Transcript Roadmap in PPT format

NIGERIA
Roadmap to Achieve 31.12.2010 RBM
Targets
September 2009 – December 2010
Country Summary
Population at risk:
(158.9m in 2010)
Intervention
Need to 2010
Already
covered
Funded and expected
to be distributed before
end 2010
Gap
LLINs
62.9m LLINs: (22.3m from
4.4m
49.378m
9.2m
8.3m
94,267,437
34,927,387
2,540,843 HHs:
840,000
4.24m
2009: 280,000; 2010: 2,260,843
280,000 (2009)
560,000 (2010)
Sept 2009; 40.5m in 2010
@2LLINs /HH with 5pers/HH
+wastage)
ACTs
129,194,824 doses:
Sept 2009: 28,175,491;
2010: 101,019,333 (80%
coverage)
IRS
RDTs
59, 202,251 tests:
0
34,353,875m
28,848,376
18.3m
0
2009: 29,135,153 tests (30% coverage)
2010: 30,067,098tests
IPTp
18.3m doses
Sept-Dec 2009: 2,340,830
2010: 16m
Quinine
Country Summary -2.
Population at risk:
(158.9m)
Intervention
Need to 2010
M&E
$20.4m
(About 10% of Total
budget)
BCC/IEC
$15,768,978
2009: 7,940,265; 2010: 7,828,713
Human
Resources
(Capacity Bldg)
Others:
Service Delivery
10.5m in trainings and
TAs (Excluding salaries)
Already
covered
1m
Funded and expected
to be distributed before
end 2010
Gap
WBBP = 15.4m
GF-R8 = 2.4m
WHO = $354,000
2.2m
WBBP: $9m
GF R8: $4.8m
WHO: $350,000
WBBP: $2m (NIFAA)
WB = 3.0m
GF R8 = 4.1m
Govt = Salaries of
health workers and
prog managers at all
levels
RBM = TAs
LLIN resources available to achieve the 2010 targets
FUNDS AVAILABLE
(US $)
SOURCE
COMMENT
Mechanism and
when
Available
Total Need
Gap
140,000 LLINs
8,300,00 LLINs
3,966,786 LLINs
1,949,763 LLINs
590,000 LLINs
2,782,749 LLINs
1,259,048 LLINs
3,390,609 LLINs
629,533 LLINs
FGN/MDG
WB 1
WB 2
DFID
USAID
UNITAID / UNICEF
GF R4
GF R8
USAID
Campaign 2009
Campaign 2009
Campaign 2009
Campaign 2009
Campaign 2009
Campaign 2009
Campaign 2009
Campaign 2009
Mop-up 2009
22,378,956
22,378,956
0
629,533
629,533
0
3,717,251 LLINs
17,807,958 LLINs
UNITAID/UNICEF
GF R8
Campaign May-Jun
2010
Campaign May-Jun
2010
21,525,209
21,525,209
0
9,177,755 LLINs
GF R8
Campaign Oct-Nov
2010
9,177,755
18,444,832
9,177,755
TOTAL
TOTAL
53,800,775
(4.4m was
distr. in JunAug. 09)
62,978,530
9,177,755
53,800,775 LLINs
LLIN Ordering & Distribution to end 2010
Quantities
62.8m
Procurement dates
VPP July 14, 2009
[WB, UNITAID/UNICEF]
Expected delivery
In country. Oct. 19, 2009
Campaign Date
Sept 2009; Nov. / Dec 2009; May –
Dec 2010
BCC
Tools and materials; TV/Radio
jingles/Talk shows; Drama;
Community channels
Community mobilization
Demand creation; LLIN hang-up
campaign
Distribution
2 per HHs
Mechanisms of distribution
Stand-alone campaigns
Monitoring and evaluation
LQAS (Sept 2009); MIS (2010);
LLIN Follow-up Survey: USAID (2009,
Kano) and SuNMap (2009, Anambra)
Case management (ACTs)
ACTs required
2009: 37,877,320 doses (30% coverage)
2010: 130,297,982 (100% coverage)
Already distributed: 8.3m
Procurement schedules
(ACTs)
Ordered: 2m (GF); 2m (WBBP 1), delivery date: August 2009
Procurement initiated already: 7m (WBBP II)
Procurement to be initiated after R8 is signed : 56m
Procurement to be initiated in 2010: 8m WBBP II; FGN and States 9.5m; DFID/ SuNMap = 2m;
USAID 1.2m;
BCC
Continuously:
Improve Health seeking behaviour and informed demand for commodities
Early recognition of signs and symptoms and management by COPRs
Community sensitization
Empowerment of CORPs for prompt referral in suspected complicated cases
Mechanisms of distribution
HF treatments (Public and Private),
Community and Home Management (PPMVs and RMMs, CBDs, etc),
Drug Efficacy Monitoring
Sentinel Sites monitoring sites increased from 6 to 14 in 2008
2009: 3 Sites may commence DET in 2009
2010: National DET implementation, planning and training has commenced
Monitoring and evaluation
2009: Results of NDHS 2008 released, showed 25% and 22% IMR and U5MR reduction
respectively
2009: Evaluation of WBBP performance using LQAS in selected States
2009: HF Assessment conducted for WBBP States and 2 non WBBP States
2009: Planning for MIS, Program Performance review commenced
ACTs resources available to achieve the 2010 targets
ACT doses
SOURCE
COMMENT
when
Available
Total Need
Gap
3,374,509 ACTs
3,250,000 ACTs
2.400,000 ACTs
FGN/MDG
SFH
GF R4
Distributed 2009
Distributed 2009
Distributed 2009
9,024,509
(early 2009)
37.2m for 2009
28,175,491
as @ August
2009
850,000 ACTs
9,354,707ACTs
600,000 ACTs
GF R4
WB
USAID
Expected 2009
Expected 2009
Expected 2009
10,804,707
(2009)
28,175,491 as
@ August 2009
17,370,784
for remaining
2009
18m ACTs
53.3m ACTs
600,000 ACTs
9.5m
2.0m
WB
GF R8
USAID
MDG
DFID
Expected 2010
Expected 2010
Expected 2010
Expected 2010
Expected 2010
83,462,730
(2010)
101,019,333
17.556,603
TOTAL
103,291,946
138,219,333
34,927,387
(entire 2009 -2010)
(entire 2009-2010)
94,267,437
129,194,824
(expected so far for
Sept 2009 -2010)
(from Sept 20092010)
Case management
(Parasite based diagnosis -1)
Microscopy
Total required: 1000 (2009)
Acquired: 14 (Baseline=14 in Sentinel sites)
Gap: 986 microscopes
Cost is @ USD450 / microscope
Procurement schedule:
-- Nov 09 (175 by WBBP);
-- Procurement commences when R8 grant is signed, 405 in 2009 and 406 in 2010.
RDTs required
2009: 29,135,153 (30% coverage nationwide)
NB: Discounting potential 70% coverage in 2009 in 7 WBBP States)
2010: 30,067,098 (30% nationwide)
NB: Discounting 60% coverage in 7 WB States
Total: 59,202,251
Cost = USD1 / strip
Procurement schedules
(RDTs)
2009: Procurement initiated already: 7.1m (WBBP II);
Procurement to be initiated in 2010: 5.03m (GF); 20.12m WBBPII)
Training
Policy revised; Tools updated; Tool production is on-going
Trained 14 Sentinel Sites Lab. Scientists;
User-friendly training manuals are being produced
ToT commences in October 2009
Support from: GF R8 and WBBP
Case management
(Parasite based diagnosis -2)
BCC
Continuously:
Health care Worker reorientation on RDTs
Awareness creation for Health Care Seekers on RDTs
Mechanisms of
distribution
Using morbidity data from HFs direct distribution will be to:
HF treatments (Public and Private)
Under GF R8: Two PRs (NMCP and SFH in 3 Northern and 3
Southern States respectively)
WBBP: 4 Northern and 3 Southern States
Drug Efficacy
In all Sentinel Sites monitoring sites
Monitoring / Quality WHO TDR certified Laboratories will quality assure
Assurance
Monitoring and
evaluation
Supportive supervision
2009: Evaluation of WBBP performance using LQAS in selected
States
2009: HF Assessment conducted for WBBP States and 2 non
WBBP States
2009: Planning for MIS, Program Performance review commenced
RDT resources available to achieve the 2010 targets
FUNDS AVAILABLE (US $)
SOURCE
COMMENT
BCC resources available to achieve the 2010
targets
FUNDS AVAILABLE (US
$)
LLINs Campaigns
Routine
IRS
Env. Mgt
Case Mgt (jingles)
Printing Materials
Know the Facts
IPT
LLINs Campaigns
LLINs Campaigns
Routine
IRS
Env. Mgt
Case Mgt (Jingles)
SOURCE
WB
WB
WB
WB
WB
WB
WB
WB
WB
GF R8
WHO
AMFm
WB (NIFFA)
USAID
COMMENT
when
Available
Total Need
Gap
Already covered
Already covered
Already covered
Already covered
Already covered
Already covered
Already covered
Already covered
Expected 2010
Expected 2010
Expec ted 2010
Expected 2010
Expected 2010
Expected 2010
$220,400
$72,782
$72, 782
$34,220
$757,789
$72,782
$38,114
$72,782
$1m
$4.8m
$350,000
$............
$2m
$350,000
$1,334,417.66
(2009)
0
$8,500,000
0
IRS resources available to achieve the 2010 targets
FUNDS AVAILABLE (US $)
SOURCE
COMMENT
Indoor Residual Spraying:
Total HHs targeted
Pyrethroids required
8% coverage of Total HHs = 2,540,843
85% of HHs/structures per targeted LGAs;
Lamdacyhalothrin CS 10%: 0.030 g/m2
Alphacypermethrine WP10%: 0.030 g/m2
Bifenthrine 10% WP: 0.050 g/m2
Carbamate
Procurement schedules
Procurement of IRS logistics: Some in 2008; more in Sept. 2009
Release of funds by WBBP to the IRS Contractors: Dec 2009
Distribution
Distribution of IRS logistics to the target districts
Implementation of IRS: Sept 2009; March 2010; Sept 2010.
Training
Training of spray personnel – commenced already; March 2010; Sept 2010
(ToTs in collaboration with private sector partners)
Implementation of IRS: Sept 2009; March 2010; Sept 2010
BCC
Advocacy and BCC/IEC campaigns: July 2009 – Dec 2010
Spraying
Supervision and monitoring including quality assurance: Sept 2009; March
2010; Sept 2010.
Data management and report writing: Oct 2009; July 2010
Feedback Nov 2009; August 2010; Dec 2010
Monitoring and evaluation
(bioassays, insecticide
resistance etc)
Conduct insecticide susceptibility studies: Sept 2009; March 2010 (Sentinel
sites PIs)
Baseline entomological and epidemiological studies: July 2009;
TA from WHO Reconnaissance and Evaluation, ANVR, etc: (Nov 2009; July
2010; Jan 2011
IPTp resources available to achieve the 2010 targets
FUNDS AVAILABLE (US $)
SOURCE
COMMENT
Intermittent Preventive Therapy:
SP doses required
Distributed 5,353,098 doses(as @ July 2009);
Required 2009 = 7,693,928 @ 50% coverage (Gap =2,340,830)
Required in 2010 = 16m @ 100% coverage
Total = 23,081,584m; 18.3m (from Sept 2009-Dec 2010)
Procurement schedules
All doses of SPs will be procured by Governments and Partners
WBBP II in & States: August 2009; Dec 2009; 2010
Government (MDG and States) in all FMCs and States: April 2010
DFID / SuNMap in selected States: Dec 2009
Distribution
Logistics support through WBBP and States, LGAs
Implementation through ANC clinics; DOT at public and private health
facilities; on a continuous basis
Training
Training: On-going with GF-R2 Phase II and WBBP; More trgs through in all
States with support from GF-R8. It will go on till 2010
BCC
Improve ANC attendance to increase IPT uptake;
Improve Health seeking behaviour and informed demand for commodities
Early recognition of signs and symptoms
Monitoring and evaluation
HF Assessment done (May / June 2009)
Community Survey using LQAS (2009)
Program Performance Review (June 2009 - 2010)
MIS Evaluation (Sept 2009 - 2010)
Other core interventions to be delivered over
the next 17 months
• HSS issues:
– Improving utilization of ANC services
– Recruiting and training community health workers
– Community systems strengthening
• GF R8 HSS Component
– Strengthen NHMIS
• GF R8 MAL and HSS Component
– Expand HR capacity
• Recruitment at all levels
• Secondment
• TAs from Partners and Private-Publication Partnership
– Coordination:
• ATM task Force, CCM, PRs’ Forum; TWGs, Partners, Bi-Annual
Review and Planning ; State Support Teams; State Partners forum;
etc
Summary of rate-limiting factors over the
next 17 months
• Gap of 10m LLINs and key operational
issues (costs, taxes and tariffs) to achieve
SUFI including shortage in operational
costs
• Sub-optimal capacity at sub-national levels
• Under utilization of commodities (Nets)
• Surveillance, M&E: delay and underreporting
Summary of technical assistance needs to end 2010
Need
From whom
Capacity building for program managers on CM,
LLIN, IRS, MIP, M&E and PM
WHO, UNICEF, WB, AMP, JHIPIEGO,
Financial Management support
KPMG, GF,
Partnership / Coordination
RBM-HWG, All Partners
Program performance review
WHO, CDC,
Malaria Indicator Survey (MIS)
WHO, UNICEF, MEASURES, MERG,
WB, GF
Drug Efficacy Trial
WHO, WAMNAT, WB, GF, Consortium of
RBM Experts in Research / Academia,
NAFDAC,
Capacity building for program managers on IRS,
WHO, IRS Partners e.g.
Capacity building on Pharmaco-vigillance
WHO, MSH, CF
Capacity building on PSM
MSH, USAID Deliver, WHO,
STATE
Region
7Benue
1
5FCT
2
3Kogi
2
4Kwara
2
6Nasarawa
2
7Niger
3
2Plateau
NC
2Adamawa
NE
5Bauchi
NE
8Borno
1
6Gombe
3
5Taraba
3
6Yobe
1
8Jigawa
1
9Kaduna
NE
2
0Kano
2
1Katsina
2
2Kebbi
3
4Sokoto
3
7Zamfara
Jan-09
Feb-09
Mar-09
Apr-09
May-09
Jun-09
Jul-09
Aug-09
Sep-09
Oct-09
Nov-09
Dec-09
NC
NC
NC
NC
NC
1,746,812
NC
1,380,718
2,067,946
11
NE
1,034,864
NE
NE
NW
1,895,224
NW
NW
NW
NW
NW
NW
1Abia
SE
4Anambra
1
1Ebonyi
1
4Enugu
1
7Imo
SE
3Akwa Ibom
SS
6Bayelsa
SS
9Cross River
1
0Delta
1
2Edo
3
3Rivers
1
3Ekiti
2
5Lagos
2
8Ogun
2
9Ondo
3
0Osun
3
1Oyo
T
o
t
a
SS
SE
4,137,464
P
L
A
N
N
I
N
G
1,784,523
L
E
S
S
O
N
S
L
E
A
R
N
I
N
G
1,615,924
SE
SE
1,733,527
SS
SS
SS
2,293,000
SW
1,045,155
SW
SW
SW
SW
SW
1,643,797
STATE
7Benue
Region
Jan-10
Feb-10
Mar-10
Apr-10
May-10
NC
1,956,504
15FCT
NC
657,956
23Kogi
NC
24Kwara
NC
26Nasarawa
NC
27Niger
NC
32Plateau
NC
Jun-10
Jul-10
Aug-10
Sep-10
Oct-10
1,520,266
1,099,497
864,019
1,452,658
2Adamawa
NE
5Bauchi
NE
8Borno
NE
16Gombe
NE
35Taraba
NE
1,061,704
36Yobe
NE
1,102,929
18Jigawa
NW
19Kaduna
NW
20Kano
NW
21Katsina
NW
2,686,074
22Kebbi
NW
1,463,712
34Sokoto
NW
37Zamfara
NW
1Abia
SE
4Anambra
SE
1,962,617
2,731,188
1,526,355
1,295,126
11Ebonyi
SE
998,126
14Enugu
SE
1,510,440
17Imo
SE
3Akwa Ibom
SS
6Bayelsa
SS
9Cross River
SS
Nov-10
1,842,435
786,037
10Delta
SS
1,918,986
12Edo
SS
1,470,764
33Rivers
SS
13Ekiti
SW
25Lagos
SW
28Ogun
SW
29Ondo
SW
1,595,636
30Osun
SW
1,602,999
31Oyo
SW
2,643,613
Total
4,220,400
12,681,618
8,843,591
21,525,209
4,555,007
13,889,825
18,444,832
Dec-10