OSUNSTATECDTI PROJECT ORIGINAL: English CO /|.{OTE : Nigeria Proiect Name : Osun State CDTI Approval year: 1998 Launching year : 1998 Reportin s Period: From: 1" Jan., 2005 TO: 31't Dec.,,nO5 (Month / Year) Proiect year of this report : (circleone) I 2 3 4 5 6 (7)89 l0 Date submitted: February 2007 NGDO Partner: UNICEF ANNUAL PROJEGT TECHNICAL REPORT SUBMTTTED TO TECHNTCAL CONSULTATTVE COMMTTTEE (TCc) DEADLINE FOR SUBMISSION To APoC Management by 31 Januarv. 2007 for March rcc meeting To APoC Management by 31 Jvlv. 2007 for september TCC meeting AFRICAN PROG]RAMME FOR ONCHOCERCIASIS CONTROL (APOC) I I ,' "-j i o$ ,-) I i i 1 d 1 e r. a -D> ';> t bii q JUIL 2007 2 rt I b+b :'. lA ,! oii Li C, o B$r, i.i i fs ) ANNUAL PROJECT TECHNICAL REPORT TO TECHNICAL CONSULTATIVE COMMITTEE (TCC) ENDORSEMtrNT Please confirm you have read this report by signing in the appropriate space. OFFICERS to sign the report: Country: NIGEzuA National Coordinator Name: Mrs. P. Ogbu-Pearce Signature cr-'Y Crt- Date: D D () Zonal Oncho Coordi nator Name: Otunba A. O. Jaiyeoba a Signature: ) t- Date: EB D D This report has been prepared by Name: Mr. M. E. Ilelaboye Designation: State Coordinator Signature: Signed 4 Date: l3th Feb .2007 L ll TABLE OF CONTENTS ACRONYMS VI DEFINITIONS vil FOLLOW UP ON TCC RECOMMENDATIONS 1 EXECUTIVE SUMMARY 2 SECTION 1: BACKGROUND INFORMATION 4 1,1 GENERAL INFORMATION 4 1.1.1 Description of the project (Elriefly) 4 1.1.2 Partnership 7 1.2 POPULATION 8 SECTION 2: IMPLEMENTATION OF CDTI I 2.1 TIMELINE OF ACTIVITIES I 2.2 ADVOCACY 10 2.3 MOBILIZATION, SENTIZATION AND HEALTH EDUCATION AT RISK COMMUNITIES 10 2,4 COMMUNITY INVOLVEMENT 13 2.5 CAPACITY BUILDING 15 2.6 TREATMENTS 18 2.6.1 Treatment Figures 19 2.6.2 What are the causes of absenteeism 20 2.6.3 What are the reasons for rerfusals 20 , Briefly describe all known and verified serious adverse events (SAEs) 20 ?.0 2.6.5 Trend of treatment achievement from the CDTI project inception lll to the current year 22 2.7 ORDERING, STORAGE AND DELIVERY OF INVERMECTIN 23 2.7.1 Mectizan inventory 24 2.8 COMMUNITY SELF-MONITORING AND STAKEHOLDERS MEETING 25 2.9 SUPERVISION ?6 2.9.1 Provide a flow chart of supervision hierarchy 26 2.9.2 what are the main issues identified during supervision? 26 2.9.3 Was a supervision checklist used? 26 2.g'4 Wnat were the outcomes at all level of CDTI implementation supervision 26 2.9.5 was feedback given to the person or groups supervised? 26 How 2.9'6 was the feedback used to improve the overall performance of the project 26 SECTION 3: SUPPORT TO CDT| 27 3.1 EQUIPMENT 27 3.2 FINANCIAL CONTRIBUTIONS OF THE PARTNERS AND COMMUNITIES 29 3.3 OTHER FORMS OF COMMUNITY SUPPORT 29 3.4 EXPENDITURE PER ACTIVITY 30 SECTION 4: SUSTAINABILITY OF CDTI 31 4.1 INTERNAL:INDEPENDENTpARTtCtpATORy MONITORING EVALUATION ' 31 4.1.1 was monitoring/evaluation carried out during the repcrting period? (tick any of the following which are applicable) 31 4.1.2 What were the recommendations? 31 0.1., How have they been implemented? 31 4.2 SUSTAINABILITY OF PROJECTS: PLAN AND SET TARGETS lv ) (MANDATORY AT YR 3) 31 4.2.1 Planning at all relevant levels 31 4.2.2 Funds 31 4.2.3 Transport (replacement and maintenance) 32 4.2.4 Other resources 32 4.3 INTERGRATION 32 4.3.1 lvermectin delivery mechanisms 32 4.3.2 Training 32 4.3.3 Joint supervision and monitoring with other programmes 33 4.3.4 Release of funds for project activities 33 4.3.5 ls CDTI included in the PHC budget 33 4.3.6 Describe other health programmes that are using the CDTI structure and how this was achieved. What have been the achievements? 33 4.3.7 Describe other issues considered in the integration of CDTI? 33 SECTION 5: STRENGHTS, WEAKNESSES, CHALLENGES AND OPPORTUNITIES 34 SECTION 6: UNIQUE FEATURES OF THE PROJECT / OTHER MATTERS 35 Acronyms APOC African Programme for Onchocerciasis Control ATO Annual Treatment Objective AtrO Annual Training Objective cBo Community - Based Organization CDD Community - Directed Distributor CDTI Community - Directed Treatment with lvermectin CSM Community Self-Monitoring FLHF First Line Health Facility FMOH Federal Ministry of l'lrralth GCCC Government Cash Counterpart Contribution IFESH lnternational Foundation for Education and Self Help LGA Local Government Area LOCT Local Government Onchocerciasis Control Team MOH Ministry of Health NGDO Non-Governmental Development Organization NGO Non-Governmental Organization NID National lmmunization Day NOCP National Onchocerciasis Task Force NOTF National Onchocerciasis Task Force NPI National Programme on lmmunization PHC Primary Health Care REMO Rapid Epidemiological Mapping of Onchocerciasis SAE Severe Adverse Event SHM Stakeholders Meeting SMOH State Ministry of Health SOCT State Onchocerciasis Control Team TCC Technical Consultative Committee (APOC scientific advisory group) TOT Trainer of Trainers UNICEF United Nations Children's Fund UTG Ultimate Treatment Goal WHO World Health Organization vl Definitions (i) Total Population: the total population living in meso / hyper-endemic communities within the project area (based on REMO and census taking) (ii) Eligible Population: Calculated as 84% of the total population in meso/hyper- endemic communities in the project area. (iii) Annual Treatment Objectives: (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 rrteso/hyper-endemic areas within the project area, ultimately to be reached when the project has reached full geographic coverage (normally the project should be expected to reach the UTG at the end of the 3'o year of the project). (v) 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) lntegration: 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 maximize cost effectiveness and empower communities to solve more of their health problems. This does not include activities or interventions carried out by commun'ity distributors outside of CDTI. (viii) Sustainability: CDTI activities in an arca arc 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 mobilized 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. lt encourages the community to take full responsibility of ivermectin distribution and make appropriate modifications when . necessary. vll FOLLOW UP ON TCC RECOMMENDATIONS Using the table below, fill in the recommendations of the last TCC on the project and describe how they have been addressed. TCC Session 21- Number of TCC ACTIONS TAKEN BY THE PROJECT FOR TCC/ Recommendat RECOMMENDATI APOC ion in the orvs MGT USE Reporl ONLY 1 Project should use The new reporting format has been the new reporting used for this report format in the next report 2 Project should This has been done in the report harmonise LGA and Community data 3 The treatment The treatment period was reduced from period should be January to April. However, mop up reduced treatment carried out between November and December com limented the treatment riod 4 Select and train Comprehe nsive proposals on the more CDDs training of more CDDs and Health workers have been forwarded to ApOC via NOCP Abuja as a panacea to this persistent problem. However, the slight reduction observed in the population to be covered by a CDD was informed by on-the-spot training / retraining conducted by SOCT during field assignments. The FLHF staff also took the challenge of report rendition of CDDs on monthly basis for educating them on proper record keeping. LOCTs supervisory visits of Oncho field activities equally utilized for the informal training of CDDs during the od under review 5 Reduce absertees The number of either absentees and / or and Refusals refusals was significantly reduced (during the reporting period). This success was attributable to aggressive health education and mobilization of endemic communities. (Please add more rows if necessary) I EXECUTIVE SUMMARY Osun State is one of the States in the South Western part of Nigeria and is located in the B Health Zone. The State has a population of about 2.2million (1991 census). lt is estimated that 830310 people are at risk of Oncho infection in all the 30 LGAs in the State. lt is predominantly Yoruba State. Other ethnic groups like Hausa, lbo, Fulanis and Agatus also reside in all parts of the State. Osun State project is in the seventh year of its implementation. Ennphasis was mostly placed on grass-root involvement and participation for CDTI sustainability. lntegration planning meetings were held as an important strategy to enlist the active involvement of other PHC Programme Officers in the State. Population movements occur with periodic relocation of some farmers from the communities during the farming period, festivity migrations from rural to urban areas, and some mothers travel to look after their sons' wives who have been delivered of babies.