project El

South Sudorn Eq.st Bahr El Ghszql CDTI

project

ORIGINAL:

English

COUNTRYAIOTF: South Sudan Proiect Name:EBEG CDTI

Approval year: 2003 Launching Yearz 2004

Reporting Period: From: July 2004 To: June 2005

(Montliear)

⁽ Month/Year)

Proiectvearofthisreport: (circleone)(f 2 3 4 5 6 7 8 g

¹⁰

Date submitted :

22107 12005

NGDO partner:

Chirstoffel Blinden Mission

)

__ -l I I I I

ANNUAL PROJECT TECHNICAL REPORT SUBMITTED TO

TECHNICAL CONSULTATIVE COMMITTEE (TCC)

DEADLINE FO SUBMISSION:

To APOC Management by 31 January for March TCC meeting To APOC Management by 31 Julv for September TCC meeting

AFRICANPROGRAMME FOR

ONCHOCERCTASTS CONTROL (APOC)

Fu:r

roj

t^l li

pl L lvl E bs .t

For lriioi"mot;o.

T",$[(}

'f frtrt;'

2 7 it]tl

²⁰⁰⁵

I

I

#

I

I I

I I

ANNUAL PROJECT TECHNICAL REPORT TO

TECHNICAL CONSULTATIVE COMMITTEE (TCC)

ENDORSEMENT

Please confirm you have read this report by signing in the appropriate space.

OFFICERS to sign the report:

Country: South Sudan

National Coordinator ^{Name: Dr.}

Sams

Baba

Signature: _o,('

Date: 2210712005

Zonal Oncho Coordinator Name: Agum

Issac

Daniel

Signature

Date:

2210712005

NGDO Representative Name: Fasil

Signature:

Date:

2210712005

This report has been prepared by Name

:

Dr.Baba/Salah/Fasil/Agum Designation

/DeputyA..l

Signature

Date

2210712005

ll ^{WHO/APOC, 24} November 2004

I

I : I I I

!

Table of contents

ACRONYMS v

DEFINITIONS VI

FOLLOW

UP ON

TCC RECOMMENDATIONS I

EXECUTIVE SUMMARY

¹

SECTION

1:

BACKGROUND INFORMATION...

...3

].1.

GpNpRar. rNFoRMATroN...

1.1.1

Description of the

project

(briefly)

I.1.2.

Partnership

1.2.

PopuLerroN...

SECTION 2: IMPLEMENTATION OF CDTI...

^...8

2.1. Trvelme

oF ACTrvrrrES

...

^{... 8}

2.2. ^{Aovocacy l0}

J 3 4 7

MosrltzartoN,

SENSITIZATIoN AND HEALTH EDUCATIoN oF AT RISK coMMuNtues 10

CouuuNrry rNVoLVEMENT...

^...12

CRpecrrv

BUTLDTNG..

^{... 13}

TRearvpNTS...

... 15

6.1. Treatmentfigures...

... 15

6.2

^What are the causes of

absenteeism?...

.. ... . ... 18

6.3 Wat

are the reasons

for refusals?...

...

/8

6.4 Briefly

describe

all

lmown and verified serious adverse events (SAEs) that ...

l8

6.5. Trend of treatment achievementfrom CDTI

project

inception to the curuent

year20 Onoenntc,

sroRAGE AND DELIvERy oF

IVERMECTIN...

...21

2.8. CouuuNrry

sELF-MoNrroRrNGaNoSrereHoLDERSMeern{c. 22 2.3. 2.4. 2.5. 2.6. 2 2 2 2 2 2.7. 2.9. 2 2 2 2 2 2 3.1. 3.2. J.J. 3.4.

SupeRvrsroN...

...23

9.1.

^{Provide a}

_flow

^chart of supervision

hierarchy.

... 23

9.2.

^{What were the main issues} identified during supervision? ... 23

9.3.

^Was a supervision checklist

used?

... 23

9.4.

^What were the outcomes at each level of CDTI implementation supervision? 24

9.5.

Wasfeedback given to the person or groups supervised?...24

9.6.

^How was the feedback used to improve the overall performance of the project? 24

SECTION 3:

SUPPORT

TO CDTI

...24

EqurrueNr FneNcrar.

coNTRTBUTToNS oF THE ^pARTNERS AND coMMUNrrtES

Oruen

^FoRMS oF coMMUNrrY suPPoRT. ExpeNplruRE PER ACTIVITY 24 25 25 26

SECTION 4: SUSTAINABILITY OF CDTI...

...27

4.1. ^INrenNel;

TNDEnENDENT pARTrcrpAToRy MoNrroRrNc;

EveluarloN...

...27

4.1.1

^Was Monitoring/evaluation carried out during the reporting

period?

(tick any of the

following

^{which are}

applicable)...

... 27

4.

L2.

What were the

recommendations?

... 27

4.1.3.

^How have they been implemented?

...

...28

lrl

^{WHO/APOC, 24} November 2004

4.2.

SusrerNesrt.rry oF nRoJECTS: rLAN AND sET TARGETS

(ueNoeroRy

AT....

Yn

3)

...28

...28

...28

...28

... 28

...28

...28

...28

4.2.1 4.2.2 4.2..1

4.2.4 4.2.5

4.3.

[NrpcRarroN Planning at

all

relevant levels... Funds... Transport (replacement and maintenance). Other resources To what extent has the

plan

been implemented

4.3.1.

Ivermectin delivery mechanisms...

Error! Bookmsrk

not deJined.

4.3.2. Training....

....

Etor! Bookmark

not deJined.

4.3.3.

^Joint supervision ond

monitoringwith

other

progroms....Eruor!

Bookmark

not

defined.

4.3.4.

Release offunds

for ^project activities ^Error! Bookmark

not deJined.

4.3.5.

^{Is CDTI included in the PHC} budget? ...

Error! Bookmark

not deJined.

4.3.6.

Describe other health programmes that are using the CDTI structure and how this was

achieved.

What have been the achievements?.,...

Error! Bookmark

not deJined.

4.3.7.

Describe others issues considered in the integration of

CDTL Error! Bookmark

not defined, 4.4. OpenarroNAL RESEARCH.

4.4.1.

Summarize in not more than one half of a page the operational research undertaken in the

project

area

within

the reporting

period.

... 29

4.4.2.

^How were the results applied in the

project?....

... 29

SECTION 5: STRENGTHS, WEAKNESSES, CHALLENGES, AND OPPORTUNITIES....

...29

SECTION 6: UNIQUE FEATURES OF THE PROJECT/OTHER MATTERS...30

29

Acronyms/Abbreviations

African Programme for Onchocerciasis Control Annual Treatment Objective

Annual Training Objective Communiry-Based Organization Chirstoffel Blinden Mission Community-Directed Distributor

Community-Directed Treatment

with

Ivermectin County Health Department

Community Health Workers County OV Supervisor

Comprehensive Peace Agreement Community Self-Monitoring Local Government Area Ministry of Health

Non-Governmental Development Organization Non-Governmental Organization

National Onchocerciasis Task Force Project Coordination Officer Primary health care

Payam OV Supervisor

Rapid Epidemiological Mapping of Onchocerciasis Severe adverse event

Stakeholders meeting Secretariat of Health

South Sudan Oncho Task Force

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

United Nations Children's Fund Ultimate Treatment Goal World Health Organization APOC

ATO ATrO CBO CBM CDD CDTI CHD CHWs COS CPA CSM LGA MoH NGDO NGO NOTF PCO PHC POS REMO SAE SHM SOH SSOTF TCC TOT UNICEF UTG

wHo

v

^{WHO/APOC, 24} November 2004

Definitions

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

84o/o

of the total

population

in

meso/hyper- endemic communities in the project area.

(ii i) 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.

(iv)

Ultimate Treatment Goal (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

ofthe

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)

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.

(viii)

Sustainability:

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.

(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.

It

encourages the community

to

take

full

responsibility of Ivermectin distribution and make appropriate modifications when necessary.

(i)

FOLLOW UP ON TCG REGOMMENDATIONS

Using the table below,

fill

in the recommendations of the last TCC on the project and describe how they have been addressed.

TCC

session

(Please add more rows

if

necessary)

Executive Summary

Prepare an Executive summary of the report

in

not more thun one page,

1.

Background on treqtment and population data

- Tolal communities, communities treated, total population, UTG, ATO and persons trealed.

2.

Background on population movements.

3.

Training data

- CDDS, health workers, Total population (community) per CDD trained.

4.

Challenges and how they were overcome.

I Number

of

Recommendation in lhe Reporl

TCC

RECOMMENDATIONS

ACTIONS TAKEN BY THE PROJECT

FOR TCC/APOC

MGT

USE ONLY

There were

^no

recommendations made for

East Bahr el

Ghazal CDTVSSOTF project. The

CDTI project is

in

its first year of implementation.

The East Bahr

el Ghazal CDTI project

launched and

^the

project

office consolidated.

Executive summary

WHO/APOC, 24 November 2004

The

East

Bahr eI

Ghazal

CDTI project is an

expansion

of formally existing semi CDTI implemented program coordinated by 4 NGO paftners. Financing was done by

APOC

through HealthNet International.

REMO

exercise was conducted

in

South Sudan

from March -|uly

2003, 38 Villages were

randomly

selected

in

East

Bahr El

Ghazal

and REMO

was successfully

conducted in

30

villages, 2 were uninhabited, 4 were not

accessed

due to insecurity and 2 were not

assessed.

Of

these 30

communities, 7 were hyper-endemic,

17

were

meso-endemic and 6 were

hypo-endemic. It

is estimated and anticipated

that

1,001 communities

will

be treated

in the region over 5

year's

period.

East Bahr

el

Ghazal has an

ultimate treatment

goal

of

778,920

populations at the end of five

years;

a five year plan

has

been

developed and approved.

From fanuary ²⁰⁰⁵ - ^{fune 2005} the preliminary treatment data showed that

196,058

people were treated and 1332 persons developed minor side effects after

Mectizan

treatments which were all

successfully managed

by the drug distributors.

73.3o/o

of

the

ATO

and 25.5o/o of UTG have been achieved.

Before

the conflict the pattern of settlement in

East

Bahr EI

Ghazal was semi-nomadic

among the cattle

keepers.

The communities practiced

subsistence

farming along fertile river banks. In the dry

season

they

move

with their cattle to

swampy areas

in

search

of

grasslands.

This

semi-nomadic

life

has been

interrupted by just

concluded

war. Internally

displaced people

from

Upper

Nile

region also

live in

the project area.

CDTI training started in late November

2004

and continued in February through May

2005.

A total of

887 CDDs, 64Payam

OV

Supervisors, 4 Counry

OV

Supervisors, 65 health

workers

and 219

different

groups of

community

leaders were

trained in the four

Counties of the project area. The

ratio

of one CDD to the

population

is 1:878

which still very high.

Supervision and monitoring were not very effective due to the vast

geographical area,

inaccessibility

and inadequate

OV

supervisors at

all levels.

This was overcome by

training more

CDDs

in all the

geographical

locations to improve

accessibiliry

which resulted in

reduce area and

population

per CDD.

More

supervisors were selected

by the

communities

and trained to reduce the load on current

supervisors.

This was improved by logistic

support

for supervision/monitoring

by

provision

of motorbikes _and bicycles.

There is a

high illiteracy

rate

in

the communities, selection

of

CDDs becomes

difficult.

The best CDDs selected by

the

communities

normally

require a

lot

of

time for training.

Local translators are used

for

better understanding of

the CDTI strategy.

On site

training during

supervision were carried out.

More

refresher courses were planned and conducted.

The

number

of female CDDs and women

participation

on

CDTI

are

still

too

low.

Formal and

informal

meetings

with women

groups and local

authorities

were conducted.

It

was agreed

that

more

women

be

involve in CDTI activities

since

they would

play a

vital

role

in

CDTI.

SEGTION {: Background information

1.1. Genera! information

1.1.1 Description

of the

project (briefly) -

Geographical location, topography, climate

-

Population: activities, cultures, language

-

Communicationsystems (roads...)

-

Administrationstructure

-

Health system & health care delivery furovide lhe number of health posts/centers in the project area if the information is availab le).

-

Number of health staf m project area and number of health staflinvolved in CDTI activities.

-

Geographical

location,

topogtaphy,

climate

East Bahr el Ghazal

CDTI project

is

in the

southeast

of

Bahr el Ghaza1 region.

It

comprises

four

Counties

namely

RumbeVCueibet,

YiroUAwerial, Tonj,

and

Mvolo.

The East Bahr el Ghazal

CDTI project coordination office

is

within

Rumbek

town

and is housed

within

the SSOTF secretariat. The

project

area borders

Mundri to the

south, Terekeka

County to

the

south

east,

and Panyjar to the noftheast in Upper Nile, Gogrial to the north and Wau County

to the west.

The

project

area is made

up of

Sudan savanna and Guinea savannah

to the

west and

flood region to the

eastern

part. In the western part of

East

Bah El

Ghazal

the soil rype is

^a basement

complex resting on iron stone plateau. In the western part of

^East

Bahr

El

Ghazal, the soil type is made up of superficial clay. Rainfall

ranges

from 750mm -

1200mm. The

climate

varies

from wet

monsoon

to medium wet

monsoon

in the

west and

dry

monsoon

to long dry

monsoon.

- Population:

actiuities, cultutesr language

Total overall population in the project

area

is estimated at 7,687,098. The

esrimated

population at risk is 927,285 in East Bahr el Ghazal. With the signing of

^the

comprehensive peace agreement (CPA)

the population

is expected

to

increase due

to

IDPs and refurnees

from the neighboring

countries.

Currently

Rumbek

Counry

alone hosts more

than

10,000

Nuer

IDPs

from

western Upper

Nile (Bentiu). The county

has also

attracted a

sizeable

number of

traders,

and

SPLM/A

officials from other regions. The dominant ethnic group are the Dinka who are

agro- pastoralists whereas

the minority

_Jur

Bel

are

agriculruralists. But through

socioeconomic

interactions, the two communities have gradually begun to influence each other.

For instance,

the Dinka

have

now

started

to grow

cassava and

plantain,

a

practice that

was

unthinkable

some years back. Conversely, the

|ur

^{Bel are}

^acquiring

cattle keeping habits.

Languages spoken are;

Dinka Agar (the majoriry), )ur

Bel, Bongo, ]uba

Arabic (written in

English alphabets) as the

lingua

franca and English is spoken as

the official

language.

- Communication

system

(toad...)

The

state

of the

roads is

very poor

because

of the current war.

Since 1983,

there

has been

no

road maintenance. Some

rudimentary work

was

carried out on certain

sections

of

the roads

manually. The

best

time of

movement

for CDTI activities

is

in the dry

season

from

J ^WHO/APOC, 24 November 2004

November to May, the land is dry,

cars,

motor

bikes

etc

can

move

easily.

The

roads are expected to be repaired

in the

near

future.

WFP and other private

companies

provide flights to the project

area

from Nairobi

and

Lokichogio in

Kenya and

there

are also

flights from

Entebbe

in Uganda.

The

project

area is also accessible

by

road

from northwestern

Uganda and West Equatoria

though

the roads are

worn

out.

Adminis

ttation

s

tuctute

The administrative levels of SPLM/A

are as

follows: The

regions

form the first level of administration followed by the

Counties, Payams and Bomas.

However,

new changes have

taken place with the states becoming the first level of administration. States

are

administered by governors, Counties by County Commissioners (SPLM

secretaries), Payams

by

Payam administrators, and Bomas

by

Boma

liberation

councils. The

project

has 4 counties

which

are used as supervision centers.

Health

system

& health

carc

delivery

(prouide the

number

of heahh

posts/centets in

^the

project

atea

if

the

information is

available),

East

Bahr el

Ghazal

CDTI project

area has

48

PHCUs, 18 PHCCs,

and 3 rural

hospitals,

namely Billing, Marial Lou and

Rumbek.

The rural

hospitals are

the referral

cenrers

for

the PHCCs. The Primary Health care system is poorly developed and is not well

coordinated. There is acute shortage of

qualified

manpower

in this

vast region.

Table 1: Number of health staff involved in

CDTI

(Please add more rows

if

necessary)

District/LGA

Number of health staff involved in CDTI activities.

Total Number of health staff in the entire project area

B

Number of health staff involved in

CDTI

B2

Percentage

Br=Brl B' ^*100

YIROL/AWERIAL

1,42 32 22.5o/o

RUMBEK/Cuiebet NA 1t NA

TONJ NA NA NA

MVOLO

23 t4 60%

TOTAL

165 57 34.5o/o

1.1.2. Partnership

Indicate the partners involved in projecl tmplementation at all levels [MoH, NGDOs (national/international), communities, local organizations, etc.l

Describe overall working relationship among partners, clearly indicating speci/ic areas of project activities (planning, supemision, advocacy, planning, mobilization, etc) where all partners are involved.

State plans, if any, to mobilize the state/region/district/LGA decision-makers, NGDOs, NGOs, CBOs, to assist in CDTI implementation.

-

fndicate

the partners involved in

prcject implementation

at all levels

(MoIf, NGDOs

-

n a ti on aI, in tem a ti on

al)

SSOTF Secretariat

(Ministry

of Health):

Dr.

Bellario

Ahoy

Ngong, SSOTF Chairman

Dr.

Samson Paul Baba, SSOTF

Coordinator Mr.

Salah Emmanuel,

Deputy Coordinator Mr.

Ceaser Longa, Data Manager

Mrs.

Rukia _Juma, Finance

Officer Mr.

_|acob

Madut

Tong, Secretary

EBEG

CDTI

Project Secretariat

Olinistry

of Health):

Mrs.

Agum

Issac,

project Coordinating Officer Mr.

Deng

Ayen,

Finance Assistant

Mr.

Salah

Michael,

Assistant

driver

Mr. Mario

Machot

Akot,

Cuiebet/Rumbek Supervisor

Mr.

Salva

Awet

MeI,

Tonj

Supervisor

Mr. Wisely

B'Count,

Mvolo

Supervisor

Mr.

Gabriel Hussein

Marial, YiroVAwerial

Supervisor

Chirstoffel Blinden

Mission:

Mr.

Fasil Chane,

NGDO Coordinator World Health Orsanization

South Sudan:

Agnes

Wanyoike, Administration/Finance

Manager Members of

the Mini

SSOTF at project level:

o

EBEG

Health

Secretariat (2), PCO, Finance Assistant

o

^Sudan

^Inland

Development Association (NGO

Coalition

Chair)

o County Health

Department (1), Rumbek

o ^{County OV}

Supervisors (2) Cuiebet,

Mvolo

Members of

the Mini

SSOTF at

County

level:

o ^{County OV}

^Supervisor

o

^Counry

Medical Officer

o

^Partner

^NGO

⁽¹⁾

International/NationaVCommunity

based organization

o

Payam Representatives (2),

-Descdbe ovetall working relationship

among

pafinerc, cleaily indicating specific

ateas

of ptoject actiuities (planning,

superuision, advocacy,

mobilization, etc)

where all

pattnerc

are involved.

The

EBEG

CDTI

has strong

partnership with the

affected

communities who

are

the

sole decision makers

on the period

and mode

of Ivermectin distribution, they

select

their own drug distributors who

are

then trained prior to Ivermectin distribution. The

EBEG

CDTI project office is

situated

within the

SSOTF headquarters.

The

SSOTF

coordination office

occupies a space

within

SoH/MoH. There is a strong partnership between the PCO and the SSOTF

coordination office. There are four National and International NGDOs which

liaise closely

with the

East Bahr el Ghazal

project coordination office. The County Health Department (CHD)

at

the counry level

is also

involved in the OV treatment activities. All the stakeholders coordinate the CDTI activities through the following meetings

and workshops

o _Quafterly

operational plans

o

Project area and

County Mini

SSOTF

Meeting

o County

specific

with

NGO lead

o Village Health committee

meeting

5 WHO/APOC, 24 November 2004

Quarterly operational planning is normally

done

jointly with partner

NGDOs,

the

PCO and

the

COS. Supervision at

the county level

is done

by the

COS,

paftner

NGDOs and the

county health department while at the

Payam

level it is

done

by

Payam

OV

Supervisor

and at the communiry level it is done by CHWs, CDDs and the community

leaders.

Advocacy,

mobilization

and sensitization is carried out

by the

PCO, CHWs, COS and POS.

Project

area

and County Mini

SSOTF

meetings are conducted to coordinate and

plan

CDTI activities within the project

area. These are useful meeting because

all

NGOs, CBO,

CMO,

COS are

involved

and there is

wide

sharing of

opinion

and consensus

building.

County specific with NGO

lead:

The CDTI project office work

closely

with

these groups

to promote CDTI in the communities. Each endemic county has a

designate

county

onchocerciasis

(OV) supervisor. Each

Payam

(local district) within the counry have

a

Payam onchocerciasis supervisor (Communiry supervisor) most of them are

already engaged as

health

staff

by the

NGOs.

The

supervisors

will

be responsible

for mobilization

and sensitization of communities.

Village Health committee

meetings

All

^plans

for implementation

and

monitoring

were developed

in

close

consultation with the

Bomas

Liberation

Councils

(communities)

being

the

grassroots

arm of the administrative system of southern Sudan. All ^health

and development programs

in the communities

must receive

the formal

approval

of the

Boma

Liberation

Councils.

Community health workers

and

Traditional birth

attendants are the lowest cadre of

health

service providers

who

are supervised

by Village health

Committees.

The

communities

elect these groups.

-

State

plans if any to mobilize the state/region/district/LGA

decision-makers,

NGDOs, NGOs,

CBOs, to assist

in CDTI implementation,

The regional

authorities including County,

Payam and

the traditional authorities,

plus the Sudan

Relief

and

Rehabilitation

Commission are

informed

and

involved in

assisting

CDTI implementation. The policy of the

SoH

is that all

NGOs

involved in PHC program

are expected

to include OV

^as

part of the control of

10 most

important public health

diseases

in the

region. This is

now

being implemented.

Involvement of authorities at all levels, the NGDO/NGO, whether national or international in CDTI activities

and

the community is impoftant

as

an

advocacy

tool

as

well

as a

tool for community

ownership.

o

$

o

_N

Lq)

3

c)

z s

C.l

o

Or

E

6

x

u 1

E E

I

.EU 0,

EA_(J

d0,

t

^i-'

5E e-8

'a

trt

0.)

E SH

E T;

.g ^RH

E \H E jo E tz

!

^r

EH

^h(J

^HE

E E.E ^d.:

E *r _tg

: Ioo

fr SE ^SE

g iE ^Is

E +* ^s;

E _E s€: _t;

u,b.li

B _ii $nE _b

^q.r

_{u tF f}

t sE! _{e S gPtX} ^s: _S': =

e SE* ^E€

E lEtH ^N*

r ^{EE$Ed Sg} EiixiHHtr

o

Q

I I

I I

^l

c/)

oo

(€

2N ;;"

_o

LL5(d

i1 ^(.)

d>

-$

.l

N.

\

_o

Lq)

a- on 1:

.:>

!s ils

-t -:s-

i.s

_s$

\s 'is

xt

sh,

o's

s8 \r

.bs

ts u=

si :r\

r-

- z

14

€ o

tr a ri

q)

CE

ri &

.s

o

C)

a

o aio

!

ort) k0)

o

lu

l$

IL lb.lo- IU luot\

t\t\

ls IUIB ls

t\

t4

ls

9 o'

\\

s

\

q)+ () U

\

U

ss

! I

J L ()$

o'

\\

p

$'6-sJ\

B*-$

.y .s ig ^o'

$t

!r' Xha

6.s

P\.

.U

='!

st _te

rl\U!)

$-s

q

:

o

\

t\

N

q) F;

q)

-.:

fi 0.)

a

o0 Lo

a

C) L<

(.) b0 L

o

Lo

(.) (B()

L.

G)ti

C€

>'

0) Lr C)

o

B cl{) Lcl I() L

a

q)L oo

J4

cn

! d o (!

)a

o

a

!

Cd

(/)o

Qo ojrol -ol_dt

FI

E

o

t-fl

-

IE

=

c

E o N

I

rFa

x

tso

INB

st

*s _+\

ps

clQ.r Il- -Q F-o^a)

S.tl

=%

NP

o\

t!

s\

\='

_u(J

sl s.r

ds,

nS lcb

Fra

")

uq) q)

F

6);

5 (()

Noo ca c.loo

(r) N o\c- c.l

l-t

$ N

\oo\

€

N

GIo\

€ r- r-

+

llb

itr .o .= -()o

o.N

=.3.g

:>

^E

i r3

c.l

€

co

c\oo ( c.l\n o\(-r

(t.l

F-

s

c.l

\oo\

oo o.t

(\Io\

6t-- t--

., ^q!

, qrE i

l-'-- e G

*Ei;t

E6Fg ^{z z z z}

o\F-

NN o\tc t:

tro

a

'Egs €:

^H

gsi F;E ^{z z z z}

!t\o

\o

a

N

I 0)o. -.

ON? <,t

-o c! ^c)

F

i

+

il

00 r- $ ^(r} t

N

.gB E'F

_o:

=-,ct 9E E

iea6

&.E

>r 0)

|'rE

N

$

o

N r-

E

U2

o)b!

cl

ahq)

I

f-

trq)

!

zl 'Egs

€:

^k

gsi F;E

$ F- N $ t-

E9

CE

.=E.!

_!.r

=EEE _{E 3g}

_P'

H AE q

r*

$ N

a.lta)

o\r-

a.t

@N C"I C.l00

\oo\

oo

c.i olo\

€

r- t-

'!t o

ra! ^cJ

.9E

^q)

3{ RqEc ^rH

a-l

^F

(d

!c)

.!

o -oa)_c)

O

!

_c)

,.o .F

Fo o

j

tr

o

F

L

\

SEGTION 2: Implementation of GDTI 2.1. Tlmeline of activities

Fill in table 3, timeline of activities for ^areas treated in current year, indicating when the key activities were implemented by the month they began and the month they ended.

O\t oN kC)

-o o

z

o tN

d o

o.

o

H

o

&

_(J

-v_5ro olr

(u

F(t) 0l lr P(J

(I, P(d

t

o

!o p.

E

_o

E

o

(J cl) 0) P

trH

-lro

E

_Po tro

E

$

liJ

_o

(*

Pa

!o_(!

_oli (+r

t

_o

t) (!

J-{

P(J

o lr

a

o

P L)

A

_o

&

(J

-q B

<t)

E

d

(+ra

P_(J

o o! (+{

A

o -oti H

U)

H(6 PI

C)

a

cu

T,o (!

(n

c!

B oL{

o E-

!

ql

U

I

n

qU't

\)I q)

\-

q1 o

\

o

t

R q)4

5

a) Lr

()0d

>.

C)k

L

o

0.)

o

(oo

k

CA(d (.) L{

CB

0) lr g

t)o o(s

+io

C)

0)

F

c.ir 6)l -l-ol_(Bt

FI

o\

o

ah

Lq)

a

o

EE

*o Uo

bb >) t-?

k

q x

h

)

a0EE

?tr6=

o _lr

a s

_o ^lr

_a

L

ra AI L

o

U

EE

>.

l-

>.

h

oL

z

(t

>t

a0EE 1iE

a-

h(E o (!

(n

d

C)t<

(n

q) 6l

.a (h

U

o)

o

EE

U

EEED

d=

C)

o

z

o

q)

z

o

c)

o

z

o

0)

o

z

o

axE

GL

t.

o o.=

EE I

o

an

bo tt) bo

t) oo

a bo

a0EE

6:

h

(!

L

*

0)

x

L (B

s

_q)L fJ.

b p

L

Irio

L

Cd

-o_C)

E

rG) .Y .i

ajE

s=

AE oo

=() a

o

*o

I EE

L(€

-oLo

h h

(6

!L

triC) L cd L ErC) trr^C)

uotrE a-6r=

o0)

a z

^o

z

^o

z

^o

F]

I L

ah

'=

F

o E0)_q)

(J

E

q)

&

6, trq)

'

L o

r- 2

F]

o F

t'r

2.2. Advocacy

State the number ofpolicy/decision makers mobilized at each relevant level during the current year; the reason(s) for

undertaking the advocacy and the outcome. Describe dfficulties/constraints beingfaced and suggestions on how to improve advocacy.

In November

2004; soon

after the launching of the

East

Bahr el

Ghazal

CDTI proiect in Rumbek, couftesy calls were paid by the

SSOTF Secretariat

and the proiect office

to several

SPLM

offtces

in Rumbek. Eleven

(11)

policy/decision

makers

were

sensitized as

part of

an advocacy

to the CDTI

strategy. These

policy/decision

makers have accepted

to participate in the implementation

of the program and

to

sensitize

their

communities.

2.3. Mobilization, sensitization and health education of at risk communitles

Prowde information on:

-

^The use of media and/or other local systems to disseminate information

-

Mobilization and health educatron of communities including women and minorities

-

Response of target communittes/villages

-

Accomplishments

-

Suggest ways to improve mobilization and sensitization of the larget communities.

o There is no radio, TV ^{and mobile} cinemas in South Sudan.

Therefore,

dissemination of information is through word of mouth,

posters,

flipchart,

comic books

for

school

children,

T-shirts.

o

Local translators are used to get message across

to

the people.

o

Since most parts

of

South Sudan are

still

remote, local methods

of

dissemination

of information like songs, drama, traditional dances are used. Churches, public

gatherings and

traditional

feasts are also another method of passing messages

o Video shows on CDTI are

also

used during training if situation allows

mosrly governed

by availability

of power source.

- Mobilization

and

health

education

of

women and

minodties -Method

and rcsponse

-

Response of target

communities/uillages

o The

method used

to

sensitize

the women

and

minorities

is

through

home

visits to the communities and focus group

discussions

in villages, health

centers, prayer places,

and market gathering.

Special

attention is paid to the men in order to

sensitize

them to understand the role that women and minorities can play in

a

society and

in the control

and eventual eradication of OV.

o Communities now know that

onchocerciasis

is

a disease

of public health

concern

and have accepted fuIl participation and contribution in all

onchocerciasis

treatment activities in the project

area.

They know Ivermectin is the only

drug

that

can reduce and

eventually eliminate the burden of

onchocerciasis

from their

communities.

o Communities do

appreciate

the fact that Mectizan is

safe

and

has

other health

benefits.

Accomplishments

o

Negative

attitude

towards

the

effects of the drug is

minimised.

o

The

number

of drug

distributors trained

has increased.

o

Increased annual

treatment

coverage attained.

o Communities have known and accepted Ivermectin as the d*g to fight

onchocerciasis

o

Female CDDs

now

parricipate

actively in

drug

distribution.

Suggest ways to

imptove mobilization

of the tatget

communities.

o Involve women

CDDs.

. _Full participation and follow up by local authorities in the

^programme

implementation.

o

Increase

health

education sessions

in the

communities.

o Training and refresher courses for CDDs, CHWs, and OV supervisors

are

continuously

encouraged.

.

Supply

sufficient Information

and Education

communication

materials to the target

communities in the

simplest forms.

l1

^{WHO/APOC, 24} November 2004

c.) c..lr -oo

q)

z

o

$N O

o

c..l

s

\39

3

+E

_Ebo

:o

:rr EH

d.A s-,J :tr d.9

qiE

Ho

th _s? s'

koJ;L{

EA 3(o _E'C

o# o) L6VBli

.2Etc g-88

s i-J ^(u

EF€ ! EEr

⁸⁰

;- ^>'tr * B ^I.

$ EBf ^E

gr _EEr r ^;.,\

F H'E'E.a '2 ^s?'eF

s{ ^e€$ E ^Hi$

i:g[e :'-*.pp,"o ^ie flf ili ^BTE

I P ^ E'=,:i ^{S H gE}

i ^E :E: fr[.Iit

s.$ EEE ^EEEE:E

E!$ EEg {EE€#E

EtR #SE ^EesgqE

is! EE g _{#EE EEfi} tsi ^{E€ E. {Ei.* E}

^E

ig$s{i{s{l+{il

00

o

<:

\

o B

oI

o'

(

€

o

s

_B

o' t,

is

!=

qq)

()q)

U't

t\

q)L o

t

q)q

! g

F o

Q

C)

(ho

€

U

o

+

flE

o

E

o

a:

o

.=

a,.E

f

E E

o

t, 1

ooo

CE

o o

o ll *

.i

^ca

o\.o

9

^o\qO

t--

\oo\

9

co 1Q oq

o

s

o\

t

\o od

'=v tr6EE

=-o

;'t

9o

E 6t)

zl

=6

Ect i

=E{

E

EEU

z i'i

ce c.l c.) o\ ia

\o

C€

Fo

la+

trI tr

Or-

+ ^{c.l rnN}

cO rr_O

O

e

9q_€qa

E

[rvO r\

cON $

c.) ^cO

$6 N

q)

€r

o

-oY>

HEo2

a.= a

U o

z

AU

I

cE

2

trr +

cON

@N o\

cn N ?a

o\o o

EO CE

q) it)

o ll r EAle

tr

q

\o ^\oo\vl

$

\oo\ \oo\

(')

t

s

i

\o

Eae r

i ^EEI

EE E*

\t

€

^(--

N

=

^\a

>a

a0i

>q

8ft

tr€)5!

EOEE otr -aEo=

ze

=o ^le

j

..9

=

=.!.E

^s

(€EE=o'L .-"

i']-

^{E E}

^*

Fo

rn

ca)

N + ^rnN

\c

o o

I

J

>

.2

a

6, q)

i

E o o Q>_q)

il

F^o

oo

2

6

Fo

2.5. Gapacity building

- Describe the adequacy ofavailable knowledgeable manpower at all levels.

Training at various levels of CDTI whether for

management, advocacy,

distribution of

drugs and

all other

aspects

of CDTI implementation

is

very crucial.

To

that

effect

training

takes a

lot of

logistics,

coordination

and

time input. In

most cases

NGO health

workers, teachers,

county OV

supervisors,

project coordinating

officers are used as

TOTs. Training

and

re-training is

almost an ongoing process especially due

to the fact that the

education Ievel

of the communities

is

very low.

The project

coordination office

needs strengthening

by training on

selective

computer

packages

for

general

communication,

data processing, analysis and

compilation.

CDTI TRAINING:

The

below

table shows

the

number of male and female

county

supervisors, payam

supervisors and CDDs

trained by

the project

office

and

partner

NGDOs between February and

March

2005.

Communiw

leaders trained

by

the

proiect office

Feb

- ^March

²⁰⁰⁵

COUNTY NUMBER TRAINED

Yitol/Awerial 0

Rumbek /Cuiebet ¹⁴³

Toni 26

Mvolo 50

TOTAL 219

On

site

comoutet

packages

training

for the

proiect staff

Wherefrequent transfers oftrained staffoccur, state what the project is doing, or intends to do, to remedy the situation. (fhe most important issue to describe is whal measures were taken to ensure adequate CDTI implementalion where nol enough knowledgeable manpower was available or if staffs are frequently transferred during ^{the ciourse} of the campaign).

This is not applicable in our situation because staff transfer does not occur at this moment.

However, in cases where a gap has resulted as a result

of

sudden staff movement members from the nearest CDTI project office are asked to cover. Besides this there is acute shortage

of

knowledgeable manpower in all project areas

in

South Sudan.

COUNTY COUNTY

SUPERVISORS

PAYAM SUPERVISORS

CDDS REFRESHED

CDDS

Male Female Male Female Male Female Male Female

Yirol/Awetial 1 0 14 0 234 236 NA NA

Rumbek,/Cuiebet I 0 18 0 128 34 29 72

Toni 1 0 22 5 139 13 4 2

Mvolo 1 0 5 0 102 1 52 1

TOTAL 4 0 59 5 603 284 85 15

Package Number trained Designation Section

MS Word & Excel 01 Secretary ssoTF H/Q

MS !7ord & Excel 01 Tonj Ptoject supervisor Project Office MS Word & Excel 01 Yirol Project supervisor Project Office

MS Word & Excel 01 Finance Assistant Project Office

TOTAL 04

r3 WHO/APOC, 24 November 2003

c.)O

a.l Ho -o

0.)

z

$ N

(-)

o

o.

o

rJr

+

bb

Io

o

s

\

{

s:

so

ho

t

o

*

|.

oa s

t

o

\

o

ts

*

r.\

! U.1 v2

Uq)

\.-

q I\

q)L

!

\

F.

5

(c

o ()

a

F

Oqr

(h (,)

o

C)! .()H H

€

(.) (€

oo

(BH

F

.iir ol -ol

S.i

qv

*d

ir

I-t

v

o\

CO

@

*

ta)

l-t\c N F-

*

ca)

.Oro

ra

r\6 6

oo\

\l r\o\

?o

o

ccL o

Q Lo

z ?:

_FL) ^O

rn rnO

N ^tr)N

oo o

s

r-

6@

()

Q)

o

q)

\o

Q +- (J II Q

U=

6

,L 0<

iss ri

=v

N I-t

ra)

+

O N

e.l

O N

ro

1,) ahL

0)

.a'0'

!! tr L f-r

o):

.oE

i0 o L!l^f--

z

^{FL (J $}

^*

^{e.t oN}

s

\o

o

q)

() o

s

+.q

z

U.

.i

F-d E.t+

^NcO

O

NrO

ca)

@

O

O NN

NN

ro\o

roN

o

-l q)

clh

ts

!=

92 tr>

zJo

q)I Q + ^rr)

o o

c)

o

c) q)

o\

s

rO

\o

A<

a

s

E,','r +

F-d

^N

N

]n

rt

cl

oo

:] 9z

_9q)

Zc!

L4)

z

^U

o

F ^{N \o}

j

c)

0 !

o o L)

&_o

'a

o o o

(!

(.)

j

Er

o

q) o)

o

<)

s

(a?

rO

€

Trainees

Typ.

of training

CDDs

Other Community membets e.g.

Community supervisors

Health Workers (frontline health facilities)

MOH staff or Other

Political

Leaders Others(specifr) Progtam

management How ^to conduct Health education Management of SAEs CSM SHM Data collection Data analysis

Report writinq Others (specify) Introduction to Computer

Table 6: Type of training undertaken

(Tick the boxes where specific

training

wos caruied out during the reporting

period)

- Any

other comments

There was

a

delay in the transfer of project funds which kept the proiect on halt for about four (4) months from the scheduled period that activities were to kick off.

During this reporting period, activities which have not been carried out

so

far shall be executed at the next quarter.

2.6. Treatments

2.6.1. Treatment figures

If the project is not achieving I 00% geographical coverage and a minimum of 65% therapeutic coverage or the coverage rate is lluctuating, state the reasons and the plans being made to remedy this.

'.'*EASd BIiifliEi cirezAi

^ii:i Number Treated ATO Achievedoh UTG Achievedoh

RUMBEK/CUIEBET

RUMBEK COUNTY

Proiect office 75,953

CCM ACROSS

IRC

CUIEBET

COUNTY Project office

OXFAM-GB

Sub Total 15,953

35.8% 6%

YrROL/AWERTAL

15 WHO/APOC, 24 November 2003