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THE UNITED REPUBLIC OF TANZANIA MINISTRY OF HEALTH

ANNUAL PROJECT TECHNICAL REPORT SUBMITTED TO TECHNICAL CONSULTATIVE COMMITTEE ^(TCC) DEADLINE FOR SUBMISSION:

-J-,

Y\r5"

TO APOC Management by 31 J,anuarv for March TCC .Stti

TO APOC Management by 31 Julv for September TCC mee

E

I

AFRICAN PROGRAMME FOR ONCHOCERCIASI CONTROL (APOC)

a

, -;lr(-'at

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-C,

,4hi|lr$

COUNTRYAIOTF

: ^T anzania

Proiect Name:

Tunduru Focus

CDTI

Project

Approval year:2004 Launching

year

:

^{26h Jan 2005}

Repaatag fanad: From: May 2005 To: April

2006

(MONTH/YEAR)

⁽

MONTTyYEAR)

Projectvearofthisreport: (circleone) tll 2 ³ 4 5 6 7 8 9

¹⁰

Date submitted: January 2006 NGDO partner:

Sight Savers International

-*1rfrr--ri

I

,qi ;:;I1

D ecember' 2 oo 5

AFRICAN PROGRAMME FOR ONCHOCERCIASIS CONTROL

(APOC)

ANNUAL

PROJECT

TECHNICAL REPORT TO

TECHNICAL CONSULTATIVE COMMITTEE

TCC

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CDTI

Proiect

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l\ National

Co

- ^ordinatot

Dr.Grace Saguti Signature

Date... rt2 ^Oq-

Zona,l

Co-ordinator Dr.J.B.Lindi

Signature

Date 3l

NGDO

tatrve .Pius

Mabuba

Signature

Date...

l(eP,,rr P|cPllrt'rl ^br-

Mr.Nurdin K.Malloya

Designation

PI{OIE(-T' (]O-(

)RDIN,\'I'(

)R Date

JlolL &E+ a-ou{

(

\

Acronyms APOC

ATO ATrO

CBO CDD

CDTI

CSM

LGA MOH

NGDO NGO NOTF PHC REMO SAE SHM TCC TOT I"INICEF UTG

wHo

CCHP

African

Programme for Onchocerciasis Control Annual Treatment Objective

Annual Training Objective Community-Based Organization Community-Directed

Distributor

Community-Directed Treatment

with

Ivermectin Community Self-Monitoring

Local Government Area

Ministry

of Health

Non-Governmental Development Organization Non-Governmental Organization

National Onchocerciasis Task Force Primary health care

Rapid Epidemiological Mapping of Onchocerciasis Severe adverse event

Stakeholders meeting

Technical Consultative Committee (APOC scientific advisory group) Trainer of trainers

United Nations Children's Fund Ultimate Treatment Goal

World Health Organization

Comprehensive Council Health Plan

3 WHO/APOC 31 December, 2005

Definitions

Total population: the total population living in meso/hyper-endemic communities within the project area (based on REMO and census taking).

Eligible population: calculated as 84o/o of the total population in meso/hyper-endemic communities in the project area.

Annual Treatment Objective: (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.

Ultimate Treatment Go,al (UTG): calculated as the maximum number of people to be treated annually in meso/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'd year

of

the project).

Therapelrtic coverage: number of people ffeated in ^a given year over the total population (this should be expressed as a percentage).

Geo8raphical covgrage: 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).

Integration: 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 maximise cost-effectiveness and empower communities to solve more of their health problems. This does not include activities or interventions carried out by community distributors outside of CDTI.

Sustainabilitv: CDTI activities in an area are 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 mobilised by the community and the government.

Communitv 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 prograrnme), with a view to ensuring that the prograrnme is being executed in the way intended.

[t

encourages the community to take

full

responsibility of Ivermectin distribution and make appropriate modifications when necessary.

Table of contents

Table

1

CDTI Activities...

⁶ SECTION 1: Background

information

⁷

1.1. ^General information

⁷

1.1.1

Brief Description

of the of the

CDTI project ...8

1.1.2. Partnership....

^...8

1.2. Population

9

1.3.

Communication. ^...9

SECTION 2: Implementation

of

CDTI

2.1. Timeline of activities... ...9

2.2.

^Advocacy

in 2005

⁹

2.3. Mobilization

and

sensitization ^l0

2.4. ^Community involvement

10

2.4.1

Community involvement Table

4... ...1I

2.5. ^Capacity building

2.6. ^Treatments

2.6.1. Treatment figures Error! Bookmark not

defined.

2.6.2 What

are the causes

of

absenteeism?...

...13

2.6.3 What

are

the

reasons

for refusals?...

...13

2.6.4 Briefly

describe

all known

and

verified

serious adverse events (SAEs)

that...13

2.6.5.

Trend

of

treatment

achievement

from CDTI project inception to

the

current year

¹³

2.7. Ordering,

storage and

delivery

of

ivermectin

¹⁴

2.8. Community self-monitoring

and Stakeholders

Meeting l5

2.9. Supervision

15

2.9.1. Provide

a

flow chart of

supervision

hierarchy. l5 2.9.2. What

were the

main

issues

identilied during

supervision?

2.9.3.

Was a

supervision checklist

used?

2.9.4. What

were the outcomes at each level

of CDTI implementation

supervision?

2.9.5.

Was feedback given to the person

or

^groups

supervised?

¹⁶

2.9.6. How

was the feedback used to

improve

the

overall performance

of the

project?

SECTION 3: Support

to

CDTI

3.1. ^Equipment

¹⁶

3.2. ^Financial contributions

of the

partners

and

communities

3.3. ^Other forms of community support

3.4. Expenditure per activity

¹⁷

SECTION 4: Sustainability of

CDTI

4.1. Internal;

independent

participatory monitoring; Evaluation Error! Bookmark not

defined.

4.1.1 Planning of all relevant

levels..

4.1.2. Integration... ...---J9

4..4. Operational Research

t6

...19

SECTION

5:

STRENGTHS, WEAKNESSES, CHALLENGES, AND OPPORTUNITIES

.19

SECTION 6: UNIQUE FEATURES OF THE PROJECT/OTHER MATTERS

5

20

WHO/APOC

31 December, 2005

Tunduru

CDTI

project launched

officially

On 26ft January 2OO5,but due to bank transactions

(NMB)

problems raised beyond our control,

MoH

and APOC agreed to revise the agreement

again

that the year one of Tunduru

CDTI

project should commence On 1't

May

2005 up to 30fr

April2006

instead of the previous agreement

-

l't

November 2004 up to

3l't

October 2005.

FOLLOW UP ON TCC RECOMMENDATIONS.

There is no TCC recommendations as the project is the new one ( In year one period of implementation)

I'tMay

2005 up to 30th

April2006.

EXECUTIVE SUMMARY

This report of Tunduru

CDTI

project covers a period

of

8 months of the

first

year; Starting

I't

May 2005 up to 31't December 2005 (New _agreement

l't

year starts 1't

May

2005 up to 30ft

Aprit

2ObQ.

Despite of

difficulties

faced,, the project managed to implement/conduct the

following CDTI

activities:- Launching

CDTI

project 26'n January 2005.

lTth August 2005 Advocacy/Sensitizationmeeting to

District

leaders and

CHMT

members.

T.O.T

training

l8th

-

^{lgth August 2005}

Frontline

Facility

Health Workers (Rural Health workers) September 5th

-

^{9th 2005.}

Community leaders: -

Division,

ward and village level sensitization meetings June 2005 and October 2005

Selection of CDDs by the community - October 2005.

CDDs training October 2005.

Conduct census

-

^house to house October 2005.

Mass Mectizan distribution

to all

525 communities.

Supportive supervision November

-

December 2005.

Data collection December 2005.

Data compilation and analysis December 2005.

Report

writing

December 2005.

Mectizan Tablets were obtained from _Central Medical Stores

-

^{Dar es Salaam}

Via Ministry

of Health.

Geographical coverage I00% was achieved for the

l't

year in a total

of

525 communities

with

a total population

of

105857. The number of person treated was74094

giving

a therapeutic coverage of 70Yo.

Yet we need to implement other

CDTI

activities such as Community Self

Monitoring,

Retraining

for

facility

Health workers and CDDs Re-sensitization to communities

with low

therapeutic coverage and those

with

high number of refusal.

TABLE

1:

CDTI ACTIVITIES IMPLEMENTED THE YEAR

^2OO5

ACTIVITIES ^{JAN FEB} MA

R

APR MAY JUNE ruLY AUG SEPT OCT NOV DEC

Project Launching

CDTI

Project

account opened

Advocacy/sensitizatio n district

leader/CHMT T.O.T. training Rural Health workers training

Community leaders advocacy meetings CDDs selection by the community

CDDs training House to House census

Mectizan distribution Supportive

supervision Data collection Data analysis Report

writing

7 WHO/APOC

3l

December, 2005

BACKGROUND INFORMATION

1.1.

GENERAL INFORMATION

Geographical

Location

Tunduru district is located far south of Tanzania between 10'15 and 11.45 south of equator and longitudes 36'30 and 38o East of Greenwich.

It

borders

with

Namtumbo district to west

-

ⁱⁿ Ruvuma Region,

Liwale

and Nachingwea to the north in

Lindi

Region. Masasi district in Mtwara Region to East. In south there is the

Ruwma river

which forms a physical Intemational boundary

with

peoples Republic of Mozambique.

AREA:

Tunduru district covers ^a total land area

of

18,778 Sq km out of which 413 square kilometers (2.2%) are covers by water bodies leaving the area

of

18,365 Sq km the land.

TOPOGRAPHY AND CLIMATE

Tunduru district situated between 200 and 500 meters above sea level

ECOLOGICAL ZONES.

There are three ecological zones namely:-

MATEMANGA ZONE:

This covers the north

-

^{west part} of Tunduru and includes almost all

of

Matemanga division. This part falls under selous Game reserve,

it's

a zone where by big rivers such as

Muhuwesi, Nampungu and Mbarang'andu

"Luwegu river"

starts at the

rolling

hills.

SOUTHERN TUNDURU ZONE:

This zone covers the whole of the Southern part of Tunduru

District

including the divisions of Lukumbule, Nalasi, Namasakata, Nampungu and West

Mlingoti

ward.

It

is a zone characterized by

rolling hills,

dominated by miombo woodland.

NAKAPANYA ZONE:

This small zone located eastern part of Tunduru district bordering to Masasi district.

It

covers Nakapanya division and East

Mlingoti

ward.

It

has rock mountains and miombo woodland.

CLIMATE:

The temperature ranges between 20oC up to 30'C

Dry

season: June

-

^November

Rain season: December

- ^May

Farming season:

Preparation: August

-

^October

Planting and weeding: November

- ^April

Harvest: May to July (Food crops)

Harvest Cashew nuts November to December (Cash crop)

BRIEF DESCRIPTION OF THE CDTI PROJECT

Tunduru

District

has been distributing mectizan irregularly

for

several years since 1994 immediately after

REA

and skin snip study .The bridging funds donated by River blindness Foundation

I.M.A,

CSSC and Sight Savers International, also in 2001

DED

facilitated the

activity

of Mectizan Distribution to 34 villages Meso and Hyper endemic communities.

The main task was to train 2 CDDs each village sensitize the local village leaders thus to facilitate the Mectizan

Distribution

to villages concerned. The project _commenced

with

17 villages slowly year by year we added communities up to 2004 we had 42 villages total.

1n2002

REA

study were conducted to 3 divisions remained. On 26ft January 2005

-

^{Launching of}

^CDTI

project at Tunduru were carried out. The NOTF member

(MoH),

NGDO

-

SSI representative and

RMO

representative and other

CDTI

project staffs participated

well. District

Government leaders I.E.

District

Commissioner,

District

Administrative secretary,

DED

and other departmental Heads

- ^CMT

^members

participated and contributed in Launching activity, also Urban residents participated especially drummer groups. The

CDTI

project now has 65 villages

with

525 Sub villages/communities.

I.

I.2. PARTINERS/PARTINERSHIP [A] MoH

Provides strategies and guidelines in approachin

g

any planning activity.

Provides financial support to the project and personnel.

lBl s.s.r

Provision

of

funds

for

different activities

like

advocacy, sensitization mobilization of the community.

Provides

building

capacity to implementers.

Provides funds for

office

activities

like

improvement of infrastructure

IE.

Construction of

CDTI

Office and Eye

clinic

(Renovation and Furnishing)

Provides funds for capital equipments LE. purchase of Motorcycles.

[CI DISTRICT COUNCIL

Provision of human resource and non human resource to ensure sustainability of the project.

Salaries of Health workers

Provision

of

supportive supervision and monitoring.

lDl

COMMUNTTTES

Provides several local materials in their respective Sub villages LE Preparation of Measuring sticks, storage of the drug and Willingness to convice the community members to take the drug

"Ivermectin"

I.1.3 TABLE

2:

NUMBER OF HEALTH STAFF INVOLVED IN CDTI ACTIVITIES

9

District/LGA

Number of health staff involved in

CDTI

activities

TTINDURU NO.OF HEALTH STAFF IN THE DISTRICT

NUMBER OF HEALTH STAFF TRAINED/INVOLVED IN CDTIACTIVITIES

o//o NO. OF CHMT MEMBERS SENSITIZED/INVOLVED IN CDTI

293 40 40 5

WHO/APOC

3l

December, 2005

1.2.

POPULATION

The total population in the Tunduru

District

is about 267612 (Projected number 2002 census).

Major

tribes are Yao 60%,

Makua2}oh,

Matambwe, Ndendeule and others20Yo.

The main activities are:-

Cultivating

Fishing and hunting

in

small scale Timbering in small scale.

CULTURE

Main culture are:-

Traditional ngomas (dances) Use of traditional medicine

Conduction of mosque session and rarely church

LANGUAGE

Main

language include:- Swahili as a national language

Local language as mentioned above (tribe) 1.3.

COMMUNICATION

Regional trunk

roads

380 Kms

District

feeder roads

Village

feeder roads

Telecommunications:-

T.T.C.L.

Mobile phones:-

Vodacom (Urban area) Celtel

Radio calls for Missionary institutions and Police stations.

Air

strips for Urban area, Mbesa Mission and Kiumma.

SECTION

2:

IMPLEMENTATION OF CDTI

2.1.

TIMELINE OF ACTIVITIES

Mentioned already, please see Table I

2.Z.Table

3

- ADVOCACY IN

2005

ACTIVITIES ^{JAN FEB MAR APR} MAY JTINE ruLY AUG SEPT OCT NOV DEC

DISTRICT LEVEL DIVISION LEVEL WARD LEVEL VILLAGE LEVEL SUB VILLAGE ^- COMMUNITY

2.3.

SENSITIZATION AI\D N'0BTLIZATION

We used the different Media

Method used: RadioTanzaniabroadcasting, Local Television at Tunduru, Pamphlets and Posters sensitization meetings at

District

Level, division, ward, village and Sub village/community level.

Community response was good

Suggestion for improvement

-

^{Sub village leaders} (Community leaders should be

well

sensitized as they are key person

in CDTI

Project implementation.

Incentives and motivations to CDDs should be considered when planning and budgeting (Both _donor, Govt and Community).

2.4.

COMMUNITY INVOLVEMENT

Most of the community leaders themselves participated

well

even to distribute the drug Male/Female CDD ratio

- Male CDDs

were

⁵²⁷

- Female CDDs

were

523

CDDS Per population 1 CDD per

l0l

^persons

Incentives

-

Exemption of some duties during Mectizan Distribution.

Atrition:

Provision/issued Usubi T-Shirts for each CDD.

1l

WHO/APOC 31 December, 2005

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2.5.

CAPACITY BUILDING

ATO

85955 target population ando/o achieved 70% (74094) treated out

of

105857 total population.

Number of

District/LGA

staff trained 20

Number of Health Centre/post staff trained ^are 40 Number of CDDs trained are 1050

Community Self

Monitoring

not implemented, though in some communities

with

low treatment coverage we discussed

with

them and agreed to re-distribute mectizan.

Training of management

of

SAEs was implemented during CDDs and

facility

health workers training prior to Mectizan distribution.

There is inadequate human resource in numbers and their skills as this is the first year of the project. We suggest to add

2

more DOTS in the district. According to geographical location of Tunduru district poor state of the road

work,

increase number of personnel

will

facilitate/improve

CDTI

activities

implementation.

2.6.

TREATMENT

TABLE

5a :

TREATMENT GEOGRAPHICAL & THERAPEUTICAL District

/LGA

Total

of

Communities in Meso/ Hyper endemic areas

Annual treatment objective

Number

of

communities treated

Geographic

al

cov erage %o

Tunduru 52s 525 525 rc0%

Table 5b: TREATMENT THERAPEUTICAL

Totalpopulation

of

Meso/ Hyper endemic

Annual treatment obiective

Number

of

^person

treated

Therapeutic coverage ^oh

Number of refusal

Number

of

absentees

Children P S

105857 8595s 74094 70% 4962 7867 15048 2858 1028

e

13 WHO/APOC 31 December, 2005

2.6.1 Ordering storage and delivery of Ivermectin.

Activities

performed by Health care personnel

Filling

ordering forms.

Making

follow

up of mectizan at

MoH

Collection of mectizan from

MSD

Receiving of ordering forms from

FLRHW

TO Health facilities.

Distribution

of Mectizan to Health facilities according to requisition forms

FLHW

distributes information to sub village leaders and CDDs about the arrival of mectizan Supportive supervision.

2.6.2. What are the causes of abscentism?

Most of the villagers were harvesting the cash crop ^' 'Cashew nut'

'

_{and other} field work E.g.

Timbering,

Mining,

Fishing Etc.

2.6.3. What are the reasons for refusal?

Ignorance

Misconception of the drug

Minor

side effects

2.6.4.

Briefly

describe

all

known and verified serious adverse events (SAEs) No serious adverse events occurred.

2.6.5. Trend of treatment achieved from

CDTI

project inception to the current year

Table

7:

COMMUNITIES

Table

8:

POPULATION

Year Total # of Communities in the Meso/ Hyper endemic areas

Annual treatment objective

# of communities treated

Geographical coverageo/o

ATO coverage

2005 525 525 525

rco% t00%

Year Total population of the Meso/ Hyper endemic areas

Annual treatment objective

Number

of

person treated

Therapeutic coverage/o

ATO UTG

2005 105857 85955 74094

70%

86% 86%

{

Ordering,

storage and

delivery

of

lvermectin

Mectizan@

MOH

Other (please

ordered/applied for by

-

^{(please tick the} appropriate answer)

WHO ^UNICEF

delivered by

-

^{Qtlease tick the} appropriate answer)

NGDO specifo)

Mectizan@

MOH

wHo

NGDO

Other (please specify):

Please describe how Mectizan@ is ordered and how

it

^gets to the communities

Mectizan retirement by

filling

in the ordering forms and sent them to the National Onchocerciasis Control Task Force in the

Ministry

of Health.

The

NOTF

Secretariat went through the Re-Application forms and sent them to Mectizan @ Donation Programme.

The

MDP

scrutinize the form and sent the drug to the

Ministry

of Health through Medical Stores Department.

The MSD

notiff NOTF

Secretariat on arrival of Mectizan@ who then

inform

the Project Co-ordinator.

The Project Co-ordinator collects the drug from Medical Stores Department and enters the received drug to the

District

Pharmacy.

The

District

Oncho Team members together

with

frontline

facility

health workers make orders to the Project Co-ordinator who distributes the drug through normal channels of the govemment system

of

health facilities according to their requisitions.

FLHW

informs the

village,

Sub village leaders and CDDs about the arrival of Mectizan@

They come for collection and distribution to the community members in the entire area Table

9:

Mectizan@

Inventory

(Please add more rows dnecessary)

{

District

Number of

Mectizant

tablets

Requested Received Used Lost Waste Expired

Tunduru

l8l

148 248,000 182436 2616

TOTAL

^{248,000 182436 2616}

l5

WHO/APOC

3l

December, 2005

2.8. ^Community self-monitoring and Stakeholders Meeting

Has any training (of trainers) for community self-monitoring been done in the project area?

If

so, When? No any training for CSM been done in the Project area.

:

Commu

self-mo and Stakeholders

Meetin

Tunduru 525

N.A

2.9

SUPERVISION.

2.9.1.

A flow

chart

of

Supervision hierarchy Table I

l:

2.9.2. What were the main issues identified during supervision?

The main issues were misconception of the drug Ivermectin, so were supposed to educate more community members the importance of taking the drug Mectizan @.

2.9.3. Was a supervision checklist used?

(We had no checklist)

just

routine supervision on how the distribution process was being implemented.

2.9.4. What were the outcome at each level of

CDTI

implementation supervision?

The out come

of

supervision at each level of

CDTI.

From

District

level to Front line Health facilities we corrected some misunderstanding also we encouraged people to take the drug and FLHF to Community (CDDs) they corrected some mistakes as this is the

first

year of

CDTI

Project, usually we had some elrors E.g. how to register community members, some CDDs were not able to catch the dose by height method so Rural Health Workers supported CDDs

by

Supervision.

Generally supervision improved the therapeutic coverage through proper sensitization/community mobilization.

District/ LGA Total # of communities/villages in the entire project area

No of Communities that carried out self

monitoring (CSM)

No of Communities that conducted stakeholders meeting (SHM)

N.A

PERSONNEL FLHF VILLAGE SUB VILLAGE

/COMMUNITY

HOUSE HOLD

COMMUNITY MEMBER PROJECT CO-ORDINATOR

CHMT MEMBERS DOT

FLHW

VILLAGE LEADER

COMMUNITY-SUB VILLAGE LEADER CDDs

HOUSE HOLDER

2.9.6. How was the tbedback used to lmprove the overall pertbrmance ot'the prolect'l

The feedback kept the communities more aware on the drug Mectizan@ and its effects to different conditions I.E. Onchocerciasis, Lymphatic filariasisi Etc.

3. SUPPORT TO

CDTI

3.1. EQUTPMENT

Table 12. STATUS oF ^EeUTPMENTS

The Desktop computer, Printer, Photocopier machine and Fax machine are brand new. The installation not yet, waiting

for grill

protection

for

security purpose of these equipments.

Grill

to our new building we hope in two weeks ahead

will

be ready

-

Government contribution to the project.

(MoH/LGA)

3.2. FINANCIAL CONTRIBUTION OF THE PARTNERS AND CoMMUNITIES

Table 13:

YEAR

ONE

If

there are problems

with

release of counter part funds how were they addressed?

We had no serious problem

of

funds from SSI and

MoH,

funds were released as budgeted.

ADDITION COMMENTS: Late disbursement

of

funds for Tunduru

CDTI

Project from APOC trust fund.

We only received

first

installment in

May

2005, yet we are

waiting for

second installment

for

implementation of other

CDTI

activities year 1.

3.3. Other forms

of

Community support Describe (Indicate forms

of in-kind

contributions

of

communities

if

any).

There was inadequate support provided by the community, but they managed to prepare wooden measuring sticks each Sub village/Community. The community provided incentives to CDDs during distribution, the incentive are

in

form of exemption from communal work,

Affection

and recognition to the society/community.

3.4. Table 14: Indicate how much the project spent for each

activity

listed below during the reporting period.

Source ^{APOC MoH DISTRICT} LGA NGDO OTHERS

NO Type of equipment ^{NO Condition NO Condition NO Condition NO Condition NO Condition}

I Vehicle ^{I F}

2 Motorcycles(s) ^{2 F}

3 Desklop Computer ^{I F}

4 Printer ^{I F}

5 Photocopier ^{I F}

6 Fax Machine ^{I F}

7 Others

CONTRIBUTION TOTAL CASH (US$) TOTAL CASH RELEASED (US$)

MoH

(Central Govt) 37,538.18 37,538. ^I 8 (Staffs Salaries)

MoH (District/LGA)

1500 2780

NGDO Partner 26,000 23,000

Other

Communities 525 525

APOC Trust Fund 37146 I 8573

TOTA

102,709.18 82,416.18

t7

WHO/APOC

3l

December, 2005

EXPENDITURE

^PER

ACTIVITY

Activity

Expenditure ($

US)

Source(s) of

funding -Drug delivery fromNOTF

IlQreqlg

^central

Mobilization and health education of communities

Tfeiql4gg{health staffat all

lev*

Supervising CDDs ^and distribution CDTI activities

to health and authorities IEC materials

Summary (reporting) fo141s fo4req!14gq!

Vehicles/ Motorcycles/ maintenance -Offi g" Eqglplqqnl G€.9ornpU!9IqI44!9I!

qgl

Others

(A)

1e00

APOC MoIVLGA

SSI SSI APOC SSI

SSI APOC SSI APOC SSI

APOC MolI/LGA

SSI

(B) 630 1800 2600 4000 2000 0 0 2900 600 300

(A) s00 (E)20Q0

4800

TOTAL 24030

Total number of persons treated ⁷⁴⁰⁹⁴

Any

comments or explanations? No.

4.1.2. What were the recommendations?

Training session for CDDs and Health personnel should be increased or repeated and the periods should be longer.

Community education on key issues like programme ownership, community responsibility, Council responsibility, reporting

of

side effects, house to house census should be emphasized during Advocacy meetings and CDD training.

Motivation

to CDDs should be considered by the community, Council and NGDO partner in order to maintain good therapeutic coverage.

4.1.3.Training session for CDD and Health Personnel implemented as recommended

We discussed

with

Government leaders, Village/Community leaders on issues of ownership of the project and their responsibilities to

CDTI

project.

Motivations to CDDs were considered as Usubi T-Shirts were issued to CDDs only.

Sustainability of

^projects:

plan

and set targets (mandatory

at

Yr 3) No

Was the project evaluated during the reporting No Was a sustainability plan

written?_

N.A

cq ! l

e!!9qp9!!!

q&q1q!fr!!_r ty

Arrangements have been made to sustain CDTI after APOC funding

ceases

in terms of:

The Government and NGDO have promised to support the project more over, Onchocerciasis activities has been incorporated in C.C.H.P

4.2.1.

Planning at all relevant levels

4.2.2.

Funds;

Tunduru District

Council has been allocating a

little

of amount of funds for Eye Care services in general including

CDTI

activities.

4.2.3

Transport (replacement and maintenance); Our Vehicle and Motorcycle are

still

brand new.

4.2.4.

Other resources; None

4.2.5.

To what extent has the plan been implemented; None

Integration

Outline the extent

of

integration of

CDTI

into PHC structure and the plans for complete integration We managed to collect Essential Drug Programme

Kits

(EDP

Kits)

to Rural Health facilities during

CDTI

activities implementation.

We also used

DMO's

vehicles

for

supervision or

CHMT

members were assigned to supervise

CDTI

activities and Data collection from FLHF to

District

Hospital.

CDTI

Project Vehicle has been also used in Hospital Emergencies.

Ivermectin delivery is done through MSD up to Project level. Project Co-ordinator and DOTs collects drug from

District

Pharmacy to FLHF, the drug is transported through existing PHC Structure during supervision and Monitoring.

We have two programmes using

CDTI

Structure Phylosophy

.

Oncho control Project.

.

Trachoma Control Programme.

The CDDs distributing Mectizan @ are the same CDDs distributing Zithromax drug for Trachoma through their Sub villages/communities, as they conduct house to house census, determine dose by height method registration of house holds Etc.

4.4.

OPERATIONAL RESEARSCH

4.4.1.

No operation research has been carried out through the treatment period.

4.4.2How

were the results: No Applicable.

l9

WHO/APOC

3l

December, 2005

SECTION 5: Strengths, Weakness, Challenges and Opportunities.

List

the Strengths and weakness of

CDTI

implementation process.

CHALLENGES;

Other community members were reluctant to take the drug; We went to see Village/community leaders and discuss

with

them, then they were ready to swallow the drug Mectizan @.

We had no funds allocated for CDDs training. We communicated

with MoH

and NGDO partner Sight Savers lnternational they released funds

(T)

Shs.2,600,000 (US$ 2600)

for

training of CDDs.

SECTION 6: Unique features of the Project/Other matters

The Project has ^a new

CDTI office

Constructed/donated by Sight Savers International costing more than

$21500 this ^has been handed over to the

District

authourity.

Due to geographical location of Tunduru

District in

some areas especially near Selous Game Reserve and near Mozambique CDDs complained, risk of being attacked

with

Lions man

killer

during house to house census and Mass Mectizan Distribution.

STRENGTH \ilEAKNESS

The project has prominent Partner (SSI) who supports the implementation of

CDTI

activities.

Late disbursement of funds from APOC

for

implementation

of CDTI

activities.

CDTI

activities are incorporated in the CCHP Councils are

providing limited

funds to implement

CDTI

activities.

Community acceptance to take/swallow the drug Mectizan and implement

CDTI

activities

Some of the community members had Misconception on the effect of the drug