MINISTRY OF HEALTH AND SANITATION GOVERNMENT OF SIERRA LEONE THE NATIONAL NEGLECTED TROPICAL DISEASES PROGRAMME MASTER PLAN FOR NEGL ECTED TROPICAL DISEASES ELIMINATION I N S I E R R A LEONE 2016- 2 020th Insert Photos i CONTENTS ACRONYMS ............................................................................................................................................................ 6 FOREWARD ............................................................................................................................................................ 9 ACKNOWLEDGEMENT .......................................................................................................................................... 10 LIST OF CONTRIBUTORS ....................................................................................................................................... 11 INTRODUCTION ................................................................................................................................................... 12 PART 1: SITUATION ANALYSIS .............................................................................................................................. 13 1.1. COUNTRY PROFILE ...................................................................................................................................... 13 1.1.1 Administrative, demographic and community structures ...................................................................... 13 1.1.2 Geographical Characteristics ..................................................................................................................... 15 1.1.3 Socio-economic status and indicators ........................................................................................................ 16 1.1.4 Transportation and Communication ...................................................................................................... 17 1.2 HEALTH SYSTEM SITUATION ANALYSIS ................................................................................................................. 18 1.2.1 Health system goals and priorities ......................................................................................................... 18 1.2.2 Analysis of the overall health system ......................................................................................................... 19 1.3 NTD SITUATION ANALYSIS ................................................................................................................................. 24 1.3.1 Epidemiology and burden of disease ..................................................................................................... 24 1.3.2 NTD programme implementation .......................................................................................................... 27 1.3.3 Gaps and Priorities ................................................................................................................................. 32 PART 2: NTD STRATEGIC AGENDA ........................................................................................................................ 34 2.1 OVERALL NTD PROGRAMME MISSION, VISION AND GOALS .................................................................................. 34 2.2 GUIDING PRINCIPLES AND STRATEGIC PRIORITIES .................................................................................................... 34 2.3 NATIONAL NTD PROGRAMME GOALS, OBJECTIVES, STRATEGIES AND TARGETS ........................................................... 36 2.4. NATIONAL MILESTONES ................................................................................................................................... 42 3.1 SCALING UP ACCESS TO NTD INTERVENTIONS AND TREATMENT AND SERVICE DELIVERY CAPACITY .................................... 46 3.1.1 Scaling up preventive chemotherapy interventions ............................................................................... 46 3.1.2 Scaling up NTD Case management Interventions .................................................................................. 52 3.1.3 Scaling up NTD transmission control interventions ............................................................................... 55 3.2 PHARCOVIGILANCE IN NTD CONTROL ACTIVITIES ............................................................................................................ 57 3.4 STRENGTHENING CAPACITY AT NATIONAL LEVEL FOR NTD PROGRAMME MANAGEMENT AND IMPLEMENTATION ........................ 59 3.5 ENHANCE PLANNING FOR RESULTS, RESOURCE MOBILIZATION AND FINANCIAL SUSTAINABILITY OF NATIONAL NTD PROGRAMMES ............................................................................................................................................................. 63 3.6 STRENGTHENING GOVERNMENT OWNERSHIP, ADVOCACY, COORDINATION AND PARTNERSHIPS..................................... 66 3.7 MONITORING AND EVALUATION ........................................................................................................................ 69 3.8. POST INTERVENTION SURVEILLANCE AND INTEGRATION WITHIN PRIMARY HEALTH CARE ...................................................... 73 ANNEXES ............................................................................................................................................................. 75 PART I: SITUATION ANALYSIS ............................................................................................................................... 76 ANNEX 1.1 SUMMARY POPULATION TABLE ........................................................................................................................ 76 ANNEX 1.2: DISTANCES BETWEEN MAIN CITIES AND DISTRICT HEADQUARTERS OF THE COUNTRY .............................................. 77 ANNEX 1.3: ORGANISATIONAL CHART OF THE MOHS AND THE NTD NATIONAL PROGRAMME............................................... 78 ANNEX 1.4: SUMMARY ON AVAILABLE DATA OF PCT-NTD DISTRIBUTION ............................................................................... 79 ANNEX 1.5: SUMMARY ON AVAILABLE DATA ON CM-NTD DISTRIBUTION ............................................................................... 80 2 ANNEX 1.6: SUMMARY ON STATUS OF IMPLEMENTATION OF PCT NTD INTERVENTIONS IN DISTRICTS ........................................... 81 ANNEX 1.7: SUMMARY ON STATUS OF IMPLEMENTATION OF CM INTERVENTIONS IN DISTRICTS ................................................... 83 PART II: STRATEGIC AGENDA AND OPERATIONAL FRAMEWORK ......................................................................... 84 ANNEX 2. 1: PACKAGE OF PREVENTIVE CHEMOTHERAPY (PCT) - MASS DRUG ADMINISTRATION (MDA) ...................................... 84 ANNEX 2.2: PACKAGE OF CASE MANAGEMENT (CM) AND CHRONIC CARE ............................................................................... 85 ANNEX 2. 3: PCT ALGORITHM 1 ..................................................................................................................................... 86 ANNEX 2.4: PCT ALGORITHM 2 ...................................................................................................................................... 87 ANNEX 2.5: ALGORITHM FOR CO-ENDEMICITY OF CM-NTDS (LEPROSY, BURULI ULCER, HAT) IN COUNTRIES OF THE WHO AFRICAN REGION ...................................................................................................................................................................... 88 ANNEX 2.6 PACKAGE OF TRANSMISSION CONTROL - VECTOR/RESERVOIR CONTROL ................................................................... 89 ANNEX 2.7: PACKAGE OF IMPROVEMENT OF ENVIRONMENT, SUPPLY OF SAFE DRINKING WATER, SANITATION, AND OPERATIONAL RESEARCH ................................................................................................................................................................... 90 ANNEX 2.8: “WHAT TO DO” BY DISTRICT (OPERATIONAL UNIT) BY OPERATIONAL PACKAGE ...................................................... 91 ANNEX 2.9: DRUG ESTIMATES AND LOGISTICS .................................................................................................................... 92 ANNEX 2.10: DRUG FORECASTING AND LOGISTICS .............................................................................................................. 92 ANNEX 2.11: SUMMARY OF PROGRESSIVE SCALE UP AND PHASE OUT OF PCT INTERVENTIONS PACKAGE ....................................... 93 ANNEX 2.12: RESULTS FRAMEWORK FOR THE WHO-HQ-AFRO-APOC STRATEGIC PLAN, 2016–2020 .................................... 94 PART III: DISEASE SPECIFIC ANNEXES ................................................................................................................... 95 ANNEX 3.1 DISTRICT PREVALENCE OF LF ......................................................................................................................... 95 ANNEX 3.2: DISTRICT PREVALENCE OF ONCHO ................................................................................................................. 96 ANNEX 3.3: DISTRICT PREVALENCE OF SCH ..................................................................................................................... 98 ANNEX 3.4 SCH PREVALENCE DATA BY RANGE ............................................................................................................ 100 ANNEX 3.5 DISTRICT PREVALENCE OF STH ....................................................................................................................