,I I BIUGIII SMIT PROGNI$S NHllRI illarch 2000 - fG[,2001 SUBilIIIEII MIRGH 20ll1 r0 fi]RrGlil Pn08n[ililt ron ONGilIIGTNGNSF GOilIROl NPllSI For Actica 0ufiGfft0u80u BURmlilm$0 l1 '{{ .,t t., jl t I : .{ 1i KEV @ cATt L.G,n,e ('6, ruofr/ r elit ns. [] SECTION ONE BACKGROUND Bauchi State project is located in the North-East of Nigerian. There are 20 local Govemment Ares in the State. The State shares boundaries with Plateau, Kano, Jigawa, Yobe, Borno, Taraba and Gombe States. The State lies in the Savannah region of Nigeria, with variation in ecological conditions with the southern and western parts being sudan or guinea Savannah, having a relatively higher rainfall, the northern part of the State is sahel Savannah with flat lands and fewer hills. Some major rivers traverse the State. These include the river Hadeja, Jama'are, Gongola and Dindima. Most of the endemic local government areas lies along these river systems. The State has two distinct seasons', dry and rain seasons. There are six months of rain, beginning in May and ending in October. The farming season is from May to December. Most of the onchocerciasis endemic communities are not accessible all year round; the dirt and laterite roads to these communities are usually not motor-able during the height of the rainy season. Even in dry season, where the roads are sandy, four-wheel drive vehicles may be required in some instances along with motorcycles and bicycles. The settlement pattern varies in different part of the State. Generally, there is a pattern of nuclear settlements, with surrounding farmlands. In some areas there is dispersed settlement and in others a combination of nuclear and dispersed settlement is found. There are numerous ethnic groups in the CDTI LGAs, namely the Hausa Fulani, Jarawa, Sayawa, Kanuri Pa'awa and other minority tribes. The majority of the indigenous population are farmers. There are 13 CDTI LGAs with an endemic population of 964,138 persons. The LGAs are Ningi, Warji, Darazo, Alkaleri, Kirfi, Dass, Tafawa Balewa, Toro, Shira, Ganjuwa, Misau, Zal<r and Gamawa. However, the results of the registration update are provisional and awaiting validation. The proposal for the implementation of CDTI in the State was approved in December 1999. Funds were received in March 2000 and the financial cycle was revised to start from March 2000 to February 2001. The number of Hyper endemic communities before CDTI was 140 while there are 225 meso endemic communities. With the implementation of CDTI the number of endemic communities are: - Total - 623 communities. The State has been carrying out treatment under CBTI since 1991. DEFINITION A community is a group of people living together having the same culture and tradition while a village is an administrative area headed by a village head comprising of about 15 to 40 communities each of which has a population of about 500 to 1000 people. SECTION TWO IMPLEMENTATION OF CDTI (YEAR ONE) S/l{o LGAs No of No of Comm. No of No of No of No of Comm. No of Communities Which Comm. Comm. Comm. With trained Comm. selected Which Decided on Decided CDDS Paying in CDDS Collected method of on Cash or Drugs Distribution method of Kind TX Alkaleri 3l 30 30 30 0 30 20 2 Ningi 73 65 65 65 0 65 30 3 Warji 28 25 25 25 0 25 20 4 Kirfi 18 18 18 18 0 18 t2 5 Toro 7l 65 65 65 0 65 3 6 Dass 70 62 62 62 0 62 40 7 T/Balewa 34 30 30 30 0 30 25 8 Ganjuwa 9t 83 83 83 0 83 60 9 Misau 39 35 3s 35 0 35 32 10 Shira 53 50 50 50 0 50 45 ll Zaki 54 50 50 s0 0 50 50 r2 Gamawa 23 22 22 22 0 22 20 13 Darazo 38 36 36 36 0 36 25 TOTAL 623 571 571 571 0 571 382 TRAINING OF THE DIFFERENT LEYELS OF STAFF INVOLVED IN CDTI IMPLEMENTATION SAIo LGAs No of Training No of TOT No of Health No ofLOCTS No ofCDDS undertaking Trained Centre/Post staff Trained Trained Trained on CDTI 1 Alkaleri 2 2 2 2 t43 Ningi 2 2 2 2 r60 2 Warji 2 2 2 2 146 3 Kirfi 2 2 I 2 222 4 Toro 2 2 I 2 t76 5 Dass 2 2 1 ) r54 6 T/Balewa 2 2 I 2 151 7 Ganjuwa 2 2 I 2 175 8 Misau 2 2 ) 2 t67 9 10 Shira 2 2 I 2 r66 1l Zaki 2 2 I 2 159 t2 Gamawa 2 2 I 2 160 13 Darazo 2 2 I 2 153 TOTAL 26 26 18 26 2132 t LOCTS and CDDS training were undertaken (2 training in each LGAs) Annual training objective was to train 39 LOCTs of which 26 (67%) were trained and 2336 CDDS of which 2132 (91%) were trained. The materials used for the training are Brochures, flipcharts, measuring sticks, posters and registration log books. From the performance of the CDDs it is apparent that some have understood their roles while some are yet to. Intensive training and supervision at community level will be done to improve CDDs' performance. MOBILAZATION EDUCATION OF' TARGET COMMUNITIES S/l{o LGAs No of Comm. No of Target No of Advocacy visit No of MOH No of NGDO Mobilized Comm. Which to State/LGA Staff involved in Staff involved in received H/E about Directors of Health's Mobilization Mobilization import of extended Treatment a I Alkaleri 30 30 4 J I Ningi 65 65 6 4 I 2 Warji 25 25 7 4 I 3 a Kirfi 18 l8 3 J I 4 Toro 65 65 5 2 1 5 Dass 62 62 6 3 3 6 T/Balewa 30 30 6 4 2 7 Ganjuwa 83 83 4 3 I 8 Misau 36 36 3 2 I 9 l0 Shira 35 35 4 3 1 11 Zaki 50 50 4 3 1 t2 Gamawa 50 50 5 3 I 13 Darazo 22 22 5 4 I TOTAL 571 571 62 7 3 *NB At community level information are given through lectures, posters, flipcharts and discussions. not supporting the CDDS and there is political interference in the selection of CDDS and mectizan distribution. Therefore, there is the need for intensive advocacy and mobilization to target communities by giving information through TV, Lectures, Posters, drama groups, and use of religious and traditional leaders. SECTION THREE Achievements L. Treatment coverage rate Number of people treated x 100 :379723 x 100 Total (census) population 964,138 1 : 40oh 2. Total (census) population The total (census) population for hyper endemic communities are 452,914 while for meso endemic communities are 511,224. 3. Eligible population The total population minus - the excluded. : 964,138- 195,958 : 768.180 Mectizan Treatment Table S/1.{o LGAs No of No of Eligible Cost per No of Comm. No of No of Treated Target person treated person CDDS is a Distribution Comm. With Comm. treated Health Worker supervised by summary treated Ilealth workers forms. I Alkaleri 30 52,511 NA 0 2 Ningi 65 62,785 NA 2 2 2 Wa{i 25 1,5,719 NA 0 I 3 Kirfi 18 26,712 NA 0 2 4 Toro 65 63,776 NA 0 2 5 Dass 62 31,963 NA 0 1 6 T/Balewa 30 15,982 NA 0 1 7 Ganjuwa 83 15,979 NA 0 1 8 9 Misau 35 l4,l4l NA 0 I l0 Shira 50 3 1870 NA 0 I 11 Zaki 50 16.438 NA 0 I t2 Gamawa 22 t5.271 NA 0 I 13 Darazo 36 t5.976 NA 2 2 TOTAL 571 379,723 NA 4 18 *NB * The proportion of absenteeism is not higher than expected. 't The most common reason for absenteeism is migration especially for cattle rearers. {. The action that needs to be taken by the project to reach absentees is to carry out treatment before perennial migrations especially for cattle- rearers or nomads. I SECTION FOAR Strengths ofthe project are: - 1. Remote areas are reached with more CDDs 2. Recording system is improving 3. Increased supervision 4. Awareness at community level is improving 5. Policy makers in some LGAs are supporting the programme. 6. State government has supported by giving its counterpart funds to the tune of N3million which was used for the production of calendars, T - shirts, and for holding advocacy workshops. 7. Full support and direct supervision by NOCP 8. Availability of logistics Weaknesses/Constraints of the Project are: - 1. Not all communities accept the ownership of the project 2. CDDs are expecting incentive and employment from the project. 3. Some communities are not supporting their CDDs. 4. Political interference in the selection of CDDs andmectizan distribution 5. Inadequate support by some policy makers 6. Low literacy level within the project area 7. Inadequate support by assisting NGDO Future Plans: - 1. Intensive advocacy and mobilization at all level 2. Intensive training at all levels Support needed from Government: - 1. Prompt and regular release of counterpart fund 2. Support for Oncho staff to carry out their duties effectively Support from APOC 1. Advocacy visit to the State policy makers 2. Prompt release of funds Bauchi State project is located in the North-East of Nigerian. There are 20 local Govemment Ares in the State. The southern and western parts being sudan or guinea Savannah, having a relatively higher rainfall. The northern part of the State is sahel Savannah with flat lands and fewer hills.