika that the beneficiary population shows. In coordination with the MOH Department of Health Promotion and Education (Departamento de Promoción y Educación para la Salud, PROEDUSA), ZAP placed priority on minimizing the use of printed materials; instead, it increased the use of education- entertainment efforts to promote the change of behaviors