(SSOTF) and APOC Management

South

Sudan

Onchocerciasis Task

^X'orce

(SSOTF) and APOC Management

Working sessions with onchocerciasis control partners

South Sudan,

22"d

-

3O'h

March

2009

Mission Report

By

Dr. M.

Noma,

CEV/APOC Mr. K.B. Agblewonu, BFO/APOC

Mr. N.

Lazants,

TAiAPOC Mrs. A.

Wanyoike,

AAF/APOC

t

,

_::.;*;,

t

h^

i

{

l 1(

t

t n

It ,

a

, ,

I

^{-.1a .J}

t

-/+

)

r

^a

qat..' :

"',.

Table of contents

1. TERMS OF REFERENCE OF THE MISSION...

2. ^SETPS IN CARRYING OUT THE MISSION...

3. ^{FINDINGS AND} OUTCOMES....

3.1. ^Programme coordination: SSOTF

and

projects

..

3.2. Financial and administrative issues...

3.3. Projects: operations, experiences

and

challenges

3.4. Capital equipment of projects

4, STATUS OF DISEASE MAPPING...

4.1. Completion of

disease

mapping

4.2. Funding

and

managing the approved budget of

disease

mapping

5. ^{OTHER IMPORTANT} MATTERS...

5.1. Government's financial contributions...

4 4 5

..,6

...8 ...8 .10 ....10

5.2. ^{Mechanism of releasing funds for} Technical advisor: request approval, TA

and

claims..10

5.3. Regular supervision activities by WHO/South Sudan-APOC Management-AAF/APOC

10

6. CONCLUSIONS. ACTION POINTS AND RECOMMENDATIONS

...

ll

ANNEXES

12

...3

...3

1. TERMS OF REFERENCE

^OF

THE MISSION 1.

Transferoffunds

r

Past and current experiences

o

Action for improvement of the transfer of funds

2.

^{Release of funds}

r

Collaboration and Support of WHO Office, CBM and SSOTF/HQ ^to projects

e

Financial structurc in place at national, state, county and project level

o

APOC manual and procedure: Project team

o

Plan ofAction and Budget and submission

r

Availability oftrained project accountants

o

New mechanism

of

^releasing

of

Trust fund to WHO office, Projects, Stafl members, other suppliers

r

GSM requirement -Bank account details

r

Signature ofproject bank accounts

o

Financial reports using the format of GSM

o

Financial rehrms :Channel from Project ^to APOC

Technical reports (endorsement, submission dates, technical format, project years)

Pending retums and pending pa),ments for year 2008

3.

Support to country

r

Inventory of capital equipment

.

Status

of

disease mapping funds and results

of the

exercise (Data o1

REMO/RAPLOA)

o

Operationalization ofthe SSOTF: Chair and South Sudan Oncho Coordinator

4.

Other Affairs and Business

2.

^SETPS

IN CARRYING OUT THE MISSION

APOC delegation (Dr.

M.

Noma,

Mr.

K.B. Agblewonu, Mrs.

A. wanyoike, Mr. N.

^Lazarus) WHO/South Sudan, (Juba,24 March ²⁰⁰⁹⁾

Government

of

sourh Sudan

(Goss) Ministry

of Health (Juba,24-25 March 2009) Banking

institutions

(Juba,25 March 2009)

South Sudan Onchocerciasis

Task

Force

(SSOTF) HQ

and

CDTI

Projects (Rumbek, 26-27-28 March 2009)

GoSS MOFVDirector of Finance (Juba, 28 March 2009)

Debriefing of the Head of the office/WHO/South Sudan (Juba, 29

March2009)

Meeting

with

CBM ^Regional Director in Nairobi was not possible

for

conflict of agenda

a

2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8

Findings

3. FINDINGS AND OUTCOMES

3.f

.

^Programme

coordination:

SSOTF and projects

Partners recognized that there is no functional South Sudan Onchocerciasis Task Force (SSOTF) Onchocerciasis Control is now under the leadership of the General Director of Preventive Medicine SSOTF chair and Onchocerciasis National Coordinator to be nominated

Location of the SSOTF HQ not clarified (Rumbek or Juba?)

Project team composition assessed and

it

was noted that 2 Project Coordination officers (PCOs) out

of

5 are not Goss

MOH

staff members

SSOTF HQ and projects' team members insufficient and not trained on APOC financial procedures 3.1.

L

3.1.2.

3.t.3.

3.r.4.

3. 1 .5.

3. 1 .6.

Outcomes

3.1.7.

Agreement

to

keep

the

SSOTF

HQ office in its

current location

in

Rumbek.

Offie building

was renovated and have enough office rooms

3.1.8.

Chair

of

SSOTF is the Director General of Preventive Medicine, Dr. John Rumuni

3.1.9.

National Coordinator is the Director of NTDs, Dr. Christo

Muniri

3.1.10.

^Deputy National Coordinator to be identified, nominated and based in Rumbek

3.1.11. The new management team (SSOTF Chair and National Coordinator) demonstrated willingness

of

transparency and commitment to enhance

CDTI

activities

in

South Sudan

Follow

Up actions

3.1

.12. Official

nomination documents

of the Chair of the SSOTF

and

the National

Coordinator

to

be communicated to APOC Management and WHO/South Sudan

3.1.13.

Terms of

reference

(TOR) of project

team members

including

SSOTF

HQ

Finance

officer for

integration

in

Goss

MOH

personnel

will be

available

by end of April 2009. APOC

^Technical Advisor

in

South Sudan was requested to assist in elaboration of the TOR.

3.1.14. Estimated budget

for

training/retraining

on financial and

administrative management

of all

the project team members should be submitted to APOC Management as soon as possible.

3.2. ^Financial

^and

administrative

^issues

Findings

3.2.1. Only one (l)

commercial

bank is functional in

South Sudan,

Kenya

Commercial

Bank

(KCB).

Banking

in

Juba/Rumbek

is not yet efficient. KCB

^{could be used}

for few

need

of

dollars and

for

pound transactions,

3.2.2. Existing

agreement between

WHO/South

Sudan and

DASHBILL (for

transfer

of

funds between Nairobi and Juba offices)

3.2.3. All

parbrers' funding to government programmes should be domiciliated at the Bank

of

South Sudan (BoSS) according to GoSS' financial regulation

3.2.4.

GoSS/MOtVUndersecretary and General

Director of

Finance are the

principal

signatories

of

these

types of ^accounts. Withdrawal of funds

based

on the

request

of the

Programme Manager (SSOTF/Chair,

National Coordinator, Deputy national Coordinator) with co-signing of

NGDO Coalition chair.

3.2.5 Lack

of

capacity

of

project teams to manage 70oh

of

approved funds under direct financial contract (DFC)

Need to split 2009 budget approved by state covered by

CDTI

^projects Eight months of delay

in

submission of financial reports as at 30'h March 2009 Outcomes

3.2.8.

Agreement to open six

(6)

sub bank accounts at Bank

of

^South Sudan (BoSS)

in

Juba

for

(5)

CDTI

projects and (1) SSOTF HQ

3.2.9.

^{Consensus obtained}

^for

^release

^of

^{funds per} sub-installment based on micro-planning

of

^the

CDTI

activities to be submitted to APOC technical advisor

for

South Sudan,

3.2.10 TrainingonfinancialmanagementofAPOCTrustFundtobeorganizedforprojectteams,mainly

for new

staff

3.2.11. Project team

^members

bnefed on GSM, mainly the bank information for suppliers

^(projects, individual partners) and on the technical, financial DFC reporting format

Follow

Up actions

3.2.12.

Bank details

for

the six accounts and specimens

of

authorized signatories

from

GoSS/MOH

will

be communicated to APOC Management and WHO/South Sudan

within

the

first

^week of

April

2009

3.2.13.

Project Bank account name should be structured as follows:

MOH

/ GoSS/

xxxxx CDTI

Project 3.2.6.

3.2.7.

3.2.14

3.2.15

3.2.16

3.2.17

Findings

MOH/Director of Administration and

Finance

(DAF) will

^share

with APOC

Management all financial relevant regulation documents of GoSS

Based on micro-planning budget submitted

by

SSOTF/HQ via WHO/Juba, APOC Management

will

indicate the portion of the approved amount to be released to projects by WHO/Juba

With

the assistance

of

the SSOTF, 2009 budget approved

will

be split per state covered

by

a

CDTI

project. 2010 budget should clearly indicate the requested amount

for

each state

by

using the new plan of action and budget format.

AAF/APOC will

liaise

with

the project teams

for

submission

of

the pending returns

within

the

first

week of

April

2009

3.3. I .

3.3.2.

3.3.J.

3.3.4.

3.3.5.

3.3.6.

5.5. I .

3.3.8.

3.3.9.

3.3. Projects:

operations, experiences and challenges

3.3. 10

Training of CDDs and distribution of ivermectin during raining season Long distance between counties and from village to village,

Lack of primary health facilities

No maintenance of vehicles because of non allocation of budget line Delay

in

disbursement of APOC Trust Fund

Delay in payment of Top up Delay in ordering of the Mectizan

Non availability of office supplies and stationeries

in

South Sudan (to purchased in Nairobi)

Non involvement

of

Project Coordination Officers (PCOs)

in

specific activities e.g. November 2008 REMO exercise (PCOs not involved

in

appointment

of

enumerators, training and implementation

of

REMO/RAPLOA survey) carried in their areas of responsibility.

No

collaboration between Project coordinators,

NGDO

partner and

APOC

Technical

Advisor

in management of REMO exercise (funding, implementation and

follow

up)

Problem of autonomy of East Bahr

El

Ghazal CDTI project from HQ/SSOTF, mainly in allocation

of

capital equipment

PCOs (2/5) non integrated as staff members of

MOH

Most the PCOs have never seen or received Letter of Agreement of their projects

Need

the

increase

of CDD

Supervisors

for new

counties due

to the fact

that

the CDD

refuse to distnbute ivermectin out of their areas

3.3. I

I

3.3.12 3.3.13 3.3.14

3.3.1s

3.3.20 3.3. 16.

3.3.17 .

3.3.18.

3.3.19.

Onchocerciasis control programme

(OV

programme) has operated

without referring to

any

MOH

structure;

CDTI

activities are carried without involvement

of

local

MOH

structures and control data was not shared

with

^county and state health authonties

Claim of incentives by the CDDs

Migration

of

population from DRC and increase of population to be treated Some of the CDD supervisors are not

MOH staff

The forum was informed that

disease

surveillance officers will be appointed for

Malaria, Tuberculosis, and

NTDs

(onchocerciasis control included). These officers

will

be

in

charge

of

data management. These officers

will

be recruited based on selection tests.

Projects' financial and

implementation years

were

discussed:

there was not

misunderstanding between projects' coordination and APOC Management

Outcomes

The projects made the

following

suggestions:

3.3.21. To

receive funds and start the distribution at least

in April

2009

to

avoid treatment during raining season

3.3.22.

Need cross boarder collaboration between Northern and Southern Sudan for treatment of

communities located on the borders

3.3.23. Need

a letter from

the MOFVDirection

of

Preventive Medicine

notifying to

the projects the focal structure at state

MoH.

3.3.24.

Projects should report

to

the GoSS/MOH the ^status

of their staff

^{members regarding GoSS}

MOH

payroll.

3.4. Capital

equipment of

projects Findings

3.4.1.

^{Lack of equipment inventory}

3.4.2.

No insurance of project vehicles

3.4.3 Availability

of companies of insurance

in

South Sudan

3.4.4.

^Transfer

of

some projects' equipment to Government

(MOH)

is been assessed by

WHO staff

Outcomes

3.4.5.

^Inventory cards to be submitted before end

April

²⁰⁰⁹

3.4.6.

Quotation

for

insurance

of APOC

vehicles should

be

communicated

to APOC

Management

for

action

4.

STATUS OF

DISEASE MAPPING

4.1. Completion

of disease

mapping Findings

4.1.1

4.t.2

4.t.3 4.t.4

Outcomes

In ^November 2008, the

Management

of ^APOC

^assisted

the SSOTF to refine the

rapid epidemiological mapping of onchocerciasis and to assess country-wide the endemicity of Loa loa.

Three temporary advisors were provided to assist

in

training

of

nationals and implementation

of

the disease mapping.

A

budget of 51,699.85 US _{$ was} allocated to fund this important mapping exercise

As at 27 March 2009, the disease mapping were partially completed

A total of

140

villages were

sampled

for

refinement

of the rapid

epidemiological mapping

of

onchocerciasis

(REMO)

and completion

of

rapid assessment procedure

of

Loa loa

(RAPLOA).

61 villages were covered for REMO and 62 for RAPLOA.

Follow

ap actions

4.1.5.

2008

REMo'results

(figure

A-1)

did not provide more details on onchocerciasis status compared to what was already known. Figure A-2 revealed the update status of onchocerciasis

in

South Sudan

4.1.6.

The disease mapping carried out 2008 provided more information on Loa loa endemicity

in

South Sudan. Before November 2008 mapping

(figure B-1)

the status

of Loa

loa endemicity was known only for the Equatoria regions. The update map of Loa loa endemicity reveals that counties out of the Equatoria regions (figure

B-2)

are not in the Loa loa belt

in

Sudan.

4.1.7.

^{The SSOTF}

^HQ

^{and APOC} Management should urgently complete the mapping

of

the outstanding selected communities (79 villages to be mapped)

with

the available funds.

4.2. Funding

and managing the approved budget of disease

mapping

Findings

4.2.2.

4.2.3.

4.2.4.

4.2.5.

Funds received

by WCO/Mrs

^Agnes

WANYIOKE:

^50,006.00

USD, ^lost of 1,683'85 USD in

exchange rate

Lack of collaboration between APOC Technical advisor and PCOs in implementation of REMO/RAPLOA

^survey

Management

of

52o/o

of

mapping funds

by Mr

Lazarus has led to unnecessary problems among the team (PCO, SSOTF/Accountant and Enumerators)

Balance available for the remaining for completion

REMO/RAPLOA

exercise: 17'660.20 USD

td$ ardr; 2001 iElO

I4".

l4arir

, . _' ," ^'

^,

' lli' li

^r.

t r&: U9.r.lido orltr o llertt ^I

ued

-*.

Figure

A-l:

Results of November of 2008 REMO Figure A-2: Udpate REMO results

&.ff Lrdr: iAtl'OA..|trlE -.1gfl ²⁰⁰⁴

lrlt!

Figure

B-l:

RAPLOA results before November 2008 Figure B-2: Update RAPLOA results l,+-

6rmse$stne,

.t

_-:

_.r

tl

hh s{ds: RA'IOA t.s{. 6 ^at !4., 2007

-l

t'

I-n

Outcomes

4.2.6 Status

of the REMO

funds established and balance available rendered

to the

SSOTF/Accountant

(usD

10,168.70)

Advice provided

to Mr

Lazarus regarding

(i)

his TOR;

(ii) to

avoid

conflict

situation

in

team

work

and to safeguard the transparency management of APOC Trust Fund and

(iii)

to never use unjustified (US _$ 5,991.50 to recovered)

4.2.7

5. OTHER IMPORTANT MATTERS

5.1. Government'sfinancialcontributions

Senior

staff of

GoSS

MOH

sensitized

on

govemment's

financial

contributions

to CDTI

activities. Senior Staff agreed to track government's financial contributions.

5.2.

Mechanism of releasing funds

for

Technical

advisor:

request

approval, TA

and claims

Senior staff

of WHO office in

South Sudan sensitized and agreed on the mechanism to handle the cost and the approval for field visits of APOC Technical Advisor.

5.3.

Regular supervision activities by

WHO/South

Sudan-APOC

Management-AAF/APOC

The Head

of WHO office in

South Sudan recommended frequent visits (every three months)

to

the project teams. He decided himself to undertake more frequently such visits which

will

be supported by his ofhce.

6. CONCLUSIONS, ACTION POINTS AND RECOMMENDATIONS

The main conclusion, actions points and recommendations are listed below

(") Officiat nomination

documents

of the SSOTF Chair and National Coordinator to

^be

communicated to APOC Management and WHO/South Sudan,'

(b)

With assistance of

APOC

Technical advisor,

terms of reference should

be

available by

end of

April

2009,

for projects' staffmembers, including

the SSOTF

Finance Officer,

not

part of

Goss

MOH payroll;

(c)

Budget should be submitted to APOC

Management

for ^{the training of all of}

^the

^project

team members as

soon

as

possible;

(d) Bank details

for ^the

^six accounts and specimens of authorized signatories

from

^GoSS/MOH

will

be communicated to APOC Management and WHO/South Sudan within

thefirst

week of

April

2009;

(e)

Project

Bank account

name

should

be

structured

^as

follows: MOH /

^GoSS/

xxxxx CDTI Project;

(fl

With

the

assist(tnce of

the

SSOTF,

2009

budget

approved will

^be

split per state covered by

a

CDTI project. 2010 budget should clearly indicate the requested

^amount

for each state

by

using

the new

plan of action

^and

budgetformat;

(g)

MOH/DAF will

share

with

APOC Management all

financial

^relevant

regulation

documents

of

GoSS;

(h) Based on micro-planning budget submitted by SSOTF/HQ

via

^{WHO/Juba, APOC Management}

will

indicate the

portion of

approved amount to be released to projects by

llHO/Juba;

(i) AAF/APOC will liaise with

the

project

teams

for submission of the pending returns within thefirst

week of

April 2009;

(j)

Inventory cards to be submitted before end of

April

2009 and quotation

for

insurance of APOC vehicles should be communicated to APOC Managementfor action.

ANNEXES

Sqlth Soudrn: StrtGs Csnmunitci dirccttd tr..tm.nt with ivcrmactin prcticct3 COll prq.(ll

Er B*r EJGhutl

f ^wuerrEtaur I ExEcrc,r

!weocou I ^uppMo

0 137 5 2t5 550

r----

R.t APOC€O/$dV230!09

States and counties covered by CDTI projects

1 0 States 25 Counties

5 CDTI projects

West Equatoria )per Nile

West Equatoria Mundri, Maridi, Yambio, Ezo, Tambura

East Equatoria Magwi

Juba, Yei,Kajo Keji, Terekeka East Equatoria

Central Equatoria

Wau, Raja West Bahr El Ghazal

North Bahr El Ghazal Aweil South, Aweil East, Aweil West Twic

West Bahr EI Ghazal

Unity

Rumbeck. Yirol East Bahr El Ghazal

Tonj, Grogorial Lakes

Warab

Upper Nile Renk

Jonqlei Pibor, Pocholla, Akobo, Diror

WORLD HEALTH ORGANISATION

.

REMO/RAPLOA

Summary

of

REMO

fund

- Persons

involved

in

the

management

Summary

of

REMO

fund

- Breakdown

of expenditure

and

the

balance

Petty Cash (USD) Balance

17 Date Totals from previous page or Balance from last month Petty Cash (USD)

Received Managed

11t7t2008 FROM APOC - KSH 3,850,437.41 50,006.00

Funds Manaoed bv [Vr Lazarus 25,991.00 52%

Funds Managed by Mr Sala, SSOTF Accountant 15,350.00 31Yo

Funds Manaqed by Mrs Aqnes 8.665.00 17Yo

Total _{50,006.00 50,006.00 100%}

Date Totals from previous page or Balance from last month

Received Spent 111712008 FROM APOC - KSH 3,850,437.41

Funds Manaoed bv Mr Lazarus 2s,991.00 8,330.80

Funds Manaoed bv Mr Sala, SSOTF Accountant 15,350.00 15,3s0.00

Funds Manaoed bv Mrs Aqnes 8,665.00 8,665.00

Total _{50,006.00 32,345.80 17,660.20}

a

Financial Transactions Chart for SSOTF / CDTI Proiects

CDTI Project teams in South Sudan

Technical report

Retums Release of

funds Submission

Micro-Plan

Transfer of funds

Reviewed retums

Rivised Micro-Plan

WHO/Juba&Nairobi WHO/APOC&

^GSC

- Secretary - Data Manager - Book keeper -Deputy Coordinator 5 Available

&

^trained

HQ/SSOTF

Available

&

^trained

4 YES

Eastern Equatoria

Not available

5 NO

Western Equatoria

NO Not available 4

a

MOH / DAF

Signing of cheques

ssor / HQ

Request of withdrawal offunds

CDTI Project

Request of funds

Project Project

year

PCO Status

(MOH staff)

Trained

accountant

Other

team members missing

Status of financial report submission

^as

at

30th

March

2009

LIST OF PERSONS MET DURING THE MISSION Project Last month of financial returns

submission

fengtn ofdelay

^{as at 30ft} March 2009

HQ/SSOTF ^{June 2008 8} months

Eastern Equatoria June 2008 8 months

Western Equatoria ^June 2008 8 months

Upper

Nile

^{June 2008 8 months}

Eastern Bahr

El

GhazaL June 2008 8 months

Western Bahr

El

Ghazal June 2008 8 months

N

o

^NAMES DESIGNATION

EMAIL

ADDRESS

TELEPHONE NUMBER

1 Dr. Abdi Mohamed Head of Office - WHO [email protected]. int

+24992736t44 0

2 Mr. Neiib Youssef Administration Officer nei ibO I [email protected]

+24992604359 9

3 Dr. John Rumunu

Director General Preventive

Medicine [email protected]

+25647710841 7

4

Dr. Mounir Christo Lado Lugga

Director for NTDs ^- National

Coordinator [email protected]

+2567643561 2499260019

5

Dr. Samson Paul Baba

Director General External

Affairs samson [email protected]

+25647712579 9

6

Mr. Adwok Laa

Aiak Director of Finance [email protected]

+24912276768

8

7 John Ndungu KCB Manager - Juba Branch i uba@kcb. co.ke/i [email protected]

+25647713060

5

Mr. Fasil Chane CBM NGDO Coordinator [email protected]

+25647718395 2

9

Mr. Lazarus

Nweke Technical Advisor [email protected]

+25647719847 7

l0

Daniel Anthony Umido

PCO - West Bahr El Ghazal

Proiect [email protected]

+25647717833 2

1l David Bido PCO - West Equatoria Project [email protected]

+25647720050 2

12 Chuol Both PCO - Upper Nile Proiect

[email protected]@ymail.co m

+25647718988 0

l3 Emmanuel Ezama PCO - East Equatoria Proiect iane [email protected]

+25647714055 J

t4

Chol Manyiel

PCO - East Bahr El Ghazal

Proiect [email protected]

+25647714055

3

15 Salah Michael Finance/Admin Officer - HQ mikesallahO2 @vahop.pq4n

+25647717833 2

16 Agnes Wanyoike Finance/Admin Assistant ^wanyo ike [email protected] ^o

in!

+25472281697

5 8

Key staff of OV programme in South Sudan

SSOTF Chair

Dr Rumunu

John

SSOTF National Coordinator

Dr Mounir Christo

NGDO Coalition / CBM Country Rep.

Mr Fasil

Fane Upper CDTI

Mr Chuol Both

West Bahr ElGhazal

.-I

Dr. Daniel Anthony Umido

West Equatoira

Mr.

David Bido East Bahr El Ghazal

Mr.

Chol Manyiel

Equatoria

Mr.

EmmanuelBzama

ilrr

^{t SSOTFAccountant}

I

^!6*o,. "..',*,*

Mr.

Salah Michael

a I

flr t'

b

l _{\ il}

HQ